Because this text refers to allergy issues, I recommend reading it together with an introductory text about allergy, atopy, allergen and allergic reactions. Asthma is a chronic respiratory disease caused by an allergic reaction. Its symptoms are similar to COPD and so is the treatment. There are, however, some differences between these two conditions.


The principle of asthma development is much like in COPD, i.e. bronchial narrowing and obstruction. The difference is follows. COPD is a normal reaction of respiratory tract and its immune system to harmful inhaled substances (like cigarette smoke) while bronchial asthma is as consequence of a hypersensitive allergic reaction. When exposed to a certain allergen, an allergic reaction occurs with narrowing of the bronchial walls by smooth muscle contractions, increased mucus secretion and excessive activity of immune cells.

Risk factors

It can be practically every substance like food, dust, pollen, stress, physical exertion, temperature etc. The true is that asthmatic attack more often starts when the allergen is inhaled and comes into direct contact with upper airways.


Symptoms are very similar to COPD – wheezing, cough, shortness of breath, tight feeling on the chest etc. The difference is that COPD occurs many years and it slowly progresses with episodes of acute exacerbation. Physical activity becomes more and more exhausting for a patient with COPD. In contrast, asthma arises in healthy airways and only after contact with an certain allergen. An asthma attack can be pretty strong and can cause quick suffocation. After such attacks ends, everything returns to normal and such person’s airways seem to be completely healthy until allergen repeated exposure when a new attack occurs.


Prevention is quite difficult for people with bronchial asthma. A medical examination is need, preferably by an allergologist. By discovering personal history and performing skin tests the allergens may be found that trigger asthmatic attacks. Such allergens must be avoided when possible. It is quite obvious that asthmatics should have never smoked because a combination of asthma and chronic bronchitis would endanger them much more.


For people with moderate and more serious forms of asthma with often and severe asthmatic attacks a long-term therapy is appropriate. Doctors prescribe drugs dilating bronchi and anti-inflammatory drugs, mainly corticosteroids. Especially corticosteroids are perfect in control of allergic reactions, but they have many side effects. To avoid side effects of any anti-asthmatic medication, we prefer to use them in form of inhalation. Inhaled drugs have a direct effect on airways but don’t significantly affect other body systems.

In case of an acute attack when breathlessness occurs we have to use strong drugs applied intravenously – large doses of corticoids and bronchodilating agents. An application of concentrated oxygen by an oxygen mask is highly preferable.

Summary of differences between Asthma and COPD


It is a consequence of normal reaction of the airways to air pollutants, especially cigarette smoke.

It slowly progresses; sudden deterioration may occur during exertion, or by episodes of bacterial infection (like pneumonias).

Even if a person with COPD has no serious subjective problems, his airways are not healthy and his lung function is not normal. That can be shown during lung function tests like spirometry.


It is an abnormally sensitive response of our airways to an allergen that doesn’t irritate other healthy people.

Symptomatic asthma exists only in episodes that are induced by an allergic reaction.

Between attacks a person is completely healthy, as well as his airways. Lung function tests like spirometry are normal except for attack episodes.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources