Department of Molecular Pharmacology, University of Groningen, Groningen, The Netherlands.
Proc Am Thorac Soc. 2009 Dec;6(8):683-92. doi: 10.1513/pats.200907-056DP.
Chronic asthma is an inflammatory airways disease characterized by pathological changes in the airway smooth muscle (ASM) bundle that contribute to airway obstruction and hyperresponsiveness. Remodeling of the ASM is associated with an increased smooth muscle mass, involving components of cellular hypertrophy and hyperplasia, and changes in the phenotype of the muscle that facilitate proliferative, synthetic and contractile functions. These changes are considered major contributing factors to the pathophysiology of asthma, because of their role in exaggerated airway narrowing. The mechanisms that regulate changes in ASM mass and phenotype are incompletely understood, but likely involve the regulatory role of mediators and growth factors secreted from inflammatory cells on ASM cell proliferation and phenotype. An alternative hypothesis is that cellular and structural components that together constitute the airway wall, such as the airway epithelium, airway nerves, and the extracellular matrix, interact with the ASM bundle to facilitate changes in smooth muscle phenotype and function that drive remodeling under inflammatory conditions. This review discusses the mechanisms by which structural components of the airway wall communicate with the ASM bundle to regulate remodeling and discusses these mechanisms in the context of the pathophysiology of asthma.
慢性哮喘是一种气道炎症性疾病,其特征是气道平滑肌(ASM)束的病理性改变,导致气道阻塞和高反应性。ASM 的重塑与平滑肌质量的增加有关,涉及细胞肥大和增生的成分,以及肌肉表型的变化,这些变化有利于增殖、合成和收缩功能。这些变化被认为是哮喘病理生理学的主要致病因素,因为它们在气道狭窄的过度发生中起作用。调节 ASM 质量和表型变化的机制尚不完全清楚,但可能涉及炎症细胞分泌的介质和生长因子对 ASM 细胞增殖和表型的调节作用。另一种假设是,共同构成气道壁的细胞和结构成分,如气道上皮、气道神经和细胞外基质,与 ASM 束相互作用,促进在炎症条件下驱动重塑的平滑肌表型和功能的变化。本综述讨论了气道壁的结构成分与 ASM 束相互作用调节重塑的机制,并在哮喘病理生理学的背景下讨论了这些机制。
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