Korean J Asthma Allergy Clin Immunol.
2012 Mar;32(1):1-7.
Mechanical Stimuli to Airway Remodeling in Asthma
Abstract
- Airway remodeling implies structural changes in the airways of patients with asthma. These changes are associated with poor long-term clinical outcomes and are attributed to chronic airway inflammation. However, some recent studies suggest that traditional anti-inflammatory therapies play a limited role in the modulation of airway remodeling. These findings have questioned the concept that persistent inflammation leads to airway remodeling. Growing evidence demonstrates that physical forces elicit a number of biologically relevant signals in the human body. The airway is exposed to a variety of mechanical stimuli, the most prominent of which is acute compressive stress caused by bronchoconstriction. A variety of in vitro studies have demonstrated that airway epithelial cells, as well as lung fibroblasts and smooth muscle cells, are responsive to mechanical stimuli. A recent in vivo study has shown that airway remodeling can be promoted simply by episodic administration of an inhaled bronchoconstrictor, methacholine. This result suggests another possibility of the association between airway remodeling and mechanical stimuli. However, further studies are required using well-designed, 3-dimensional in vitro experimental models as well as more patients with varying severities of asthma. These studies will help understand the interplay between mechanical and inflammatory contributions to airway remodeling.
