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.