Airway inflammation may not account for all the clinical manifestations of
asthma. Airway remodeling, which is thought to be a result of airway chroni
c inflammation, may help fill this void. Remodeling is described for fatal
and nonfatal asthmatics including changes in smooth muscle, collagen deposi
tion, noncollagenous matrix, and mucus glands. This article also reviews th
e correlation of airway remodeling with clinical, physiologic and biologic
data, experimental models of airways remodeling, and effect of therapy on a
irway remodeling. Throughout, it is emphasized that the concept of airway r
emodeling is a dynamic process that is active and potentially progressive i
n asthmatic patients but that may be prevented by appropriate therapy.