Excessive airway obstruction is the cause of symptoms and abnormal lung function in asthma.As airway smooth muscle (ASM) is the effecter controlling airway calibre, it is suspected that dysfunction of ASM contributes to the pathophysiology of asthma. However, the precise role of ASM in the series of events leading to asthmatic symptoms is not clear. It is not certain whether, in asthma, there is a change in the intrinsic properties of ASM, a change in the structure and mechanical properties of the noncontractile components of the airway wall, or a change in the interdependence of the airway wall with the surrounding lung parenchyma. All these potential changes could result from acute or chronic airway inflammation and associated tissue repair and remodelling.Anti-inflammatory therapy, however, does not ''cure'' asthma, and airway hyperresponsiveness can persist in asthmatics, even in the absence of airway inflammation. This is perhaps because the therapy does not directly address a fundamental abnormality of asthma, that of exaggerated airway narrowing due to excessive shortening of ASM.In the present study, a central role for airway smooth muscle in the pathogenesis of airway hyperresponsiveness in asthma is explored.

On the terminology for describing the length-force relationship and its changes in airway smooth muscle. J Appl Physiol 97: 2029 -2034, 2004; doi:10.1152/japplphysiol.00884.2004.-The observation that the length-force relationship in airway smooth muscle can be shifted along the length axis by accommodating the muscle at different lengths has stimulated great interest. In light of the recent understanding of the dynamic nature of length-force relationship, many of our concepts regarding smooth muscle mechanical properties, including the notion that the muscle possesses a unique optimal length that correlates to maximal force generation, are likely to be incorrect. To facilitate accurate and efficient communication among scientists interested in the function of airway smooth muscle, a revised and collectively accepted nomenclature describing the adaptive and dynamic nature of the lengthforce relationship will be invaluable. Setting aside the issue of underlying mechanism, the purpose of this article is to define terminology that will aid investigators in describing observed phenomena. In particular, we recommend that the term "optimal length" (or any other term implying a unique length that correlates with maximal force generation) for airway smooth muscle be avoided. Instead, the in situ length or an arbitrary but clearly defined reference length should be used. We propose the usage of "length adaptation" to describe the phenomenon whereby the length-force curve of a muscle shifts along the length axis due to accommodation of the muscle at different lengths. We also discuss frequently used terms that do not have commonly accepted definitions that should be used cautiously.smooth muscle contraction; adaptation; plasticity; cytoskeleton; contractile apparatus THE CAPACITIES OF AIRWAY SMOOTH MUSCLE to generate force and to shorten are not a unique function of muscle length. Instead, they change appreciably depending on the histories of muscle loading, length, and activation. These changes can occur over the course of days, hours, and even seconds (9, 11-14, 24, 35, 41, 44, 46). As a result, the length-force relationship of airway smooth muscle is highly mutable, and its characterization is meaningful only when the histories on which the relationship is derived are included. Length-dependent force generation in other smooth muscles is also known to be influenced by various factors (18,29,34,36,39), with the extent of influence varying from one type of smooth muscle to another. The following description of phenomena and terminology is based on and intended for airway smooth muscle, and it may or may not apply to other smooth muscle types. Current terminology that describes the length-force characteristic in airway smooth muscle is borrowed from the physiology of striated muscle but is inadequate, and in some cases ill-suited, to depict the mutable relationship in airway smooth muscle. Thus there is a need to seek a consensual agreement among scientists working in the field of airway smooth muscle biomechanics concern...

It is now accepted that a host of cytokines, chemokines, growth factors, and other inflammatory mediators contributes to the development of nonspecific airway hyperresponsiveness in asthma. Yet, relatively little is known about how inflammatory mediators might promote airway structural remodeling or about the molecular mechanisms by which they might exaggerate smooth muscle shortening as observed in asthmatic airways. Taking a deep inspiration, which provides relief of bronchodilation in normal subjects, is less effective in asthmatic subjects, and some have speculated that this deficiency stems directly from an abnormality of airway smooth muscle and results in airway hyperresponsiveness to constrictor agonists. Here, we consider some of the mechanisms by which inflammatory mediators might acutely or chronically induce changes in the contractile apparatus that in turn might contribute to hyperresponsive airways in asthma.

-We hypothesized that differences in actin filament length could influence force fluctuationinduced relengthening (FFIR) of contracted airway smooth muscle and tested this hypothesis as follows. One-hundred micromolar AChstimulated canine tracheal smooth muscle (TSM) strips set at optimal reference length (L ref) were allowed to shorten against 32% maximal isometric force (F max) steady preload, after which force oscillations of Ϯ16% F max were superimposed. Strips relengthened during force oscillations. We measured hysteresivity and calculated FFIR as the difference between muscle length before and after 20-min imposed force oscillations. Strips were relaxed by ACh removal and treated for 1 h with 30 nM latrunculin B (sequesters G-actin and promotes depolymerization) or 500 nM jasplakinolide (stabilizes actin filaments and opposes depolymerization). A second isotonic contraction protocol was then performed; FFIR and hysteresivity were again measured. Latrunculin B increased FFIR by 92.2 Ϯ 27.6% L ref and hysteresivity by 31.8 Ϯ 13.5% vs. pretreatment values. In contrast, jasplakinolide had little influence on relengthening by itself; neither FFIR nor hysteresivity was significantly affected. However, when jasplakinolide-treated tissues were then incubated with latrunculin B in the continued presence of jasplakinolide for 1 more h and a third contraction protocol performed, latrunculin B no longer substantially enhanced TSM relengthening. In TSM treated with latrunculin B ϩ jasplakinolide, FFIR increased by only 3.03 Ϯ 5.2% L ref and hysteresivity by 4.14 Ϯ 4.9% compared with its first (pre-jasplakinolide or latrunculin B) value. These results suggest that actin filament length, in part, determines the relengthening of contracted airway smooth muscle.actin filament dynamics; force oscillations; isotonic contractions; hysteresivity A NUMBER OF PREVIOUS STUDIES in animals (22,24,25,27) and humans (7,29) have demonstrated that tidal breathing per se reduces airway constriction during contractile stimulation, and deep breathing does so more effectively. Even a single deep inspiration can substantially reverse experimentally induced bronchoconstriction in normal individuals (1, 4, 11). However, the ability of deep breathing to dilate the airways is absent in asthmatic subjects (4, 11). Understanding why this protective mechanism fails in asthma is the focus of ongoing investigation in several laboratories and is the ultimate goal of the present study.Fredberg and coworkers (13, 14) studied the influence on airway smooth muscle shortening of the load fluctuations imposed by breathing. They stimulated bovine trachealis strips with ACh and allowed them to shorten isotonically against a constant load to a steady-state length and then superimposed sinusoidal force oscillations of increasing amplitudes (to simulate tidal breathing) on the constant mean load (5). These increasing force oscillations caused substantial smooth muscle relengthening, despite continued contractile stimulation. They showed that relengthening coul...

Lakser, Oren J., Robert P. Lindeman, and Jeffrey J. Fredberg. Inhibition of the p38 MAP kinase pathway destabilizes smooth muscle length during physiological loading. Am J Physiol Lung Cell Mol Physiol 282: L1117-L1121, 2002 10.1152/ajplung.00230.2000.-We tested the hypothesis that mechanical plasticity of airway smooth muscle may be mediated in part by the p38 mitogen-activated protein (MAP) kinase pathway. Bovine tracheal smooth muscle (TSM) strips were mounted in a muscle bath and set to their optimal length, where the active force was maximal (Fo). Each strip was then contracted isotonically (at 0.32 Fo) with ACh (maintained at 10 Ϫ4 M) and allowed to shorten for 180 min, by which time shortening was completed and the static equilibrium length was established. To simulate the action of breathing, we then superimposed on this steady distending force a sinusoidal force fluctuation with zero mean, at a frequency of 0.2 Hz, and measured incremental changes in muscle length. We found that TSM strips incubated in 10 M SB-203580-HCl, an inhibitor of the p38 MAP kinase pathway, demonstrated a greater degree of fluctuation-driven lengthening than did control strips, and upon removal of the force fluctuations they remained at a greater length. We also found that the force fluctuations themselves activated the p38 MAP kinase pathway. These findings are consistent with the hypothesis that inhibition of the p38 MAP kinase pathway destabilizes muscle length during physiological loading. mitogen-activated protein; contraction; plasticity; perturbed myosin binding ASTHMA IS CHARACTERIZED by reversible airway obstruction, airway inflammation, and airway hyperresponsiveness to nonspecific agonists. The end result is excessive airway narrowing. Airway narrowing is driven by the action of airway smooth muscle and its actomyosin contractile machinery, but myosin exerts its mechanical effects within a cytoskeletal scaffolding that is extensible and in a continuous state of remodeling (6,8,21,23,24).In this connection, load fluctuations are imposed continuously on airway smooth muscle by the tidal action of breathing. These fluctuations are known to inhibit the development of active force and stiffness (7,9,22,27) and result in smooth muscle lengthening (4). Although the direct effects of tidal stretch on actomyosin bridge dynamics can explain much of the force and stiffness inhibition (4), it is thought that important changes in the cytoskeleton are also induced by changes of the muscle load in time (8, 21).Here we have investigated the hypothesis that activation of p38 mitogen-activated protein (MAP) kinase may modulate muscle mechanical responses to imposed load fluctuations during contractile stimulation. We show that the p38 MAP kinase inhibitor SB-203580-HCl increased the degree of smooth muscle lengthening induced by load fluctuations. As such, these data suggest that activation of p38 MAP kinase stabilizes airway smooth muscle subjected to dynamic loading conditions that approximate those that prevail in vivo. Moreover, t...

Clinical heterogeneity in cystic fibrosis (CF) often causes diagnostic uncertainty in infants without symptoms and in older patients with milder phenotypes. We performed a cross-sectional evaluation of a comprehensive set of clinical and laboratory descriptors in a physician-defined cohort (N = 376; Children’s Hospital of Wisconsin and the American Family Children’s Hospital CF centers in Milwaukee and Madison, WI, USA) to determine the robustness of categorizing CF (N = 300), cystic fibrosis transmembrane conductance regulator (CFTR)-related disorder (N = 19), and CFTR-related (CRMS) metabolic syndrome (N = 57) according to current consensus guidelines. Outcome measures included patient demographics, clinical measures, sweat chloride levels, CFTR genotype, age at diagnosis, airway microbiology, pancreatic function, infection, and nutritional status. The CF cohort had a significantly higher median sweat chloride level (105 mmol/l) than CFTR-related disorder patients (43 mmol/l) and CFTR-related metabolic syndrome patients (35 mmol/l; p ≤ 0.001). Patient groups significantly differed in pancreatic sufficiency, immunoreactive trypsinogen levels, sweat chloride values, genotype, and positive Pseudomonas aeruginosa cultures (p ≤ 0.001). An automated classification algorithm using recursive partitioning demonstrated concordance between physician diagnoses and consensus guidelines. Our analysis suggests that integrating clinical information with sweat chloride levels, CFTR genotype, and pancreatic sufficiency provides a context for continued longitudinal monitoring of patients for personalized and effective treatment.

Breathing is known to functionally antagonize bronchoconstriction caused by airway muscle contraction. During breathing, tidal lung inflation generates force fluctuations that are transmitted to the contracted airway muscle. In vitro, experimental application of force fluctuations to contracted airway smooth muscle strips causes them to relengthen. Such force fluctuation-induced relengthening (FFIR) likely represents the mechanism by which breathing antagonizes bronchoconstriction. Thus, understanding the mechanisms that regulate FFIR of contracted airway muscle could suggest novel therapeutic interventions to increase FFIR, and so to enhance the beneficial effects of breathing in suppressing bronchoconstriction. Here we propose that the connectivity between actin filaments in contracting airway myocytes is a key determinant of FFIR, and suggest that disrupting actin-myosin-actin connectivity by interfering with actin polymerization or with myosin polymerization merits further evaluation as a potential novel approach for preventing prolonged bronchoconstriction in asthma.

Bronchial hyperresponsiveness (BHR), the occurrence of excessive bronchoconstriction in response to relatively small constrictor stimuli, is a cardinal feature of asthma. Here, we consider the role that airway smooth muscle might play in the generation of BHR. The weight of evidence suggests that smooth muscle isolated from asthmatic tissues exhibits normal sensitivity to constrictor agonists when studied during isometric contraction, but the increased muscle mass within asthmatic airways might generate more total force than the lesser amount of muscle found in normal bronchi. Another salient difference between asthmatic and normal individuals lies in the effect of deep inhalation (DI) on bronchoconstriction. DI often substantially reverses induced bronchoconstriction in normals, while it often has much less effect on spontaneous or induced bronchoconstriction in asthmatics. It has been proposed that abnormal dynamic aspects of airway smooth muscle contraction velocity of contraction or plasticity- elasticity balance might underlie the abnormal DI response in asthma. We suggest a speculative model in which abnormally long actin filaments might account for abnormally increased elasticity of contracted airway smooth muscle.