Alsayed Ahmad R, Abu-Samak Mahmoud S, Alkhatib Mohammad
Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11937, Jordan.
Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Roma, Italy.
J Pers Med. 2023 Apr 18;13(4):677. doi: 10.3390/jpm13040677.
Asthma and COPD have characteristic symptoms, yet patients with both are prevalent. Despite this, there is currently no globally accepted definition for the overlap between asthma and COPD, commonly referred to as asthma-COPD overlap (ACO). Generally, ACO is not considered a distinct disease or symptom from either clinical or mechanistic perspectives. However, identifying patients who present with both conditions is crucial for guiding clinical therapy. Similar to asthma and COPD, ACO patients are heterogeneous and presumably have multiple underlying disease processes. The variability of ACO patients led to the establishment of multiple definitions describing the condition's essential clinical, physiological, and molecular characteristics. ACO comprises numerous phenotypes, which affects the optimal medication choice and can serve as a predictor of disease prognosis. Various phenotypes of ACO have been suggested based on host factors including but not limited to demographics, symptoms, spirometric findings, smoking history, and underlying airway inflammation. This review provides a comprehensive clinical guide for ACO patients to be used in clinical practice based on the available limited data. Future longitudinal studies must evaluate the stability of ACO phenotypes over time and explore their predictive powers to facilitate a more precise and effective management approach.
哮喘和慢性阻塞性肺疾病（COPD）有其特征性症状，但同时患有这两种疾病的患者也很常见。尽管如此，目前对于哮喘和COPD之间的重叠，即通常所说的哮喘-COPD重叠综合征（ACO），尚无全球公认的定义。一般来说，从临床或发病机制角度看，ACO都不被视为一种独特的疾病或症状。然而，识别同时患有这两种疾病的患者对于指导临床治疗至关重要。与哮喘和COPD类似，ACO患者具有异质性，可能存在多种潜在的疾病过程。ACO患者的变异性导致了多种描述该病症基本临床、生理和分子特征的定义的建立。ACO包含多种表型，这会影响最佳药物选择，并可作为疾病预后的预测指标。基于包括但不限于人口统计学、症状、肺功能检查结果、吸烟史和潜在气道炎症等宿主因素，已提出了ACO的各种表型。本综述基于现有的有限数据，为ACO患者提供了一份可用于临床实践的全面临床指南。未来的纵向研究必须评估ACO表型随时间的稳定性，并探索其预测能力，以促进更精确、有效的管理方法。
