Asthma and COPD: Similarities and Differences in the Pathophysiology, Diagnosis and Therapy

  • Josef Yayan
  • Kurt Rasche
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 910)


Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common chronic lung diseases worldwide. Distinguishing between these different pulmonary diseases can be difficult in practice because of symptomatic similarities. A definitive diagnosis is essential for correct treatment. This review article presents the different symptoms of these two chronic inflammatory lung diseases following a selective search of the PubMed database for relevant literature published between 1996 and 2012. While cough occurs in both diseases, asthmatics often have a dry cough mainly at night, which is often associated with allergies. In contrast, COPD is usually caused by years of smoking. Paroxysmal dyspnea, which occurs in asthma, is characterized by shortness of breath, while in COPD it occurs during physical exertion in early stages and at rest in later stages of the disease. Asthma often begins in childhood or adolescence, whereas COPD occurs mainly in smokers in later life. It is possible to live with asthma into old age, whereas the life expectancy of patients with COPD is significantly limited. Currently, there is no general curative treatment for either disorder.


Asthma COPD Detection Symptoms Treatment 


Competing Interests

The authors report no conflicts of interest in relation to this work.


  1. Abramson MJ, Schattner RL, Sulaiman ND, Del Colle EA, Aroni R, Thien F (2012) Accuracy of asthma and COPD diagnosis in Australian general practice: a mixed methods study. Prim Care Respir J 21:167–173CrossRefPubMedGoogle Scholar
  2. Andersén H, Lampela P, Nevanlinna A, Säynäjäkangas O, Keistinen T (2013) High hospital burden in overlap syndrome of asthma and COPD. Clin Respir J 7:342–346CrossRefPubMedGoogle Scholar
  3. Aoshiba K, Nagai A (2004) Differences in airway remodeling between asthma and chronic obstructive pulmonary disease. Clin Rev Allergy Immunol 27:35–43CrossRefPubMedGoogle Scholar
  4. Athanazio R (2012) Airway disease: similarities and differences between asthma, COPD and bronchiectasis. Clinics (Sao Paulo) 67:1335–1343CrossRefGoogle Scholar
  5. Aydin Ö, Celik GE, Önen ZP, Yilmaz İ, Özdemir SK, Yildiz Ö, Mungan D, Demirel YS (2013) Triggers of asthma and COPD: are they different? Allergol Immunopathol (Madr) 41:30–36CrossRefGoogle Scholar
  6. Beeh KM, Kornmann O, Beier J, Ksoll M, Buhl R (2004) Clinical application of a simple questionnaire for the differentiation of asthma and chronic obstructive pulmonary disease. Respir Med 98:591–597CrossRefPubMedGoogle Scholar
  7. Bleecker ER (2004) Similarities and differences in asthma and COPD. The Dutch hypothesis. Chest 126:93S–95SCrossRefPubMedGoogle Scholar
  8. Bumbacea D, Bogdan MA (2011) Update in pneumology – focus on asthma and COPD. Maedica (Buchar) 6:339–340Google Scholar
  9. Carolan BJ, Sutherland ER (2013) Clinical phenotypes of chronic obstructive pulmonary disease and asthma: recent advances. J Allergy Clin Immunol 131:627–634CrossRefPubMedGoogle Scholar
  10. Chang J, Mosenifar Z (2007) Differentiating COPD from asthma in clinical practice. J Intensive Care Med 22:300–309CrossRefPubMedGoogle Scholar
  11. Cukic V, Lovre V, Dragisic D, Ustamujic A (2012) Asthma and chronic obstructive pulmonary disease (COPD) – differences and similarities. Mater Sociomed 24:100–105CrossRefPubMedPubMedCentralGoogle Scholar
  12. Decramer M, Selroos O (2005) Asthma and COPD: differences and similarities. With special reference to the usefulness of budesonide/formoterol in a single inhaler (Symbicort) in both diseases. Int J Clin Pract 59:385–398CrossRefPubMedGoogle Scholar
  13. Górska K, Krenke R, Kosciuch J, Korczynski P, Zukowska M, Domagala-Kulawik J, Maskey-Warzechowska M, Chazan R (2009) Relationship between airway inflammation and remodeling in patients with asthma and chronic obstructive pulmonary disease. Eur J Med Res 14(Suppl 4):90–96Google Scholar
  14. Guerra S (2005) Overlap of asthma and chronic obstructive pulmonary disease. Curr Opin Pulm Med 11:7–13PubMedGoogle Scholar
  15. Hoshino T, Toda R, Aizawa H (2009) Pharmacological treatment in asthma and COPD. Allergol Int 58:341–346CrossRefPubMedGoogle Scholar
  16. Jenkins CR, Thompson PJ, Gibson PG, Wood-Baker R (2005) Distinguishing asthma and chronic obstructive pulmonary disease: why, why not and how? Med J Aust 183:S35–S37PubMedGoogle Scholar
  17. Kaneko Y, Yatagai Y, Yamada H, Iijima H, Masuko H, Sakamoto T, Hizawa N (2013) The search for common pathways underlying asthma and COPD. Int J Chron Obstruct Pulmon Dis 8:65–78PubMedPubMedCentralGoogle Scholar
  18. Kardos P, Brutsche M, Buhl R, Gillissen A, Rabe KF, Russi EW, Sauer R, Worth H, Menz G (2006) Combination of asthma and COPD: more frequent as considered to be? Pneumologie 60:366–372CrossRefPubMedGoogle Scholar
  19. Kuebler KK, Buchsel PC, Balkstra CR (2008) Differentiating chronic obstructive pulmonary disease from asthma. J Am Acad Nurse Pract 20:445–454CrossRefPubMedGoogle Scholar
  20. Löfdahl CG, Ericsson A, Svensson K, Andreasson E (2005) Cost effectiveness of budesonide/formoterol in a single inhaler for COPD compared with each monocomponent used alone. Pharmacoeconomics 23:365–375CrossRefPubMedGoogle Scholar
  21. Mallia P, Contoli M, Caramori G, Pandit A, Johnston SL, Papi A (2007) Exacerbations of asthma and chronic obstructive pulmonary disease (COPD): focus on virus induced exacerbations. Curr Pharm Des 13:73–97CrossRefPubMedGoogle Scholar
  22. Martinez FJ, Standiford C, Gay SE (2005) Is it asthma or COPD? The answer determines proper therapy for chronic airflow obstruction. Postgrad Med 117:19–26CrossRefPubMedGoogle Scholar
  23. Miglino N, Roth M, Tamm M, Borger P (2012) Asthma and COPD – The C/EBP connection. Open Respir Med J 6:1–13CrossRefPubMedPubMedCentralGoogle Scholar
  24. Miravitlles M, Andreu I, Romero Y, Sitjar S, Altés A, Anton E (2012) Difficulties in differential diagnosis of COPD and asthma in primary care. Br J Gen Pract 62:e68–e75CrossRefPubMedPubMedCentralGoogle Scholar
  25. Mishima M (2009) Physiological differences and similarities in asthma and COPD – based on respiratory function testing. Allergol Int 58:333–340CrossRefPubMedGoogle Scholar
  26. Morice AH, Hochmuth L, Ekelund J, Thorén A, Puterman AS (2008) Comparable long-term safety and efficacy of a novel budesonide/formoterol pressurized metered-dose inhaler versus budesonide/formoterol turbuhaler in adolescents and adults with asthma. Pulm Pharmacol Ther 21:32–39CrossRefPubMedGoogle Scholar
  27. Mosenifar Z (2009) Differentiating COPD from asthma in clinical practice. Postgrad Med 121:105–112CrossRefPubMedGoogle Scholar
  28. Nakawah MO, Hawkins C, Barbandi F (2013) Asthma, chronic obstructive pulmonary disease (COPD), and the overlap syndrome. J Am Board Fam Med 26:470–477CrossRefPubMedGoogle Scholar
  29. Oga T, Tsukino M, Hajiro T, Ikeda A, Koyama H, Mishima M, Chin K, Nishimura K (2010) Multidimensional analyses of long-term clinical courses of asthma and chronic obstructive pulmonary disease. Allergol Int 59:257–265CrossRefPubMedGoogle Scholar
  30. Pauwels RA (2004) Similarities and differences in asthma and chronic obstructive pulmonary disease exacerbations. Proc Am Thorac Soc 1:73–76CrossRefPubMedGoogle Scholar
  31. Postma DS, Kerstjens HA (1998) Characteristics of airway hyperresponsiveness in asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 158:S187–S192CrossRefPubMedGoogle Scholar
  32. Rothe T (2012) COPD and asthma: same but different. Praxis (Bern 1994) 101:233–237Google Scholar
  33. Sciurba FC (2004) Physiologic similarities and differences between COPD and asthma. Chest 126:117S–124SCrossRefPubMedGoogle Scholar
  34. Silvestri IC, Pereira CA, Rodrigues SC (2008) Comparison of spirometric changes in the response to bronchodilators of patients with asthma or chronic obstructive pulmonary disease. J Bras Pneumol 34:675–682CrossRefPubMedGoogle Scholar
  35. Sköld CM (2010) Remodeling in asthma and COPD-differences and similarities. Clin Respir J 4(Suppl 1):20–27CrossRefPubMedGoogle Scholar
  36. Spencer P, Krieger B (2013) The differentiation of chronic obstructive pulmonary disease from asthma: a review of current diagnostic and treatment recommendations. Open Nurs J 7:29–34CrossRefPubMedPubMedCentralGoogle Scholar
  37. Sutherland ER, Martin RJ (2003) Airway inflammation in chronic obstructive pulmonary disease: comparisons with asthma. J Allergy Clin Immunol 112:819–827CrossRefPubMedGoogle Scholar
  38. Tandon S, Khutarkar A, Ansari S (2013) Asthma diagnosis and treatment – 1008. Is small airways disease a widely prevalent yet underdiagnosed phenotype of asthma and COPD in India? World Allergy Organ J 6(Suppl 1):P8PubMedPubMedCentralGoogle Scholar
  39. Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ (2006) Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma 43:75–80CrossRefPubMedGoogle Scholar
  40. Welte T, Groneberg DA (2006) Asthma and COPD. Exp Toxicol Pathol 57(Suppl 2):35–40CrossRefPubMedGoogle Scholar
  41. Yawn BP (2009) Differential assessment and management of asthma vs chronic obstructive pulmonary disease. Medscape J Med 11(1):20; Epub 2009PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic WuppertalWitten/Herdecke UniversityWuppertalGermany

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