James A L, Wenzel S
West Australian Sleep Disorders Research Institute, Internal mailbox 201, Queen Elizabeth II Medical Centre, Hospital Avenue, Nedlands, Western Australia 6009, Australia.
Eur Respir J. 2007 Jul;30(1):134-55. doi: 10.1183/09031936.00146905.
Asthma and chronic obstructive pulmonary disease (COPD) are characterised by airflow obstruction, airway remodelling (measurable structural change) and inflammation. The present review will examine the relationship between airway remodelling in these two conditions with respect to symptoms, abnormal lung function, airway hyperresponsiveness and decline in lung function. The potential for remodelling to be a protective response will also be discussed. Asthma is associated with variable symptoms and changes in lung function and also fixed abnormalities of lung function and an increased rate of decline in lung function with age. There is a relative preservation of the relaxed airway lumen dimensions, prominent thickening of the smooth muscle layer and reduced airway distensibility. The severity of asthma is related to the degree of airway remodelling, which is most marked in cases of fatal asthma. In COPD, symptoms are persistent and predictable but also progressive and are related to fixed abnormalities of lung function. Remodelling is associated with narrowing of the airway lumen and an increased thickness of the airway wall, although not usually to the extent seen in asthma. COPD is most often due to smoking where there is also remodelling of the parenchyma that may contribute to symptoms.
哮喘和慢性阻塞性肺疾病（COPD）的特征是气流受限、气道重塑（可测量的结构变化）和炎症。本综述将探讨这两种疾病中气道重塑与症状、异常肺功能、气道高反应性及肺功能下降之间的关系。还将讨论重塑作为一种保护性反应的可能性。哮喘与症状多变、肺功能改变有关，也与肺功能的固定异常以及随年龄增长肺功能下降速率增加有关。气道管腔尺寸在舒张时相对保持正常，平滑肌层显著增厚，气道扩张性降低。哮喘的严重程度与气道重塑程度相关，在致死性哮喘病例中最为明显。在COPD中，症状持续且可预测，但也呈进行性发展，且与肺功能的固定异常有关。气道重塑与气道管腔狭窄及气道壁厚度增加有关，尽管通常程度不及哮喘所见。COPD最常见的病因是吸烟，此时实质组织也会发生重塑，这可能导致症状出现。
