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Bronchiectasis in severe asthma and asthmatic components in bronchiectasis
1Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, 377-2, Ohno-higashi, Osakasayama City, Osaka, 589-8511, Japan.
Respiratory Investigation
|December 20, 2021
Summary
Differentiating asthma and bronchiectasis is challenging due to shared symptoms. Understanding their complex relationship and specific phenotypes is crucial for effective treatment strategies.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Immunology
Background:
- Asthma and bronchiectasis present overlapping symptoms and physiological characteristics, complicating differential diagnosis.
- Comorbidities between asthma and bronchiectasis are frequent, with bronchiectasis found in 7-46% of asthma patients and severe asthma in 3.3% of bronchiectasis cases.
- Severe asthma frequently co-occurs with bronchiectasis (25-68%), often presenting as eosinophilic bronchiectasis or chronic infectious bronchiolitis/bronchiectasis.
Purpose of the Study:
- To highlight the diagnostic challenges in distinguishing asthma from bronchiectasis.
- To review the prevalence and characteristics of comorbid asthma and bronchiectasis.
- To explore current and potential therapeutic approaches for these overlapping conditions.
Main Methods:
- Literature review of studies investigating asthma and bronchiectasis.
- Analysis of epidemiological data on comorbidity prevalence.
- Examination of clinical phenotypes and treatment responses.
Main Results:
- Significant overlap in symptoms (wheezing) and inflammation (eosinophilic) exists between asthma and bronchiectasis.
- High rates of bronchiectasis in severe asthma patients and considerable rates of asthma in bronchiectasis patients are reported.
- Eosinophilic bronchiectasis shows positive response to type-2-targeted biologics, potentially before oral corticosteroid use.
Conclusions:
- Accurate differentiation between asthma and bronchiectasis requires careful clinical evaluation due to shared features.
- Effective management strategies for comorbid severe asthma and bronchiectasis are still under investigation.
- Further research is essential to define optimal treatments for complex cases of asthma and bronchiectasis.
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