2023-09-11 08:20:40
by Antonella Sparvoli
Both are characterized by obstruction of the airways, of varying degrees, causing both chronic and acute problems
Bronchial asthma and chronic obstructive pulmonary disease (COPD) are among the most common chronic respiratory diseases. Although they have different causes, they sometimes manifest so similarly that it can become difficult to distinguish them, especially when the asthma is very severe.
The typical characteristics of asthma and COPD
Both asthma and COPD are very common diseases. Both are characterized by obstruction of the airways, of varying degrees, causing both chronic and acute problems. In COPD, however, the obstruction can become irreversible, with permanent damage.
«Asthma, although it can take on very different contours and forms, is always characterized by a variable but reversible degree of obstruction of the bronchi and by an increased sensitivity of the airways to various stimuli, from air pollution to allergens, resulting in breathing difficulties. In asthma, phases of relative or complete well-being usually alternate with moments of even very serious breathing problems: asthma attacks. During these crises, which can be sudden or gradual, symptoms and respiratory function worsen. Wheezing, a sense of chest tightness, shortness of breath and coughing are the disorders that most characterize the attack” he explains Sergio Hararidirector of the Pneumology Operational Unit at the San Giuseppe MultiMedica Hospital in Milan and professor of Internal Medicine at the State University of Milan.
COPD is also characterized by an obstruction to the flow of air, which however is not completely reversible. «COPD is associated with an inflammatory response of the lung to particles dispersed in the air and inhaled (starting from cigarette smoke), has a progressive course and more or less frequent exacerbations. Shortness of breath and chronic productive cough (with phlegm) are the main warning signs. Other less common complaints include chest tightness and wheezing” explains Harari.
The distinctive aspects that can guide the diagnosis
Both the diagnosis of asthma and COPD are based primarily on a careful evaluation of the patient’s symptoms and history, which in most cases offer the most valid and safe criterion for distinguishing them. «Asthma usually develops in childhood or at a young age, although there are cases in which it arises at older ages – continues the expert -. COPD, on the other hand, typically occurs in adults and even more so in the elderly, especially in smokers or ex-smokers. A personal or family history of asthma and/or allergic rhinitis and atopic dermatitis increases the likelihood of a diagnosis of asthma, while a personal history of smoking or professional exposure to harmful substances leans towards COPD.”
A diagnostic test that has a crucial role in the diagnosis of asthma and COPD is spirometry, with which the quantity of exhaled air and the speed of expiration are measured. «In asthma, the limitation to air flow is reversible spontaneously or after therapy with fast-acting inhaled bronchodilator drugs, while in COPD the limitation is not reversible or barely reversible and is usually progressive» points out Harari.
Personalized treatments for asthma and COPD
«For COPD there is no treatment that allows you to restore lost respiratory function, but you can count on numerous therapies that help keep the disease under control. The first indication is always to stop smoking” explains Harari. Then, depending on the respiratory compromise, various drugs are used, bronchodilators and cortisone in particular, which are administered mainly by inhalation.
«Asthma is not curable, but the therapies are very effective. You can count on numerous drugs often used in combination, which include cortisone, bronchodilators and antileukotriene drugs. For the more serious forms that do not respond to these therapies, new, very effective drugs have been developed. These are monoclonal antibodies, also called biological drugs, which act selectively on the cells or inflammatory mediators responsible for asthma. Recent studies are predicting the possible use of biological drugs also in COPD. What remains fundamental, both in asthma and COPD, is to personalize the treatment and teach patients to take the drugs continuously and correctly, an indispensable prerequisite for the success of the therapies” concludes Harari.
September 11, 2023 (modified September 11, 2023 | 08:19)
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