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The Proceedings of the American Thoracic Society 6:301-305 (2009)
© 2009 The American Thoracic Society
doi: 10.1513/pats.200808-089RM
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Remodeling in Asthma

Céline Bergeron1, Wisam Al-Ramli2 and Qutayba Hamid2

1 Hotel-Dieu Hospital, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montréal, Quebec, Canada; and 2 Meakins-Christie Laboratories, McGilll University, Health Centre Research Institute, Montréal, Canada

Correspondence and requests for reprints should be addressed to Qutayba Hamid, M.D., Ph.D., Meakins-Christie Laboratories, McGill University, 3626 St Urbain Street, Montréal, PQ, H2X 2P2 Canada. E-mail: qutayba.hamid{at}mcgill.ca

ABSTRACT

Airway remodeling refers to the structural changes that occur in both the large and the small airways of miscellaneous diseases, including asthma. In asthma, airway structural changes include subepithelial fibrosis, increased smooth muscle mass, enlargement of glands, neovascularization, and epithelial alterations. Although controversial, airway remodeling is commonly attributed to the underlying chronic inflammatory process. These remodeling changes contribute to thickening of airway walls and consequently lead to airway narrowing, bronchial hyperresponsiveness, airway edema, and mucous hypersecretion. Airway remodeling is associated with poorer clinical outcome among patients with asthma. Early diagnosis and prevention of airway remodeling has the potential to decrease disease severity, to improve control, and to prevent disease expression. In this article, we briefly provide an update on the characteristic features of airway remodeling observed in asthma and their clinical consequences.

Key Words: remodeling • asthma • inflammation






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