Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland.
Curr Opin Allergy Clin Immunol. 2013 Apr;13(2):203-10. doi: 10.1097/ACI.0b013e32835e122c.
Remodeling and inflammation together with airway hyperresponsiveness are essential components of asthma but their role in development of the disease is still obscure.
Recent data imply that remodeling can occur early in childhood, not necessarily subsequent to but rather, in parallel with inflammation. The assumption of thickening of the reticular basement membrane being a prerequirement for chronic asthma is questioned but development of airway responsiveness is a significant factor. Airway responsiveness is at least partially linked to bronchial inflammation but there are several other genes and pathways regulating airway responsiveness. Increased airway smooth muscle in early childhood is associated with later development of asthma and may be one link between inflammation and airway responsiveness. Novel findings on genetic variation in genes regulating lung growth and remodeling in early childhood shed light on the pathophysiological mechanisms leading to chronic asthma.
Even young children with chronic asthma have detectable elements of airway remodeling, inflammation and increased airway responsiveness, which all contribute to impaired lung function.
重塑和炎症以及气道高反应性是哮喘的重要组成部分，但它们在疾病发展中的作用仍不清楚。
最近的数据表明，重塑可能在儿童早期发生，不一定是继炎症之后，而是与炎症同时发生。假设网状基底膜增厚是慢性哮喘的先决条件这一观点受到质疑，但气道反应性的发展是一个重要因素。气道反应性至少部分与支气管炎症有关，但还有其他几个基因和途径调节气道反应性。儿童早期气道平滑肌的增加与以后哮喘的发展有关，可能是炎症和气道反应性之间的一个联系。关于早期调节肺生长和重塑的基因遗传变异的新发现，揭示了导致慢性哮喘的病理生理机制。
即使是患有慢性哮喘的幼儿，也有可检测到的气道重塑、炎症和气道高反应性的元素，这些都导致了肺功能受损。
