HAVE WE FORGOTTEN ABOUT THE ROLE OF NERVES IN ASTHMA?

Bronchial asthma is well defined by the clinical characteristics including chronic airway inflammation, recurrent reversible airway obstruction and development of airway hyperresponsiveness as pathogenic components. Several studies have shown that genetic, environmental, immunologic, and pharmacologic factors contribute to the development of this complex disease. However, there is one important component which had long been forgotten but now steps out of the shadow into the spotlight of bronchial asthma: the neuronal network. Our approach to understanding bronchial asthma needs to be broadened to include alterations in the function of this neuronal network with afferent nerves that supply airways and modulate neuroimmune interactions. Changes in the activity of these nerves offer a possible mechanism by which asthmatic subjects are uniquely responsive to a wide range of physiological and chemical stimuli- which may offer novel therapeutic strategies