Article information
Resumen
La enfermedad pulmonar obstructiva crónica y el asma son dos enfermedades inflamatorias muy prevalentes, caracterizadas por obstrucción del flujo aéreo, que tienen diferentes mecanismos patogénicos y diferentes grados de respuesta al tratamiento antiinflamatorio. Sin embargo, en la práctica clínica aparecen con frecuencia presentaciones clínicas que solapan ambas enfermedades y que no están claramente representadas en los ensayos clínicos. Estos pacientes pueden tener una pérdida acelerada de la función pulmonar y un pronóstico peor, por lo que es importante su identificación temprana. Biomarcadores, como la hiperreactividad bronquial o el óxido nítrico en aire exhalado, han mostrado resultados desiguales. Su caracterización fenotípica nos permitiría individualizar y optimizar el tratamiento con corticosteroides inhalados.
Palabras clave:
Overlap
Hiperreactividad
Atopia
Corticosteroides inhalados
Abstract
Chronic obstructive pulmonary disease and asthma are both highly prevalent inflammatory diseases characterized by airway obstruction with distinct pathogenic mechanisms and different degrees of response to antiinflammatory therapy. However, forms of presentation that show overlap between both diseases and which are not clearly represented in clinical trials are frequently encountered in clinical practice. These patients may show accelerated loss of pulmonary function and have a worse prognosis. Therefore their early identification is essential. Biomarkers such as bronchial hyperreactivity or nitric oxide in exhaled air have yielded discrepant results. Phenotypic characterization will allow treatment with inhaled corticosteroids to be individually tailored and optimized.
Keywords:
Overlap
Hyperreactivity
Atopy
Inhaled corticosteroids
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