Airway hyperresponsiveness in asthma : the role of the epithelium

Copyright © 2024. Published by Elsevier Inc..

Airway hyperresponsiveness (AHR) is a key clinical feature of asthma. The presence of AHR in people with asthma provides the substrate for bronchoconstriction in response to numerous diverse stimuli, contributing to airflow limitation and symptoms including breathlessness, wheeze and chest tightness. Dysfunctional airway smooth muscle (ASM) significantly contributes to AHR and is displayed as increased sensitivity to direct pharmacological bronchoconstrictor stimuli, such as inhaled histamine and methacholine (direct AHR), or to endogenous mediators released by activated airway cells such as mast cells (indirect AHR). Research in in vivo human models has shown that the disrupted airway epithelium plays an important role in driving inflammation that mediates indirect AHR in asthma, through the release of cytokines such as TSLP and IL-33. These cytokines upregulate type 2 cytokines promoting airway eosinophilia and induce the release of bronchoconstrictor mediators from mast cells such as histamine, prostaglandin D2 and cysteine leukotrienes. While bronchoconstriction is largely due to ASM constriction, airway structural changes termed 'remodelling', likely mediated in part by epithelial-derived mediators, also lead to airflow obstruction and may enhance AHR. In this review, we outline the current knowledge of the role of the airway epithelium in AHR in asthma and its implications on the wider disease. Increased understanding of airway epithelial biology may contribute to better treatment options, particularly in precision medicine.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

The Journal of allergy and clinical immunology - (2024) vom: 21. Feb.

Sprache:

Englisch

Beteiligte Personen:

Bradding, Peter [VerfasserIn]
Porsbjerg, Celeste [VerfasserIn]
Côté, Andréanne [VerfasserIn]
Dahlén, Sven-Erik [VerfasserIn]
Hallstrand, Teal S [VerfasserIn]
Brightling, Christopher E [VerfasserIn]

Links:

Volltext

Themen:

Airway hyperresponsiveness
Asthma
Bronchoconstriction
Cytokines
Epithelium
Inflammation
Journal Article
Mast cells
Respiratory
Review

Anmerkungen:

Date Revised 23.02.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1016/j.jaci.2024.02.011

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368850684