Airway Structure in Asthma: A Role for Confocal Microscopy?

Abstract

A particularly prominent feature of chronic severe That asthma is an inflammatory obstructive lung asthma is epithelial damage and desquamation, a disease has long been established, with a great deal phenomenon which has been confirmed many times of research being focused on the actions in the bronchi in histological studies and which may be linked to the of an array of inflammatory mediators released from bronchial hyperresponsiveness to inhaled spasmostructural and inflammatory cells. It has also been genic stimuli commonly detected in asthma. Epiestablished that chronic asthma involves major thelial shedding in asthma can also be detected by the changes to airway wall structure, including airway presence of Creola bodies (epithelial cell clusters) in smooth muscle hyperplasia and hypertrophy, subsputum. Damage to the epithelium has been linked epithelial fibrosis and airway blood vessel proliferation to the presence of airway inflammation and, in par(angiogenesis), and that these changes are linked to ticular, to the presence of eosinophils which can secrete the inflammatory component of this disease. This the epithelium-sensitive cytotoxic cationic peptide brief review focuses on a description of what is known known as major basic protein. However, subconcerning the major structural changes (remodelling) epithelial oedema, which is an obligatory acto the respiratory tract in chronic asthma. In addition, companiment to airway inflammation and which is the issue of a possible role for the novel endogenous promoted by increased microvascular permeability, peptide endothelin-1 (ET-1) in these and other promay also contribute to the epithelial damage seen cesses relevant to asthma, will be addressed. in asthma. Extensive clogging of the airways with