 ASTHMA AND COPD: OVERLAPPING, UNDERSTANDING AND MANAGEMENT |
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 Author : Dr Razia Khanam Lecturer, Department of Pharmacology Faculty of Pharmacy Jamia Hamdard New Delhi-110062 |
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Bronchial asthma and chronic obstructive pulmonary disease (COPD) are two airway chronic diseases that exact an enormous toll on patients, healthcare providers and the society. Asthma, where airway inflammatory component occupies a preponderant place is characterized by recurrent episodes of several symptoms such as breathlessness, wheezing, chest tightness, airway obstruction and cough. The essential alterations of asthma includes bronchospasm (hyper reactivity), oedema and mucous hyper secretion (bronchial obstruction) etc. It is estimated that around 300 million people in the world currently have asthma. On the other hand, COPD is a disorder of progressive airflow limitation caused by chronic inflammation of the airways and lung parenchyma and associated with symptoms such as cough, sputum production, and dyspnea. Smoking is the primary risk factor for the development of COPD. Worldwide it ranks as the fourth leading cause of death, alongside HIV/AIDS. By the year 2020, COPD is predicted to become the third leading cause of death worldwide (exceeded only by heart disease and stroke). Although they have similar characteristics such as the signs of coughing and wheezing, they are two distinct conditions in terms of disease onset, frequency of symptoms and reversibility of airway obstruction. There has been a substantial increase in the prevalence of both diseases that has lead to sizable concerns being expressed from national and international healthcare authorities. The onset of asthma typically occurs during childhood or adolescence, COPD most often develops in smokers and former smokers who are in their mid-40s.
Exacerbations of asthma - characterized by recurrent wheezing, shortness of breath, chest tightness and cough - often have identifiable triggers such as allergens, cold air or exercise 4. However, exacerbations in COPD patients are commonly caused by respiratory tract infections 5. Both these diseases were once considered to be at the opposite ends of the spectrum of airway disease, where asthma was thought to be highly responsive to treatment and essentially reversible; COPD was characterized by fixed airway narrowing and was unresponsive to the treatment The currently accepted definitions still emphasize these features, but there may be significant overlap between the two diseases. Today it is recognized that they have many common features and are impossible to distinguish clinically
There exists an understandable confusion between asthma and COPD as both involve restriction or obstruction of the airways in the lungs leading to difficult breathing. However, there are a number of differences between COPD and asthma .
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