ABSTRACT
Airway remodeling is a summary term for the pathological changes that occur in airway structure in
allergic or suppurative airway diseases. Characteristic changes of airway remodeling
in asthma include goblet cell hyperplasia, deposition of collagens in the basement
membrane zone, increased size and number of microvessels in the submucosa, hyperplasia
and hypertrophy of airway smooth muscle, and hypertrophy of submucosal glands. Some
of these changes, such as goblet cell hyperplasia and subepithelial collagen deposition,
are present even in mild asthma; other changes such as increases in airway smooth
muscle and gland volume appear to be more characteristic of severe asthma. Airway
narrowing, airway hyperresponsiveness, and mucus hypersecretion are all functional
consequences of airway remodeling leading to clinical manifestations such as dyspnea,
wheeze, sputum production, and susceptibility to asthma exacerbations. Noninvasive
measures of remodeling are lacking, and monitoring the effects of treatment on remodeling
has been difficult. For this reason relatively little is known about the effects of
current asthma treatments on airway remodeling. As mechanisms of airway remodeling
are developed, it is hoped that novel therapeutic targets will be identified. Treatments
specifically targeting mediators of remodeling hold promise as treatments that could
modify disease progression in asthma.
KEYWORDS
Asthma - remodeling - goblet cell - smooth muscle - collagen
