Asthma vs. COPD
Similar symptoms, different causes and treatment
As many as 50 percent of older adults with obstructive airway disease have overlapping characteristics of Asthma and COPD. And this percentage increases as people get older.
Coughing, wheezing and shortness of breath are symptoms asthma sufferers are used to. They are also the symptoms of chronic obstructive pulmonary disease (COPD). For sufferers, as well as physicians, it can be difficult to tell the difference between the two conditions.
According to a presentation at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, as many as 50 percent of older adults with obstructive airway disease have overlapping characteristics of asthma and COPD. And this percentage increases as people get older.
Based on symptoms alone, it can be difficult to diagnose COPD vs. asthma. The pathway to a diagnosis of COPD or asthma — smoking vs. a long-term persistence of asthma — can be quite different,” said allergist William Busse, MD, ACAAI fellow and presenter.
In every patient, but in older patients in particular, we need to take a thorough history and perform a physical examination, as well as measurements of lung functions. In patients with COPD and asthma, the changes in lung function may be severe, and it is not often readily apparent, which is the predominant, underlying condition — asthma or COPD. Treatment will differ depending on diagnosis.”
Lung function changes in asthma are due to airway inflammation, and treatment is directed at reducing inflammation with corticosteroids — largely, inhaled corticosteroids. But the changes in lung function associated with COPD are caused by cigarette smoking and, except with an exacerbation, are not particularly responsive to corticosteroids.
The primary treatment in COPD is bronchodilators, including long-acting beta agonists. They help relax muscles around the airways in the lungs, allowing air to flow more freely,” said allergist Michael Foggs, MD, ACAAI president.
They should not be given alone to people with asthma. In COPD, but not asthma, inhaled corticosteroids have been associated with an increased risk for pneumonia and in some cases, features of both asthma and COPD exist. For these patients a combination of inhaled corticosteroids and long-acting beta agonists is usually best.
Some treatments for COPD and asthma are similar. Bronchodilators are used for both conditions. Other treatments tend to be more condition-specific. People with asthma are encouraged to avoid their personal triggers, like keeping pets out of the home or avoiding the outdoors when allergen concentrations are high. While people with COPD are also encouraged to avoid triggers, the emphasis in this condition is to stop smoking. Similarly, if a patient has asthma, smoking makes the underlying disease worse and reduces the response to inhaled corticosteroids.
Allergists who treat these conditions recognize that each patient, and their symptoms, must be treated according to their unique set of circumstances. People need to tell their allergists all their symptoms and complete medical history in order to receive the correct diagnosis and appropriately tailored therapy.
In our market review we have seen that some clinics are offering experimental stem cell treatments for COPD patients, in case traditional medication and its treatment is not anymore stabilizing or improving further Quality of Life of COPD patients.
There are mainly two experimental stem cell treatment options available:
1. Stem cells from allogeneic (other person) or autologous (own) stem cells are developed in a Laboratory via clinical trials by certain health care providers. This is a treatment method where stem cells harvested from bone marrow, placenta, cord blood, peripheral blood, or adipose tissue, specifically treated and expanded in a lab and supplied after being approved by FDA / EMA to the market as “stem cell treatment in a bottle” ready to use via a Medical Doctor. In this case you may enroll in clinical trials for safety and efficacy studies before the product is approved.
2. more recently in many international but also local clinics, autologous stem cells are harvested from adipose tissue (own fat) minimal manipulated and non-expanded used in the responsibility of a physician in a same day medical procedure to support unmet medical need in the frame of patient funded experimental medical studies.
There is much controversy going on in the world of stem cell therapy and COPD. Why? Autologous stem cell treatment without manipulation is legal, also in the United States, but some scientist claim that without manipulation, treatments are not likely to be clinically relevant. For stem cell treatments to be clinically relevant, millions of stem cells need to be implanted into a designated recipient. Because generating millions of stem cells is difficult once they are removed from the body, some scientists believe they must manipulate them somehow to produce larger quantities. The FDA says that manipulation turns them into prescription drugs, and that this practice must therefore be tightly regulated. Some scientist and Stem cell advocates don’t agree with the FDA’s stand on this, and are currently fighting to get this changed besides that, some scientists believe even minimal manipulated stem cell are treatment relevant as they increase quick and natural the potential of a body to heal itself.
We, in fairness to regulators, do acknowledge that some clinics may promote even not IRB approved medical treatment and here we fully agree that measures to protect patients have to be initiated.
Various international and local clinics with high quality standard, however, cannot be put in the same basket with those providing the famous “snake oil treatment”, although some people and bloggers enjoying doing it and with it confusing authorities and patients.
It appears furthermore, that there is sometimes a conflict of interest, even often disguised by scientists, when they are becoming inventors and may be able to patent their product or method and with it, are financially rewarded by those marketing their product. There is nothing against those inventing something and getting rewarded. Authorities have, however, to be open minded when regulating two quite different stem cell technologies. Both are stem cell treatments, alright, and undoubted have the capability to become disruptive technologies in the field of medical treatment, but one is using the philosophy of a drug, i.e. “Stem cells heavily manipulated in a bottle ready to use” whereas the other is a medical procedure using “Own stem cells very minimal manipulated in a surgical procedure”. If a regulatory agency is placing both methods in the same regulatory basket it is reducing artificially competing new quality treatment processes which cannot be neither in the interest of those paying for treatment nor for those in urgent need of medical treatment for unmet medical need.
A Stem cell harvested from one specific person, only minimal manipulated and returned to the same person in a same day surgical procedure is not causing any immunoreaction but improves the natural capability to increase its own specific healing mechanism as stem cells have the capability to home in, that means to go to places where the “own cell repair crews” are working and do ask for “natural assistance” of the body’s own cell structure.
For patients and patient advocates it is difficult to understand that the two very different technologies are regulated with the same regulatory tool. Asian countries have obviously already understood the difference and did already roll out the red carpet for the new technology with more easy approvement rules than Western Countries. They see it obviously already as a tool which could revolutionize the present treatment methods, benefiting quality of life of patients but also those paying for the treatment.
American College of Allergy, Asthma and Immunology (ACAAI)
Stem cell treatment and Market Opinion.
November 7, 2014
All information provided in our web-side or BLOG is for educational purpose only and does not promote any pharmaceutical drug or medical treatment. For medical information on Asthma and COPD and its treatment please contact you trusted physician.