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The relationship between asthma and COPD. Lessons from transgenic mice
1Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520, USA. jack.elias@yale.edu
Chest
|August 11, 2004
Summary
Asthma and COPD share overlapping features but differ in cytokine profiles. T helper 1 (Th1) cytokines like interferon-gamma are linked to COPD, while T helper 2 (Th2) cytokines such as interleukin-13 are associated with asthma.
Area of Science:
- Pulmonary medicine
- Immunology
- Respiratory diseases
Background:
- Asthma involves eosinophilic infiltration, mucous metaplasia, airway remodeling, and reversible airflow obstruction.
- COPD is characterized by irreversible airflow obstruction, mucous metaplasia, and alveolar destruction.
- Significant overlap exists in the pathogenesis and clinical presentation of asthma and COPD.
Purpose of the Study:
- To differentiate asthma and COPD based on distinct cytokine profiles.
- To explore the roles of T helper 1 (Th1) and T helper 2 (Th2) cytokines in asthma and COPD pathogenesis.
- To investigate the continuum of disease states between asthma and COPD.
Main Methods:
- Review of studies on asthma and COPD pathogenesis.
- Analysis of cytokine profiles, specifically T helper cell-mediated cytokines.
- Examination of findings from transgenic mouse models.
Main Results:
- T helper 1 (Th1)-mediated interferon-gamma is implicated in COPD, supporting the British hypothesis.
- T helper 2 (Th2)-mediated interleukin-13 is associated with asthma, supporting the Dutch hypothesis.
- Evidence suggests asthma and COPD may exist on a disease continuum.
Conclusions:
- Cytokine profiles offer a key distinction between asthma and COPD.
- Interferon-gamma and interleukin-13 play specific roles in the pathogenesis of COPD and asthma, respectively.
- Patients may present with varying degrees of both asthma and COPD, indicating a spectrum of disease.