Similarity and differences in elderly patients with fixed airflow obstruction by asthma and by chronic obstructive pulmonary disease.
BACKGROUND
Epidemiologic studies have demonstrated that elderly patients with fixed airflow obstruction can be affected by asthma or chronic obstructive pulmonary disease (COPD).


METHODS
We studied 49 consecutive elderly outpatients, presenting fixed airflow obstruction, by clinical history (smoking), pulmonary function tests, blood gas analysis, and induced sputum.


RESULTS
The age was not different in patients with COPD (n=28) and asthma (n=21) (70.2+/-3.9 years vs. 69.6+/-3.7 years), also the degree of fixed airflow obstruction was similar (FEV1: 58.3+/-1.5% vs. 59.0+/-1.4% of predicted). Patients with asthma had significantly more eosinophils in peripheral blood (0.43+/-0.05x10(-3)microL vs. 0.27+/-0.1x10(-3)microL, P<0.0001), and in induced sputum (5.0% [(p25th and p75th) 5.0-6.0%] vs. 1.0% [(p25th and p75th) 0.01-1.0%]; P<0.0001), as well as serum ECP (18.6+/-4.9ng/mL vs. 7.7+/-4.7ng/mL, P<0.0001) and ECP in the induced sputum (31.6+/-2.9ng/mL vs. 5.6+/-4.9ng/mL, P<0.0001). Finally, in induced sputum the eosinophils EG2+ were higher in patients with asthma than in patients with COPD (40.5 [(p25th and p75th) 39.3-44.3] MFI vs. 3.9 [(p25th and p75th) 0-11.4] MFI, P<0.0001). They also had significantly higher diffusing capacity, and a greater reversibility to steroids, after 14-day course of therapy, whereas the reversibility to 400microg of salbutamol was similar.


CONCLUSIONS
Despite similar fixed airflow obstruction, elderly patients with asthma have distinct characteristics compared with patients with COPD.
Di Lorenzo
Gabriele
G
Dipartimento di Medicina Clinica e delle Patologie Emergenti, Università degli Studi di Palermo, Italy. dilo601@unipa.it
Mansueto
Pasquale
P
Ditta
Vito
V
Esposito-Pellitteri
Maria
M
Lo Bianco
Claudia
C
Leto-Barone
Maria S
MS
D'Alcamo
Alberto
A
Farina
Cristina
C
Di Fede
Gaetana
G
Gervasi
Francesco
F
Caruso
Calogero
C
Rini
GiovamBattista
G
D000368:Aged; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D004804:Eosinophils; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D012129:Respiratory Function Tests; D013183:Sputum / Q000166:cytology; D014797:Vital Capacity