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Mechanisms of Airway RemodelingMechanisms of Airway Remodeling

Nobuaki Hirota, MD, PhD; James G. Martin, MD, DSc
Author and Funding Information

From the Meakins-Christie Laboratories, Department of Medicine, McGill University, Montreal, QC, Canada.

Correspondence to: James G. Martin, MD, DSc, Meakins-Christie Laboratories, Department of Medicine, McGill University, 3626 St-Urbain, Montréal, QC, H2X 2P2, Canada; e-mail: james.martin@mcgill.ca


Funding/Support: This work was supported in part by the Canadian Institutes of Health Research [Grant MOP-93747] and the Richard and Edith Strauss Canada Foundation.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(3):1026-1032. doi:10.1378/chest.12-3073
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Airway remodeling comprises the structural changes of airway walls, induced by repeated injury and repair processes. It is characterized by the changes of tissue, cellular, and molecular composition, affecting airway smooth muscle, epithelium, blood vessels, and extracellular matrix. It occurs in patients with chronic inflammatory airway diseases such as asthma, COPD, bronchiectasis, and cystic fibrosis. Airway remodeling is arguably one of the most intractable problems in these diseases, leading to irreversible loss of lung function. Current therapeutics can ameliorate inflammation, but there is no available therapy proven to prevent or reverse airway remodeling, although reversibility of airway remodeling is suggested by studies in animal models of disease. Airway remodeling is often considered the result of longstanding airway inflammation, but it may be present to an equivalent degree in the airways of children with asthma, raising the necessity for early and specific therapeutic interventions. In this review, we consider the factors that may contribute to airway remodeling and discuss the current and potential therapeutic interventions.

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