Woodruff Prescott G, Fahy John V
Department of Medicine, University of California at San Francisco, 94143, USA.
Semin Respir Crit Care Med. 2002 Aug;23(4):361-7. doi: 10.1055/s-2002-34331.
Airway remodeling is a summary term for the pathological changes that occur in airway structure in allergic or suppurative airway diseases. Characteristic changes of airway remodeling in asthma include goblet cell hyperplasia, deposition of collagens in the basement membrane zone, increased size and number of microvessels in the submucosa, hyperplasia and hypertrophy of airway smooth muscle, and hypertrophy of submucosal glands. Some of these changes, such as goblet cell hyperplasia and subepithelial collagen deposition, are present even in mild asthma; other changes such as increases in airway smooth muscle and gland volume appear to be more characteristic of severe asthma. Airway narrowing, airway hyperresponsiveness, and mucus hypersecretion are all functional consequences of airway remodeling leading to clinical manifestations such as dyspnea, wheeze, sputum production, and susceptibility to asthma exacerbations. Noninvasive measures of remodeling are lacking, and monitoring the effects of treatment on remodeling has been difficult. For this reason relatively little is known about the effects of current asthma treatments on airway remodeling. As mechanisms of airway remodeling are developed, it is hoped that novel therapeutic targets will be identified. Treatments specifically targeting mediators of remodeling hold promise as treatments that could modify disease progression in asthma.
气道重塑是过敏性或化脓性气道疾病中气道结构发生的病理变化的统称。哮喘气道重塑的特征性变化包括杯状细胞增生、基底膜区胶原蛋白沉积、黏膜下层微血管大小和数量增加、气道平滑肌增生和肥大以及黏膜下腺肥大。其中一些变化，如杯状细胞增生和上皮下胶原沉积，即使在轻度哮喘中也存在；其他变化，如气道平滑肌和腺体体积增加，似乎更具重度哮喘的特征。气道狭窄、气道高反应性和黏液分泌过多都是气道重塑的功能后果，导致呼吸困难、喘息、咳痰和哮喘加重易感性等临床表现。目前缺乏气道重塑的非侵入性测量方法，监测治疗对气道重塑的效果也很困难。因此，对于目前哮喘治疗对气道重塑的影响了解相对较少。随着气道重塑机制的深入研究，有望确定新的治疗靶点。专门针对重塑介质的治疗方法有望成为改变哮喘疾病进展的治疗手段。
