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Treating asthma means treating airway smooth muscle cells

¹ Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands, ² Airway Disease Section, National Heart and Lung Institute, Imperial College London, London, UK, ³ Dept of Physiology, University of Manitoba, Winnipeg, MB, Canada, ⁴ Respiratory Research Group, Discipline of Pharmacology, Bosch Institute, University of Sydney, and ⁵ Woolcock Institute of Medical Research, Sydney, Australia.

CORRESPONDENCE: S. Zuyderduyn, Dept of Pulmonology, Building 1, C3-P, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. Fax: 31 715266927. E-mail: s.zuyderduyn{at}lumc.nl

Keywords: Airway hyperresponsiveness, airway inflammation, airway remodelling, airway smooth muscle, asthma therapy

Received: April 27, 2007
Accepted March 5, 2008

Asthma is characterised by airway hyperresponsiveness, airway inflammation and airway remodelling. Airway smooth muscle cells are known to be the main effector cells of airway narrowing. In the present paper, studies will be discussed that have led to a novel view of the role of airway smooth muscle in the pathogenesis of asthma in which airway hyperresponsiveness, remodelling and inflammation are, at least in part, attributable to airway smooth muscle. Furthermore, how this new view may lead to a change in the phenotyping and treatment of patients with asthma will be discussed.