Remodeling Airways
According to Marianne Frieri, M.D., Ph.D., elderly asthma patients may experience airway remodeling, a condition where the physiological characteristics of the airway changes, thereby creating irreversible effects. With persistent and severe asthma, especially, obstruction in the bronchial tubes may not be reversible, and could be difficult to differentiate from COPD or other lung conditions.
According to an article published in the American Journal of Respiratory Critical Care Medicine, injured tissues typically respond with acute inflammation. In healing, those tissues regenerate and replace connective tissues that eventually turn into scar tissue. Usually, this process is beneficial, but in asthma, a chronic inflammatory process, airways sometimes heal in a way that alters the structure of those tissues.
The structural changes could manifest as a thickened airway, involving increased muscle mass, mucous glands and vessel area, which permanently reduces the airway’s caliber. The result is reduced airflow and increased mucous secretion, which could close the airway.
Remodeling occurs in both children and adults. Studies show that FEV1 decreases mainly in those with persistent asthma, but remodeling is more prevalent in severe asthma cases. Studies suggest that irreversible airway obstruction is usually associated with the frequency of wheezing and ongoing asthma, according to the journal. In addition, it appears that patients whose asthma appears after age 50 usually experience steeper declines in lung function.
