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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2009, Número 2

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Alerg Asma Inmunol Pediatr 2009; 18 (2)


Remodelación de la vía aérea en asma

Huerta LJ, Jiménez GC, Olmo TH, Maza LM

Idioma: Español
Referencias bibliográficas: 80
Paginas: 60-78
Archivo PDF: 603.78 Kb.


RESUMEN

El asma fue considerada en algún momento como una enfermedad completamente reversible, y por muchos años se consideró que los principales mecanismos responsables de esta patología eran la obstrucción de la vía aérea, el edema y la hipersecreción de moco. Los estudios histopatológicos y morfométricos demuestran variaciones estructurales en la vía aérea de los pacientes afectados en comparación con sujetos sanos, lo cual se ha denominado remodelación de la vía aérea. Es consecuencia de un proceso inflamatorio crónico que al reparar de forma prolongada la vía aérea produce alteración en su estructura. Se puede definir también la remodelación de la vía aérea como los cambios en la composición, organización y cantidad de células y constituyentes extracelulares de la pared de la vía aérea. En niños se ha valorado la remodelación por medio de estudios no invasivos como la densitomografía e invasivos como el lavado bronquial y biopsia bronquial. Durante los últimos años se han producido avances importantes en el conocimiento de la fisiopatología de la remodelación de la vía y la implicación de este fenómeno nosológico en la evolución del padecimiento desde la niñez hasta la edad adulta, aérea (factores genéticos, cambios epiteliales, cambios en la membrana basal, sobreproducción de moco, cambios en la musculatura lisa y microvasculatura, así como cartílago y procesos específicos de inflamación). Es de suma importancia el entendimiento de estos fenómenos para establecer líneas de investigación terapéuticas que tengan como meta desarrollar tratamientos dirigidos a interactuar con los mecanismos descritos, entre ellos la angiogénesis y neuroplasticidad.


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