New insights into airway remodelling in asthma and its possible modulation.

PURPOSE OF REVIEW: Airway remodelling, a central feature of asthma, is characterized by an alteration in the size, mass or number of tissue components which occur in and around the trachea, bronchi and bronchioles in the airways in response to injury and/or inflammation. The present review focuses on the most recent literature on airway remodelling and on the different drugs commonly used or potentially useful in the treatment of asthma with a particular attention to the studies conducted by our group in the last few years.

RECENT FINDINGS: The interaction between the epithelium and mesenchymal elements such as fibroblasts is essential for normal airway repair. An abnormal response of this epithelial-mesenchymal trophic unit has been proposed to be central to the airway pathology and physiology characteristic of asthma. Current treatments may indirectly control airway remodelling through a reduction of inflammation but such a kind of approach is only in part successful.

SUMMARY: The clear understanding of the events that take place during remodeling and the targeting of its specific components will be helpful in the development of novel therapies that might restore lung function.