A pilot study to test the feasibility of histological characterisation of asthma–COPD overlap

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Asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that share some common characteristics. Asthma is associated with airway hyperresponsiveness, airway inflammation and airflow limitation that is reversible [1]. COPD is characterised by persistent and progressive airflow limitation and airway inflammation [2]. In recent years, there has been an ongoing discussion of whether asthma and COPD are different diseases, since a significant proportion of patients with symptoms of obstructive lung disease has features of both asthma and COPD [3–5]. In this respect, the most clinically significant phenotypes are COPD patients with asthmatic features and asthmatic patients that smoke. These patients may necessitate different therapeutic approaches and, therefore, there is a great need for diagnostic criteria that would allow proper diagnosis and treatment [6, 7]. Histological analysis has been previously suggested as a tool to identify and understand overlapping clinical and physiological phenotypes, thereby helping to better design treatments and plan long-term management [8]. However, there are few studies that have examined the histological patterns of patients who may be characterised as having asthma–COPD overlap.