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Origins of increased airway smooth muscle mass in asthma

Rachid Berair, Ruth Saunders and Christopher E Brightling*

Author Affiliations

Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE3 9QP, UK

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BMC Medicine 2013, 11:145  doi:10.1186/1741-7015-11-145

Published: 6 June 2013

Abstract

Asthma is characterized by both chronic inflammation and airway remodeling. Remodeling - the structural changes seen in asthmatic airways - is pivotal in the pathogenesis of the disease. Although significant advances have been made recently in understanding the different aspects of airway remodeling, the exact biology governing these changes remains poorly understood. There is broad agreement that, in asthma, increased airway smooth muscle mass, in part due to smooth muscle hyperplasia, is a very significant component of airway remodeling. However, significant debate persists on the origins of these airway smooth muscle cells. In this review article we will explore the natural history of airway remodeling in asthma and we will discuss the possible contribution of progenitors, stem cells and epithelial cells in mesenchymal cell changes, namely airway smooth muscle hyperplasia seen in the asthmatic airways.

Keywords:
Airway remodeling; Airway smooth muscle; Asthma; Fibrocytes; Mesenchymal stem cells