Airway Remodeling

Tightened airway muscles, inflamed (swollen) airway linings, and too much mucus cause asthma symptoms like coughing and wheezing. Asthma medications almost always reverse this process, making the airway muscles relax, swelling fade away, and mucus glands make less mucus.

However, for a small number of people with asthma, airway swelling over long periods of time can cause changes in the lungs that may lead to a loss of airway function. These changes can include thickened airway membranes, larger airway muscles and mucus glands, and growth of scar tissue under the airway lining, making the airways narrow, and causing asthma symptoms. This condition is called airway remodeling.

Scientists still question the actual definition of airway remodeling and how it affects asthma patients. Researchers are working to find the link between asthma severity and airway remodeling. They are also trying to see if remodeling is to blame for the lungs exaggerated response to asthma triggers and lower lung function.

More research is needed to find out how early the remodeling process begins, how it develops over time, and if treatment can prevent remodeling or at least make symptoms less severe. There is some evidence, however, that inhaled corticosteroids may help those who have remodeled airways.

In the meantime, it is helpful for patients with asthma to work with their doctor to get an early diagnosis, make an asthma action plan, and begin taking inhaled corticosteroids if needed. If a patient has been prescribed a long-term controller medication that keeps the airways from becoming swollen, it is important that they take it regularly, even when they are breathing well. By taking medication and following their asthma action plan, people with asthma can help prevent airway remodeling.