Junjie Peng1, Min Wang1, Yanqiu Wu1, Yongchun Shen1, Lei Chen1. 1. Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, People's Republic of China.
Abstract
Background: Some clinical indicators have been reported to be useful in differentiating asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) from pure asthma/COPD, but the results were inconsistent. This study aims to evaluate the diagnostic value of these indicators for ACO. Methods: Databases of PubMed, EMBASE, Ovid and Web of Science were retrieved. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated in random-effects models. Results: 48 eligible studies were included. The pooled results indicated, compared with pure asthma, ACO patients had lower levels of forced expiratory volume in the first second (FEV1)% predicted (pred) (SMD=-1.09, 95% CI -1.3 to -0.87), diffusion lung capacity for carbon monoxide (DLCO)% pred (SMD=-0.83, 95% CI -1.24 to -0.42), fractional exhaled nitric oxide (FeNO) (SMD=-0.23, 95% CI -0.36 to -0.11), and higher levels of induced sputum neutrophil (SMD = 0.51, 95% CI 0.21 to 0.81), circulating YKL-40 (SMD = 0.96, 95% CI 0.27 to 1.64). However, relative to COPD alone, ACO patients had higher levels of FEV1% pred (SMD = 0.15, 95% CI 0.05 to 0.26), DLCO% pred (SMD = 0.38, 95% CI 0.16 to 0.6), FeNO (SMD = 0.59, 95% CI 0.40 to 0.78), serum total immunoglobulin (Ig)E (SMD = 0.42, 95% CI 0.1 to 0.75), blood eosinophil (SMD = 0.44, 95% CI 0.29 to 0.59), induced sputum eosinophil (SMD = 0.62, 95% CI 0.42 to 0.83), and lower levels of induced sputum neutrophil (SMD=-0.48, 95% CI -0.7 to -0.27), circulating YKL-40 (SMD=-1.09, 95% CI -1.92 to -0.26). Conclusion: Compared with pure asthma/COPD, ACO patients have different levels of FEV1% pred, DLCO% pred, FeNO, serum total IgE, blood eosinophil, induced sputum eosinophil/neutrophil, and circulating YKL-40, which could be helpful to establish a clinical diagnosis of ACO.
Background: Some clinical indicators have been reported to be useful in differentiating asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) from pure asthma/COPD, but the results were inconsistent. This study aims to evaluate the diagnostic value of these indicators for ACO. Methods: Databases of PubMed, EMBASE, Ovid and Web of Science were retrieved. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated in random-effects models. Results: 48 eligible studies were included. The pooled results indicated, compared with pure asthma, ACO patients had lower levels of forced expiratory volume in the first second (FEV1)% predicted (pred) (SMD=-1.09, 95% CI -1.3 to -0.87), diffusion lung capacity for carbon monoxide (DLCO)% pred (SMD=-0.83, 95% CI -1.24 to -0.42), fractional exhaled nitric oxide (FeNO) (SMD=-0.23, 95% CI -0.36 to -0.11), and higher levels of induced sputum neutrophil (SMD = 0.51, 95% CI 0.21 to 0.81), circulating YKL-40 (SMD = 0.96, 95% CI 0.27 to 1.64). However, relative to COPD alone, ACO patients had higher levels of FEV1% pred (SMD = 0.15, 95% CI 0.05 to 0.26), DLCO% pred (SMD = 0.38, 95% CI 0.16 to 0.6), FeNO (SMD = 0.59, 95% CI 0.40 to 0.78), serum total immunoglobulin (Ig)E (SMD = 0.42, 95% CI 0.1 to 0.75), blood eosinophil (SMD = 0.44, 95% CI 0.29 to 0.59), induced sputum eosinophil (SMD = 0.62, 95% CI 0.42 to 0.83), and lower levels of induced sputum neutrophil (SMD=-0.48, 95% CI -0.7 to -0.27), circulating YKL-40 (SMD=-1.09, 95% CI -1.92 to -0.26). Conclusion: Compared with pure asthma/COPD, ACO patients have different levels of FEV1% pred, DLCO% pred, FeNO, serum total IgE, blood eosinophil, induced sputum eosinophil/neutrophil, and circulating YKL-40, which could be helpful to establish a clinical diagnosis of ACO.
Authors: Hea Yon Lee; Ji Young Kang; Hyoung Kyu Yoon; Sook Young Lee; Soon Suk Kwon; Young Kyoon Kim; Chin Kook Rhee Journal: Yonsei Med J Date: 2014-07 Impact factor: 2.759
Authors: Luis Pérez de Llano; Borja G Cosío; Amanda Iglesias; Natividad de Las Cuevas; Juan Jose Soler-Cataluña; Jose Luis Izquierdo; Jose Luis López-Campos; Carmen Calero; Vicente Plaza; Marc Miravitlles; Alfons Torrego; Eva Martinez-Moragon; Joan B Soriano; Antolin Lopez Viña; Irina Bobolea Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-02-12