What effect does asthma treatment have on airway remodeling

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Presentation transcript:

What effect does asthma treatment have on airway remodeling What effect does asthma treatment have on airway remodeling? Current perspectives Sheharyar R. Durrani, MD, Ravi K. Viswanathan, MD, William W. Busse, MD Journal of Allergy and Clinical Immunology Volume 128, Issue 3, Pages 439-448 (September 2011) DOI: 10.1016/j.jaci.2011.06.002 Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Integrative model of the components of airway remodeling. In asthmatic patients airway inflammation, epithelial and goblet cell phenotype alterations, subepithelial fibrosis (eg, reticular basement membrane in the text), excess mucus secretion, smooth muscle cell hypertrophy and hyperplasia, and angiogenesis are present. Copyright 2003, Ethan F. Geehr. Reproduced with permission from Lazaar et al.99 Journal of Allergy and Clinical Immunology 2011 128, 439-448DOI: (10.1016/j.jaci.2011.06.002) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 A, Individual changes in reticular layer thickness beneath the epithelium in bronchial biopsy specimens before and after 2 years of treatment according to the reference and AHR strategies. Bars indicate mean values at the visits for both strategies. There was a significant decrease in reticular layer thickness within the AHR strategy group, which was significantly greater than in the reference strategy group. Excerpted with permission from Sont et al.30 B, Relationship between changes in EG2+ eosinophils and changes in methacholine PC20 values during 2 years of treatment according to the reference and AHR strategies. The greater the decrease in the number of EG2+ eosinophils, the greater the improvement in AHR to inhaled methacholine. Excerpted with permission from Sont et al.30 Journal of Allergy and Clinical Immunology 2011 128, 439-448DOI: (10.1016/j.jaci.2011.06.002) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Comparison of changes in RBH thickness for fluticasone propionate (FP; solid circles) and placebo (PL; open circles) at 3 and 12 months’ treatment. ∗∗P < .01, 12-month FP versus baseline; P < .05 versus placebo. Reproduced with permission from Ward et al.31 Journal of Allergy and Clinical Immunology 2011 128, 439-448DOI: (10.1016/j.jaci.2011.06.002) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions