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It can be roughly classified into five features: (i) epithelial cell destruction causing impaired barrier integrity and function, (ii) excessive goblet cell formation leading to mucus overproduction and air trapping 9 , (iii) abnormal extracellular matrix (ECM) accumulation causing airway fibrosis, (iv) smooth muscle hypertrophy and increased contractility leading to bronchial hyperreactivity and narrowing 10 , and (v) angiogenesis promoting immune cell infiltration and inflammation 11

Complicated otitis media and its implications

Goshen, T., Ben-Gera, J., Koren, O., Bdolah-Abram, T

Caldern-Garcidueas L, Ayala A, Mukherjee PS