Copd And Asthma Overlap With Bronchiectasis

The association of COPD and asthma with bronchiectasis is well known but the prevalence of these combinations varies.COPD and bronchiectasis share common risk factors, clinical features and functional abnormalities. In clinical practice, it is common to identify patients with both COPD and bronchiectasis. In these patients, it can be unclear whether recurrent bronchiectasis exacerbations have led to the obstructive pattern, or whether COPD with frequent exacerbations has led to the development of bronchiectasis. The COPD/bronchiectasis overlap should be identified as a specific phenotype as it requires a different therapeutic approach.The association between asthma and bronchiectasis is more complex. Bronchiectasis has been detected in severe asthma in <= 40% of patients who experience frequent exacerbations; it usually has a non-eosinophilic inflammatory pattern that is poorly responsive to standard asthma treatment. These patients require a different kind of pharmacological treatment (antibiotic therapy and/or physiotherapy). In patients with bronchiectasis without a history of asthma, some "asthma-like features" may be observed.The definition of these "bronchietasis phenotypes" has a strong impact on prompt diagnosis and personalised therapy.