THE ROLE OF SMOOTH MUSCLE AND SUBMUCOSAL GLANDS IN THE AIRWAY REMODELING IN ASTHMA
DOI:
https://doi.org/10.22551/MSJ.2026.02.02Abstract
Aim: Bronchoconstriction, chronic inflammation, and airway remodeling are the main factors associated with the airflow restriction in patients with asthma. Airway remodeling includes all morphological changes of the bronchial wall in asthma, contributing to clinical manifestations and progressive loss of lung function. The aim of this study was to evaluate the morphological changes associated with airway remodeling, being focused on submucosal glands and muscular tissue, in a group of asthmatic patients. Materials and methods: We performed a retrospective analysis on 38 patients with a history of bronchial asthma, with different degrees of severity. All patients were classified according to the latest Global Initiative for Asthma (GINA) criteria and underwent a fibro bronchoscopy examination associated with biopsy of tissue samples for microscopy. Results: The study included 38 asthmatic patients, with a female predominance (68.42%) and a mean patient age of 49+16 years. The microscopic exam revealed an increase of smooth muscle and submucosal glandular areas in asthmatic patients in comparison to healthy persons and a close correlation with the asthma severity, reflected by FEV1 values. The statistical analysis showed an inverse correlation between FEV1 (%) values and muscular (r = -0.8997, p < 0.001) and glandular area hypertrophy (r=-0.887, p < 0.01). Conclusions: The increase of muscle and submucosal glands areas, as part of the airway remodeling process, represents a specific pathological feature mainly associated with severe forms of asthma, being correlated with lung function restriction.
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