Abstract
The autonomic nervous system provides both cholinergic and noncholinergic neural inputs to end organs within the airways, which includes the airway and vascular smooth muscle. Heightened responsiveness of the airways to bronchoconstrictive agents is a hallmark feature of reactive airways diseases. The mechanisms underpinning airways hyperreactivity still largely remain unresolved. In this paper we summarize the substantial body of evidence that implicates dysfunction of the autonomic nerves that innervate smooth muscle in the airways and associated vasculature as a prominent cause of airways hyperresponsiveness in asthma.
Highlights
With the exception of airway smooth muscle, perhaps no other group of cells has as clear a role in the pathogenesis of asthma as the neurons comprising the afferent and efferent innervation of the airways and lungs
In this brief review we summarize the large body of evidence supporting a primary role for airway autonomic nerve dysfunction in the hyperresponsiveness of the airway smooth muscle in asthma
The Understated Role of Nerves in Asthma. Guidelines such as those produced by the NHLBI and British Thoracic Society (BTS), in which immune cells including eosinophils are given a central role in asthma pathogenesis appropriately highlight the prominent feature of inflammation in the asthmatic lung
Summary
With the exception of airway smooth muscle, perhaps no other group of cells has as clear a role in the pathogenesis of asthma as the neurons comprising the afferent and efferent innervation of the airways and lungs. Even the recent and potentially landmark study by Peters et al [3], in which the anticholinergic tiotropium was found to be at least as good as steroids or β-agonists (perhaps better) for treatment of asthma, nerves are not mentioned in the article itself nor in the accompanying editorial [4]. In this brief review we summarize the large body of evidence supporting a primary role for airway autonomic nerve dysfunction in the hyperresponsiveness of the airway smooth muscle in asthma
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