Airways remodelling

Remodelling of the airways is a major feature of chronic persistent asthma, resulting in epithelial goblet cell metaplasia, subepithelial and mucosal fibrosis, smooth muscle hypertrophy and increased microvasculature, The epi thelium is a major source of cytokines, chemokines and growth factors that control remodelling in the adjacent myofibroblasts, microvasculature and ne rves. Indeed, activation of the epithelial mesenchymal trophic unit is a fu ndamental abnormality in chronic asthma. There are shortfalls in small anim al models of relatively acute allergen-driven airway inflammatory responses , since they do not identify effects on airway remodelling.