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2017 ; 367
(3
): 551-569
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Airway remodeling in asthma: what really matters
#MMPMID28190087
Fehrenbach H
; Wagner C
; Wegmann M
Cell Tissue Res
2017[Mar]; 367
(3
): 551-569
PMID28190087
show ga
Airway remodeling is generally quite broadly defined as any change in
composition, distribution, thickness, mass or volume and/or number of structural
components observed in the airway wall of patients relative to healthy
individuals. However, two types of airway remodeling should be distinguished more
clearly: (1) physiological airway remodeling, which encompasses structural
changes that occur regularly during normal lung development and growth leading to
a normal mature airway wall or as an acute and transient response to injury
and/or inflammation, which ultimately results in restoration of a normal airway
structures; and (2) pathological airway remodeling, which comprises those
structural alterations that occur as a result of either disturbed lung
development or as a response to chronic injury and/or inflammation leading to
persistently altered airway wall structures and function. This review will
address a few major aspects: (1) what are reliable quantitative approaches to
assess airway remodeling? (2) Are there any indications supporting the notion
that airway remodeling can occur as a primary event, i.e., before any
inflammatory process was initiated? (3) What is known about airway remodeling
being a secondary event to inflammation? And (4), what can we learn from the
different animal models ranging from invertebrate to primate models in the study
of airway remodeling? Future studies are required addressing particularly
pheno-/endotype-specific aspects of airway remodeling using both
endotype-specific animal models and "endotyped" human asthmatics. Hopefully,
novel in vivo imaging techniques will be further advanced to allow monitoring
development, growth and inflammation of the airways already at a very early stage
in life.
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