Comment on: “The prevalence of asthma-COPD overlap (ACO) among COPD patients and the role of prostaglandin D2 (PGD2) in differential diagnosis”

Abstract

Asthma-COPD overlap (ACO) is a controversial concept without a universally accepted definition. In the study by Aslan and Enli, ACO was defined based on airflow limitation and reversibility; however, this approach may not fully reflect current guideline perspectives. Recent GINA and GOLD reports emphasize a phenotype-based approach rather than defining ACO as a distinct disease entity. Therefore, the observed limited diagnostic value of prostaglandin D2 (PGD2) may be influenced by methodological limitations, particularly patient selection and classification strategy.

 

 

 

Keywords

• Asthma-COPD overlap
• prostaglandin D2
• biomarkers

KOAH hastaları arasında astım-KOAH overlap (AKO) sıklığı ve ayırıcı tanıda prostaglandin D2 (PGD2)' nin rolü "hakkında"

Abstract

Asthma-COPD overlap (ACO) is a controversial concept without a universally accepted definition. In the study by Aslan and Enli, ACO was defined based on airflow limitation and reversibility; however, this approach may not fully reflect current guideline perspectives. Recent GINA and GOLD reports emphasize a phenotype-based approach rather than defining ACO as a distinct disease entity. Therefore, the observed limited diagnostic value of prostaglandin D2 (PGD2) may be influenced by methodological limitations, particularly patient selection and classification strategy.

Keywords

• Asthma-COPD overlap
• prostaglandin D2
• biomarkers

References

1. Aslan SH, Enli Y. The prevalence of asthma-COPD overlap (ACO) among COPD patients and the role of prostaglandin D2 (PGD2) in differential diagnosis. Pam Med J. 2026;19:413-422.
2. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2022.
3. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of COPD, 2022.
4. Awad MT, Sankari A. Asthma and COPD overlap. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
5. Uzan GC, Borekci S, Doventas YE, Koldas M, Gemicioglu B. The relationship between inflammatory markers and spirometric parameters in ACOS, asthma, and COPD. J Asthma. 2020;57(12):1273-1279.
6. Özdemir F. KOAH tanılı hastalarda astım-KOAH overlap sıklığı ve prostaglandin D2’nin tanısal değeri. Tıpta Uzmanlık Tezi, 2021.