Asthma versus COPD: What's the difference?
Coughing, shortness of breath, anxiety and wheezing could signal several diseases. In particular, they are symptoms of Chronic Obstructive Pulmonary Disease, or COPD, and asthma.
These are some ways to tell which one you might have.
There are nearly 24 million adults living with COPD, while 25 million people are affected by asthma. The symptoms might seem identical. How do you tell which one you have?
One difference is that asthma can start at any age, but COPD does not occur in people until they're over the age of 40.
So, even if you've never had asthma growing up, "The fact is that we don't know why some people have it as adults," pulmonologist Dr. Mark Millard said. "We don't know what factors of the environment that interact with this genetic predisposition."
Also, COPD is mainly triggered by cigarette smoke, first or secondhand. But asthma has many triggers, such as mold, dust, pollen or pet dander.
Your breathing changes in asthma, but with the help of your inhaler, it can go back to normal. In COPD patients, it never gets better.
"There's no cure for asthma, but it can be controlled easily," respiratory therapist Mary Hart said. "And you don't have the deterioration of the lungs like you do with COPD. COPD, like I said, it's progressive, and you have that deterioration of lung function over time."
It is possible to have them at the same time, called asthma-COPD overlap syndrome, or ACOS.
Those with severe asthma are 32% more likely to develop COPD later in life.
ASTHMA vs COPD: WHAT'S THE DIFFERENCE?
BACKGROUND: More than 25 million people in the United States have asthma, while approximately 14.8 million adults have been diagnosed with COPD and approximately 12 million people have not yet been diagnosed. Deaths from asthma have decreased since the mid-1990's, while COPD is considered the 4th leading cause of death in the United States. Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airway narrowing and obstruction. These episodes can range in severity from mild to life threatening. Symptoms of asthma include wheezing, coughing, chest tightness, and shortness of breath. COPD is a preventable and treatable disease characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases (typically from exposure to cigarette smoke). (Source: https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases)
TREATMENT IN BOTH ASTHMA AND COPD: Although many of the medications used for asthma are also used for COPD, there are some striking differences in recommendations between the 2 conditions, leading to potential risk when patients have features of both. Although long-acting B2-agonists (LABAs) are recommended as the sole initial therapy for patients with COPD, this is not recommended for people with asthma because of the risk of severe worsening of symptoms. Conversely, although inhaled corticosteroids (ICS) are the mainstay of treatment for asthma because of their profound benefit in reducing mortality and hospitalizations, ICS treatment is only recommended for patients with COPD with FEV1 of less than 50% of predicted value and a history of worsening and not without a connected LABA, long-acting muscarinic antagonist (LAMA), or both. Most COPD studies have used moderate or high ICS doses. It's recommended an increase in bronchodilator and controller medications for people with asthma but antibiotics and oral corticosteroids for patients with COPD. (Source: https://www.jacionline.org/article/S0091-6749(15)00945-8/pdf)
RESEARCH BREAKTHROUGH FOR COPD: Jonathan Baker, MD is on a team of researchers at the British Lung Foundation (BLF) investigating how well people's lungs work and why they decline at a much faster rate in people with COPD than in other people of the same age. This shows people living with COPD have genes that cause accelerated aging in their lungs, which may be the result of these patients having more 'senesecent' cells in their lungs, or cells that can't divide anymore, so they can't repair themselves. However, these cells are still active in other ways, which means they can cause inflammation in the lungs and cause damage. This research, which the BLF is helping fund, looks at how a small 'miRNA', a molecule that can inhibit proteins, may be bringing down the levels of Sirtuin-1 in people with COPD. By reducing the amount of miRNA, levels of Sirtuin-1 can be raised, which brings down the senescent cells that cause inflammation and damage. Identifying the right molecules means they can be used as 'biomarkers', which could be positive for all sorts of reasons. It could mean that we get better at detecting people with COPD earlier, and so people could get a diagnosis and start treatment sooner. (Source: https://www.blf.org.uk/your-stories/were-making-breakthroughs-in-copd-research)