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array:23 [ "pii" => "S1579212916300271" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.03.021" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "1261" "copyright" => "SEPAR" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:343" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2194 "formatos" => array:3 [ "EPUB" => 136 "HTML" => 1541 "PDF" => 517 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289615003750" "issn" => "03002896" "doi" => "10.1016/j.arbres.2015.09.008" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "1261" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:343" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2871 "formatos" => array:3 [ "EPUB" => 92 "HTML" => 2000 "PDF" => 779 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Reflexiones sobre la rinitis como un marcador clínico de fenotipo EPOC-asma" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "343" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Rhinitis: A clinical marker of COPD-asthma overlap phenotype?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Marco Figueira Gonçalves" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Juan Marco" "apellidos" => "Figueira Gonçalves" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916300271" "doi" => "10.1016/j.arbr.2016.03.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300271?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615003750?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000006/v1_201605260144/S0300289615003750/v1_201605260144/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S1579212915003286" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.08.007" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "1255" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:342" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2008 "formatos" => array:3 [ "EPUB" => 134 "HTML" => 1390 "PDF" => 484 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Cystic Lung Disease: The Importance of a Multidisciplinary Approach" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "342" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad quística del pulmón: la importancia de un enfoque multidisciplinar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Edson Marchiori, Gláucia Zanetti, Miriam Menna Barreto" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Edson" "apellidos" => "Marchiori" ] 1 => array:2 [ "nombre" => "Gláucia" "apellidos" => "Zanetti" ] 2 => array:2 [ "nombre" => "Miriam" "apellidos" => "Menna Barreto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289615003695" "doi" => "10.1016/j.arbres.2015.08.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615003695?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915003286?idApp=UINPBA00003Z" "url" => "/15792129/0000005200000006/v1_201605260126/S1579212915003286/v1_201605260126/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Rhinitis: A Clinical Marker of COPD-Asthma Overlap Phenotype?" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "343" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Juan Marco Figueira Gonçalves" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Juan Marco" "apellidos" => "Figueira Gonçalves" "email" => array:1 [ 0 => "juanmarcofigueira@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reflexiones sobre la rinitis como un marcador clínico de fenotipo EPOC-asma" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">According to the EPI-SCAN study, up to 17% of patients diagnosed with COPD may be classified as having COPD-asthma overlap syndrome, and, as such, be candidates for the early introduction of inhaled corticosteroids. For the diagnosis of asthma-COPD overlap syndrome, GesEPOC proposes the following major criteria: bronchodilator test >15% and 400<span class="elsevierStyleHsp" style=""></span>ml, eosinophilia in sputum, and a diagnosis of asthma before the age of 40 years; and minor criteria: elevated total IgE, atopy and bronchodilator test >12% and 200<span class="elsevierStyleHsp" style=""></span>ml on 2 or more occasions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Surprisingly, rhinitis, observed in up to 75% of patients with allergic asthma and up to 80% of non-allergic asthmatics, was excluded from the diagnostic criteria, in favor of atopy and elevated total IgE levels, with the aim of identifying an eosinophilic inflammatory substrate. However, diseases such as asthma or rhinitis may occur with eosinophilic infiltration, but with no evidence of sensitization or elevated IgE levels.</p><p id="par0015" class="elsevierStylePara elsevierViewall">While the concept of a single pathway in asthma is well established, very little scientific evidence on the coexistence of rhinitis and COPD is available as yet. Several studies have reported that up to 88% of COPD patients report upper respiratory tract symptoms, primarily rhinorrhea.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a> Jamieson et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> identified what they defined as an allergic phenotype in COPD patients who showed positive sensitization to pneumoallergens and/or allergic upper respiratory tract symptoms, demonstrating that these are more symptomatic subjects with a higher risk of exacerbations.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In accordance with the single pathway concept, the type of inflammatory substrate in the upper airways should give an idea of the type of inflammation occurring in the bronchi. Hurst et al. detected elevated IL-8 levels in the nasal lavage of patients with COPD, suggesting a neutrophilic response.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> These findings coincide with those of Vachier et al., who, after analyzing nasal mucosa biopsies of active smokers with COPD, found elevated levels of neutrophils and CD8.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> In contrast, Hens et al. reported high levels of eotaxin in the nasal lavage of COPD patients with no increase in IL8 concentrations compared to asthma subjects, suggesting an eosinophilic response.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> Moreover, Neves MC et al. confirmed that rhinitis symptoms in COPD patients are associated with nasal eosinophilia with an OR of 4.1 (1.59–11.39), and that these patients are more likely to show a positive bronchodilator test.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">These contradictory findings might support the concept of COPD phenotypes. Until it is confirmed in clinical trials, the high prevalence of rhinitis in asthma patients makes it reasonable to propose this symptom as a clinical marker for the COPD-asthma overlap syndrome.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Goncalves JMF. Reflexiones sobre la rinitis como un marcador clínico de fenotipo EPOC-asma. Arch Bronconeumol. 2016;52:343.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The frequency of chronic rhinosinusitis/nasal polyp in COPD and its effect on the severity of COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Kelemence" 1 => "O. Abadoglu" 2 => "C. Gumus" 3 => "S. Berk" 4 => "K. Epozturk" 5 => "I. 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