Heterogeneity of Airway Smooth Muscle Remodeling in Asthma.

Autor: James AL; West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.; School of Medicine and Pharmacology and., Donovan GM; Department of Mathematics, University of Auckland, Auckland, New Zealand., Green FHY; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada., Mauad T; Department of Pathology, Sao Paulo University Medical School, Sao Paulo, Brazil; and., Abramson MJ; School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Cairncross A; School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia., Noble PB; School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia., Elliot JG; West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.; School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
Jazyk: angličtina
Zdroj: American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2023 Feb 15; Vol. 207 (4), pp. 452-460.
DOI: 10.1164/rccm.202111-2634OC
Abstrakt: Rationale: Ventilatory defects in asthma are heterogeneous and may represent the distribution of airway smooth muscle (ASM) remodeling. Objectives: To determine the distribution of ASM remodeling in mild-severe asthma. Methods: The ASM area was measured in nine airway levels in three bronchial pathways in cases of nonfatal ( n  = 30) and fatal asthma ( n  = 20) and compared with control cases without asthma ( n  = 30). Correlations of ASM area within and between bronchial pathways were calculated. Asthma cases with 12 large and 12 small airways available ( n  = 42) were classified on the basis of the presence or absence of ASM remodeling (more than two SD of mean ASM area of control cases, n  = 86) in the large or small airway or both. Measurements and Main Results: ASM remodeling varied widely within and between cases of nonfatal asthma and was more widespread and confluent and more marked in fatal cases. There were weak correlations of ASM between levels within the same or separate bronchial pathways; however, predictable patterns of remodeling were not observed. Using mean data, 44% of all asthma cases were classified as having no ASM remodeling in either the large or small airway despite a three- to 10-fold increase in the number of airways with ASM remodeling and 81% of asthma cases having ASM remodeling in at least one large and small airway. Conclusions: ASM remodeling is related to asthma severity but is heterogeneous within and between individuals and may contribute to the heterogeneous functional defects observed in asthma. These findings support the need for patient-specific targeting of ASM remodeling.
Databáze: MEDLINE
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