New imaging techniques such as computed tomography (CT) have helped with the assessment of chronic obstructive pulmonary disease (COPD). As a result of research analyses using this novel technology, researchers have identified that bronchiectasis often accompanies COPD between 20% to 69% of the time in patients.
COPD is a group of lung diseases in which the lungs and damaged, making it difficult to breathe. The disease most often results from smoking, and can be caused by environmental factors as well, particularly in developing countries. Bronchiectasis refers to a related condition in which the airways are widened, flabby and scarred.
Both conditions together most often indicate worse outcomes. According to research published July 28th in the journal International Journal of Chronic Obstructive Pulmonary Disease, “studies have shown that patients with COPD and comorbid bronchiectasis have higher risk of becoming chronic sputum producers, have more purulent sputum, have more airway or systemic inflammation, and have more exacerbation.”
The scientists, led by Yingmeng Ni of the Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China, conducted a comprehensive review of all studies published until August 2014 that examined patient characteristics of people living with both COPD and brochiectasis. They used publicly available databases including Embase, PubMed, and the Cochrane Central Register of Controlled Trials.
The investigators identified six observational studies with a total of 881 patients examined. Bronchiectasis prevalence in patients with COPD was 54.3%, with a range of 25.6% to 69%. Bronchiectasis and COPD were more frequently found in male patients with a longer history of smoking. People with both COPD and comorbid bronchiectasis had more daily production of sputum, more frequent exacerbation (increase in symptoms), poorer lung function, more inflammatory biomarkers, more chronic bacterial infection, including the bacterium Pseudomonas aeruginosa, a frequent cause of disease.
In their report, the researchers concluded that “Although with some limitations, this meta-analysis highlighted the impact of bronchiectasis in patients with COPD in all directions. Coexistence of bronchiectasis should be considered a pathological phenotype of COPD, which may have a predictive value.”
Overall it seems that when COPD and bronchiectasis occur together, a more serious medical condition is the inevitable result. With improved diagnosis of the two conditions together, this research highlights the importance of identifying when the two diseases co-exist. More aggressive clinical treatment may be warranted for people who have both diseases.
The study authors further argued that the two conditions might be considered as symptoms of the same disease, noting “Considering the high prevalence of coexistence of bronchiectasis with COPD, as well as its poorer prognosis . . . anatomical airway abnormalities of bronchiectasis in patients with COPD are best considered a phenotype of the COPD disease spectrum.”
Further research focusing on how the treatment for the two conditions overlaps may be particularly useful for the treatment of those suffering from COPD and bronchiectasis.