Are chronic obstructive pulmonary disease (COPD) and asthma different diseases?

Abstract

In the past it has been hypothesized that asthma and chronic obstructive pulmonary disease (COPD) are related diseases. As both show high prevalences and as smoking may occur in both groups of patients the simultaneous presence of both diseases in the same subject may well occur. The most characteristic features of asthma are short-term changes in airway caliber, reversible airflow limitation, bronchial hyperresponsiveness as well as eosinophilic and lymphocytic airway inflammation. The common definition of COPD implies long-term changes in airway calibre, less or irreversible airflow obstruction, no or less common bronchial hyperresponsiveness and neutrophilic airway inflammation. By analysing the results of epidemiology, risk factors, airway morphology, lung function and markers of airway inflammation in both diseases, it becomes clear that asthma and COPD share some similarities. However, their pathological presentations differ considerably and this provides evidence that the two syndromes are, in fact, different diseases. Furthermore, the analysis of data on lung volumes, diffusion capacity and aerosol-derived airway morphology shows important differences between asthma and COPD. It is suggested that the specific type of airway inflammation in both diseases is responsible for the peculiar pattern of lung function abnormalities.