From the Research
Yes, an increased proportion of myofibroblasts is a key feature of irreversible airway remodeling in patients with chronic asthma. Myofibroblasts are specialized cells that accumulate in the airways of asthmatic patients and contribute significantly to the structural changes that characterize airway remodeling, as noted in a study published in 2019 1. These cells produce excessive amounts of extracellular matrix proteins, particularly collagen and fibronectin, which lead to subepithelial fibrosis and thickening of the airway wall. The transformation of normal fibroblasts into myofibroblasts is stimulated by various inflammatory mediators and growth factors, especially transforming growth factor-beta (TGF-β), which is often elevated in asthmatic airways.
Key Features of Airway Remodeling
- Increased myofibroblast population
- Excessive deposition of extracellular matrix proteins
- Subepithelial fibrosis and thickening of the airway wall
- Persistent airflow limitation and reduced lung function
This process is part of a pathological repair mechanism that occurs in response to chronic inflammation and repeated epithelial injury. Once established, the increased myofibroblast population and resulting structural changes are difficult to reverse with standard asthma medications, contributing to persistent airflow limitation and reduced lung function in patients with chronic asthma, as discussed in a study from 2013 2. This irreversible component explains why some patients with long-standing asthma develop fixed airway obstruction despite optimal anti-inflammatory treatment.
Clinical Implications
- Early intervention with inhaled corticosteroids may help prevent the progression of airway remodeling, as suggested by research from 2007 3.
- New biologic treatments targeting specific phenotypes and endotypes in asthma may offer personalized treatment options for patients with severe refractory asthma, as noted in a 2017 review 4.
- The importance of fibroblasts and myofibroblasts in asthma-induced airway remodeling has been highlighted in several studies, including one from 2007 5, emphasizing the need for targeted therapeutic approaches.