Consequences of long-term inflammation. Airway remodeling

Airway inflammation may not account for all the clinical manifestations of asthma. Airway remodeling, which is thought to be a result of airway chronic inflammation, may help fill this void. Remodeling is described for fatal and nonfatal asthmatics including changes in smooth muscle, collagen deposition, noncollagenous matrix, and mucus glands. This article also reviews the correlation of airway remodeling with clinical, physiologic and biologic data, experimental models of airways remodeling, and effect of therapy on airway remodeling. Throughout, it is emphasized that the concept of airway remodeling is a dynamic process that is active and potentially progressive in asthmatic patients but that may be prevented by appropriate therapy.