Airways Remodeling

In most cases, asthma is a variable condition characterized by intermittent and fully reversible airway narrowing. However, for some people, asthmatic inflammation of the airways leads to permanent changes. The bronchial tubes become narrower and less flexible, and do not return to normal. The term used for these permanent changes in airway wall architecture is airway remodeling.

The consequence of airway remodeling is reduced lung capacity, even when you are at your best. You may feel well, without coughing or wheezing, yet your breathing tests show a decreased capacity to expel air from your lungs. If the permanent narrowing is severe, even simple activities like climbing a flight of stairs can become an effort.

No one knows why airway remodeling happens in some people with asthma and not in others. One theory is that airway remodeling is most common in people with severe and longstanding asthma, especially if the disorder has not been treated with anti-inflammatory medications. Studies suggest that people with mild asthma tend to continue with mild asthma and are unlikely to develop permanent loss of lung function.