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Physiologic similarities and differences between asthma and chronic obstructive pulmonary disease.
Arthur F Gelb1, Noe Zamel, Anita Krishnan
1Pulmonary Division, Department of Medicine, Lakewood Regional Medical Center, Lakewood, California, USA. afgelb@msn.com
Current Opinion in Pulmonary Medicine
|November 29, 2007
Summary
Asthma and chronic obstructive pulmonary disease share airflow limitation mechanisms. Unexplained loss of lung elastic recoil causes significant expiratory airflow reduction in non-smoking asthma patients, similar to COPD.
Area of Science:
- Pulmonary Physiology
- Respiratory Medicine
- Asthma Pathogenesis
Background:
- Persistent maximum expiratory airflow limitation is a hallmark of moderate to severe asthma.
- Understanding the underlying mechanisms is crucial for effective management.
Purpose of the Study:
- To compare the physiologic mechanisms of expiratory airflow limitation in non-smoking asthma patients with those in chronic obstructive pulmonary disease (COPD).
- To investigate the role of lung elastic recoil in asthma-related airflow limitation.
Main Methods:
- Review of existing literature on asthma and COPD pathophysiology.
- Analysis of studies examining lung elastic recoil and expiratory airflow in non-smoking asthmatics.
- Comparison of findings with established mechanisms in COPD.
Main Results:
- Asthma involves acute, reversible loss of lung elastic recoil, with unexplained marked loss in stable patients.
- This recoil loss can reduce maximum expiratory airflow by up to 50% in asthma, independent of emphysema.
- COPD airflow limitation is linked to emphysema-related recoil loss and airway obstruction; unexplained recoil loss also seen in non-emphysematous small airway disease.
Conclusions:
- Non-smoking asthma and COPD patients exhibit similar mechanisms for expiratory airflow limitation.
- These shared mechanisms likely stem from distinct underlying anatomical abnormalities.
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