Asthma and COPD: Differences and Similarities

Chronic obstructive pulmonary disease (COPD) is a general term that describes progressive respiratory diseases such as emphysema and chronic bronchitis. Asthma is usually considered a separate respiratory disease but is sometimes mistaken for COPD. Let’s figure out why it is important to understand what kind of disease you have – asthma or COPD, and how to distinguish them.

According to statistics, about half of patients with COPD are not aware of the presence of this disease. It is characterized by a decrease in air flow in the lungs over time, as well as inflammation of the tissues lining the airways.

Drawing attention to symptoms, especially in people who smoke or have ever smoked, will help diagnose chronic obstructive pulmonary disease in time. This is important because early diagnosis in people with COPD can be critical in maintaining lung function.

Asthma is considered a risk factor for COPD. And about 40% of people with COPD also have asthma. The chance of getting a diagnosis of two conditions increases with age.

What are the differences between COPD and asthma?

Asthma and chronic obstructive pulmonary disease may seem similar. Both conditions have similar symptoms such as chronic cough, wheezing, and shortness of breath.

But careful consideration of their symptoms and the factors that cause these diseases will help you understand the difference between the two conditions.

At what age do asthma and COPD start?

Airway obstruction occurs in both diseases. But the age at the onset of this syndrome often becomes an obvious difference be-tween asthma and COPD.

People with asthma are usually diagnosed as early as childhood whereas COPD symptoms usually appear only in people over 40 – current or former smokers.

Causes of asthma and COPD

The causes of asthma and COPD are different.

Experts don’t know exactly why some people get asthma and others don’t. This is most likely caused by a combination of environmental and hereditary (genetic) factors.

It is known that exposure to certain types of substances (allergens) can cause allergies. However, allergens are different for different people.

Some common triggers for asthma include:

• pollen;
• dust mites;
• fungal spores;
• pet hair;
• respiratory infections;
• physical activity;
• cold air;
• smoke;
• medications such as beta-blockers and aspirin;
• stress;
• sulfites and preservatives found in some foods and drinks;
• gastroesophageal reflux disease (GERD).

A well-known cause of chronic obstructive pulmonary disease in developed countries is smoking. It is estimated that 20 to 30% of people who smoke regularly have COPD.

Smoke irritates the lungs. Therefore, the bronchi and alveoli lose their natural elasticity and expand excessively. As a result, air is trapped in the lungs when you exhale.

About 1% of people with COPD have a genetic disorder that causes alpha-1-antitrypsin (AAT) protein deficiency. This protein inhibits the excess activity of tissue proteases that destroy lung tissue.

Due to the lack of AAT, the destruction of lung tissue occurs not only in experienced smokers but also in infants and children who have never smoked.

Triggers

The factors causing chronic obstructive pulmonary disease are different from asthma triggers.

Asthma symptoms are usually aggravated by:

• allergens;
• cold air;
• physical activity.

Exacerbations of COPD are largely caused by respiratory tract infections such as pneumonia and influenza. COPD can also worsen due to exposure to environmental pollutants.

Symptoms

The symptoms of COPD and asthma are similar – especially dyspnea that occurs with both diseases. Airway hypersensitivity is a common feature of these diseases.

A significant difference between asthma and COPD is that asthma is associated with bronchial hyperreactivity. That is, their expansion in response to inhalation of adrenomimetics and an increase in forced expiratory volume in the first second by more than 12%.

Accompanying illnesses

Comorbidities that exist in addition to the main one in asthma and COPD are also often the same.

Possible concomitant illnesses:

• hypertension;
• impaired mobility;
• insomnia;
• rhinosinusitis;
• migraine;
• depression;
• stomach ulcer;
• cancer.

One study found that more than 20% of people with COPD have three or more concomitant conditions.

Treating asthma and COPD

Asthma is a long-term medical condition that can be controlled with proper treatment. One of the main parts of treatment involves identifying your asthma triggers and taking steps to avoid them.

It’s also important to pay attention to your breathing to make sure your medications are working effectively. Common treatments include:

• Rapid-acting medicines (bronchodilators): short-acting beta-agonists, oral and intravenous corticosteroids;
• Allergy medications: allergen-specific immunotherapy medications and so-called biological medications that block asthma factor molecules in your body;
• Medications for long-term control: inhaled corticosteroids, leukotriene modifiers, long-acting beta-agonists, combined inhalation drugs, theophylline.

Like asthma, COPD is a long-term condition. The goal of the treatment is to control your symptoms so you can lead an active and healthy life. Since it is a progressive disease, the second main goal of treatment is to prevent the condition from getting worse.

You must quit smoking and avoid exposure to secondhand smoke. This is the only way to prevent COPD from getting worse.

Some smoking cessation methods include nicotine products and medications, as well as therapy, hypnosis, and support group sessions.

Other common treatments for COPD include:

• Medicines: bronchodilators, inhaled steroids, combined inhalers, oral steroids, phosphodiesterase-4 inhibitors, theophylline, and antibiotics;
• Lung treatment: oxygen therapy and pulmonary rehabilitation programs. The latter include education, exercise training, nutritional advice, counseling to improve your quality of life;
• Surgery to reduce lung volume (removal of damaged lung tissue), lung transplant or bullectomy (removal of an abnormally large airspace from the lungs to improve breathing).

The body’s response to treatment

Both COPD and asthma respond well to smoking cessation and medications such as bronchodilators. However, lung function is only completely reversible in people with asthma.

The simultaneous diagnosis of asthma and chronic obstructive disease often means that the decrease in lung function will occur more rapidly due to the progression of COPD. This decrease is observed even in people with mild forms of the disease.

Forecast

Both asthma and COPD are long-term conditions that cannot be cured. But the prospects for each of them are different.

Asthma is usually easier to manage on a daily basis. In contrast, COPD gets worse over time.

People with asthma and COPD tend to suffer from these conditions for their entire lives. But in some cases of childhood asthma, the disease can be outgrown.

Patients with asthma or COPD can reduce their symptoms and prevent complications by following established treatment plans.