Phenotype of Asthma-COPD Overlap in COPD and Severe Asthma Cohorts

被引：8

作者：

Joo, Hyonsoo ^{[1
]}

Park, So-Young ^{[2
]}

Park, So Young ^{[3
]}

Park, Seo Young ^{[4
]}

Kim, Sang-Heon ^{[5
]}

Cho, You Sook ^{[6
]}

Ha Yoo, Kwang ^{[2
]}

Jung, Ki Suck ^{[7
]}

Rhee, Chin Kook ^{[8
]}

机构：

[1] Catholica Univ Korea, Uijeongbu St Marys Hosp, Div Pulm & Crit Care Med, Dept Internal Med,Coll Med, Seoul, South Korea

[2] Konkuk Univ, Div Pulm Allergy & Crit Care Med, Dept Internal Med, Sch Med, Seoul, South Korea

[3] Eulji Univ, Eulji Gen Hosp, Dept Internal Med, Sch Med, Seoul, South Korea

[4] Korea Natl Open Univ, Dept Stat & Data Sci, Seoul, South Korea

[5] Hanyang Univ, Dept Internal Med, Coll Med, Seoul, South Korea

[6] Univ Ulsan, Dept Allergy & Clin Immunol, Asan Med Ctr, Coll Med, Seoul, South Korea

[7] Hallym Univ, Dept Pulm Allergy & Crit Care Med, Sacred Heart Hosp, Anyang, South Korea

[8] Catholica Univ Korea, Seoul St Marys Hosp, Div Pulm & Crit Care Med, Dept Internal Med,Coll Med, Seoul, South Korea

来源：

JOURNAL OF KOREAN MEDICAL SCIENCE | 2022年 / 37卷 / 30期

关键词：

Asthma; Chronic Obstructive Pulmonary Disease; Phenotype; OBSTRUCTIVE PULMONARY-DISEASE; HETEROGENEITY; EOSINOPHILS;

D O I：

10.3346/jkms.2022.37.e236

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Asthma and chronic obstructive pulmonary disease (COPD) are airway diseases with similar clinical manifestations, despite differences in pathophysiology. Asthma-COPD overlap (ACO) is a condition characterized by overlapping clinical features of both diseases. There have been few reports regarding the prevalence of ACO in COPD and severe asthma cohorts. ACO is heterogeneous; patients can be classified on the basis of phenotype differences. This study was performed to analyze the prevalence of ACO in COPD and severe asthma cohorts. In addition, this study compared baseline characteristics among ACO patients according to phenotype. Methods: Patients with COPD were prospectively enrolled into the Korean COPD subgroup study (KOCOSS) cohort. Patients with severe asthma were prospectively enrolled into the Korean Severe Asthma Registry (KoSAR). ACO was defined in accordance with the updated Spanish criteria. In the COPD cohort, ACO was defined as bronchodilator response (BDR) >= 15% and >= 400 mL from baseline or blood eosinophil count (BEC) >= 300 cells/mu L. In the severe asthma cohort, ACO was defined as age >= 35 years, smoking >= 10 pack-years, and post-bronchodilator forced expiratory volume in 1 s/forced vital capacity < 0.7. Patients with ACO were divided into four groups according to smoking history (threshold: 20 pack-years) and BEC (threshold: 300 cells/mu L). Results: The prevalence of ACO significantly differed between the COPD and severe asthma cohorts (19.8% [365/1,839] vs. 12.5% [104/832], respectively; P < 0.001). The percentage of patients in each group was as follows: group A (light smoker with high BEC) - 9.1%; group B (light smoker with low BEC) - 3.7%; group C (moderate to heavy smoker with high BEC) - 73.8%; and group D (moderate to heavy smoker with low BEC) - 13.4%. Moderate to heavy smoker with high BEC group was oldest, and showed weak BDR response. Age, sex, BDR, comorbidities, and medications significantly differed among the four groups. Conclusion: The prevalence of ACO differed between COPD and severe asthma cohorts. ACO patients can be classified into four phenotype groups, such that each phenotype exhibits distinct characteristics.

引用

页数：10

共 24 条

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