Anbarasan Thiru*, Srivastava Govind Narayan, Pulkit Gupta, Bhupendra Kumar Rajak, Brighton Michael, Mishra J. K.


Background: According to Dutch hypothesis Asthma and COPD are the chronic airway diseases with different presentation which was determined by genetic and environmental factors. So Asthma-COPD Overlap (ACO) defined as a different entity by GINA and GOLD report. But the exact prevalence of the disease is not yet identified due to different diagnostic criteria applied in different studies worldwide. To solve this problem GINA reported a stepwise approach to the diagnosis of ACO. Aim: To estimate the prevalence of ACO in Patients who were receiving treatment for COPD. Methods: This is a cross sectional study conducted in a tertiary care center. This study included 75 COPD patients who were identified by age ≥ 40 years, chronic respiratory symptoms with airflow limitation (FEV1/FVC < 0.7). ACO patients were diagnosed by the stepwise approach stated by GINA. Result: Our study has shown that the prevalence of ACO in COPD patients 36% (n=27). ACO patients were younger (ACO 60.19 years vs 66.44 years, p=0.004), higher Post bronchodilator FEV1/FVC Ratio (0.61 vs 0.53, p=0.001), higher Absolute Eosinophil Count (239.63 vs 105.75, p=0.004), higher Total Serum IgE (565.48 vs 333.08, p<0.001) than COPD only patients. Raised total serum IgE(>100) and Absolute Eosinophil Count(>300) are the significant biomarkers for ACO diagnosis (IgE p=0.001 & AEC, p=0.016). Conclusion: The results of our study shows that the ACO phenotype differs in clinical characteristics of COPD. GINA Stepwise approach is a helpful tool in identifying ACO. IgE and AEC are important biomarkers to differentiate ACO from COPD.

Keywords: COPD, ACO, IgE and AEC.

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