Effect of Bronchoconstriction on Airway Remodeling in Asthma

• Published in: The New England journal of medicine Vol. 364; no. 21; pp. 2006 - 2015
• Main Authors: Grainge, Christopher L, Lau, Laurie C.K, Ward, Jonathon A, Dulay, Valdeep, Lahiff, Gemma, Wilson, Susan, Holgate, Stephen, Davies, Donna E, Howarth, Peter H
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 26-05-2011
• Subjects: Adult; Albuterol - pharmacology; Allergens; Animals; Asthma; Asthma - pathology; Asthma - physiopathology; Biological and medical sciences; Biopsy; Bronchi - pathology; Bronchi - physiology; Bronchial Provocation Tests; Bronchoconstriction; Bronchoconstriction - drug effects; Bronchoconstriction - physiology; Bronchodilator Agents - pharmacology; Bronchoscopy; Chronic obstructive pulmonary disease, asthma; Collagen; Eosinophils; Epithelium; Female; Forced Expiratory Volume - drug effects; General aspects; Glands; Humans; Inflammation; Inhalation; Laboratories; Leukocytes (eosinophilic); Male; Medical sciences; Methacholine; Methacholine Chloride - pharmacology; Pneumology; Pyroglyphidae - immunology; Recruitment; Respiratory tract; Spirometry; Young Adult; Medicine; Respiratory tract; Lung disease; Bronchoconstriction; Respiratory disease; Bronchus disease; Obstructive pulmonary disease; Remodeling; Respiratory system; Asthma
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1014350

Airway remodeling in asthma has been classically considered to be the result of inflammatory changes. In this study, the investigators show that bronchoconstriction alone can result in changes consistent with airway remodeling.
Asthma is a common chronic respiratory condition characterized clinically by an excessive tendency toward reversible airway narrowing. This may arise in response to everyday environmental exposure and is worsened both by intercurrent infection and, in sensitized persons, by allergen exposure. In pathological terms, asthma is characterized by airway inflammation and by structural changes in airway tissues, such as epithelial goblet-cell hyperplasia, subepithelial collagen deposition, and smooth-muscle hypertrophy — collectively referred to as airway remodeling.
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Since an inhaled-allergen challenge in atopic asthma induces eosinophilic inflammation of the airway and changes in the extracellular matrix,
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and since a reduction in airway . . .