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Bronchoconstriction and Airway BiologyBronchoconstriction and Airway Biology: Potential Impact and Therapeutic Opportunities

Reinoud Gosens, PhD; Chris Grainge, PhD
Author and Funding Information

From the Groningen Research Institute for Asthma and COPD (Dr Gosens), Department of Molecular Pharmacology, University of Groningen, Groningen, The Netherlands; and Hunter Medical Research Institute (Dr Grainge), University of Newcastle, Newcastle, NSW, Australia.

CORRESPONDENCE TO: Reinoud Gosens, PhD, Groningen Research Institute for Asthma and COPD, University of Groningen, Hanzeplein 1, PO Box 30.001, NL-9700 RB Groningen, The Netherlands; e-mail: r.gosens@rug.nl


FUNDING/SUPPORT: Dr Gosens received grant support from Chiesi and Boehringer Ingelheim Pharma GmbH.

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


Chest. 2015;147(3):798-803. doi:10.1378/chest.14-1142
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Recent work has demonstrated that mechanical forces occurring in the airway as a consequence of bronchoconstriction are sufficient to not only induce symptoms but also influence airway biology. Animal and human in vitro and in vivo work demonstrates that the airways are structurally and functionally altered by mechanical stress induced by bronchoconstriction. Compression of the airway epithelium and mechanosensing by the airway smooth muscle trigger the activation and release of growth factors, causing cell proliferation, extracellular matrix protein accumulation, and goblet cell differentiation. These effects of bronchoconstriction are of major importance to asthma pathophysiology and appear sufficient to induce remodeling independent of the inflammatory response. We review these findings in detail and discuss previous studies in light of this new evidence regarding the influence of mechanical forces in the airways. Furthermore, we highlight potential impacts of therapies influencing mechanical forces on airway structure and function in asthma.

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