Zespół nakładania astmy i przewlekłej obturacyjnej choroby płuc

• Authors: Jadwiga Kroczyńska-Bednarek , Paweł Górski , Iwona Grzelewska-Rzymowska

Title variants

EN

The overlap syndrome of asthma and chronic obstructive pulmonary disease

• Languages of publication: EN PL

Abstracts

EN

Asthma and chronic obstructive pulmonary disease (COPD) are both inflammatory respiratory diseases which links the presence of airflow limitation, that is emphasized in their definition. Underlying inflammation demonstrate a qualitatively difference in the prevailing cells and leading inflammatory mediators in each disease. Response to bronchodilators is also generally different in asthma and COPD. Despite these differences, and significant distinctness of the natural course, prognosis and pathogenesis, in clinical practice a proper diagnosis between these two conditions is often difficult to achieve and may be even impossible in some patients due to overlapping features of asthma and COPD in the same patient. Over the years, some patients with asthma becomes irreversible, and many patients with COPD show significant airway hyperreactivity and partially reversible airflow obstruction. Even the profile of inflammation in severe asthma may change similar to that observed in COPD, and exacerbations of COPD proceed with a greater participation of eosinophils. Common risk factors and the fact that asthma itself can increase the likelihood of developing COPD is considered the main reason of coexistence of both diseases (overlap syndrome). Prevalence of the phenomenon forces to develop effective methods of preventing the emergence overlap syndrome, to better differentiate the both diseases, and to search for optimal management strategies and treatment in the cases of their coexistence.

PL

Astma i przewlekła obturacyjna choroba płuc (POChP) to zapalne choroby dróg oddechowych, które łączy obecność ograniczenia przepływu powierza przez drogi oddechowe podkreślane w ich definicji. Zapalenie, które leży u podłoża obu chorób, różni się jakościowo rodzajem przeważających komórek i głównych mediatorów zapalnych. Inna jest też na ogół odpowiedź na leki rozszerzające oskrzela w astmie i POChP. Pomimo tych różnic i znaczących odrębności naturalnego przebiegu, rokowania i patogenezy właściwe rozpoznanie obu chorób w praktyce jest trudne, a niekiedy nawet niemożliwe z powodu nakładania się cech astmy i POChP u tego samego pacjenta. Wraz z upływem lat u części chorych na astmę dochodzi do utrwalenia się obturacji, a wielu pacjentów z POChP wykazuje istotną reaktywność oskrzeli i częściową odwracalność obturacji. Nawet profil zapalenia w ciężkiej astmie może zmieniać się na podobny do obserwowanego w POChP, a zaostrzenie POChP przebiega niejednokrotnie z większym udziałem eozynofilów. Głównej przyczyny takiego współwystępowania obu schorzeń (zespołu nakładania) upatruje się we wspólnych czynnikach ryzyka i fakcie, że sama astma może zwiększać prawdopodobieństwo wystąpienia POChP. Powszechność zjawiska zmusza do wypracowania skutecznych metod zapobiegania rozwojowi zespołu nakładania, lepszego różnicowania obu chorób, a w przypadku ich współistnienia – do poszukiwania optymalnych sposobów postępowania i leczenia.

Keywords

EN

asthma; astma; chronic obstructive pulmonary disease; inflammation; nieswoista nadreaktywność oskrzeli; nonspecific bronchial hyperresponsiveness; overlap syndrome; przewlekła obturacyjna choroba płuc; reversibility test; test odwracalności; zapalenie; zespół nakładania

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Pediatria i Medycyna Rodzinna
• Year: 2011
• Volume: 7
• Issue: 2
• Pages: 136-143

Contributors

author

Jadwiga Kroczyńska-Bednarek

• Klinika Pneumonologii i Alergologii KPiA Uniwersytetu Medycznego w Łodzi. Kierownik Kliniki: prof. dr hab. n. med. Paweł Górski

author

Paweł Górski

• Klinika Pneumonologii i Alergologii KPiA Uniwersytetu Medycznego w Łodzi. Kierownik Kliniki: prof. dr hab. n. med. Paweł Górski

author

Iwona Grzelewska-Rzymowska

• Klinika Pneumonologii i Alergologii KPiA Uniwersytetu Medycznego w Łodzi. Kierownik Kliniki: prof. dr hab. n. med. Paweł Górski

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• Document Type: article