The Three A’s in Asthma – Airway Smooth Muscle, Airway Remodeling & Angiogenesis



L.F. Keglowich, P. Borger*
Department of Biomedicine, University Hospital Basel, Switzerland


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© Keglowich and Borger; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Pulmonary Cell Research, Department of Biomedicine, Lab 305, University of Basel, Hebelstrasse 20, CH-4031 Basel, Switzerland; Tel: +41 61 265 3254; Fax: +41 61 265 2350; E-mail: pieter.borger@unibas.ch


Abstract

Asthma affects more than 300 million people worldwide and its prevalence is still rising. Acute asthma attacks are characterized by severe symptoms such as breathlessness, wheezing, tightness of the chest, and coughing, which may lead to hospitalization or death. Besides the acute symptoms, asthma is characterized by persistent airway inflammation and airway wall remodeling. The term airway wall remodeling summarizes the structural changes in the airway wall: epithelial cell shedding, goblet cell hyperplasia, hyperplasia and hypertrophy of the airway smooth muscle (ASM) bundles, basement membrane thickening and increased vascular density. Airway wall remodeling starts early in the pathogenesis of asthma and today it is suggested that remodeling is a prerequisite for other asthma pathologies. The beneficial effect of bronchial thermoplasty in reducing asthma symptoms, together with the increased potential of ASM cells of asthmatics to produce inflammatory and angiogenic factors, indicate that the ASM cell is a major effector cell in the pathology of asthma. In the present review we discuss the ASM cell and its role in airway wall remodeling and angiogenesis.

Keywords: Asthma, airway smooth muscle, airway remodelling, angiogenesis.