Remodeling Airways Asthma

Prof. Jean Bousquet, Pulmonologist, University of Montpellier and Hôpital Arnaud de Villeneuve, Montpellier

Remodeling & Asthma: What does it mean for asthmatic patients?

One possible consequence of asthma is the remodeling of the airways. “Remodeling” means that, caused by the disease, the airways are undergoing a change process and bronchial walls are thickening, restricting the lung function even more. MeinAllergiePortal talked with Prof. Jean Bousquet, Pulmonologist, University of Montpellier and Hôpital Arnaud de Villeneuve, Montpellier, who proposed the concept of airways remodeling in asthma about his findings.  

Prof. Bousquet, what does remodeling mean in the context of asthma?

Let me give you an example: When someone has a wound in the skin, a natural repair process is setting in and the tissue is “reconstructed”. In some cases the wound will just heal and a minimum scar will be left. In some cases, unfortunately, the scar will be more noticeable, the tissue is hardening and the scar itself becomes a problem.  

With asthma, there is a similar process taking place in the airways, caused by inflammation. Inflammation leads to a repair process in the airways and this is what we call “remodeling”. As a consequence, the airways’ structure is changed and breathing becomes more difficult. And: inflammation is not only causing the remodeling process – it also enhances it!

Does this mean the airways are hardening?

The remodeling process is relatively well organized as long as the repairing process is working almost normally and not overly extensive. Like in the example with the skin, a minimum scar is not a problem, but extensive scars are because this would lead to extensive hardening and eventually pulmonary fibrosis in some lung diseases  -not in asthma.

What are the consequences for the patient when remodeling sets in?

We have histologic evidence of muscle thickening, elastic fiber disruption and collagen disposition in the airways. So we know perfectly well what the remodeling effect on the airways looks like.

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