What can we learn about airway smooth muscle from the company it keeps?

I n severe and fatal asthma dramatic changes in airway structure have been described, collectively referred to as remodelling [1, 2]. Current dogma dictates that remodelling reflects aberrant repair in response to ongoing inflammation and injury. However, the interplay between inflammation and remodelling, and, more importantly, between airway structure and function remains elusive, such that we remain uncertain whether these changes protect the airways from the effects of inflammation or are integral to disease progression. To begin to unravel this conundrum we need to recognise the complexity and heterogeneity of asthma.