The relationship between asthma and COPD. Lessons from transgenic mice.
Asthma is characterized by eosinophilic and mononuclear cell infiltration, mucous metaplasia, airway remodeling, reversible airflow obstruction, and airway hyperresponsiveness. COPD is typified by nonreversible or incompletely reversible airway obstruction, often accompanied by mucous metaplasia and alveolar destruction. There is considerable overlap in pathogenesis and clinical features between the conditions. However, asthma and COPD may be distinguished by their respective cytokine profiles. Studies in transgenic mice have illuminated the roles of the T helper (Th) 1-mediated cytokine interferon-gamma in COPD, supporting the British hypothesis, and the Th2-mediated cytokine interleukin-13 in asthma, supporting the Dutch hypothesis. COPD and asthma may represent disease states along a continuum, with varying degrees of each disease often present in the same patient.
Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520, USA. jack.elias@yale.edu
Jack
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Elias
D000818:Animals; D001249:Asthma / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D016207:Cytokines / Q000378:metabolism / Q000502:physiology; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism / Q000502:physiology; D051379:Mice; D008822:Mice, Transgenic; D011650:Pulmonary Alveoli / Q000378:metabolism / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology
D016207:Cytokines; D018836:Inflammation Mediators