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KMID : 1141720190070020089
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폐쇄성폐질환
2019 Volume.7 No. 2 p.89 ~ p.93
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Airway Disease in Elderly; Can We Differentiate Asthma and COPD?
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Jung Ji-Ye
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Abstract
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Chronic obstructive pulmonary disease (COPD) and asthma are not rare airway diseases in old ages. These airway diseases show several common characteristics despite important differences in the pathogenesis, course, and prognosis. Moreover, smoking and aging induces overlap in pathogenesis and clinical features between those. Because of underestimation of the severity of significance of their symptoms in elderly patients, differentiation of symptoms between COPD and asthma is not always as straight forward. Pulmonary function test has been generally used to distinguish COPD and asthma according to the presence of bronchodilators response. However, patients with long-term asthma show diminished reversibility of airway obstruction and increased neutrophil in the airway. On the other hand, a subgroup of COPD patients show airway reversibility, and increased exhaled nitric oxide and sputum eosinophilia similar to asthma. In conclusion, distinguishing between COPD and asthma is often difficult, especially in elderly patients. Combined approaches with pulmonary function test, bronchial hyperresponsiveness, atopy status, and chest computed tomography scans, and newly developed biomarkers are needed for the distinction between the diseases.
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KEYWORD
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Chronic obstructive pulmonary disease, Asthma, Elderly
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