Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), School of Medicine, University of Naples Federico II, WAO Center of Excellence, Naples, Italy.
Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, Naples, Italy.
Eur Respir J. 2024 Apr 18;63(4). doi: 10.1183/13993003.01619-2023. Print 2024 Apr.
Asthma is a chronic, heterogeneous disease of the airways, often characterised by structural changes known collectively as airway remodelling. In response to environmental insults, including pathogens, allergens and pollutants, the epithelium can initiate remodelling an inflammatory cascade involving a variety of mediators that have downstream effects on both structural and immune cells. These mediators include the epithelial cytokines thymic stromal lymphopoietin, interleukin (IL)-33 and IL-25, which facilitate airway remodelling through cross-talk between epithelial cells and fibroblasts, and between mast cells and airway smooth muscle cells, as well as through signalling with immune cells such as macrophages. The epithelium can also initiate airway remodelling independently of inflammation in response to the mechanical stress present during bronchoconstriction. Furthermore, genetic and epigenetic alterations to epithelial components are believed to influence remodelling. Here, we review recent advances in our understanding of the roles of the epithelium and epithelial cytokines in driving airway remodelling, facilitated by developments in genetic sequencing and imaging techniques. We also explore how new and existing therapeutics that target the epithelium and epithelial cytokines could modify airway remodelling.
哮喘是一种气道的慢性、异质性疾病,通常以气道重塑为特征,这是一种共同的结构变化。在环境刺激物(包括病原体、过敏原和污染物)的作用下,上皮细胞可以启动重塑,这是一个涉及多种介质的炎症级联反应,对结构细胞和免疫细胞都有下游影响。这些介质包括上皮细胞因子胸腺基质淋巴细胞生成素、白细胞介素(IL)-33 和 IL-25,它们通过上皮细胞和成纤维细胞之间、肥大细胞和气道平滑肌细胞之间的相互作用,以及与巨噬细胞等免疫细胞的信号转导,促进气道重塑。上皮细胞也可以在没有炎症的情况下独立于炎症,对支气管收缩时存在的机械应激做出反应,启动气道重塑。此外,上皮细胞成分的遗传和表观遗传改变被认为会影响重塑。在这里,我们回顾了上皮细胞和上皮细胞因子在驱动气道重塑方面的作用的最新进展,这得益于遗传测序和成像技术的发展。我们还探讨了针对上皮细胞和上皮细胞因子的新型和现有治疗方法如何改变气道重塑。
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