What effect does asthma treatment have on airway remodeling? Current perspectives

Pathogenetic and prognostic roles of bloodborne fibrocytes in asthma

“…The histopathologic abnormalities most frequently observed in the airways of patients with persistent asthma include a chronic inflammatory infiltrate of the bronchial mucosa and various structural alterations poorly responsive to available therapies, commonly referred to by the term "airway remodeling" (Pascual and Peters, 2009;Durrani et al, 2011). Some of the remodeling lesions are not specific as they reflect persistent tissue injury or defective repair (or both), but the thickening of the lamina reticularis and the increase in the SM/contractile mass are characteristic structural alterations of asthma (Jeffery, 2004).…”

“…Some of the remodeling lesions are not specific as they reflect persistent tissue injury or defective repair (or both), but the thickening of the lamina reticularis and the increase in the SM/contractile mass are characteristic structural alterations of asthma (Jeffery, 2004). These abnormalities are more prominent in patients who have inadequately controlled disease and frequent clinical exacerbations and may cause irreversible airway narrowing, with progressive deterioration of lung function (Pascual and Peters, 2009;Durrani et al, 2011).…”

“…Considering that none of the currently approved pharmacological interventions block the progression of structural changes nor reverse them (Royce and Tang, 2009;Durrani et al, 2011), inhibition of Fc trafficking and function in patients whose disease is not adequately controlled with currently available therapies may greatly reduce the overall incidence of adverse outcomes in asthma and the associated healthcare costs. The reader is referred to a recent review (Mattoli, 2015) where I identified potential therapeutic candidates and future research directions on the basis of the mechanisms described above and schematically illustrated in Fig.…”

“…These patients with poor asthma control have persisting airway inflammation and are at increased risk of acute exacerbations and of adverse outcomes resulting from the development of irreversible structural alterations of the bronchial wall, such as subepithelial fibrosis, bronchial smooth muscle (SM) hypertrophy/hyperplasia, and increased density of myofibroblasts and other non-SM contractile cells in the airways (Holgate, 2008;Pascual and Peters, 2009;Bai, 2010;Halwani et al, 2010;Durrani et al, 2011;Olin and Wechsler, 2014). In the next sections, I discuss the major involvement of bloodborne fibrocytes (Fcs) in the amplification of immune responses and progression of structural changes, and describe the potential advantages of using blood Fcs count as a biomarker to monitor the level of asthma control and recognize patients at high risk of future adverse outcomes.…”

Bronchial asthma, wheezing, flatter: probable relationships

“…В соответствии с со временными представлениями БА -это хроничес кое персистирующее воспалительное заболевание, ведущее к структурным изменениям и ремоделиро ванию дыхательных путей (ДП). В понятие «ремо делирование» включены следующие основные ком поненты: гипертрофия гладких мышц, гиперплазия бокаловидных клеток, субэпителиальный (субба зальный) фиброз и ангиогенез [1][2][3][4][5]; развитие брон хиальной гиперреактивности [6].Хронический воспалительный процесс, ремоде лирование ДП, бронхиальная гиперреактивность, бронхиальная обструкция определяют характерные клинические симптомы БА -свистящие хрипы, ка шель, диспноэ [7][8][9], причем свистящее дыхание относится к наиболее частым из них. Так, по данным эпидемиологического исследования ECRHS (Euro pean Community Respiratory Health Survey) о распрост раненности симптомов БА среди лиц (мужчин и жен щин) 20-44 летнего возраста приступы удушья встречаются в среднем у 9,7 %, а свистящее дыха ние -у 32,0 % больных [10].…”