Clinical, functional and laboratory features of asthma–COPD overlap syndrome
https://doi.org/10.18093/0869-0189-2016-26-6-649-656
Abstract
The purpose of this study was to investigate clinical, functional and laboratory features of the ACOS syndrome (asthmaCOPD overlap syndrome).
Methods. We examined 108 patients: 54 patients with ACOS syndrome and 54 patients with severe asthma.
Results. The ACOS syndrome was characterized by severe course, lower lung function and pulmonary hyperinflation. A high level of systemic inflammatory markers (IL6, TNFα, CRP) was registered in both the groups. An increased neutrophil elastase blood plasma concentration was revealed in patients with the ACOS syndrome that could indicate a role of neutrophils in the inflammation. sCD31/SPECAM1 and CD38 on blood lymphocytes were higher in the ACOS group compared to the asthma group; this could be related to cellular and molecular mechanisms of endothelial dysfunction.
Conclusion: The current knowledge on the ACOS syndrome is insufficient. Clinical course and pathogenesis of this disease require further investigation.
About the Authors
S. V. Chubarova
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022, Russia
Candidate of Medicine, Assistant Lecturer at Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; allergist at Krasnoyarsk State Territorial Clinical Hospital; tel.: (913) 5158999
E. A. Sobko
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022, Russia
Doctor of Medicine, Associate Professor at Head of Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Head of Division of Pulmonology and Allergy, Krasnoyarsk State Territorial Clinical Hospital; tel.: (923) 3271192
I. V. Demko
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022, Russia
Doctor of Medicine, Professor, Head of Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; tel.: (913) 5078408
O. P. Ishchenko
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022, Russia
Candidate of Medicine, Assistant Lecturer at Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; allergist at Krasnoyarsk State Territorial Clinical Hospital; tel.: (908) 2073217
A. Yu. Kraposhina
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
Candidate of Medicine, Assistant Lecturer at Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; tel.: (902) 9903767
I. A. Solov'eva
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022, Russia
Candidate of Medicine, Assistant Lecturer, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; tel.: (913) 8352643
N. V. Gordeeva
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022, Russia
Candidate of Medicine, Assistant Lecturer at Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; tel.: (913) 1990653
A. B. Salmina
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Russian Federation
Russian Federation
ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022, Russia
Doctor of Medicine, Professor, Head of Department of Biological Chemistry with the course of Medicinal, Pharmaceutical and Toxicological Chemistry, V.F.VoynoYasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; tel.: (913) 1920624
References
1. Chuchalin A., Khaltaev N., Antonov N. et al. Chronic respiratory diseases and risk factors in 12 regions of Russian Federation. Intern. J. COPD. 2014; 9: 963–974.
2. Chuchalin A.G., Aysanov Z.R., Avdeev S.N. et al. Federal Clinical Guidelines on Diagnosis and Management of Chronic Obstructive Pulmonary Disease. Russkiy meditsin skiy zhurnal. 2014; 22 (5): 331–346 (in Russian).
3. Zykov K.A., Agapova O.Yu., Beylina V.B. et al. Novel approach to treatment of patients with comorbidity of asthma and COPD: an emphasis on longacting anticholer gics. Russkiy meditsinskiy zhurnal. 2014; 25: 1836–1941 (in Russian).
4. Fu J., McDonald V., Gibson P. et al. Systemic inflammation in older adults with asthmaCOPD overlap syndrome. Allergy Asthma Immunol. Res. 2014; 6 (4): 316–324.
5. Сочетание хронической обструктивной болезни легких и бронхиальной астмы: согласительный документ Испанского общества пульмонологов и торакальных хирургов. Пульмонология. 2013; (1): 13–19.
6. Wylam M., Sathish V., Van Oosten S. et al. Mechanisms of cigarette smoke effects on human airway smooth muscle. PLoS One. 2015; 10(6): e0128778.
7. Guedes A., Deshpande D., Dileepan M. et al. CD38 and airway hyperresponsiveness: studies on human airway smooth muscle cells and mouse models. J. Physiol. Phar macol. 2015; 93 (2): 145–153.
8. Sobko E.A., Kraposhina A.Yu., Demko I.V. et al. CD38/Frybosyl cyclase as a marker of endothelial dysfunction in asthma. Klinicheskaya meditsina. 2013; 2: 34–38 (in Russian).
9. Global Strategy for Asthma Management and Prevention. Revised 2015. Available at: www.ginasthma.com
10. De Marco R., Pesce G., Marcon A. et al. The coexistence of asthma and chronic obstructive pulmonary disease (COPD): prevalence and risk factors in young, middleaged and elderly people from the general population. PLoS One. 2013; 8 (5): e62985.
11. Diagnosis of diseases of chronic airflow limitation: asthma, COPD and asthmaCOPD overlap syndrome (ACOS). Global Strаtegy for Asthma Management and Prevention. 2014. Available at: http//www.jinasthma.org (Accessed at: 15.01.2016).
12. Papaiwannou A., Zarogoulidis P., Porpodis K et al. Asthma chronic obstructive pulmonary disease overlap syndrome (ACOS): current literature review. J. Thorac. Dis. 2014; 6 (Suppl. 1): 146–151.
13. SolerCataluña J., Cosío B., Izquierdo J. et al. Consensus document on the overlap phenotype COPDasthma in COPD. Archivos de bronconeumología. 2012; 48 (9): 331–337.
14. Avdeev S.N. Airway inflammation in COPD and new opportunities of antiinflammatory treatment. Prakticheskaya pul'monologiya. 2012; 3: 28–36 (in Russian).
15. Vaguliene N., Zemaitis M., Lavinskiene S. et al. Local and systemic neutrophilic inflammation in patients with lung cancer and chronic obstructive pulmonary disease. BMC Immunology. 2013; 6:14–36.
Review
For citations:
Chubarova S.V., Sobko E.A., Demko I.V., Ishchenko O.P., Kraposhina A.Yu., Solov'eva I.A., Gordeeva N.V., Salmina A.B. Clinical, functional and laboratory features of asthma–COPD overlap syndrome. PULMONOLOGIYA. 2016;26(6):649-656. (In Russ.) https://doi.org/10.18093/0869-0189-2016-26-6-649-656
Views:
2714
Email this article 