Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS): current literature review

Antonis Papaiwannou, Paul Zarogoulidis, Konstantinos Porpodis, Dionysios Spyratos, Ioannis Kioumis, Georgia Pitsiou, Athanasia Pataka, Kosmas Tsakiridis, Stamatis Arikas, Andreas Mpakas, Theodora Tsiouda, Nikolaos Katsikogiannis, Ioanna Kougioumtzi, Nikolaos Machairiotis, Stavros Siminelakis, Alexander Kolettas, George Kessis, Thomas Beleveslis, Konstantinos Zarogoulidis


Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases, very common in general population. These obstructive airway illnesses are manifested with chronic inflammation affecting the whole respiratory tract. Obstruction is usually intermittent and reversible in asthma, but is progressive and irreversible in COPD. Asthma and COPD may overlap and converge, especially in older people [overlap syndrome—asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS)]. Although ACOS accounts approximately 15-25% of the obstructive airway diseases, is not well recognised because of the structure of clinical trials. COPD studies exclude asthma patients and asthma studies exclude COPD patients, respectively. It is crucial to define asthma, COPD and overlap syndrome (ACOS), as notable clinical entities, which they share common pathologic and functional features, but they are characterized from differences in lung function, acute exacerbations, quality of life, hospital impact and mortality.