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'asthma'
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Diagnosis of asthma–COPD overlap: the five commandments 1) A patient with asthma may develop non-fully reversible airflow obstruction but this is not COPD, not even ACO; it is obstructive asthma. 2) A patient with asthma who smokes may also develop non-fully reversible airflow obstruction, which differs from obstructive asthma and from “pure” COPD. This is the most frequent type of patient with ACO. 3) Some patients who smoke and develop COPD may have a genetic Th2 background (even in the absence of a previous history of asthma) and can be identified by high eosinophil counts in peripheral blood.These individuals could be included under the umbrella term of ACO. 4) A patient with COPD and a positive bronchodilator test (>200 mL and >12% FEV1 change) has reversible COPD but is not an asthmatic, or even ACO. 5) A patient with COPD and a very positive bronchodilator test (>400 mL FEV1 change) is more likely to have some features of asthma and could also be classified as ACO.
Personalised Medicine for Asthma and Chronic Obstructive Pulmonary Disease Asthma and chronic obstructive pulmonary disease (COPD) are prevalent condition sboth significant heterogeneity within each of these conditions and additionally significant overlap in many of the clinical and inflammatory features useful clinical and immunological biomarkers which inform about prognosis and response to therapy have emerged in both asthma and COPD. These biomarkers will allow both better targeting of existing treatments and the identification of those patients who will respond to novel therapies which are now becoming available Delivery of precision medicine in airways disease is now feasible and is a core component of a personalised healthcare delivery in asthma and COPD
Use of Biological Agents in Asthma: Despite advances in asthma initiatives, there continues to be a large population of patients with severe asthma whose condition remains uncontrolled despite the use of inhaled combination corticosteroids and long-acting beta-agonist treatment. For this population, which may include as many as one-third of all patients with asthma, biological therapy is often a treatment consideration in specialist clinics.
Severe eosinophilic asthma: a roadmap to consensus Adult-onset asthma patients with a high blood eosinophil count (⩾0.3×109 per L) have been found to have a distinct phenotype of severe asthma with frequent exacerbations and poor prognosis Persistent airflow limitation and distal inflammation with air trapping are common in these patients, as is upper airway pathology such as chronic rhinosinusitis with nasal polyposis .
Obstructive Sleep Apnoea Accelerates FEV1 Decline in Asthmatic Patients. Asthmatic patients with OSA had substantially greater declines in FEV1 than those without OSA. Moreover, CPAP treatment alleviated the decline of FEV1 in asthma patients with severe OSA
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