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Blurred lines. Eosinophilic COPD: ACOS or COPD phenotype?

¹Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine, University of Coimbra, Portugal.

Revista Portuguesa De Pneumologia

|March 26, 2016

Summary

Asthma and COPD overlap, making diagnosis difficult. Eosinophils are key biomarkers for understanding these chronic obstructive airway diseases and guiding treatment.

Keywords:

ACOS Asthma COPD Eosinophilia

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Identification and Characterization of Immunogenic RNA Species in HDM Allergens that Modulate Eosinophilic Lung Inflammation

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Published on: May 30, 2020

Area of Science:

Pulmonary Medicine
Immunology

Background:

Asthma and COPD are chronic obstructive airway diseases with inflammatory components.
Clinical presentations can overlap, leading to diagnostic challenges, including eosinophilic asthma with fixed obstruction, eosinophilic COPD, and asthma-COPD overlap syndrome (ACOS).
Current guidelines are insufficient for classifying obstructive airway diseases due to the blurred pathophysiological boundaries between asthma and COPD.

Purpose of the Study:

To highlight the diagnostic complexities in differentiating asthma and COPD.
To advocate for a re-evaluation of current classification systems for obstructive airway diseases.
To emphasize the importance of eosinophils as biomarkers in the diagnostic and therapeutic approach.

Main Methods:

Review of clinical expressions and pathophysiological processes of asthma and COPD.
Analysis of the limitations of current diagnostic guidelines.
Discussion on the role of eosinophils in obstructive airway diseases.

Main Results:

The distinction between asthma and COPD is not always clear, with significant overlap in some patients.
Existing classifications may oversimplify the complex nature of these conditions.
Eosinophils play a crucial role in the pathology, prognosis, and therapeutic response across obstructive airway diseases.

Conclusions:

A new taxonomy for airway diseases is needed, moving beyond binary classifications like ACOS.
Eosinophils should be integrated into diagnostic algorithms for all obstructive airway patients.
A multidimensional approach considering phenotypic, immunopathological, and functional complexity is essential for managing chronic obstructive airway diseases.