• A diagnosis of asthma is established based on a history of recurrent wheeze, cough, or shortness of breath, reversible airway obstruction demonstrated by pulmonary-function testing, and, in cases where questions exist, a methacholine challenge demonstrating airway hyperresponsiveness. (jci.org)
  • More recent studies have demonstrated that asthma can cause progressive lung impairment and, in some patients, eventuate in partially reversible or irreversible airway obstruction. (jci.org)
  • Often, at baseline there is evidence of reversible lower airway obstruction. (bmj.com)
  • It was concluded that both proximal and distal airways were involved in asthma and that distal airways were the major determinant of airflow obstruction. (ersjournals.com)
  • Although these airways contribute little to airflow obstruction in normal airways, studies have revealed that distal airways accounted for up to 50-90% of total airflow resistance in asthmatics [ 1 ], implying that distal airways were the main site of airflow obstruction in asthmatics. (ersjournals.com)
  • Alterations in the structure of the airways, collectively termed airway remodelling, contribute to airflow obstruction in a variety of chronic lung diseases. (ersjournals.com)
  • The usefulness and limitations of various techniques used for assessing distal airways were also evaluated, including pulmonary function tests and imaging. (ersjournals.com)
  • Computed tomography (CT)-estimated dimensions of the airway lumen and wall, and accompanying pulmonary artery. (ersjournals.com)
  • Pulmonary vasculature is remodeled in COPD. (nih.gov)
  • Kistemaker LE , Oenema TA, Meurs H, Gosens R. Regulation of airway inflammation and remodeling by muscarinic receptors: Perspectives on anticholinergic therapy in asthma and COPD. (rug.nl)
  • Asthma and chronic obstructive lung disease (COPD) are both inflammatory conditions of the lung associated with structural "remodeling" inappropriate to the maintenance of normal lung function. (nih.gov)
  • The clinically observed distinctions between asthma and COPD are reflected by differences in the remodeling process, the patterns of inflammatory cells and cytokines, and also the predominant anatomic site at which these alterations occur. (nih.gov)
  • In COPD, there is epithelial mucous metaplasia, airway wall fibrosis, and inflammation associated with loss of surrounding alveolar attachments to the outer wall of small airways: bronchiolar smooth muscle is increased also. (nih.gov)
  • An aerosol antigen challenge of an appropriately sensitized asthmatic patient can induce two types of airway responses. (jci.org)
  • Early investigators postulated that there was an intrinsic airway smooth muscle abnormality at the root of the asthmatic diathesis. (jci.org)
  • 1 6 EIB is characterised by falls in forced expiratory volume in one second (FEV 1 ) after exercise, while in people with asthma there is persistent airway inflammation and recurrent symptoms outside of exercise (that is, with allergen exposure or upper respiratory infections). (bmj.com)
  • Technical advances in computed tomography allow the assessment of airway wall dimensions, and are ideally suited for the noninvasive investigation of the pathogenesis of airway wall remodelling and the evaluation of new therapeutic interventions. (ersjournals.com)
  • Noninvasive methods are required to further investigate the pathogenesis of airway wall remodelling, to assess changes over time, and to allow the assessment of new therapeutic interventions designed to attenuate or reverse these structural changes. (ersjournals.com)
  • Such studies have provided valuable information on the processes and consequences of airway remodelling, but require access to surgical or autopsy samples of the airways and are necessarily cross-sectional in design. (ersjournals.com)
  • The following synopsis defines and compares the key remodeling processes and proposes several hypotheses. (nih.gov)
  • Comprehensive tissue remodeling processes, in particular, require further investigation, highlighting the necessity of elucidating regulatory mechanisms underlying tissue remodeling based on endotype classification. (molcells.org)
  • Nasal mucosal inflammation induces remodeling processes within the mucosa characterized by changes in extracellular matrix (ECM) protein deposition, macrophage and lymphocyte infiltration, and histological structure. (molcells.org)
  • EIB is defined as "the transient narrowing of the lower airway following exercise in the presence or absence of clinically recognized asthma. (bmj.com)
  • However, airway inflammation and remodelling also occur in cold weather athletes with and without asthma and EIB. (bmj.com)
  • The present review is the summary of an expert workshop that took place in Vence (France) in 2007 on the role of distal airways in asthma. (ersjournals.com)
  • The evidence showing inflammation and remodelling in distal airways, and their possible involvement in asthma control and natural history, was reviewed. (ersjournals.com)
  • Finally, the available data studying the benefit of treatment better targeting distal airways in asthma was examined. (ersjournals.com)
  • Inflammation in distal airways appeared more intense in severe and uncontrolled asthma. (ersjournals.com)
  • Distal airways were poorly attained by conventional aerosol of asthma medications owing to their granulometry, being composed of 3-5 μm particles. (ersjournals.com)
  • Thus, it is not surprising that the roles of distal airways in the natural history of asthma have long been neglected. (ersjournals.com)
  • The role of endogenous H2S formation in reversible remodeling of lung tissue during hibernation in the Syrian hamster. (rug.nl)
  • Chronic rhinosinusitis (CRS) is a multifactorial, heterogeneous disease characterized by persistent inflammation of the sinonasal mucosa and tissue remodeling, which can include basal/progenitor cell hyperplasia, goblet cell hyperplasia, squamous cell metaplasia, loss or dysfunction of ciliated cells, and increased matrix deposition. (molcells.org)
  • 85% of maximal voluntary ventilation) dehydrates the respiratory mucosa and leads to a transient increase in airway osmolarity, mast cell activation with mediator release (including histamine, serine proteases, prostaglandins, and leukotrienes 8 ), and bronchoconstriction. (bmj.com)
  • Tissue remodeling in CRS is the reorganization or renovation of nasal mucosa, which can be either physiological or pathological. (molcells.org)
  • Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and paranasal sinuses that lasts longer than 12 weeks and is the most common upper respiratory tract disease associated with tissue remodeling. (molcells.org)
  • In this review, we summarize the roles of PCs in CRS-associated tissue remodeling and discuss the therapeutic potential of targeting PCs for CRS treatment. (molcells.org)
  • They are the most severe form of pathological tissue remodeling in CRS and require surgical intervention. (molcells.org)
  • Dekkers BG , Bos IS, Zaagsma J, Meurs H. Functional consequences of human airway smooth muscle phenotype plasticity. (rug.nl)
  • Both proximal and distal airways might be targeted either by delivering medications systemically or by aerosol of extra-fine particles. (ersjournals.com)
  • Dekkers BG , Pehlic A, Mariani R, Bos IS, Meurs H, Zaagsma J. Glucocorticosteroids and beta2-Adrenoceptor Agonists Synergize to Inhibit Airway Smooth Muscle Remodeling. (rug.nl)
  • Oenema TA , Smit M, Smedinga L, Racke K, Halayko AJ, Meurs H, Gosens R. Muscarinic receptor stimulation augments TGF-beta1-induced contractile protein expression by airway smooth muscle cells. (rug.nl)
  • Pera T , Atmaj C, van der Vegt M, Halayko AJ, Zaagsma J, Meurs H. Role for TAK1 in cigarette smoke-induced proinflammatory signaling and IL-8 release by human airway smooth muscle cells. (rug.nl)
  • these changes can contribute directly to airway narrowing and/or exaggerate the effect of airway smooth muscle contraction. (ersjournals.com)
  • The aim of this article is to review the use of computed tomography in the investigation of airway structure and function in health and disease. (ersjournals.com)
  • Orban N, Jacobson MR, Nouri-Aria KT, Durham SR, Eifan AO close , 2021, Repetitive nasal allergen challenge in allergic rhinitis: priming and Th2-type inflammation but no evidence of remodelling. (imperial.ac.uk)
  • Despite this limitation, the ability to measure multiple airways relatively, noninvasively and repeatedly offers major potential advantages. (ersjournals.com)
  • While histology has provided valuable insights into the structure of airway wall remodelling, this technique is invasive and does not allow the longitudinal analysis of airway wall dimensions. (ersjournals.com)
  • For example, CT cannot distinguish which components of the airway wall are thickened. (ersjournals.com)
  • Studies of distal airways have proved difficult, owing to their small size and their peripheral location. (ersjournals.com)
  • It is probable that the establishment of a certain magnitude and type of airway remodelling will contribute to AHR and symptomatic airway obstruction, in addition to playing a role in the development of fixed airway obstruction and excessive airway narrowing. (ersjournals.com)
  • Observations reported in many studies suggest a relationship between the development of airway remodelling and the progressive increase in airway responsiveness, impaired pulmonary function and development of fixed airway obstruction 5 , 16 . (ersjournals.com)
  • In order to evaluate further the correlation of Q aw and Δe°T with inflammation, we studied the acute effect of inhaled budesonide on these parameters and their reciprocal changes. (biomedcentral.com)
  • Its persistent relationship with airway hyperresponsiveness following anti-inflammatory treatment suggests that it is an important independent determinant of airway hyperresponsiveness. (bmj.com)
  • The research of structural changes in airway diseases is relatively recent compared with studies on physiological or inflammatory features. (ersjournals.com)
  • Animal models and studies of groups such as asymptomatic subjects with airway hyperresponsiveness (AHR) show that the various elements of the remodelling process evolve with time, not only with regard to the quantity of the various elements but also in type and airway distribution, possibly under the influence of epithelial cells, and particularly when there is a significant ongoing inflammatory process 3 , 7 - 9 . (ersjournals.com)
  • We investigated the relationship of Δe°T with Q aw and airway inflammation as assessed by exhaled nitric oxide (NO). We also studied the anti-inflammatory and vasoactive effects of inhaled corticosteroid and β 2 -agonist. (biomedcentral.com)
  • Significant associations between AHR and markers of eosinophilic inflammation in induced sputum 7 and the level of nitric oxide in exhaled breath 4 have been observed, but other studies have failed to show any association between airway inflammation and AHR. (bmj.com)
  • 3 Although AHR has been shown to be associated with airway inflammation 4 and ventilation heterogeneity, 5 the mechanisms that cause AHR are poorly understood. (bmj.com)
  • Hence, at this stage we will need to further elaborate on the main challenges for research in this field in order to help better understand the mechanisms of airway remodelling and to decide if, how and when to intervene on this process. (ersjournals.com)
  • Airway inflammation and ventilation heterogeneity have been separately shown to be associated with airway hyperresponsiveness. (bmj.com)
  • The various in vitro and animal models developed to study the pathways involved in the changes in the bronchial structure induced by airways allergic reactions or other stimuli confirm this vast heterogeneity. (ersjournals.com)
  • James AL, Wenzel S. Clinical relevance of airway remodelling in airway diseases. (medscape.com)
  • On the other hand, inflammation of the peripheral airways will contribute to the airflow limitation by increasing the thickness of the airway wall which, together with fibrosis and smooth muscle hypertrophy, may cause airway narrowing. (atsjournals.org)
  • Cardiac fibrosis is associated with chronic heart failure, atrial fibrillation, and cardiac remodelling following acute myocardial infarction [ 2 , 3 ]. (ersjournals.com)
  • The main site of mucus hypersecretion, expressed clinically as chronic bronchitis, is the central airways, and there is increasing evidence that the central airways are inflamed in patients with COPD. (atsjournals.org)
  • What is the influence of the various aspects of airway remodelling on airway function and clinical outcome? (ersjournals.com)
  • Increased deposition of elements such as proteoglycans in the airway wall can then occur, followed by the less reversible collagen deposition. (ersjournals.com)
  • To test this, we investigate the relationship between airway inflammation as assessed by exhaled NO, with Q aw and Δe°T measured non-invasively. (biomedcentral.com)
  • Studies examining central airways in smokers have shown that T-lymphocytes and macrophages are the predominant cells infiltrating the airway wall, whereas neutrophils, that are scanty in the airway wall, are increased in the airway lumen ( 7 , 9 ) (Table 1 ). (atsjournals.org)
  • During the past months, the European Respiratory Journal has published a series on airway remodelling in order to review the state of knowledge in this increasingly important domain 2 - 6 . (ersjournals.com)