Airway epithelial repair, regeneration, and remodeling after injury in chronic obstructive pulmonary disease

E Puchelle, JM Zahm, JM Tournier… - Proceedings of the …, 2006 - atsjournals.org
E Puchelle, JM Zahm, JM Tournier, C Coraux
Proceedings of the American Thoracic Society, 2006atsjournals.org
In chronic obstructive pulmonary disease (COPD), exacerbations are generally associated
with several causes, including pollutants, viruses, bacteria that are responsible for an excess
of inflammatory mediators, and proinflammatory cytokines released by activated epithelial
and inflammatory cells. The normal response of the airway surface epithelium to injury
includes a succession of cellular events, varying from the loss of the surface epithelium
integrity to partial shedding of the epithelium or even complete denudation of the basement …
In chronic obstructive pulmonary disease (COPD), exacerbations are generally associated with several causes, including pollutants, viruses, bacteria that are responsible for an excess of inflammatory mediators, and proinflammatory cytokines released by activated epithelial and inflammatory cells. The normal response of the airway surface epithelium to injury includes a succession of cellular events, varying from the loss of the surface epithelium integrity to partial shedding of the epithelium or even complete denudation of the basement membrane. The epithelium then has to repair and regenerate to restore its functions, through several mechanisms, including basal cell spreading and migration, followed by proliferation and differentiation of epithelial cells. In COPD, the remodeling of the airway epithelium, such as squamous metaplasia and mucous hyperplasia that occur during injury, may considerably disturb the innate immune functions of the airway epithelium. In vitro and in vivo models of airway epithelial wound repair and regeneration allow the study of the spatiotemporal modulation of cellular and molecular interaction factors—namely, the proinflammatory cytokines, the matrix metalloproteinases and their inhibitors, and the intercellular adhesion molecules. These factors may be markedly altered during exacerbation periods of COPD and their dysregulation may induce remodeling of the airway mucosa and a leakiness of the airway surface epithelium. More knowledge of the mechanisms involved in airway epithelium regeneration may pave the way to cytoprotective and regenerative therapeutics, allowing the reconstitution of a functional, well-differentiated airway epithelium in COPD.
ATS Journals