Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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REVIEW ARTICLE
Year : 2007  |  Volume : 2  |  Issue : 1  |  Page : 28-33

New insights into the pathophysiology of the small airways in asthma


1 Meakins-Christie Laboratories, McGill University, Montreal, QC Canada
2 Division of Cell Biology, Telethon Institute for Child Health Research and Centre for Child Health Research, University of Western Australia, Perth, Western Australia

Correspondence Address:
Qutayba Hamid
MUHC Strauss Chair in Respiratory Medicine, Meakins-Christie Laboratories, McGill University, 3626 St- Urbain Street, Montreal, Quebec, Canada H2X 2P2

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DOI: 10.4103/1817-1737.30361

PMID: 19724673

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Asthma is a lung disease characterized by inflammation and remodeling of the airways, which leads to airflow obstruction and symptoms of wheeze, chest tightness, cough and dyspnea. It is now widely accepted that airway inflammation and remodeling occur not only in the central airways but also in the small airways and even in the lung parenchyma. Inflammation of the distal lung can be observed even in mild asthmatics with normal or noncompromised lung function. Moreover, the small airways and the lung parenchyma can produce many Th2 cytokines and chemokines involved in initiation and perpetuation of the inflammatory process. In addition, the distal parts of the lung have been recognized as a predominant site of airflow obstruction in asthmatics. In fact, the inflammation at this distal site has been described as more severe when compared to the large airway inflammation, and evidence of remodeling in the lung periphery is emerging. Recognition of asthma as a disease of the entire respiratory tract has an important clinical significance, highlighting the need to also consider the distal lung as a target in any therapeutic strategy for effective treatment of this disease.


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