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Physiologic Similarities and Differences Between COPD and Asthma*

Frank C. Sciurba, MD, FCCP
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*From the Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.

Correspondence to: Frank C. Sciurba, MD, FCCP, Associate Professor of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, 1211 Kaufmann Bldg, Pittsburgh, PA 15213; e-mail: sciurbafc@upmc.edu



Chest. 2004;126(2_suppl_1):117S-124S. doi:10.1378/chest.126.2_suppl_1.117S
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The structural and physiologic findings in asthma and COPD appear, on average, and in the extremes of presentation, to be easily distinguished. A closer inspection of the literature reveals that significant overlap exists in individual patients with respect to airway wall thickening and low-attenuation parenchymal regions on CT scans, and in reversibility, airway hyperresponsiveness, lung diffusion, resting and dynamic hyperinflation, lung elastic recoil, exercise response, and a “pharmaceutical volume reduction” effect following therapy with bronchodilators. In particular, the subgroup of COPD patients having an airway-dominant phenotype becomes indistinguishable from asthmatic subjects with reversible disease that evolves into an incompletely reversible pattern.

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