Airway modeling and remodeling in the pathogenesis of asthma

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Abstract
Asthma remains a severe health problem since current therapies are directed to suppressing, rather than preventing or reversing, the primary disease process. Clearly, a greater understanding of the pathogenesis of asthma is critical to the development of better therapeutic modalities. In this review, we discuss the recent advancements in research targeting the role of airway remodeling in asthma. Epithelial fragility and abnormalities are being recognized as important facets of asthma, as are other features of remodeling such as angiogenesis, goblet cell hyperplasia and thickened lamina reticularis. Significantly, these anomalies occur early in disease pathogenesis. However, their impact on disease severity remains unclear. Although an altered immune response is undoubtedly important to the pathogenesis of asthma, there is increasing evidence that the tissue-specific manifestations occur independently of inflammation and significantly impact on disease development and severity.