Airway smooth muscle: new targets for asthma pharmacotherapy

Asthma, a chronic disease increasing in prevalence worldwide, is characterised by reversible airway obstruction, airway inflammation and airway smooth muscle (ASM) cell hyperplasia. The traditional view of ASM in asthma, as a regulator of bronchomotor tone, is rapidly changing. New evidence suggests that ASM cells also play an important role in the perpetuation of airway inflammation and airway remodelling. This review discusses the synthetic function of ASM cells, defined as the ability to secrete cytokines, chemokines and growth factors and express surface receptors that are important for cell adhesion and leukocyte activation. Finally, the efficacy of established asthma therapies in modifying the synthetic function of ASM cells are compared and novel targets for pharmacological intervention are discussed.