Lung cells in asthma - protectors or drivers of disease.

This review is a 'must read' for health care workers in asthma management. Below are some of the subject matters raised.

• The mechanical working of a healthy airway epithelium.
• Structural changes in the epithelium before inflammation and the diagnosis of asthma.
• Proteins that form the epithelium tight junctions and environmental products that can disrupt the barrier.
• Absence of lung dendritic cells at birth.
• How asthma affects different areas of the lung, initially affecting the conducting airways but can also spread to the trachea, larynx, small airways, and alveoli.
• The formation and function of the airway epithelium in persistent asthma.
• Chronic remodelling of the airways and the fact that this may possibly happen independently of outside stimuli.
• A Th2 response without increasing IgE markers in non-atopic asthma.
• Localised IgE in non-atopic asthma.
• Airway viral infections can be persistent or severe in asthma and non-responsive to the common practice of doubling steroid treatment.

These are examples of the subject matter discussed in this excellent review.