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.
Similar content being viewed by others
References
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.
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.
Sutherland, E. R. and Martin, R. J. (2003), J. Allergy Clin. Immunol. 112, 819–827.
Jeffery, P. K. (2001), Am. J. Respir. Crit. Care Med. 164, s28-s38.
Saetta, M. and Turato, G. (2001), Eur. Respir. J. 18(suppl. 34), s18-s23.
Cosio, M. G. and Cosio, M. G. (2001), Eur. Respir. J. 18(suppl. 34), s41-s49.
Bousquet, J., Jeffery, P. K., Busse, W. W., Johnson, M., and Vignola, A. M. (2000), Am. J. Respir. Crit. Care Med. 161, 1720–1745.
Bradley, B. L., Azzawi, M., Jacobson, M., et al. (1991), J. Allergy. Clin. Immunol. 88, 661–674.
Haley, K. J., Sunday, M. E., Wiggs, B. R., et al. (1998), Am. J. Respir. Crit Care Med. 158, 565–572.
Fahy, J. V., Kim, K. W., Liu, J., and Boushey, H. A. (1995), J. Allergy Clin. Immunol. 95, 843–852.
Lamblin, C., Gosset, P., Tillie-Leblond, I., et al. (1998), Am. J. Respir. Crit. Care Med. 157, 394–402.
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.
Sur, S., Crotty, T. B., Kephart, G. M., et al. (1993), Am. Rev. Respir. Dis. 148, 713–719.
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.
Peleman, R.A., Rytila, P. H., Kips, J. C., Joos, G. F., and Pauwels, R. A. (1999), Eur. Respir. J. 13, 839–843.
Saetta, M., Di Stefano, A., Maestrelli, P., et al. (1993), Am. Rev. Respir. Dis. 147, 301–306.
Di Stefano, A., Turato, G., Maestrelli, P., et al. (1996), Am. J. Respir. Crit. Care Med. 153, 629–632.
O'Shaghnessy, T. C., Ansari, T. W., Barnes, N. C., and Jeffery, P. K. (1997), Am. J. Respir. Crit. Care Med. 155, 852–857.
Saetta, M., Di Stefano, A., Turato, A., et al. (1998), Am. J. Respir. Crit. Care Med. 157, 822–826.
Rutgers, S. R., Postma, D. S., ten Hacken, N. H., et al. (2000), Thorax 55, 12–18.
Saetta, M., Turato, G., Facchini, F. M., et al. (1997), Am. J. Respir. Crit. Care. Med. 156, 1633–1639.
Di Stefano, A., Capelli, A., Lusuardi, M., et al. (1998), Am. J. Respir. Crit Care Med. 158, 1277–1285.
Kips, J. C. (2000), Eur. Respir. J. 18(suppl. 34), s24-s33.
Chung, K. F. (2001), Eur. Respir. J. 18(suppl. 34), s50s-s59.
Keatings, V. M., Collins, P. D., Scott, D. M., and Barnes, P. J. (1996), Am. J. Respir. Crit. Care Med. 153, 530–534.
Aaron, S. D., Angel, J. B., Lunau, M., et al. (2001), Am. J. Respir. Crit. Care. Med. 163, 349–355.
Quiu, Y., Zhu, J., Bandi, V., et al. (2003), Am. J. Respir. Crit. Care Med. 168, 968–975.
Zhu, Z., Homer, R. J., Wang, Z., et al. (1999), J. Clin. Invest. 103, 779–788.
Temann, U. A., Geba, G. P., Rankin, J. A., and Flavell, R. A. (1998), J. Exp. Med. 188, 1307–1320.
Rankin, J. A., Picarella, D. E., Geba, G. P., et al., (1996), Proc. Natl. Acad. Sci. USA 93, 7821–7825.
Lee, J. J., McGarry, M. P., Farmer, S. C., et al. (1997), J. Exp. Med. 185, 2143–2156.
Einarsson, O., Geba, G. P., Zhu, Z., Landry, M., and Elias, J. A. (1996), J. Clin. Invest. 97, 915–924.
Zheng, T., Zhu, Z., Wang, Z., et al. (2001), J. Clin. Invest. 106, 1081–1093.
Wang, Z., Zheng, T., Zhu, Z., et al. (2001), J. Exp. Med. 192, 1587–1600.
Vignola, A. M., Chanez, P., Chiappara, G., et al. (1997), Am. J. Respir. Crit. Care Med. 156, 591–599.
Redington, A. E., Springall, D. R., Ghatei, M. A., et al. (1997), Eur. Respir. J. 10, 1026–1032.
de Boer, W.I., van Shadewijk, A., Sont, J. K., et al. (1998), Am. J. Respir. Crit. Care Med. 158, 1951–1957.
Vignola, A. M., Riccobono, L., Mirabella, A., et al. (1998), Am. J. Respir. Crit. Care Med. 158, 1945–1950.
Hirst, S. J., Barnes, P. J., and Twort, C. H. (1992), Am. J. Respir. Cell Mol. Biol. 7, 574–581.
Takeyama, K., Dabbagh, K., Lee, H. M., et al. (1999), Proc. Natl. Acad. Sci. USA 96, 3081–3086.
Hogg, J. C., Chu, F., Utokaparch, S., et al. (2004), N. Engl. J. Med. 350, 2645–2653.
Dunnill, M. S., Massarella, G. R., and Anderson, J. A. (1969), Thorax 24, 176–179.
Seow, C. Y., Schellenberg, R. R., and Pare, P. D. (1998), Am. J. Respir. Crit. Care Med. 158, s179-s186.
Benaoun, L., Druilhe, A., Dombret, M.-A., Aubier, M., and Pretolani, M. (2003), Am. J. Respir. Crit. Care Med. 167, 1360–1368.
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.
Cosio, M. G., Hale, K. A., and Niewoehner, D. E. (1980), Am. Rev. Respir. Dis 122, 265–271.
Bosken, C. H., Wiggs, B. R., Pare, P. D., and Hogg, J. C. (1990), Am. Rev. Respir. Dis. 142, 563–570.
Nagai, A., West, W. W., Paul, J. L., and Thurlbeck, W. M. (1985), Am. Rev. Respir. Dis. 132, 937–945.
Charan, N. B., Baile, E. M., and Pare, P. D. (1997), Eur. Respir. J. 10, 1173–1180.
Vrugt, B., Wilson, S., Bron, A., Holgate, S. T., Djukanovic, R., and Aalbers, R. (2000), Eur. Respir. J. 15, 1014–1021.
Magee, F., Wright, J. L., Wiggs, B. R., Pare, P. D., and Hogg, J. C. (1988), Thorax 43, 183–189.
Barbera, J. A., Riverola, A., Roca, J., et al. (1994), Am. J. Respir. Crit. Care Med. 149, 423–429.
Peinado, V. I., Barbera, J. A., Abate, P., et al. (1999), Am. J. Respir. Crit. Care Med. 159, 1605–1611.
Jeffery, P. K., Wardlaw, A., Nelson, F. C., Collins, J. V., and Kay, A. B. (1989), Am. Rev. Respir. Dis. 140, 1745–1753.
Puddicombe, S. M., Torres-Lozano, C., Richter, A., et al. (2003), Am. J. Respir. Cell Mol. Biol. 28, 61–68.
Payne, D. N., Rogers, A. V., Adelroth, E., et al. (2003), Am. J. Respir. Crit. Care Med. 167, 78–82.
Cosio, M., Ghezzo, H., Hogg, J. C., et al. (1978), N. Engl. J. Med. 298, 1277–1281.
Rennard, S. I. (1999), Am. J. Respir. Crit. Care Med. 160, s12-s16.
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.
Reid, L. (1954), Lancet i, 275–279.
Aikawa T., Shimura, S., Sasaki, H., Ebina, M., and Takishima, T. (1992), Chest 101, 916–921.
Glynn, A. A. and Michaels, L. (1960), Thorax 15, 142–153.
Fabbri, L. M., Romagnoli, M., Corbetta, L., et al. (2003), Am. J. Respir. Crit. Care Med. 167, 418–424.
Finkeelstein, R., Fraser, R. S., Ghezzo, H., and Cosio, M. G. (1995), Am. J. Respir. Crit. Care Med. 152, 1666–1672.
Saetta, M., Baraldo, S., Corbino, L., et al. (1999), Am. J. Respir. Crit. Care Med. 160, 711–717.
Majo, J., Ghezzo, H., and Cosio, M. G. (2001), Eur. Respir. J. 17, 946–953.
Retamales, I., Elliott, W. M., Meshi, B., et al. (2001), Am. J. Respir. Crit. Care Med. 164, 469–473.
Aoshiba, K., Koinuma, M., Yokohori, N., and Nagai, A. (2004), Respiration 71, 184–190.
Kraft, M., Djukanovich, R., Wilson, S., Holgate, S. T., and Martin, R.J. (1996), Am. J. Respir. Crit. Care Med. 154, 1505–1510.
Kraft, M., Martin, R. J., Wilson, S., Djukanovich, R., and Holgate, S. T. (1999), Am. J. Respir. Crit. Care Med. 159, 228–234.
Nagai, A. and Thurlbeck, W. M. (1991), Am. Rev. Respir. Dis. 144, 901–908.
Vlahovic, G., Russell, M. L., Mercer, R. R., and Crapo, J. D. (1999), Am. J. Respir. Crit. Care Med. 160, 2086–2092.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Issue Date:
DOI: https://doi.org/10.1385/CRIAI:27:1:035