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Lung Mucus Production and Mucociliary Clearance: Methods of Assessment

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Abstract

The primary defence mechanism of the tracheobronchial tree against all types of inhaled particles is the mucociliary escalator. This is composed of ciliated epithelium extending from the larynx to the terminal bronchioles (16th division of Weibel, 1963), on which lies a layer of mucus, the mucus blanket. As well as ciliated columnar cells, the tracheobronchial epithelium contains goblet cells which secrete mucus, the ratio between the two being 5 to 1 with a relative decrease in the number of goblet cells from the trachea to the lung periphery. Each ciliated cell has on its surface about 200 cilia of average length 6 µm and diameter 0.2 µm. Epithelial serous and Clara cells are also secretory cells, the latter being more numerous in the bronchioles and on occasion capable of transition to goblet cells on irritation. The submucosal glands are simple tubuloalveolar structures present in the cartilage containing trachea and bronchial tree but not in bronchioles. Each gland contains both mucus and serous cells as well as myoepithelial cells which may serve to extrude secretions.

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References

  • AHMED, T., JANUSZKIEWICZ, A.J., LANDA, J.R., BROWN, A., CHAPMAN, G.A. KENNY, P.J., FINN, R.D., BONDICK, J. & SACKNER, M.A. (1979). Effect of local radioactivity on tracheal mucus velocity of sheep. Am. Rev. resp. Dis., 120, 567–575.

    PubMed  CAS  Google Scholar 

  • ALBERT, R.E., LIPPMANN, M. & BRISCOE, W. (1969). The characteristics of bronchial clearance in humans and the effects of cigarette smoking. Arch. Environ. Health, 18, 738–755.

    Article  PubMed  CAS  Google Scholar 

  • ALBERT, R.E., LIPPMANN, M., PETERSON, H.T. JR., BERGER, J., SANBORN, K. & BALMING, D. (1973). Bronchial deposition and clearance of aerosols. Arch. intern. Med., 131, 115–127.

    Article  PubMed  CAS  Google Scholar 

  • ASMUNDSSON, T. & KILBURN, K.H. (1970). Mucociliary clearance rates at various levels in dog lungs. Am. Rev. resp. Dis., 102, 388–397.

    PubMed  CAS  Google Scholar 

  • BARNETT, B. & MILLER, C.E. (1966). Flow induced by biological mucociliary systems. Ann. N.Y. Acad. Sci., 130, 891–901.

    Article  PubMed  CAS  Google Scholar 

  • BATEMAN, J.R.M., CLARKE, S.W., PAVIA, D. & SHEAHAN, N.F. (1978). Reduction in clearance of secretions from the human lung during sleep. J. Physiol., 284, 55P–56P.

    Article  Google Scholar 

  • BATEMAN, J.R.M., LENNARD-JONES, A.M., PAVIA, D. & CLARKE, S.W. (1980). Lung mucociliary clearance in normal subjects during selective and non-selective β-blockade. Clin. Sci., 58, 19P.

    Article  Google Scholar 

  • BATEMAN, J.R.M., NEWMAN, S.P., DAUNT, K.M., PAVIA, D. & CLARKE, S.W. (1979). Regional lung clearance of excessive bronchial secretions during chest physiotherapy in patients with stable chronic airways obstruction. Lancet, i, 294–297.

    Article  Google Scholar 

  • BATEMAN, J.R.M., PAVIA, D. & CLARKE, S.W. (1978). The retention of lung secretions during the night in normal subjects. Clin. Sci. mol. Med., 55, 523–527.

    CAS  Google Scholar 

  • BATEMAN, J.R.M., PAVIA, D., SHEAHAN, N.F. & CLARKE, S.W. (1979a). Tracheobronchial clearance in asthma. Thorax, 34, 418.

    Article  Google Scholar 

  • BATEMAN, J.R.M., PAVIA, D., SHEAHAN, N.F. & CLARKE, S.W. (1979b). Clearance of lung secretions and ventilatory function in patients with stable asthma after inhaled terbutaline sulphate in pressurized metered-dose inhalers. Clin. Sci., 57, 150P.

    Article  Google Scholar 

  • BERTRAND, A. & PUCHELLE, E. (1977). Mesure de la clearance muco-ciliaire des bronches proximales chez le bronchitique chronique. Path. Biol., 25, 623–627.

    CAS  Google Scholar 

  • BOOKER, D.V., CHAMBERLAIN, A.C., RUNDO, J., MUIR, D.C.F. & THOMSON, M.L. (1967). Elimination of 5 micron particles from the human lung. Nature, 215, 30–33.

    Article  PubMed  CAS  Google Scholar 

  • BRODY, J.S., WALDHAUSEN, J.A. & KUHL, D.E. (1971). Mucociliary clearance in denervated bronchi. Clin. Res., 29, 507.

    Google Scholar 

  • BÜRGI, (1965). Erste klinische- experimentelle Erfahrenger mit dem Mucolyticum Bisolvon. Schweiz. Med. Wschr., 95, 274–278.

    Google Scholar 

  • CAMNER, P., JARSTRAND, C. & PHILIPSON, (1973). Tracheobronchial clearance in patients with influenza. Am. Rev. resp. Dis., 108, 131–135.

    PubMed  CAS  Google Scholar 

  • CAMNER, P., MOSSBERG, B. & AFZELIUS, B.A. Evidence for congenitally nonfunctioning cilia in the tracheobronchial tract in two subjects. Am. Rev. resp. Dis., 112, 807–809.

    Google Scholar 

  • CAMNER, P., MOSSBERG, B., PHILIPSON, K. & STRANDBERG, K. (1979). Elimination of test particles from the tracheobronchial tract by voluntary coughing. Scand. J. resp. Dis., 60, 56–62.

    CAS  Google Scholar 

  • CAMNER, P. & PHILIPSON, K. (1978). Human alveolar deposition of 4 µ teflon particles. Arch. environ. Health, 36, 181–185

    Article  Google Scholar 

  • CAMNER, P., PHILIPSON, K. & ARVIDSSON, T. (1971). Cigarette smoking in man. Short-term effect on mucociliary transport. Arch. environ. Health, 23, 421–426.

    Article  PubMed  CAS  Google Scholar 

  • CAMNER, P., STRANDBERG, K. & PHILIPSON, K. (1974). Increased mucociliary transport by cholinergic stimulation. Arch. environ. Health, 29, 220–224.

    Article  CAS  Google Scholar 

  • CHOPRA, S.K. TAPLIN, G.V., ELAM, D., CARSON, S.A. & GOLDE, D. (1979). Measurement of tracheal mucociliary transport velocity in humans—smokers versus non-smokers (preliminary findings). Am. Rev. resp. Dis., 119, (No. 4 part 2 suppl.). 205.

    Google Scholar 

  • CLARKE, S.W., JONES, J.G. & OLIVER, D.R. (1970). Resistance to two-phase gas-liquid flow in airways. J. appl. Physiol., 29, 464–471.

    PubMed  CAS  Google Scholar 

  • DAWSON, H., DOUGLAS, R.B., PAVIA, D., REEVES, E., SHORT, M.D. & THOMSON, M.L. (1971). An inexpensive automatic two-detector lung scanner. Phys. Med. Biol., 16, 691–692.

    Article  PubMed  CAS  Google Scholar 

  • DENTON, R. (1960) Bronchial obstruction in cystic fibrosic: rheological factors. Paediatrics Springfield, 25, 611–620.

    CAS  Google Scholar 

  • DOLOVICH, M.B., SANCHIS, J., ROSSMAN, C. & NEWHOUSE, M.T. (1976). Aerosol penetrance: a sensitive index of peripheral airways obstruction. J. appl. Physiol., 30, 468–471.

    Google Scholar 

  • DULFANO, M.J. & ADLER, K.B. (1975). Physical properties of sputum. Am. Rev. resp. Dis., 112, 341–347.

    PubMed  CAS  Google Scholar 

  • ELIASSON, R., MOSSBERG, B., CAMNER, P. & AFZELIUS, B.A. (1977). The immotile-cilia syndrome. A congential ciliary abnormality as an etiologic factor in chronic airway infections and male sterility. New Engl. J. Med., 297, 1–6.

    Article  PubMed  CAS  Google Scholar 

  • FOSTER, W.M., BERGOFSKY, E.H., BOHNING, D.E., LIPPMANN, M. & ALBERT, R.E. (1976). Effect of adrenergic agents and their mode of action on mucociliary clearance in man. J. appl. Physiol., 41, 146–152.

    PubMed  CAS  Google Scholar 

  • FRIEDMAN, M., DOUGHERTY, R., NELSON, S.R., WHITE, R.P., SACKNER, M.A. & WANNER, A. (1977). Acute effects of an aerosol hair spray on tracheal mucociliary transport. Am. Rev. resp. Dis., 116, 281–286.

    PubMed  CAS  Google Scholar 

  • GAMSU, G., SINGER, M.M., VINCENT, H.H., BERRY, S. & NADEL, J.A. (1976). Postoperative impairment of mucus transport in the lung. Am. Rev resp. Dis., 114, 673–679.

    PubMed  CAS  Google Scholar 

  • GAMSU, G. WEINTRAUB, R.M. & NADEL, J.A. (1973). Clearance of tantalum from airways of different caliber in man evaluated by a roentgenographic method. Am. Rev. resp. Dis., 107, 214–224.

    PubMed  CAS  Google Scholar 

  • GOLDBERG, I.S. & LOURENÇO, R.V. (1973). Deposition of aerosols in pulmonary disease. Arch. intern. Med., 131, 88–91.

    Article  PubMed  CAS  Google Scholar 

  • GOODMAN, R.M., YERGIN, B.M., LANDA, J.F., GOLINVAUX, M.H. & SACKNER, M.A. (1978). Relationship of smoking history and pulmonary function tests to tracheal mucus velocity in nonsmokers, young smokers, ex-smokers, and patients with chronic bronchitis. Am. Rev. resp. Dis., 117, 205–214.

    PubMed  CAS  Google Scholar 

  • GREEN, G.M. (1973). Alveobronchiolar transport mechanisms. Arch. intern. Med., 131, 109–114.

    Article  PubMed  CAS  Google Scholar 

  • HASLAM, P.L., TURTON, C.W.G., HEARD, B., LUKOSZEK, A., COLLINS, J.V., SALSBURY, A.J. & TURNER-WARWICK, M. (1980). Broncho-alveolar lavage in pulmonary fibrosis; comparison of cells obtained with lung biopsy and clinical features. Thorax, 35, 9–18

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • HENDRY, W.F., KNIGHT, R.K., WHITFIELD, H.N., STANSFELD, A.G., PRYSE-DAVIS, J., RYDER, T.A., PAVIA, D., BATEMAN, J.R.M. & CLARKE, S.W. (1978). Obstructive Azoospermia : respiratory function tests, electron microscopy and the results of surgery. Br. J. Urol., 50, 598–604.

    Article  PubMed  CAS  Google Scholar 

  • HILDING, A.P. (1943). The relation of ciliary insufficiency to death from asthma and other respiratory diseases. Am. Otol., Rhinol. Laryng., 52, 5–19.

    Google Scholar 

  • IRAVANI, J. & VAN AS, A. (1972). Mucus transport in the tracheobronchial tree of normal & bronchitic rats. J. Pathol., 106, 81–93.

    Article  PubMed  CAS  Google Scholar 

  • JARSTRAND, C., CAMNER, P. & PHILIPSON, P. (1974). Mycoplasma pneumoniae and tracheobronchial clearance. Am. Rev. resp. Dis., 110, 415–419.

    PubMed  CAS  Google Scholar 

  • JONES, J.G. & CLARKE, S.W. (1970). Dynamics of cough. Br. J. Anaesthes., 42, 280–285.

    Article  CAS  Google Scholar 

  • KILBURN, K.H. (1967). Cilia and mucus transport as determinants of the response of lung to air pollutants. Arch. environ. Health, 14, 77–91.

    Article  PubMed  CAS  Google Scholar 

  • LEITH, D. (1968). Cough. Phys. Ther., 48, 439–447.

    PubMed  CAS  Google Scholar 

  • LICHTIGER, M., LANDA, J.F. & HIRSCH, J.A. (1975). Velocity of tracheal mucus in anesthetized women undergoing gynecological surgery. Anesthesiology, 42, 753–756.

    Article  PubMed  CAS  Google Scholar 

  • LIPPMANN, M. & ALBERT, R.E. (1969). The effect of particle size on the regional deposition of inhaled aerosols in the human respiratory tract. Am. Ind. Hyg. Ass. J., 30, 257–275.

    Article  CAS  Google Scholar 

  • LITT, M. Basic concepts of mucus rheology. Bull. Physiopath. Resp., 9, 33–46.

    Google Scholar 

  • LOURENÇO, R.V., KLIMEK, M.F. & BOROWSKI, C.J. (1971). Deposition and clearance of 2 µ particles in the tracheobronchial tree of normal subjects—smokers and non-smokers. J. clin. Invest., 50, 1411–1420.

    Article  PubMed  PubMed Central  Google Scholar 

  • LOURENÇO, R.V., LODDENKEMPER, R. & CARTON, R.W. (1972). Patterns of distribution and clearance of aerosols in patients with bronchiectasis. Am. Rev. resp. Dis., 106, 857–866.

    Article  PubMed  Google Scholar 

  • LUCAS, A.M. & DOUGLAS, L.C. (1934). Principles underlying ciliary activity in the respiratory tract. Arch. Otolaryngol., 20, 518–541.

    Article  Google Scholar 

  • MAXWELL, S.S. (1905). The effect of salt solutions on ciliary activity. Am. J. Physiol., 13, 154–170.

    CAS  Google Scholar 

  • MEDICI, T.C., CHODOSH, S., ISHIKAWA, S. & ESLEIN, K. (1973). Physical properties of sputum and respiratory function in chronic bronchial disease. Bull. Physiopath. Resp., 9, 315–323.

    CAS  Google Scholar 

  • MEZEY, R.J., COHN, M.A., FERNANDEZ, R.J., JANUSZKIEWICZ, A.J. & WANNER, A. (1978). Mucociliary transport in allergic patients with antigen-induced bronchospasm. Am. Rev. resp. Dis., 118, 677–684.

    Article  PubMed  CAS  Google Scholar 

  • MORROW, P.E. (1973). Alveolar clearance of aerosols. Arch. Int. Med., 131, 101–108.

    Article  CAS  Google Scholar 

  • MORROW, P.E. (1974). Aerosol characterization and deposition. Am. Rev. resp. Dis., 110, 88–99.

    PubMed  CAS  Google Scholar 

  • MOSSBERG, B., STRANDBERG, K., PHILIPSON, K. & CAMNER, P. (1976). Tracheobronchial clearance and β-adrenocepetor stimulation in patients with chronic bronchitis. Scand. J. resp. Dis., 57, 281–289.

    CAS  Google Scholar 

  • NADEL, J.A., DAVIS, B. & PHIPPS, R.J. (1979). Control of mucus secretion and ion transport in airways. Ann. Rev. Physiol., 41, 369–381.

    Article  CAS  Google Scholar 

  • PAVIA, D., BATEMAN, J.RM., SHEAHAN, N.F. & CLARKE, S.W. (1979). Effect of ipratropium bromide on mucociliary clearance and pulmonary function in reversible airways obstruction. Thorax, 34, 501–507.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • PAVIA, D., SHORT, M.D. & THOMSON, (1970). No demonstrable long term effects of cigarette smoking on the mucociliary mechanism of the human lung. Nature, 226, 1228–1231.

    Article  PubMed  CAS  Google Scholar 

  • PAVIA, D. & THOMSON, M.L. (1971). Inhibition of mucociliary clearance from the human lung by hyoscine. Lancet. i, 449–450.

    Article  Google Scholar 

  • PAVIA, D. & THOMSON, M.L. (1976). The fractional deposition of inhaled 2 and 5 µm particles in the alveolar and tracheobronchial regions of the healthy human lung. Ann. Occup. Hyg., 19, 105–114.

    Article  Google Scholar 

  • PAVIA, D., THOMSON, M.L. & CLARKE, S.W. (1978). Enhanced clearance of secretions from the human lung after the administration of hypertonic saline aerosol. Am. Rev. resp. Dis., 117, 195–203.

    Google Scholar 

  • PAVIA, D., THOMSON, M.L., CLARKE, S.W. & SHANNON, H.S. (1977). The effect of airway obstruction and tidal volume of aerosol inhaled on the depth of deposition in the human lung. Arch. environ. Health, 32, 131–137.

    Article  PubMed  CAS  Google Scholar 

  • PAVIA, D., THOMSON, M.L., POCOCK, S.J. (1971). Evidence for temporary slowing of mucociliary clearance in the lung caused by tobacco smoking. Nature, 231, 325–326.

    Article  PubMed  CAS  Google Scholar 

  • PHILIPSON, K. (1977). Monodisperse, labelled aerosols for studies of lung clearance. Ph.D. thesis, Uppsala University, 1–36.

    Google Scholar 

  • POLICARD, A. & GALY, P. (1945). Les Bronches. Paris: Masson et Cie.

    Google Scholar 

  • PUCHELLE, E. & UFFHOLTZ, H. (1975). Sputum viscoelasticity following administration of Sch 1000 MDI. Postgrad. med. J., 51, (Suppl. 7). 109.

    Google Scholar 

  • REID, L. (1959). Chronic bronchitis and hypersecretion of mucus. Lectures on the Scientific Basis of Medicine, 8, 235–254.

    CAS  Google Scholar 

  • RICHARDSON, P.S. & PHIPPS, R.J. (1978). The anatomy, physiology, pharmacology and pathology of tracheobronchial mucus secretion and the use of expectorant drugs in human disease. Pharmac. Ther. B, 3, 441–479.

    CAS  Google Scholar 

  • RUFFIN, R.E., WOLFF, R.K., DOLOVICH, M.B., ROSSMAN, C.M., FITZGERALD, J.D. & NEWHOUSE, M.T. (1978). Aerosol therapy with Sch 1000. Short-term mucociliary clearance in normal and bronchitic subjects and toxicology in normal subjects. Chest, 73, 501–506.

    Article  PubMed  CAS  Google Scholar 

  • SACKNER, M.A., LANDA, J., HIRSCH, J. & ZAPATA, A. (1975). Pulmonary effects of oxygen breathing. A 6-hour study in normal man. Ann. intern. Med., 82, 40–43.

    Article  PubMed  CAS  Google Scholar 

  • SACKNER, M.A., ROSEN, M.J. & WANNER, A. (1973). Estimation of tracheal mucus velocity by bronchofiberscopy. J. appl. Physiol., 23, 495–499.

    Google Scholar 

  • SANCHIS, J., DOLOVICH, M., CHALMERS, R. & NEWHOUSE, M. (1972). Quantitation of regional aerosol clearance in the normal human lung. J. appl. Physiol., 33, 757–762.

    PubMed  CAS  Google Scholar 

  • SANCHIS, J., DOLOVICH, M., ROSSMAN, C., WILSON, W. & NEWHOUSE, M. (1973). Pulmonary mucociliary clearance in cystic fibrosis. New Engl. J. Med., 288, 651–654.

    Article  PubMed  CAS  Google Scholar 

  • SERAFINI, S.M., WANNER, A. & MICHAELSON, E.D. (1976). Mucociliary transport in central and intermediate size airways and effect of aminophyllin. Bull. Europ. Physiopath. Resp., 12, 415–422.

    CAS  Google Scholar 

  • SILBERBERG, A. (1978). In Discussion, p. 295, of Ciba Symposium no. 54, Respiratory Tract Mucus, Eds Porter, R., Rivers, J. & O’Connor, M. Amsterdam: Elsevier.

    Google Scholar 

  • SLEIGH, M.A. & AIELLO, E. (1972). The movement of water by cilia. Acta Protozool., 11, 267–277.

    Google Scholar 

  • THOMSON, M.L. & PAVIA, D. (1974). Particle penetration and clearance in the human lung. Arch. environ. Health. 24, 214–219.

    Article  Google Scholar 

  • THOMSON, M.L. & PAVIA, D. (1975). Long-term tobacco smoking and mucociliary clearance. Arch. environ. Health, 26, 86–98.

    Article  Google Scholar 

  • THOMSON, M.L., PAVIA, D., GREGG, J. & STARK, J.E. (1974). Bromhexine and mucociliary clearance in chronic bronchitics. Br. J. dis. Chest, 68, 21–27.

    Article  PubMed  CAS  Google Scholar 

  • THOMSON, M.L., PAVIA, D., JONES, C.J. & McQUISTON, T.A.C. (1975). No demonstrable long-term effect of 5-carboxymethylcysteine on clearance of secretions from the human lung. Thorax, 30, 669–673.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • THOMSON, M.L. & SHORT, M.D. (1969). Mucociliary function in health, chronic obstructive airway disease, and asbestosis. J. appl. Physiol., 26, 535–539.

    PubMed  CAS  Google Scholar 

  • TOIGO, A., IMARISIO, J.J., MURMALL, H. & LEPPER, M.N. (1963). Clearance of large carbon particles from the human tracheobronchial tree. Am. Rev. resp. Dis., 87, 487–492.

    Article  PubMed  CAS  Google Scholar 

  • TOREMALM, N.G. (1960). The daily amount of tracheobronchial secretions in man. Acta Otolaryng., 158, (suppl.) 43–53.

    Article  CAS  Google Scholar 

  • WANNER, A. (1979). The role of mucociliary obstruction in bronchial asthma. Am. J. Med., 67, 477–485.

    Article  PubMed  CAS  Google Scholar 

  • WEIBEL, E.R. (1963). Morphometry of the human lung. New York : Academic Press.

    Book  Google Scholar 

  • WOLFF, R.K., DOLOVICH, M.B., OBMIRSKI, G. & NEWHOUSE, M.T. (1977). Effects of exercise and eucapnic hyperventilation on bronchial clearance in man. J. appl. Physiol., 43, 46–50.

    PubMed  CAS  Google Scholar 

  • WONG, J.W., KEENS, T.G., WANNAMAKER, E.M., DOUGLAS, P.T., CROZIER, N., LEVISON, H. & ASPIN, N (1977). Effects of gravity on tracheal mucus transport rates in normal subjects and in patients with cystic fibrosis. Pediatrics, 60, 146–152.

    PubMed  CAS  Google Scholar 

  • WOOD, R.E., WANNER, A., HIRSCH, J. & FARRELL, P.M. (1975). Tracheal mucociliary transport in patients with cystic fibrosis and its stimulation by terbutaline. Am. Rev. resp. Dis., 111, 733–738.

    PubMed  CAS  Google Scholar 

  • YEATES, D.B., ASPIN, N., LEVISON, H., JONES, M.T. & BRYAN, A.C. (1975). Mucociliary tracheal transport rates in man. J. appl. Physiol., 39, 487–495.

    PubMed  CAS  Google Scholar 

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J. B. L. Howell A. E. Tattersfield

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Clarke, S.W., Pavia, D. (1981). Lung Mucus Production and Mucociliary Clearance: Methods of Assessment. In: Howell, J.B.L., Tattersfield, A.E. (eds) Methods in Clinical Pharmacology—Respiratory System. Palgrave, London. https://doi.org/10.1007/978-1-349-05940-9_11

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