Does asthma-bronchiectasis overlap syndrome (ABOS) really exist?

Autores de IIS La Fe

• 

  Miguel Ángel Martínez García

  Autor

Participantes ajenos a IIS La Fe

• Tiotiu A
• Mendez-Brea P
• Roibas-Veiga I
• Gonzalez-Barcala FJ

Grupos

• Neumología

  

  Leader

  Miguel Ángel Martínez García

Abstract

OBJECTIVE: To analyse the relationship between asthma and bronchiectasis, as well as the necessary conditions that this connection must meet for this group of patients to be considered a special phenotype. DATA SOURCES: We performed a PubMed search using the MeSH terms "asthma", "bronchiectasis". The literature research was limited to clinical trials, meta-analyses, randomized controlled trials, cohort studies and systematic reviews, involving adult patients, published until November 30th, 2022. STUDY SELECTIONS: Selected papers were initially evaluated by the Authors, to assess their eligibility in contributing to the statements. RESULTS: The prevalence of bronchiectasis is higher than expected in patients with asthma, particularly in those with more severe disease, and in some patients, between 1.4 and 7 per cent of them, asthma alone could be the cause of bronchiectasisBoth diseases share aetiopathogenic mechanisms, such as neutrophilic and eosinophilic inflammation, altered airway microbiota, mucus hypersecretion, allergen sensitisation, immune dysfunction, altered microRNA, dysfunctional neutrophilic activity and variants of the HLA system. Besides that, they also share comorbidities, such as gastroaesophageal reflux disease and psychiatric illnesses.The clinical presentation of asthma is very similar to patients with bronchiectasis, which could cause mistakes with diagnoses and delays in being prescribed the correct treatment.The coexistence of asthma and bronchiectasis also poses difficulties for the therapeutic focusConclusions: The evidence available seems to support that asthma-bronchiectasis phenotype really exist although longitudinal studies which consistently demonstrate that asthma is the cause of bronchiectasis are still lacking.

Keywords

• Asthma; bronchiectasis; comorbidities; eosinophils; exacerbation; overlap; prognosis