Airway remodelling is a cardinal feature of asthma in which airways undergo structural changes - in particular, increased airway smooth muscle mass and total airway wall area. Remodelling has long been thought to have functional consequences in asthma due to geometric effects that can increase airway narrowing and luminal occlusion. Prior studies have examined the distribution of remodelling between and within patients, but none have yet considered the possibility for spatial correlations in airway remodelling. That is, is remodelling clustered locally, or interrelated along proximal and distal locations of the bronchial tree? In view of recent interest regarding airway remodelling produced by mechanical stimuli, we developed a mathematical model to examine whether spatial correlations in airway remodelling could arise due to cycles of bronchoconstriction and mechanotransduction. Further, we compared modelling predictions to the spatial distribution of airway remodelling in lungs from subjects with and without asthma. Results indicate that spatial correlations in airway remodelling do exist in vivo, and cycles of bronchoconstriction and mechanotransduction are one plausible mechanism for their origin. These findings offer insights into the evolution of airway remodelling in asthma, which may inform strategies for treatment and prevention.

气道重塑是哮喘的一个主要特征，其中气道发生结构变化——特别是气道平滑肌质量和总气道壁面积增加。由于几何效应会增加气道变窄和管腔闭塞，长期以来人们一直认为重塑会对哮喘产生功能性影响。先前的研究已经检查了患者之间和患者内部重塑的分布，但尚未考虑空间相关性的可能性在气道重塑中。也就是说，重塑是局部聚集还是沿着支气管树的近端和远端位置相互关联？鉴于最近对机械刺激产生的气道重塑的兴趣，我们开发了一个数学模型来检查气道重塑中的空间相关性是否可能由于支气管收缩和机械转导的循环而出现。此外，我们将建模预测与患有和不患有哮喘的受试者肺部气道重塑的空间分布进行了比较。结果表明气道重塑的空间相关性确实存在于体内，支气管收缩和机械转导的循环是其起源的一种可能的机制。这些发现提供了对哮喘气道重塑演变的见解，