Abstract
This article is extracted from the LANCET and was published in September 2008. It deals with asthma and COPD (chronic obstructive pulmonary disease) and particularly about their risk assessment, their progression and their control. Two most common chronic respiratory diseases but their pathogenesis and their progression are not fully understood. We can notice that these two diseases are similar for many points that's another reason to study them together. A multidimensional approach with the analysis of several parameters seems to be necessary.
The acknowledgment of disease severity and control are very important because they form the basis of asthma treatment. To have an objective characterization of the lung function we use spirometry with measures of FEV1, FVC and especially FEV1/FVC ratio for children.
Risk is difficult to assess. Moreover it's not always associated with disease severity. Thus, we have to find some markers to predict exacerbations. Few new recent studies use the analysis of the lung function particularly bronchial hyper-reactivity which can guide the treatment. Other markers like fractional exhaled NO concentration are useful without forgetting environmental risk factors. So it seems that a multidimensional approach is necessary and in practice we use a probabilistic method based on the several interacting components of the lung web. With this novelty, we can have a comprehensive understanding of different asthma phenotypes for example.
