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.