Update on airway inflammation and remodeling in asthma

Background: Until recently, airway remodeling has been considered to be a secondary phenomenon, developing later in the disease process as a consequence of persistent inflammation. The presence of airway inflammation and remodeling in children with asthma indicate that the remodeling process begins early in the disease process of asthma and occurs synchronously in ongoing and repeated airway inflammation rather than as a consequence of airway inflammation. Bronchial epithelial cell damage also occurs early in the course of childhood asthma, and injured and stressed epithelial cells trigger airway remodeling through activation of the epithelial-mesenchymal tropic unit. Therefore, the characteristic features of bronchial epithelial cells in asthmatics should be clarified. Early intervention with inhaled corticosteroids (ICS) before serious pathological changes occur, is expected to prevent the development of remodeling and improve asthma outcomes. Methods/Data base: A review of the current research and ideas regarding the mechanisms and assessment of airway inflammation and remodeling, as well as the effects of current and potential future therapeutics on airway remodeling, with a focus on bronchial epithelial cells. Results/Conclusions: Early intervention with ICS improves asthma-related symptoms and may partially prevent airway remodeling, however, the effects are not satisfactory. Therefore, therapeutic options, and how and when treatment can be effected should be investigated to reduce air-way inflammation and prevent the development of airway remodeling.