“…In contrast, under certain circumstances such as the presence of certain danger signals, an orchestrated immune response develops including cells forming the innate (eg, macrophages, DCs, mast cells, innate lymphocytes) and the adaptive immune systems (T cells), and also of structural cells (eg, epithelial cells), which results in the development of specific T-and B-cell responses against the allergen. [28][29][30][31] In these sensitized individuals, exposure with the allergen results in specific immunological responses in the lung, in which mast cells and DCs modulate the adaptive immune responses, which is characterized by a Th2 response, including IL-4, IL-5, and IL-13, and accumulation of eosinophilic granulocytes in the airway wall and lumen. [32][33][34][35] If these immune responses persist in the airway wall, structural changes, such as goblet cell metaplasia, basement membrane thickening, hypertrophy of ASM, and subepithelial fibrosis, can occur and these structural changes are summarized under the term airway remodeling.…”