Inflammation and Treatment in Asthma and COPD

By James F. Donohue, MD, FCCP; and Jill A. Ohar, MD, FCCP

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Asthma

Smooth Muscle Dysfunction

An exaggerated bronchoconstrictor response (airway hyperresponsiveness) to various stimuli plus an increase in bronchial smooth muscle mass are hallmarks of asthma. Airway hyperresponsiveness refers to the propensity of airways to "narrow too easily and too much." It leads to symptoms of wheezing and dyspnea after exposure to allergens. The increase in smooth muscle mass in asthma may result from several factors, including an increased release of inflammatory mediators, cytokines, and growth factors. The airway smooth muscle cell had been thought of primarily a resident structure cell that contracted in response to mediators. The smooth muscle cell, however, secretes a large number of inflammatory cytokines, proliferates in response to agents secreted by other cells, expresses adhesion molecules, and attracts other inflammatory cells to the site. Thus, the smooth muscle cell may have a central role in the inflammatory events of asthma.

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