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Airway remodeling in asthma: what really matters
Heinz Fehrenbach1,2, Christina Wagner3,4, Michael Wegmann5,6
1Division of Experimental Pneumology, Priority Area Asthma & Allergy, Research Center Borstel, Leibniz Center for Medicine and Biosciences, Parkallee 1-40, 23845, Borstel, Germany. hfehrenbach@fz-borstel.de.
Airway remodeling involves structural changes in the airway wall. This review distinguishes physiological remodeling from pathological remodeling, exploring assessment methods and animal models for future research.
Area of Science:
- Pulmonary Medicine
- Cellular Biology
- Respiratory Physiology
Background:
- Airway remodeling encompasses structural changes in the airway wall compared to healthy individuals.
- It is crucial to differentiate between physiological airway remodeling (normal development/transient response) and pathological airway remodeling (chronic alterations).
Purpose of the Study:
- To review quantitative approaches for assessing airway remodeling.
- To investigate whether airway remodeling can be a primary event preceding inflammation.
- To explore airway remodeling as a secondary event to inflammation and its study in animal models.
Main Methods:
- Review of literature on quantitative assessment methods for airway remodeling.
- Analysis of evidence for primary vs. secondary airway remodeling.
- Examination of findings from diverse animal models (invertebrate to primate).
Main Results:
- Distinction between physiological and pathological airway remodeling is essential for understanding lung health.
- Evidence suggests airway remodeling can be both a primary and secondary event to inflammation.
- Animal models provide valuable insights into airway remodeling mechanisms.
Conclusions:
- Future research should focus on pheno-/endotype-specific aspects of airway remodeling.
- Utilizing endotype-specific animal models and "endotyped" human asthmatics is recommended.
- Advancement of in vivo imaging techniques is needed for early monitoring of airway development and inflammation.
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