Abstract
Asthma and bronchopulmonary dysplasia are prevalent diseases characterized by airway constrictor hyperresponsiveness and excessive airway smooth muscle accumulation. It is now well accepted that some alterations in airway wall architecture can increase lumenal narrowing for a given degree of smooth muscle activation. For example, increasing the thickness of the submucosal layer between airway smooth muscle and airway lumen can magnify the airflow obstruction induced by a fixed proportion of airway smooth muscle shortening, an effect especially pronounced in smaller airways. 1 James AL Paré PD Hogg JC The mechanics of airway narrowing in asthma. Am Rev Respir Dis. 1989; 139: 242-246 Crossref PubMed Scopus (670) Google Scholar Also, structural changes that result in thickening of the adventitial portion of an airway might lead to excessive lumenal narrowing on smooth muscle activation, by reducing (or uncoupling) the external load ordinarily applied by the lung parenchyma to the airway through alveolar septal attachments that surround the circumference of intrapulmonary airways.
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