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Differences in airway remodeling between asthma and chronic obstructive pulmonary disease

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Abstract

The functional consequence of asthma and chronic obstructive pulmonary disease (COPD) is airflow limitation, which is mostly reversible in asthma and not fully reversible in COPD. In both diseases, inflammatory conditions are associated with cellular and structural changes, referred to as remodeling, and these structural changes may lead to thickening of the airway wall, thereby promoting airway narrowing and airflow limitation. However, the pattern of infilatrated cells and the pattern of structural changes occur differently in the two diseases. In asthma, CD4+, T lymphocytes, eosinophils, and mast cells are the predominant cells involved, whereas COPD, CD8+, T lymphocytes, and macrophages are predominantly involved. In severe cases of asthma and COPD, neutrophil infiltration becomes evident. Regarding structural changes, epithelial injury and early thickening of reticular basement membrane are highly characteristic of the airway wall of asthmatics. Increases in airway smooth muscle mass occur in large airways of severe asthmatics and in small airways of patients with COPD. Thickening of the airway wall, golblet cell hyperplasia, mucous gland hypertrophy, and the luminal obstruction caused by inflammatory exudates and mucous are features of both asthma and COPD. Squamous epithelial metaplasia and airway wall fibrosis are commonly observed characteristics of COPD. Destruction and fibrosis of the alveolar wall occur in COPD but not in asthma. The remodeling processes accompanied by chronic inflammatory infiltrates interact in a complex fashion and contribute to the development of airflow limitation in both asthma and COPD.

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References

  1. Global initiative for asthma. Global strategy for asthma management and prevention. NHLIB/WHO Workshop report. National Institutes of Health, National Heart, Lung and Blood Institute. Publication No. 02-3659. 2002.

  2. Global initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Workshop report. National Institutes of Health, National Heart, Lung and Blood Institute. 2003.

  3. Sutherland, E. R. and Martin, R. J. (2003), J. Allergy Clin. Immunol. 112, 819–827.

    Article  PubMed  Google Scholar 

  4. Jeffery, P. K. (2001), Am. J. Respir. Crit. Care Med. 164, s28-s38.

    PubMed  CAS  Google Scholar 

  5. Saetta, M. and Turato, G. (2001), Eur. Respir. J. 18(suppl. 34), s18-s23.

    Article  Google Scholar 

  6. Cosio, M. G. and Cosio, M. G. (2001), Eur. Respir. J. 18(suppl. 34), s41-s49.

    Article  Google Scholar 

  7. Bousquet, J., Jeffery, P. K., Busse, W. W., Johnson, M., and Vignola, A. M. (2000), Am. J. Respir. Crit. Care Med. 161, 1720–1745.

    PubMed  CAS  Google Scholar 

  8. Bradley, B. L., Azzawi, M., Jacobson, M., et al. (1991), J. Allergy. Clin. Immunol. 88, 661–674.

    Article  PubMed  CAS  Google Scholar 

  9. Haley, K. J., Sunday, M. E., Wiggs, B. R., et al. (1998), Am. J. Respir. Crit Care Med. 158, 565–572.

    PubMed  CAS  Google Scholar 

  10. Fahy, J. V., Kim, K. W., Liu, J., and Boushey, H. A. (1995), J. Allergy Clin. Immunol. 95, 843–852.

    Article  PubMed  CAS  Google Scholar 

  11. Lamblin, C., Gosset, P., Tillie-Leblond, I., et al. (1998), Am. J. Respir. Crit. Care Med. 157, 394–402.

    PubMed  CAS  Google Scholar 

  12. Wenzel, S. E., Szefler, S. L., Leung, D. Y., Sloan, S. I., Rex, M. D., and Martin, R. J. (1997), Am. J. Respir. Crit. Care Med. 156, 737–743.

    PubMed  CAS  Google Scholar 

  13. Sur, S., Crotty, T. B., Kephart, G. M., et al. (1993), Am. Rev. Respir. Dis. 148, 713–719.

    PubMed  CAS  Google Scholar 

  14. Thompson, A. B., Daughton, D., Robbins, R. A., Ghafouri, M. A., Oehlerking, M., and Rennard, S. I. (1989), Am. Rev. Respir. Dis. 140, 1527–1537.

    PubMed  CAS  Google Scholar 

  15. Peleman, R.A., Rytila, P. H., Kips, J. C., Joos, G. F., and Pauwels, R. A. (1999), Eur. Respir. J. 13, 839–843.

    Article  PubMed  CAS  Google Scholar 

  16. Saetta, M., Di Stefano, A., Maestrelli, P., et al. (1993), Am. Rev. Respir. Dis. 147, 301–306.

    PubMed  CAS  Google Scholar 

  17. Di Stefano, A., Turato, G., Maestrelli, P., et al. (1996), Am. J. Respir. Crit. Care Med. 153, 629–632.

    PubMed  Google Scholar 

  18. O'Shaghnessy, T. C., Ansari, T. W., Barnes, N. C., and Jeffery, P. K. (1997), Am. J. Respir. Crit. Care Med. 155, 852–857.

    Google Scholar 

  19. Saetta, M., Di Stefano, A., Turato, A., et al. (1998), Am. J. Respir. Crit. Care Med. 157, 822–826.

    PubMed  CAS  Google Scholar 

  20. Rutgers, S. R., Postma, D. S., ten Hacken, N. H., et al. (2000), Thorax 55, 12–18.

    Article  PubMed  CAS  Google Scholar 

  21. Saetta, M., Turato, G., Facchini, F. M., et al. (1997), Am. J. Respir. Crit. Care. Med. 156, 1633–1639.

    PubMed  CAS  Google Scholar 

  22. Di Stefano, A., Capelli, A., Lusuardi, M., et al. (1998), Am. J. Respir. Crit Care Med. 158, 1277–1285.

    PubMed  Google Scholar 

  23. Kips, J. C. (2000), Eur. Respir. J. 18(suppl. 34), s24-s33.

    Google Scholar 

  24. Chung, K. F. (2001), Eur. Respir. J. 18(suppl. 34), s50s-s59.

    Google Scholar 

  25. Keatings, V. M., Collins, P. D., Scott, D. M., and Barnes, P. J. (1996), Am. J. Respir. Crit. Care Med. 153, 530–534.

    PubMed  CAS  Google Scholar 

  26. Aaron, S. D., Angel, J. B., Lunau, M., et al. (2001), Am. J. Respir. Crit. Care. Med. 163, 349–355.

    PubMed  CAS  Google Scholar 

  27. Quiu, Y., Zhu, J., Bandi, V., et al. (2003), Am. J. Respir. Crit. Care Med. 168, 968–975.

    Article  Google Scholar 

  28. Zhu, Z., Homer, R. J., Wang, Z., et al. (1999), J. Clin. Invest. 103, 779–788.

    PubMed  CAS  Google Scholar 

  29. Temann, U. A., Geba, G. P., Rankin, J. A., and Flavell, R. A. (1998), J. Exp. Med. 188, 1307–1320.

    Article  PubMed  CAS  Google Scholar 

  30. Rankin, J. A., Picarella, D. E., Geba, G. P., et al., (1996), Proc. Natl. Acad. Sci. USA 93, 7821–7825.

    Article  PubMed  CAS  Google Scholar 

  31. Lee, J. J., McGarry, M. P., Farmer, S. C., et al. (1997), J. Exp. Med. 185, 2143–2156.

    Article  PubMed  CAS  Google Scholar 

  32. Einarsson, O., Geba, G. P., Zhu, Z., Landry, M., and Elias, J. A. (1996), J. Clin. Invest. 97, 915–924.

    Article  PubMed  CAS  Google Scholar 

  33. Zheng, T., Zhu, Z., Wang, Z., et al. (2001), J. Clin. Invest. 106, 1081–1093.

    Google Scholar 

  34. Wang, Z., Zheng, T., Zhu, Z., et al. (2001), J. Exp. Med. 192, 1587–1600.

    Article  Google Scholar 

  35. Vignola, A. M., Chanez, P., Chiappara, G., et al. (1997), Am. J. Respir. Crit. Care Med. 156, 591–599.

    PubMed  CAS  Google Scholar 

  36. Redington, A. E., Springall, D. R., Ghatei, M. A., et al. (1997), Eur. Respir. J. 10, 1026–1032.

    Article  PubMed  CAS  Google Scholar 

  37. de Boer, W.I., van Shadewijk, A., Sont, J. K., et al. (1998), Am. J. Respir. Crit. Care Med. 158, 1951–1957.

    PubMed  Google Scholar 

  38. Vignola, A. M., Riccobono, L., Mirabella, A., et al. (1998), Am. J. Respir. Crit. Care Med. 158, 1945–1950.

    PubMed  CAS  Google Scholar 

  39. Hirst, S. J., Barnes, P. J., and Twort, C. H. (1992), Am. J. Respir. Cell Mol. Biol. 7, 574–581.

    PubMed  CAS  Google Scholar 

  40. Takeyama, K., Dabbagh, K., Lee, H. M., et al. (1999), Proc. Natl. Acad. Sci. USA 96, 3081–3086.

    Article  PubMed  CAS  Google Scholar 

  41. Hogg, J. C., Chu, F., Utokaparch, S., et al. (2004), N. Engl. J. Med. 350, 2645–2653.

    Article  PubMed  CAS  Google Scholar 

  42. Dunnill, M. S., Massarella, G. R., and Anderson, J. A. (1969), Thorax 24, 176–179.

    Article  PubMed  CAS  Google Scholar 

  43. Seow, C. Y., Schellenberg, R. R., and Pare, P. D. (1998), Am. J. Respir. Crit. Care Med. 158, s179-s186.

    PubMed  CAS  Google Scholar 

  44. Benaoun, L., Druilhe, A., Dombret, M.-A., Aubier, M., and Pretolani, M. (2003), Am. J. Respir. Crit. Care Med. 167, 1360–1368.

    Article  Google Scholar 

  45. Gizycki, M. J., Adelroth, E., Rogers, A. V., O'Byrne, P. M., and Jeffery, P. K. (1997), Am. J. Respir. Cell Mol. Biol. 16, 664–673.

    PubMed  CAS  Google Scholar 

  46. Cosio, M. G., Hale, K. A., and Niewoehner, D. E. (1980), Am. Rev. Respir. Dis 122, 265–271.

    PubMed  CAS  Google Scholar 

  47. Bosken, C. H., Wiggs, B. R., Pare, P. D., and Hogg, J. C. (1990), Am. Rev. Respir. Dis. 142, 563–570.

    PubMed  CAS  Google Scholar 

  48. Nagai, A., West, W. W., Paul, J. L., and Thurlbeck, W. M. (1985), Am. Rev. Respir. Dis. 132, 937–945.

    PubMed  CAS  Google Scholar 

  49. Charan, N. B., Baile, E. M., and Pare, P. D. (1997), Eur. Respir. J. 10, 1173–1180.

    Article  PubMed  CAS  Google Scholar 

  50. Vrugt, B., Wilson, S., Bron, A., Holgate, S. T., Djukanovic, R., and Aalbers, R. (2000), Eur. Respir. J. 15, 1014–1021.

    Article  PubMed  CAS  Google Scholar 

  51. Magee, F., Wright, J. L., Wiggs, B. R., Pare, P. D., and Hogg, J. C. (1988), Thorax 43, 183–189.

    PubMed  CAS  Google Scholar 

  52. Barbera, J. A., Riverola, A., Roca, J., et al. (1994), Am. J. Respir. Crit. Care Med. 149, 423–429.

    PubMed  CAS  Google Scholar 

  53. Peinado, V. I., Barbera, J. A., Abate, P., et al. (1999), Am. J. Respir. Crit. Care Med. 159, 1605–1611.

    PubMed  CAS  Google Scholar 

  54. Jeffery, P. K., Wardlaw, A., Nelson, F. C., Collins, J. V., and Kay, A. B. (1989), Am. Rev. Respir. Dis. 140, 1745–1753.

    PubMed  CAS  Google Scholar 

  55. Puddicombe, S. M., Torres-Lozano, C., Richter, A., et al. (2003), Am. J. Respir. Cell Mol. Biol. 28, 61–68.

    Article  PubMed  CAS  Google Scholar 

  56. Payne, D. N., Rogers, A. V., Adelroth, E., et al. (2003), Am. J. Respir. Crit. Care Med. 167, 78–82.

    Article  PubMed  Google Scholar 

  57. Cosio, M., Ghezzo, H., Hogg, J. C., et al. (1978), N. Engl. J. Med. 298, 1277–1281.

    Article  PubMed  CAS  Google Scholar 

  58. Rennard, S. I. (1999), Am. J. Respir. Crit. Care Med. 160, s12-s16.

    PubMed  CAS  Google Scholar 

  59. Chu, H. W.; Halliday, J. L., Martin, R. J., Leung, D. Y., Szefler, S. J., and Wenzel, S. E. (1998), Am. J. Respir. Crit. Care Med. 158, 1936–1944.

    PubMed  CAS  Google Scholar 

  60. Reid, L. (1954), Lancet i, 275–279.

    Article  Google Scholar 

  61. Aikawa T., Shimura, S., Sasaki, H., Ebina, M., and Takishima, T. (1992), Chest 101, 916–921.

    Article  PubMed  CAS  Google Scholar 

  62. Glynn, A. A. and Michaels, L. (1960), Thorax 15, 142–153.

    CAS  Google Scholar 

  63. Fabbri, L. M., Romagnoli, M., Corbetta, L., et al. (2003), Am. J. Respir. Crit. Care Med. 167, 418–424.

    Article  PubMed  Google Scholar 

  64. Finkeelstein, R., Fraser, R. S., Ghezzo, H., and Cosio, M. G. (1995), Am. J. Respir. Crit. Care Med. 152, 1666–1672.

    Google Scholar 

  65. Saetta, M., Baraldo, S., Corbino, L., et al. (1999), Am. J. Respir. Crit. Care Med. 160, 711–717.

    PubMed  CAS  Google Scholar 

  66. Majo, J., Ghezzo, H., and Cosio, M. G. (2001), Eur. Respir. J. 17, 946–953.

    Article  PubMed  CAS  Google Scholar 

  67. Retamales, I., Elliott, W. M., Meshi, B., et al. (2001), Am. J. Respir. Crit. Care Med. 164, 469–473.

    PubMed  CAS  Google Scholar 

  68. Aoshiba, K., Koinuma, M., Yokohori, N., and Nagai, A. (2004), Respiration 71, 184–190.

    Article  PubMed  Google Scholar 

  69. Kraft, M., Djukanovich, R., Wilson, S., Holgate, S. T., and Martin, R.J. (1996), Am. J. Respir. Crit. Care Med. 154, 1505–1510.

    PubMed  CAS  Google Scholar 

  70. Kraft, M., Martin, R. J., Wilson, S., Djukanovich, R., and Holgate, S. T. (1999), Am. J. Respir. Crit. Care Med. 159, 228–234.

    PubMed  CAS  Google Scholar 

  71. Nagai, A. and Thurlbeck, W. M. (1991), Am. Rev. Respir. Dis. 144, 901–908.

    PubMed  CAS  Google Scholar 

  72. Vlahovic, G., Russell, M. L., Mercer, R. R., and Crapo, J. D. (1999), Am. J. Respir. Crit. Care Med. 160, 2086–2092.

    PubMed  CAS  Google Scholar 

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Aoshiba, K., Nagai, A. Differences in airway remodeling between asthma and chronic obstructive pulmonary disease. Clinic Rev Allerg Immunol 27, 35–43 (2004). https://doi.org/10.1385/CRIAI:27:1:035

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