Monitoring airway remodeling in asthma

Airway remodeling occurs in both mild and severe forms of asthma but, from a clinical point of view, airway remodeling in asthma is difficult to monitor.

The objective of this overview is to make an inventory of which methods could be possible to monitor airway remodeling in asthma.

Access to airway tissue through biopsies or material from surgery enables direct assessment of airway remodeling but there are no specific inflammatory markers obtained from, for example, sputum, lavage fluid, blood, exhaled air, exhaled breath condensate, urine or saliva that reflect certain aspects of airway remodeling. Physiological measures such as changes in lung function and bronchial responsiveness over time co-varies with changes in airway structure but these interactions are complex and non-specific. Novel imaging techniques have shown promising results and recent studies have demonstrated how structural airway and lung changes can be detected on computerized tomography.

Today, there are no available techniques for monitoring airway remodeling in daily clinical practice, but further development within this area and studies on co-variation between physiologic, inflammatory and visual abnormalities will likely enable us to better monitor airway remodeling in the future.