Clinical issues of mucus accumulation in COPD.
Airway mucus is part of the lung's native immune function that traps particulates and microorganisms, enabling their clearance from the lung by ciliary transport and cough. Mucus hypersecretion and chronic productive cough are the features of the chronic bronchitis and chronic obstructive pulmonary disease (COPD). Overproduction and hypersecretion by goblet cells and the decreased elimination of mucus are the primary mechanisms responsible for excessive mucus in chronic bronchitis. Mucus accumulation in COPD patients affects several important outcomes such as lung function, health-related quality of life, COPD exacerbations, hospitalizations, and mortality. Nonpharmacologic options for the treatment of mucus accumulation in COPD are smoking cessation and physical measures used to promote mucus clearance. Pharmacologic therapies include expectorants, mucolytics, methylxanthines, beta-adrenergic receptor agonists, anticholinergics, glucocorticoids, phosphodiesterase-4 inhibitors, antioxidants, and antibiotics.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
Frederick L
FL
Ramos
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
Jason S
JS
Krahnke
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
Victor
V
Kim
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D029481:Bronchitis, Chronic / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology* / Q000628:therapy; D005100:Expectorants / Q000627:therapeutic use; D020397:Goblet Cells / Q000187:drug effects / Q000378:metabolism* / Q000382:microbiology; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000378:metabolism* / Q000382:microbiology; D009079:Mucociliary Clearance / Q000187:drug effects; D009093:Mucus / Q000378:metabolism*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology* / Q000628:therapy; D016540:Smoking Cessation; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005100:Expectorants
chronic bronchitis; chronic obstructive pulmonary disease; mucus; sputum