TY - JOUR

T1 - A review on the pathophysiology of asthma remission

AU - Carpaij, Orestes A

AU - Burgess, Janette K

AU - Kerstjens, Huib A M

AU - Nawijn, Martijn C

AU - van den Berge, Maarten

N1 - Copyright © 2019. Published by Elsevier Inc.

PY - 2019/9

Y1 - 2019/9

N2 - Asthma is a chronic respiratory condition, which is highly prevalent worldwide. Although no cure is currently available, it is well recognized that some asthma patients can spontaneously enter remission of the disease later in life. Asthma remission is characterized by absence of symptoms and lack of asthma-medication use. Subjects in asthma remission can be divided into two groups: those in clinical remission and those in complete remission. In clinical asthma remission, subjects still have a degree of lung functional impairment or bronchial hyperresponsiveness, while in complete asthma remission, these features are no longer present. Over longer periods, the latter group is less likely to relapse. This remission group is of great scientific interest due to the higher potential to find biomarkers or biological pathways that elicit or are associated with asthma remission.Despite the fact that the definition of asthma remission varies between studies, some factors are reproducibly observed to be associated with remitted asthma. Among these are lower levels of inflammatory markers, which are lowest in complete remission. Additionally, in both groups some degree of airway remodeling is present. Still, the pathological disease state of asthma remission has been poorly investigated. Future research should focus on at least two aspects: further characterisation of the small airways and airway walls in order to determine histologically true remission, and more thorough biological pathway analyses to explore triggers that elicit this phenomenon. Ultimately, this will result in pharmacological targets that provide the potential to steer the course of asthma towards remission. (C) 2019 Elsevier Inc. All rights reserved.

AB - Asthma is a chronic respiratory condition, which is highly prevalent worldwide. Although no cure is currently available, it is well recognized that some asthma patients can spontaneously enter remission of the disease later in life. Asthma remission is characterized by absence of symptoms and lack of asthma-medication use. Subjects in asthma remission can be divided into two groups: those in clinical remission and those in complete remission. In clinical asthma remission, subjects still have a degree of lung functional impairment or bronchial hyperresponsiveness, while in complete asthma remission, these features are no longer present. Over longer periods, the latter group is less likely to relapse. This remission group is of great scientific interest due to the higher potential to find biomarkers or biological pathways that elicit or are associated with asthma remission.Despite the fact that the definition of asthma remission varies between studies, some factors are reproducibly observed to be associated with remitted asthma. Among these are lower levels of inflammatory markers, which are lowest in complete remission. Additionally, in both groups some degree of airway remodeling is present. Still, the pathological disease state of asthma remission has been poorly investigated. Future research should focus on at least two aspects: further characterisation of the small airways and airway walls in order to determine histologically true remission, and more thorough biological pathway analyses to explore triggers that elicit this phenomenon. Ultimately, this will result in pharmacological targets that provide the potential to steer the course of asthma towards remission. (C) 2019 Elsevier Inc. All rights reserved.

KW - Clinical asthma remission

KW - Complete asthma remission

KW - Predictors

KW - Prevalence

KW - Biomarkers

KW - Airway remodeling

KW - PLASMINOGEN-ACTIVATOR INHIBITOR-1

KW - HOUSE-DUST MITE

KW - CHILDHOOD ASTHMA

KW - FOLLOW-UP

KW - NATURAL-HISTORY

KW - ALLERGIC-ASTHMA

KW - RISK-FACTORS

KW - AIRWAY INFLAMMATION

KW - CLINICAL REMISSION

KW - ACUTE-LEUKEMIA

U2 - 10.1016/j.pharmthera.2019.05.002

DO - 10.1016/j.pharmthera.2019.05.002

M3 - Review article

C2 - 31075356

VL - 201

SP - 8

EP - 24

JO - Pharmacology & Therapeutics

JF - Pharmacology & Therapeutics

SN - 0163-7258

ER -