Airway remodeling asthma

The activation of mast cells by allergen initiates the asthma symptoms within minutes after allergen contact, the early allergic response (EAR), within horns the late allergic response (LAR), and within years and after rqDeated asthma episodes, chronic airway inflammation, airway remodeling, and airway hyperresponsiveness. 

Airway inflammation is a characteristic clinical feature of asthma. The distinction between the LAR and chronic inflammation becomes more difficult as the disease progresses. Infiltrated leukocytes release ototoxic mediators such as reactive oxygen species (ROS) and cationic (basic) proteins causing epithelial damage and cyfo/cmas that perpetuate the inflammation. Sustained inflammation leads to airway hyperrespon-siveness and airway remodeling. 

Redington AE (2001) Airway remodeling in asthma. CME Bull Respir Med 3 37-40. 

Asthma is a chronic inflammatory condition characterized by bronchial hyper-responsiveness and reversible airway obstruction. Cytokine release from a variety of cell types such as eosinophils, lymphocytes and other inflammatory cells produces epithelial sloughing, plasma protein extravasation from the tracheobronchial microcirculation and airway remodeling. Bronchial mucosal inflammation is present in all patients. The primary goal of asthma management is to maintain control of the disease process by reducing symptoms and improving lung function. 

Elias JA. 2000. Airway remodeling in asthma. Am J Respir Crit Care Med. 161 S168-S171. 

Asthma is a chronic relapsing inflammatory disorder that can lead to tissue distinction and airway remodeling characterised by epithelial dismption with smooth muscle and microvascular proliferation. Oxidative stress appears to play a central role in these changes as both increased ROS generation and decreased antioxidant defenses have been identified... 

Strong associations have been shown between IL-13 polymorphisms and atopy -related phenotypes in two studies of children [135(111), 138(111)], however, neither of these studies examined associations with asthma. In contrast, in adults, polymorphisms in IL-13 are associated with asthma not IgE levels [136(111), 139(111)]. Thus, it is possible that polymorphisms in IL-13 may confer susceptibility to airway remodelling in asthma, as well as to allergic inflammation in early life. 

Elias JA, Zhu Z, Chupp G, Homer RJ. Airway remodeling in asthma. J Clin Invest 1999 104 1001-1006. 

Ammit, A.J., Hastie, A.T., Edsall, L.C., Hoffman, R.K., Amrani, Y., Krymskaya, V.P., Kane, S.A., Peters, S.P., Penn, R.B., Spiegel, S., and Panettieri, RA Jr., Sphingosine 1-phosphate modulates human airvray smooth muscle cell functions that promote inflammation and airway remodeling in asthma, FASEB J, 15 (2001) 1212-1214. 

Chakir J, Shannon J, Molet S, Fukakusa M, Elias J, Laviolette M, Boulet LP, Hamid Q. Airway remodeling-associated mediators in moderate to severe asthma effect of steroids on TGF-beta, IL-11, IL-17, and type I and type III collagen expression. J Allergy Clin Immunol 2003 111 1293-1298. 

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