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Pathogenesis, clinical features of asthma COPD overlap (ACO), and therapeutic modalities


Dey, S and Eapen, MS and Chia, C and Gaikwad, AV and Wark, PAB and Sohal, SS, Pathogenesis, clinical features of asthma COPD overlap (ACO), and therapeutic modalities, American Journal of Physiology, 322, (1) pp. L64-L83. ISSN 1040-0605 (2022) [Refereed Article]

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Available from 20 October 2022

Copyright Statement

Copyright 2021 the American Physiological Society

DOI: doi:10.1152/ajplung.00121.2021


Both asthma and COPD are heterogeneous diseases identified by characteristic symptoms and functional abnormalities, with airway obstruction common in both diseases. Asthma COPD overlap (ACO) does not define a single disease but is a descriptive term for clinical use that includes several overlapping clinical phenotypes of chronic airways disease with different underlying mechanisms. This literature review was initiated to describe published studies, identify gaps in knowledge, and propose future research goals regarding the disease pathology of ACO, especially the airway remodelling changes and inflammation aspects. Airway remodelling occurs in asthma and COPD, but there are differences in the structures affected and the prime anatomic site at which they occur. Reticular basement membrane thickening and cellular infiltration with eosinophils and T-helper (CD4+) lymphocytes are prominent features of asthma. Epithelial squamous metaplasia, airway wall fibrosis, emphysema, bronchoalveolar lavage (BAL) neutrophilia and (CD8+) T-cytotoxic lymphocyte infiltrations in the airway wall are features of COPD. There is no universally accepted definition of ACO, nor are there clearly defined pathological characteristics to differentiate from asthma and COPD. Understanding etiological concepts within the purview of inflammation and airway remodelling changes in ACO would allow better management of these patients.

Item Details

Item Type:Refereed Article
Keywords:COPD, lung, asthma, ACO, airway remodeling, respiratory, fibrosis, inflammation
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Dey, S (Mr Surajit Dey)
UTAS Author:Eapen, MS (Dr Mathew Eapen)
UTAS Author:Gaikwad, AV (Ms Archana Gaikwad)
UTAS Author:Sohal, SS (Dr Sukhwinder Sohal)
ID Code:147615
Year Published:2022
Web of Science® Times Cited:1
Deposited By:Health Sciences
Deposited On:2021-11-10
Last Modified:2022-03-07

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