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

2009, Number 2

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Alerg Asma Inmunol Pediatr 2009; 18 (2)

Remodeling of the airway in asthma

Huerta LJ, Jiménez GC, Olmo TH, Maza LM

Language: Spanish
References: 80
Page: 60-78
PDF size: 603.78 Kb.


ABSTRACT

Asthma was considered at sometime as a fully reversible disease, and for many years it was considered that the main mechanisms responsible for this condition were the airway obstruction, edema and hypersecretion of mucus. Histopathologic and morphometric studies show structural changes in the airways of affected patients compared with healthy subjects, which has been termed airway remodeling. Histopathologic and morphometric studies show structural changes in the airways of affected patients as compared to healthy subjects, which has been termed airway remodeling. It is a consequence of a chronic inflammatory process, and long lasting repair of airway produces changes in the airway’s structure. The airway remodeling can also be defined as changes in the composition, organization and numbers of cells and extracellular constituents of the airway wall. Noninvasive studies such as bone densitometry and invasive studies such as bronchial lavage and bronchial biopsy involving children have evaluated the airway remodeling.
In recent years there have been major advances in the understanding of the physiopathology of the airway remodeling, and the implications of this nosological phenomenon on the airway, chronic inflammation, airway angiogenesis, airway neuroplasticity, the disease’s development from childhood to adulthood, airway (genetic factors, epithelial changes, changes in the baseline membrane, overproduction of mucus, changes in smooth muscles, microvasculatures and cartilage, as well as specific processes of inflammation). It is very important to understand these phenomena in order to establish of therapeutic research goals which have the objective of developing treatments aimed at interacting with the above mechanisms, including angiogenesis and neuroplasticity.


REFERENCES

  1. Global Strategy for Asthma Management and Prevention 2008 (update). http://www.ginasthma.org. 2-13.

  2. Bousquet J, Jeffery P, Busse W, Johnson M, Vignola A. Asthma: From bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med 2000; 161; 1720–1745.

  3. Schwartz RS. A new element in the mechanism of asthma. N Engl J Med 2002; 346(11): 350-361.

  4. Warner S, Knight D. Airway modeling and remodeling in the pathogenesis of asthma. Curr Opin Allergy Clin Immunol 2008; 8(1): 44-48.

  5. Elias Jack, Zhu Zhou, Chupp Geoffrey, Homer Robert. Airway remodeling in asthma. The Journal of Clinical Investigation 1999; 104(8): 1001-1006.

  6. Guill MF. Asthma update: Epidemiology and patophysiology. Pediatrics in Review 2004; 25(9): 299-305.

  7. Martínez MA. Asma y estado asmático CIE-10ª REV. J45, J46 (Primera de dos partes). Epidemiología 2004; 29(21): 1-3.

  8. Martínez MA, Torres M. Asma y estado asmático. CIE-10ª REV. J45, J46 (Segunda y última parte). Epidemiología 2004; 30(21): 1-3.

  9. Bousquet J, Bousquet P, Godard P, Daures JP. The public health implications of asthma. Bulletin of the World Health Organization 2005; 83(7): 548-554.

  10. Braman SS. The Global Burden of Asthma Chest. 2006; 130: 4S-12S.

  11. Secretaría de Salud, México; Dirección de Epidemiología. Información Epidemiológica de Morbilidad 2005 Versión Ejecutiva. http://www.dgepi.salud.gob.mx. pp. 21.

  12. Michael H, Powell R, Shaw T, Howarth P et al. ADAM33 Expression in Asthmatic Airways and Human Embryonic Lungs. Am J Respir Crit Care Med 2005; 171: 958–965.

  13. Baay G, Cueto A, Yépez S. Contribución de la hipoxia en la remodelación del tejido pulmonar en procesos asmáticos. Revista Alergia México 2008; 55(1): 18-32.

  14. Busse W, Banks-Schlegel S, Noel P et al. Future Research Directions in Asthma. Am J Respir Crit Care Med 2004; 170: 683–690.

  15. Libro Dr. Huerta.

  16. Slade D, Kraft M. Airway remodeling from bench to bedside: Current perspectives. Clin Chest Med 2006; 27: 71–85.

  17. Jeffery P. Remodeling in asthma and chronic obstructive lung disease. Am J Respir Crit Care Med 2001; 164: S28–S38.

  18. Vignola A, Mirabella F, Costanzo G, Di Giorgi R et al. Airway remodeling in asthma. Chest 2003; 123: 417S-422S.

  19. De Blic J, Tillie-Leblond I, Bernard A, Jaubert F et al. J Allergy Clin Immunol 2004; 113(1): 94-100.

  20. Payne D, Rogers A, Ädelroth E, Bandi V et al. Early thickening of the reticular basement membrane in children with difficult asthma. Am J Respir Crit Care Med 2003; 167: 78–82.

  21. Bai T, Knight D. Structural changes in the airways in asthma: Observations and consequences. Clinical Science 2005; 108: 463–477.

  22. Barbato A, Turato G, Baraldo S, Bazzan E et al. Airway inflammation in childhood asthma. Am J Respir Crit Care Med 2003; 168: 798–803.

  23. Szefler S. Advances in pediatric asthma in 2008: Where do we go now? Allergy Clin Immunol 2009; 123(1): 28-34.

  24. Panettieri R, Covar R, Grant E, Hillyer E et al. Natural history of asthma: Persistence versus progression—does the beginning predict the end? J Allergy Clin Immunol 2008: 607-613.

  25. Barbato A, Turato G, Baraldo S, Bazzan E et al. Epithelial damage and angiogenesis in the airways of children with asthma. Am J Respir Crit Care Med 2006; 174: 975–981.

  26. Jenkins H et al. Histopathology of severe childhood asthma. Chest 2003; 124: 40.

  27. Zhang J, D Paré P, Sandford A. Recent advances in asthma genetics. Respiratory Research 2008; 9: 4.

  28. Meurer J, Lustig J, Jacob H. Genetic aspects of the etiology and treatment of asthma. Pediatr Clin N Am 2006; 53: 715–725.

  29. Mutius E. Gene-environment interactions in asthma. J Allergy Clin Immunol 2009: 3-11.

  30. Hoffjan S, Ober C. Present status on the genetic studies of asthma. Current Opinion in Immunology 2002; 14: 709–717.

  31. Haitchi H, Powell R, Shaw T, Howarth P et al. ADAM33 expression in asthmatic airways and human embryonic lungs. Am J Respir Crit Care Med 2005; 171: 958–965.

  32. Broide D. New perspectives on mechanisms underlying chronic allergic inflammation and asthma in 2007. J Allergy Clin Immunol 2008: 475-480.

  33. Shapiro S, Owen C. ADAM33 surfaces as an asthma gene. N Engl J Med 2002; 347(12): 936-938.

  34. Foley S, Mogas A, Olivenstein R, Fiset P et al. Increased expression of ADAM33 and ADAM8 with disease progression in asthma. J Allergy Clin Immunol 2007: 863-871.

  35. Holgate S, Holloway J, Wilson S, Howarth P et al. Understanding the pathophysiology of severe asthma to generate new therapeutic opportunities. J Allergy Clin Immunol 117(3): 496-506.

  36. Woodruff P, Dolganov G, Ferrando R, Donnelly S et al. Hyperplasia of smooth muscle in mild to moderate asthma without changes in cell size or gene expression. Am J Respir Crit Care Med 2004; 169: 1001–1006.

  37. Simpson A, Maniatis N, Jury F, Cakebread J et al. Polymorphisms in a disintegrin and metalloprotease 33 (ADAM33) Predict Impaired Early-Life Lung Function. Am J Respir Crit Care Med 2005; 172: 55–60.

  38. Illig T, Wjst M. Genetics of asthma and related phenotypes. Paediatric Respiratory Reviews 2002; 3(1): 47-51.

  39. Bergeron C, Boulet LP. Structural changes in airway diseases: Characteristics, mechanisms, consequences, and pharmacologic modulation. Chest 2006; 129: 1068-1087.

  40. Holgate S. Epithelium dysfunction in asthma. J Allergy Clin Immunol 2007: 1233-1244.

  41. McParland B, Macklem P, Pare P. Airway wall remodeling: friend or foe? J Appl Physiol 2003; 95: 426–434.

  42. Ordóñez C, Ferrando R, Hyde D, Wong H et al. Epithelial desquamation in asthma. Artifact or pathology? Am J Respir Crit Care Med 2000; 162(6): 2324-2329.

  43. Fan C. Intrinsic differences of the airway epithelium in childhood allergic asthma. American Journal of Respiratory and Critical Care Medicine. 2006; 174: 1066-1067.

  44. Puddicombe S, Polosa R, Richter A, Krishna M et al. Involvement of the epidermal growth factor receptor in epithelial repair in asthma. The FASEB Journal 2000; 14: 1362-1374.

  45. Tagaya E, Tamaoki J. Mechanisms of airway remodeling in asthma. Allergology International 2007; 56: 331-340.

  46. Ward C, Pais M, Bish R, Reid D, Feltis B et al. Airway inflammation, basement membrane thickening and bronchial hyperresponsiveness in asthma. Thorax 2002; 57: 309-316.

  47. Barrios R, Kheradmand F, Batts L, Corry D et al. Asthma pathology and pathophysiology. Arch Pathol Lab Med 2006; 130: 447-451.

  48. Qutayba H. Images in allergy and immunology: Airway remodeling in asthma. J Allergy Clin Immunol 2003; 111: 1420-1421.

  49. Herrero T. Remodelación de la vía aérea en el asma: fisiopatología de la matriz extracelular y función de los glicosaminoglicanos. Archivos de Alergia e Inmunología Clínica 2001: 32(2).

  50. Mauad T, Bel E, Sterk P. Asthma therapy and airway remodeling. J Allergy Clin Immunol 2007: 997-1009.

  51. Chu HW, Halliday JL, Martin RJ, Leung DY et al. Collagen deposition in large airways may not differentiate severe asthma from milder forms of the disease. Am J Respir Crit Care Med 1998; 158(6): 1936-1944.

  52. Covar R, Spahn J, Murphy J, Szefler S. Progression of asthma measured by lung function in the childhood asthma management program. American Journal of Respiratory and Critical Care Medicine 2004; 170: 234-241.

  53. Ordóñez C, Khashayar R, Wong H, Ferrando R et al. Mild and moderate asthma is associated with airway goblet cell hyperplasia and abnormalities in mucin gene expression. Am J Respir Crit Care Med 2001; 163: 517–523.

  54. Berry M, Hargadon B, Shelley M, Parker, Debbie et al. Evidence of a role of tumor necrosis factor a in refractory asthma. N Engl J Med 2006; 354: 697-708.

  55. Hasaneen N, Zucker S, Lin R, Vaday G et al. Angiogenesis is induced by airway smooth muscle strain. Am J Physiol Lung Cell Mol Physiol 293: L1059–L1068.

  56. James A. Remodeling of airway smooth muscle in asthma: what sort do you have? Clinical and Experimental Allergy 2005; 35(6): 703-707.

  57. Hirst S, Martin J, Bonacci J, Chan V et al. Proliferative aspects of airway smooth muscle. J Allergy Clin Immunol 2004; 114(2): S-2-S-17.

  58. Amishima M, Munakata M, Nasuhara Y, Sato A et al. Expression of epidermal growth factor and epidermal growth factor receptor immunoreactivity in the asthmatic human airway. Am J Respir Crit Care Med 1998; 157: 1907–1912.

  59. Benayoun L, Druilhe A, Dombret MC, Aubier M et al. Airway structural alterations selectively associated with severe asthma. Am J Respir Crit Care Med 2003; 167: 1360–1368.

  60. Saunders R, Siddiqui S, Kaur D, Doe C. Fibrocyte localization to the airway smooth muscle is a feature of asthma. J Allergy Clin Immunol 2009; 123: 376-384.

  61. Borger P, Tamm M, Black J, Roth M et al. Asthma: Is it due to an abnormal airway smooth muscle cell? Am J Respir Crit Care Med 2006; 174: 367–372.

  62. Kanazawa H, Nomura S, Asai K. Roles of angiopoietin-1 and angiopoietin-2 on airway microvascular permeability in asthmatic patients. Chest 2007; 131: 1035–1041.

  63. Green F, Butt J, James A, Carroll N. Abnormalities of the bronchial arteries in asthma. Chest 2006; 130: 1025–1033.

  64. Voelkel N, Douglas I, Nicolls M. Angiogenesis in chronic lung disease. Chest 2007; 131: 874–887.

  65. Mc Donald D. Angiogenesis and remodeling of airway vasculature in chronic inflammation. Am J Respir Crit Care Med 2001; 164: S39–S45.

  66. Feltis B, Wignarajah D, Zheng L, Ward C et al. Increased vascular endothelial growth factor and receptors: Relationship to angiogenesis in asthma. Am J Respir Crit Care Med 2006; 173: 1201–1207.

  67. Simcock D, Kanabar V, Clarke G, O’Connor B et al. Proangiogenic activity in bronchoalveolar lavage fluid from patients with asthma. Am J Respir Crit Care Med 2007; 176: 146–153.

  68. Hoshino M, Takahashi M, Aoike N. Expression of vascular endothelial growth factor, basic fibroblast growth factor, and angiogenin immunoreactivity in asthmatic airways and its relationship to angiogenesis. J Allergy Clin Immunol 2001; 107: 295-301.

  69. Homer RJ, Elias JA. Consequences of long-term inflammation. Airway remodeling. Clin Chest Med 2000; 21(2): 331-343.

  70. Haraguchi M, Shimura S, Shirato K. Morphometric analysis of bronchial cartilage in chronic obstructive pulmonary disease and bronchial asthma. Am J Respir Crit Care Med 1999; 159: 1005–1013.

  71. Renz H. Neurotrophins in bronchial asthma. Respiratory Research 2001: 2(5).

  72. Carr M, Undem B. Inflammation-induced plasticity of the afferent innervation of the airways. Environmental Health Perspectives 2001; 109(Supp 4): 567-571.

  73. Nassenstein C, Kutschker J, Tumes D, Braun A. Neuro–immune interaction in allergic asthma: role of neurotrophins. Biochemical Society Transactions 2006; 34(4): 591-593.

  74. Broide D. Immunologic and inflammatory mechanisms that drive asthma progression to remodeling. J Allergy Clin Immunol 2008; 121: 560-570.

  75. Canonica W. Treating asthma as an inflammatory disease. Chest 2006; 130: 21S–28S.

  76. Brightling C, Bradding P, Symon F, Holgate S et al. Mast-cell infiltration of airway smooth muscle in asthma. N Engl J Med 2002; 346: 1699-1705.

  77. Foley S, Hamid Q. Images in Allergy and Immunology: Neutrophils in asthma. J Allergy Clin Immunol 2007.

  78. Flood-Page P, Menzies-Gow A, Phipps S, Ying Sun et al. Anti-IL-5 treatment reduces deposition of ECM proteins in the bronchial subepithelial basement membrane of mild atopic asthmatics. J Clin Invest 2003; 112(7): 1029–1036.79. Foley S, Prefontaine D, Hamid Q. Images in allergy and immunology: role of eosinophils in airway remodeling. J Allergy Clin Immunol 2007.

  79. Goleva E, Hauk J, Boguniewicz J, Martin R et al. Airway remodeling and lack of bronchodilator response in steroid-resistant asthma. J Allergy Clin Immunol 2007; 120: 1065-1072.

  80. Homer R, Jack AE. Airway remodeling in asthma: Therapeutic implications of mechanisms. Physiology 2005; 20: 28–35.




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