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Remodeling in asthma.
Al-Muhsen S, Johnson JR, Hamid Q. J Allergy Clin Immunol. 2011 Sep;128(3):451-62.
Sergio Uribe
Every day in America: 40,000 people miss school or work due to asthma. 30,000 people have an asthma attack. 5,000 people visit the emergency room due to asthma. 1,000 people are admitted to the hospital due to asthma. 11 people die from asthma http://www.aafa.org/display.cfm?id=8&sub=42
Valdivia C et al . Changes in asthma prevalence among school children during a 6 -year period: Influence of socioeconomic status. Rev. md. Chile. 2009 Feb; 137(2): 215-225.
HISTOPATHOLOGIC FEATURES OF REMODELING IN ASTHMATIC PATIENTS Epithelial alterations Mucus secretion and goblet cells Subepithelial fibrosis Increased smooth muscle mass Angiogenesis
Inflammation Epithelial injury Cell-cell interactions Inflammatory mediators Imbalance between repair and removal of ECM proteins
Inflammation Epithelial injury Cell-cell interactions Inflammatory mediators Imbalance between repair and removal of ECM proteins
Structural-physiologic relationship Asthma exacerbation and remodeling Viral infection and remodeling Tobacco smoking and remodeling Natural history of airway remodeling Therapeutic interventions and remodeling Tools to measure airway remodeling (OCT
METHODS
Subjects
In conclusion, this study demonstrates that, even among children, a considerable proportion of asthmatics do not have evidence of tissue eosinophilia. Interestingly, the typical airway remodelling is present in children with noneosinophilic asthma just as in those with the eosinophilic form of the disease. These results suggest that structural changes develop early in the airways of children with asthma, and eosinophilic inflammation is not a necessary requirement.