Abstract

The role of breathing and deep inspirations (DI) in modulating airway hyperresponsiveness remains poorly understood. In particular, DIs are potent bronchodilators of constricted airways in nonasthmatic subjects but not in asthmatic subjects. Additionally, length fluctuations (mimicking DIs) have been shown to reduce mean contractile force when applied to airway smooth muscle (ASM) cells and tissue strips. However, these observations are not recapitulated on application of transmural pressure (PTM) oscillations (that mimic tidal breathing and DIs) in isolated intact airways. To shed light on this paradox, we have developed a biomechanical model of the intact airway, accounting for strain-stiffening due to collagen recruitment (a large component of the extracellular matrix (ECM)), and dynamic actomyosin-driven force generation by ASM cells. In agreement with intact airway studies, our model shows that PTM fluctuations at particular mean transmural pressures can lead to only limited bronchodilation. However, our model predicts that moving the airway to a more compliant point on the static pressure-radius relationship (which may involve reducing mean PTM), before applying pressure fluctuations, can generate greater bronchodilation. This difference arises from competition between passive strain-stiffening of ECM and force generation by ASM yielding a highly nonlinear relationship between effective airway stiffness and PTM, which is modified by the presence of contractile agonist. Effectively, the airway at its most compliant may allow for greater strain to be transmitted to subcellular contractile machinery. The model predictions lead us to hypothesize that the maximum possible bronchodilation of an airway depends on its static compliance at the PTM about which the fluctuations are applied. We suggest the design of additional experimental protocols to test this hypothesis.

Highlights

  • Hyperresponsiveness of airway smooth muscle (ASM) to certain external stimuli is a cardinal feature in asthma, making it of widespread clinical significance [1]

  • The results obtained from the two methods, suggest contrasting mechanical behavior: length oscillations applied to strips cause a dramatic decrease in contractile force, which is attributed to disruption of cross-bridge cycling [24,25], but transmural pressure oscillations and deep inspirations (DI) applied to intact airways appear to have only a limited bronchodilatory effect

  • To elucidate the potential mechanisms contributing to these discrepancies we have developed a model for an intact airway, which builds on the two-layer linearly elastic model of [31], by accounting for helical ASM and collagen fibers embedded in the nonlinear elastic matrix of the tissue a pressure fluctuations in the presence of fixed agonist concentration, we have mimicked closely the experimental protocols of LaPrad et al [15]

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Summary

Introduction

Hyperresponsiveness of airway smooth muscle (ASM) to certain external stimuli is a cardinal feature in asthma, making it of widespread clinical significance [1]. Many studies have shown that this is not the case in asthmatics, for whom a DI may have a reduced bronchodilatory effect, no effect, or may even result in additional contraction [9,10]. To understand these discrepancies, experimental studies have focused on mimicking tidal breathing and DI on isolated ASM in tissue strips [11,12,13], precision-cut lung slices [14], and isolated intact airways [15,16]. The potentially bronchodilatory effects of DI have been studied at the whole-organ scale through studies in animal models and human subjects [2,17,18,19,20,21]

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