University Of Tasmania
Dey et al AJP_Lung.00121.2021.pdf (2.57 MB)
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Pathogenesis, clinical features of asthma COPD overlap (ACO), and therapeutic modalities

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journal contribution
posted on 2023-05-21, 03:55 authored by Dey, S, Mathew EapenMathew Eapen, Chia, C, Archana Gaikwad, Wark, PAB, Sukhwinder SohalSukhwinder Sohal
Both asthma and COPD are heterogeneous diseases identified by characteristic symptoms and functional abnormalities, with airway obstruction common in both diseases. Asthma COPD overlap (ACO) does not define a single disease but is a descriptive term for clinical use that includes several overlapping clinical phenotypes of chronic airways disease with different underlying mechanisms. This literature review was initiated to describe published studies, identify gaps in knowledge, and propose future research goals regarding the disease pathology of ACO, especially the airway remodelling changes and inflammation aspects. Airway remodelling occurs in asthma and COPD, but there are differences in the structures affected and the prime anatomic site at which they occur. Reticular basement membrane thickening and cellular infiltration with eosinophils and T-helper (CD4+) lymphocytes are prominent features of asthma. Epithelial squamous metaplasia, airway wall fibrosis, emphysema, bronchoalveolar lavage (BAL) neutrophilia and (CD8+) T-cytotoxic lymphocyte infiltrations in the airway wall are features of COPD. There is no universally accepted definition of ACO, nor are there clearly defined pathological characteristics to differentiate from asthma and COPD. Understanding etiological concepts within the purview of inflammation and airway remodelling changes in ACO would allow better management of these patients.


Clifford Craig Foundation


Publication title

American Journal of Physiology








School of Health Sciences


Amer Physiological Soc

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Copyright © 2021 the American Physiological Society

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Diagnosis of human diseases and conditions