Advances in asthma pathophysiology: stepping forward from the Maurizio Vignola experience

Abstract

Maurizio Vignola was a superb and innovative researcher, who wrote seminal papers on the biology of airway epithelium in asthma. Inflammation and remodelling were the main topics of his research, mostly conducted in biopsy specimens from patients with asthma of variable severity, encompassing the entire spectrum of the disease from mild to severe asthma. His observations contributed to define the biology of asthma as we know it today, and opened the way to the personalised treatment of asthma. His group has successfully continued to investigate the biology and clinical aspects of bronchial asthma, with major interest in the clinical use of biomarkers to monitor disease activity, and in the development of new therapeutic perspectives. This review summarises the latest work on these topics proudly conducted by Maurizio's closest collaborators. The results indicate significant progress in our understanding of asthma in the last 10 years, in particular increased knowledge of the complex interaction between inflammatory and remodelling pathways, improved recognition of biological and clinical asthma phenotypes, and development of new treatment strategies, especially for patients with severe corticosteroid-resistant asthma. @ERSpublications Biomarkers may help to define disease phenotypes and new treatment strategies for asthma

Mind-body interactions in the regulation of airway inflammation in asthma: A PET study of acute and chronic stress

“…Yet, research directed toward understanding the pathophysiology of asthma has mostly overlooked the role of the brain (Bonsignore et al, 2015; Carr and Kraft, 2015). Therefore, the goal of this experiment was to determine the role of the brain, and regions involved in emotion processing in particular, in modulating asthma-related inflammation in response to an acute stressor, in individuals with high and low levels of chronic life stress.…”

Novel concepts in airway inflammation and remodelling in asthma

“…The structural airway changes are apparent in asthma even in mild disease [2]; however, the degree of remodelling often worsens with increasing disease severity [3]. In addition, the onset of the pathological changes occurs early, during the pre-school years [4,5], and they are established by school age and subsequently remain (even though symptoms may remit for periods during adulthood) [6].…”

Examining the relationship between physical illness and depression: Is there a difference between inflammatory and non inflammatory diseases? A cohort study

“…Non inflammatory conditions: Osteoarthritis, respiratory disorders, allergies, peptic ulcer and gastroesophageal reflux disorder, functional disorders and locomotor pain complaints. Whilst asthma and chronic obstructive pulmonary disease (COPD), involve inflammation, they were coded as non-inflammatory as there is no clear evidence of systemic inflammation, but more of a locally situated response to pro-inflammatory substances such as tobacco smoke or air borne pollutants (18). The same principle was used for osteoarthritis, a clearly inflammatory but localised disorder, with no evidence of systemic inflammation.…”