الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 60 |  |  |
| | | from | 60 | | |
Abstract
Distinguishing asthma from COPD is difficult especially among old age and smokers Also, some patients have common features of asthma and COPD This has led to the emergence of a group of patients known as asthma COPD overlap (ACO) patients
Treatments specifically targeted at this phenotype (ACO) are lacking noticeably Patients with ACO are often overlooked or excluded in clinical trials investigating novel treatments for asthma and COPD Also, the paucity of data on the mechanistic drivers of ACO and how these might differ from those of asthma or COPD has limited the discovery of ACO specific treatments
ACO is a considerable risk factor for healthcare utilization versus the general population, the asthma population and the COPD population
Fungal sensitization is defined as the presence of immediate cutaneous hyper reactivity to fungal antigen(s) or an increase in specific IgE antibodies to a particular fungus
Evidence has mounted that fungal sensitization is associated with increased asthma severity, morbidity and decreased pulmonary function
Summary
Aspergillus sensitivity was more frequent in SAFS and asthma associated to fungal sensitization (AAFS)
Aspergillus-associated respiratory disorders are characterized by severe lung eosinophilia, increased mucus production and increased serum IgE production (total and antigen-specific)
The mean age among ACO patients was The three groups were comparable as regard age
Total IgE and serum eosinophils were higher in ACO group compared to Asthma and control groups But in comparison to control group, asthma patients had higher total IgE and eosinophils
ACO group showed more Aspergillus positive patients compared to Asthmatics but with no statistical significance
Pulmonary function test results showed that FEV of the predicted value before and after bronchodilator inhalation were significantly higher among control group compared to asthma and ACO Also, it was significantly higher among asthmatic patients compared to ACO group In addition, the value of FEV /FVC before and after was significantly lower in ACO group when compared to asthma group and control
Summary
group Both asthma and ACO groups show statistically significant lower values when compared to control group
One limitation of our study is that it is lacking follow up Follow up studies allowed other physicians to monitor acute exacerbations which was found to be higher in patients with ACO than in patients with severe asthma Also, allowed them to calculate the mean ICS dose consumed by the patients, which was higher among patients with ACO than those with “only” asthma which indicates the severity
Our study comprised healthy controls So, comparisons were made between ACO patients, asthmatic patients and healthy controls in terms of Aspergillus- sensitization and pulmonary function test results
There was significant increase in Total IgE and Eosinophils in Aspergillus positive patients FEV percent of predicted was less in Aspergillus positive patients compared to negative ones However, there was no statistically significant difference While FEV /FVC before and after bronchodilator was significantly lower in Aspergillus positive patient