Airway Remodeling in Asthma

Asthma is an inflammatory disease of the airways that may result from exposure to allergens or other environmental irritants, resulting in bronchoconstriction, wheezing, and shortness of breath. The structural changes of the airways associated with asthma, broadly referred to as airway remodeling, i...

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Published in:Frontiers in medicine Vol. 7; p. 191
Main Authors: Hough, Kenneth P., Curtiss, Miranda L., Blain, Trevor J., Liu, Rui-Ming, Trevor, Jennifer, Deshane, Jessy S., Thannickal, Victor J.
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media SA 21.05.2020
Frontiers Media S.A
Subjects:
Adults
Airway management
airway remodeling
Asthma
Biopsy
Cell adhesion & migration
Childhood
Chronic obstructive pulmonary disease
Clustering
Collagen
epithelium
Extracellular matrix
Fibroblasts
Hyperplasia
immune cells
Inflammation
Medicine
mesenchyme
Proteins
Respiratory diseases
Smooth muscle
Steroids
immune cells
mesenchyme
asthma
epithelium
airway remodeling
ISSN:2296-858X, 2296-858X
Online Access:Get full text
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Summary:Asthma is an inflammatory disease of the airways that may result from exposure to allergens or other environmental irritants, resulting in bronchoconstriction, wheezing, and shortness of breath. The structural changes of the airways associated with asthma, broadly referred to as airway remodeling, is a pathological feature of chronic asthma that contributes to the clinical manifestations of the disease. Airway remodeling in asthma constitutes cellular and extracellular matrix changes in the large and small airways, epithelial cell apoptosis, airway smooth muscle cell proliferation, and fibroblast activation. These pathological changes in the airway are orchestrated by crosstalk of different cell types within the airway wall and submucosa. Environmental exposures to dust, chemicals, and cigarette smoke can initiate the cascade of pro-inflammatory responses that trigger airway remodeling through paracrine signaling and mechanostimulatory cues that drive airway remodeling. In this review, we explore three integrated and dynamic processes in airway remodeling: (1) initiation by epithelial cells; (2) amplification by immune cells; and (3) mesenchymal effector functions. Furthermore, we explore the role of inflammaging in the dysregulated and persistent inflammatory response that perpetuates airway remodeling in elderly asthmatics.
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Reviewed by: Chih-Ming Weng, Taipei Medical University, Taiwan; Eleni Papakonstantinou, Aristotle University of Thessaloniki, Greece; Christina Pabelick, Mayo Clinic, United States; Brian Gregory George Oliver, University of Technology Sydney, Australia
This article was submitted to Pulmonary Medicine, a section of the journal Frontiers in Medicine
Edited by: Hsiao-Chi Chuang, Taipei Medical University, Taiwan
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2020.00191