Mitochondrial Dysfunction in Airway Disease

There is increasing appreciation that mitochondria serve cellular functions beyond oxygen sensing and energy production. Accordingly, it has become important to explore non-canonical roles of mitochondria in normal and pathophysiological processes that influence airway structure and function in the context of diseases such as asthma and COPD. Mitochondria can sense upstream processes such as inflammation, infection, tobacco smoke and environmental insults important in these diseases, and in turn can respond to such stimuli via altered mitochondrial protein expression, structure, and resultant dysfunction. Conversely, mitochondrial dysfunction has downstream influences on cytosolic and mitochondrial calcium regulation, airway contractility, gene and protein housekeeping, responses to oxidative stress, proliferation, apoptosis, fibrosis, and certainly metabolism: all key aspects of airway disease pathophysiology. Indeed, mitochondrial dysfunction is thought to play a role even in normal processes such as aging and senescence, and conditions such as obesity that impact on airway diseases. Thus understanding how mitochondrial structure and function play central roles in airway disease may be critical for development of novel therapeutic avenues targeting dysfunctional mitochondria. Here, it is likely that mitochondria of airway epithelium, smooth muscle and fibroblasts play differential roles, consistent with their contributions to disease biology, underlining the challenge of targeting a ubiquitous cellular element of existential importance. This translational review summarizes current state of understanding of mitochondrial processes that play a role in airway disease pathophysiology, identifying areas of unmet research need, and opportunities for novel therapeutic strategies.

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