Asthma-COPD overlap syndrome: The result of lung airway remodeling

Asthma-COPD overlap syndrome or ACOS accounts for up to a quarter of all obstructive airway diseases. Patients afflicted with it usually exhibit worse symptoms when compared to patients with asthma or chronic obstructive pulmonary disease (COPD) alone. ACOS is not well recognized because asthma and COPD have almost similar manifestations. Most patients suffering from this disease are smokers who exhibit persistent expiratory airflow obstruction despite treatment.

Asthma and COPD are widespread respiratory disorders that cost billions of dollars in healthcare-related expenses every year. Both diseases, when not properly diagnosed and treated, may escalate to worse conditions and even death.

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ACOS is characterized by a phenomenon called “remodeling.” This consists of any or a combination of the following:

• Mucosal edema, mucus hypersecretion, and formation of mucus plugs.
• Hypertrophy and hyperplasia of the airway smooth muscle 
• Increased wall thickness of the respiratory tract

 Image source: intechopen.com

Awareness of ACOS is growing and approaches for how to best manage this condition are being assessed to achieve the best possible results. There is a consensus among physicians that patients with features of both asthma and COPD experience frequent exacerbations, suffer from rapid decline in lung function, have poor quality of life, have high mortality, and on rare occasions, incur chronic inflammation even outside the respiratory system.

Dr. Lisa Marie Cannon is a recognized internist, specializing in pulmonary medicine. Follow this Twitter account for more medical news and updates.