Airway remodeling in asthma: Do histological changes and functional changes correlate?

Asthma has traditionally been conceptualized as a reversible obstructive airway disease as opposed to an irreversible obstructive lung disease like emphysema or chronic bronchitis. However, evidence has been accumulating that-at least in some patients-the chronic inflammation of the airways associated with asthma leads to airway remodeling and possibly irreversible lung disease. According to Phil Lieberman, MD, who is Clinical Professor of Medicine and Pediatrics in the Divisions of Allergy and Immunology at the University of Tennessee College of Medicine in Cordova, primary-care physicians need to be concerned about remodeling in asthma because it indicates that an asthmatic patient may be at risk for developing a chronic, irreversible obstructive lung disease that will not respond to standardized therapy. Not all experts, however, are convinced. To more closely examine the issue of asthma and remodeling and its implications for primary-care physicians, Dr. Lieberman recently moderated the following Medical Crossfire with a panel of national experts.