Airway obstruction in asthma: does the response to a deep inspiration matter?

Airway hyperresponsiveness in asthma may not be a problem of too much airway smooth muscle strength. Rather, it may be a problem of too little of the factors that oppose muscle shortening. The weight of available evidence seems to support the idea that loss of the dilating response to a deep inspiration may play a central role in this process, and that the locus of the response is within the airway smooth muscle cell. Bridge dynamics and plastic reorganization of the smooth muscle cytoskeleton are the focus of this commentary; how these factors interact and details about underlying mechanisms remain unclear.