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Biomarker-based detection of asthma-COPD overlap syndrome in COPD populations.

Tamada T, Sugiura H, Takahashi T, Matsunaga K, Kimura K, Katsumata U, Takekoshi D, Kikuchi T, Ohta K, Ichinose M - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) was proposed by the science committees of both Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD).However, the definition of ACOS has remained unclear all over the world, and the prevalence rate of ACOS is basically dependent on the patient's symptoms or the physician's opinion, based on questionnaire testing.The results from the current study should be useful to identify the subgroup requiring early intervention by inhaled corticosteroids/long-acting beta agonist combination in COPD in order to improve the long-term management for ACOS.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

ABSTRACT
Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) was proposed by the science committees of both Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD). However, the definition of ACOS has remained unclear all over the world, and the prevalence rate of ACOS is basically dependent on the patient's symptoms or the physician's opinion, based on questionnaire testing. In the current case report, we investigated the prevalence rate of COPD patients with high levels of fractional exhaled nitric oxide (FENO) or immunoglobulin E (IgE) as candidate markers of ACOS in COPD, as a multicenter, cross-sectional study. Outpatients with COPD were enrolled from Tohoku University Hospital, Sendai, Japan, and five hospitals (Tohoku University Hospital, Sendai, Japan; NTT East Tohoku Hospital, Sendai, Japan; Wakayama Medical University Hospital, Kimiidera, Japan; Hiraka General Hospital, Yokote, Japan; Iwate Prefectural Isawa Hospital, Oshu, Japan) with pulmonary physicians from March 1, 2013 to February 28, 2014. When they were estimated using 35 ppb as the cutoff value of FENO, the prevalence rate of ACOS was 16.3% in COPD. When estimated by both FENO and IgE, the high-FENO/high-IgE group was 7.8% in COPD. To the best of our knowledge, this study is the first to detect the prevalence rate of ACOS in COPD populations by using objective biomarkers. The results from the current study should be useful to identify the subgroup requiring early intervention by inhaled corticosteroids/long-acting beta agonist combination in COPD in order to improve the long-term management for ACOS.

No MeSH data available.


Related in: MedlinePlus

Number of patients when estimated by both FENO and IgE.Notes: Patients were divided into subgroups by FENO and IgE as asthma-like inflammatory and atopic biomarkers, respectively. The dark gray bar represents the high-FENO/high-IgE group; the light gray bar represents either the high-FENO/low-IgE or low-FENO/high-IgE group; and the white bar represents the low-FENO/low-IgE group.Abbreviations: FENO, fractional exhaled nitric oxide; IgE, immunoglobulin E.
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f3-copd-10-2169: Number of patients when estimated by both FENO and IgE.Notes: Patients were divided into subgroups by FENO and IgE as asthma-like inflammatory and atopic biomarkers, respectively. The dark gray bar represents the high-FENO/high-IgE group; the light gray bar represents either the high-FENO/low-IgE or low-FENO/high-IgE group; and the white bar represents the low-FENO/low-IgE group.Abbreviations: FENO, fractional exhaled nitric oxide; IgE, immunoglobulin E.

Mentions: It is reported that both elevated FENO and elevated IgE may be useful markers for predicting good responders to ICS/LABA combination in COPD.23 As estimated by both FENO and IgE, the numbers of patients in each group are summarized in Figure 3. Out of 230 COPD patients, the high-FENO/high-IgE group comprised 18 cases (7.8% of patients), the high-FENO/low-IgE group comprised 22 cases (9.6% of patients), the low-FENO/high-IgE group comprised 64 cases (27.8% of patients), and the low-FENO/low-IgE group comprised 126 cases (54.8% of patients). These findings indicated that 7.8% of COPD patients have both asthma-like airway inflammation and atopic factors, and seem to be good responders to ICS/LABA combination treatment.


Biomarker-based detection of asthma-COPD overlap syndrome in COPD populations.

Tamada T, Sugiura H, Takahashi T, Matsunaga K, Kimura K, Katsumata U, Takekoshi D, Kikuchi T, Ohta K, Ichinose M - Int J Chron Obstruct Pulmon Dis (2015)

Number of patients when estimated by both FENO and IgE.Notes: Patients were divided into subgroups by FENO and IgE as asthma-like inflammatory and atopic biomarkers, respectively. The dark gray bar represents the high-FENO/high-IgE group; the light gray bar represents either the high-FENO/low-IgE or low-FENO/high-IgE group; and the white bar represents the low-FENO/low-IgE group.Abbreviations: FENO, fractional exhaled nitric oxide; IgE, immunoglobulin E.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608617&req=5

f3-copd-10-2169: Number of patients when estimated by both FENO and IgE.Notes: Patients were divided into subgroups by FENO and IgE as asthma-like inflammatory and atopic biomarkers, respectively. The dark gray bar represents the high-FENO/high-IgE group; the light gray bar represents either the high-FENO/low-IgE or low-FENO/high-IgE group; and the white bar represents the low-FENO/low-IgE group.Abbreviations: FENO, fractional exhaled nitric oxide; IgE, immunoglobulin E.
Mentions: It is reported that both elevated FENO and elevated IgE may be useful markers for predicting good responders to ICS/LABA combination in COPD.23 As estimated by both FENO and IgE, the numbers of patients in each group are summarized in Figure 3. Out of 230 COPD patients, the high-FENO/high-IgE group comprised 18 cases (7.8% of patients), the high-FENO/low-IgE group comprised 22 cases (9.6% of patients), the low-FENO/high-IgE group comprised 64 cases (27.8% of patients), and the low-FENO/low-IgE group comprised 126 cases (54.8% of patients). These findings indicated that 7.8% of COPD patients have both asthma-like airway inflammation and atopic factors, and seem to be good responders to ICS/LABA combination treatment.

Bottom Line: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) was proposed by the science committees of both Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD).However, the definition of ACOS has remained unclear all over the world, and the prevalence rate of ACOS is basically dependent on the patient's symptoms or the physician's opinion, based on questionnaire testing.The results from the current study should be useful to identify the subgroup requiring early intervention by inhaled corticosteroids/long-acting beta agonist combination in COPD in order to improve the long-term management for ACOS.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

ABSTRACT
Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) was proposed by the science committees of both Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD). However, the definition of ACOS has remained unclear all over the world, and the prevalence rate of ACOS is basically dependent on the patient's symptoms or the physician's opinion, based on questionnaire testing. In the current case report, we investigated the prevalence rate of COPD patients with high levels of fractional exhaled nitric oxide (FENO) or immunoglobulin E (IgE) as candidate markers of ACOS in COPD, as a multicenter, cross-sectional study. Outpatients with COPD were enrolled from Tohoku University Hospital, Sendai, Japan, and five hospitals (Tohoku University Hospital, Sendai, Japan; NTT East Tohoku Hospital, Sendai, Japan; Wakayama Medical University Hospital, Kimiidera, Japan; Hiraka General Hospital, Yokote, Japan; Iwate Prefectural Isawa Hospital, Oshu, Japan) with pulmonary physicians from March 1, 2013 to February 28, 2014. When they were estimated using 35 ppb as the cutoff value of FENO, the prevalence rate of ACOS was 16.3% in COPD. When estimated by both FENO and IgE, the high-FENO/high-IgE group was 7.8% in COPD. To the best of our knowledge, this study is the first to detect the prevalence rate of ACOS in COPD populations by using objective biomarkers. The results from the current study should be useful to identify the subgroup requiring early intervention by inhaled corticosteroids/long-acting beta agonist combination in COPD in order to improve the long-term management for ACOS.

No MeSH data available.


Related in: MedlinePlus