Funding: Wellcome Senior Clinical Fellowship (CEB), AirPROM (FP7 270194)
Lung damage and airway remodelling in severe asthma
Article first published online: 22 DEC 2011
© 2011 Blackwell Publishing Ltd
Clinical & Experimental Allergy
Special Issue: Special Issue on Severe Asthma
Volume 42, Issue 5, pages 638–649, May 2012
How to Cite
Cite this as: C. E. Brightling, S. Gupta, S. Gonem and S. Siddiqui, Clinical & Experimental Allergy, 2012 (42) 638–649.
- Issue published online: 20 APR 2012
- Article first published online: 22 DEC 2011
- Manuscript Accepted: 8 NOV 2011
- Manuscript Revised: 16 OCT 2011
- Manuscript Received: 1 SEP 2011
Severe asthma is a heterogeneous disease with substantial unmet clinical need. Airway damage and remodelling is a consequence of complex host–environment interactions and is considered to be the cardinal feature leading onto the development and persistence of airflow obstruction. In this review, we shall bring together recent insights into the causes of airway damage and remodelling that propose key roles for pathogens and mechanical damage in addition to allergens, underlying genetic susceptibility, inflammatory and structural cell interactions, and impaired resolution of damage. We shall consider the consequences of airway remodelling in terms of airway geometry, mechanics and clinical expression of disease. Understanding the causes and consequences of airway damage and remodelling will shed light upon the structure–function relationships required to begin to unravel the complexity of severe asthma and will enable us to target current and novel therapies as we begin to move towards realizing personalized medicine.