Title: Airway Mucus Hypersecretion in Asthma and COPD
Abstract: The chapter addresses the above issues by discussion of similarities and differences in the pulmonary inflammatory "profile" between asthma and chronic obstructive pulmonary disease (COPD) and how these may relate to the generation of the airway mucus hypersecretory state in the two conditions. It begins with consideration of sputum, airway mucus, and mucins, followed by an outline of the characteristics of mucus hypersecretion in asthma and COPD, emphasizing differences between the two conditions and the theoretical requirements for drugs aimed at effectively inhibiting airway mucus hypersecretion. Patients with asthma or COPD invariably exhibit characteristics of airway mucus hypersecretion, comprising sputum production, excessive mucus in the airway lumen, goblet cell hyperplasia, and submucosal gland hypertrophy. The pathophysiological sequelae of mucus hypersecretion are airway obstruction, airflow limitation, ventilation-perfusion mismatch, and impairment of gas exchange. The association of airway mucus hypersecretion with asthma and COPD is not necessarily cause and effect. The excess mucus may merely be a result of the inflammatory processes causing the disease. Consequently, treating the mucus problem will not inevitably treat the disease, especially if the changes that have led to increased mucus production are irreversible. Production of airway mucus is a vital homeostatic mechanism that protects the respiratory tract from a barrage of inhaled insult. However, abnormal production of mucus can contribute to respiratory disease. Airway obstruction by mucus is a common feature of a number of severe respiratory conditions, including asthma and COPD. At present, there is considerable interest in inhibitors of EGF receptor tyrosine kinases, MEK/ERK, and CLCA channels to suppress goblet cell hyperplasia, and in molecules to selectively interfere with mucin exocytosis and thereby inhibit airway mucus hypersecretion.
Publication Year: 2009
Publication Date: 2009-01-01
Language: en
Type: book-chapter
Indexed In: ['crossref']
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Cited By Count: 7
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