Roles of mucus adhesion and cohesion in cough clearance
| Autor: | Richard C. Boucher, Liheng Cai, Henry P. Goodell, Nathan T. Shenkute, Brian Button, Yu Cheng Chen, Robert J. P. Williams, Elijah Lackey, Siddharth K. Shenoy, Robert G. Dennis, Eyad Atieh, Michael Rubinstein |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Lung Diseases Cystic Fibrosis Pulmonary disease 02 engineering and technology Cystic fibrosis 03 medical and health sciences fluids and secretions medicine Cell Adhesion Humans COPD Multidisciplinary Lung Chemistry Sputum Epithelial Cells respiratory system Hydrogen-Ion Concentration Biological Sciences 021001 nanoscience & nanotechnology medicine.disease Mucus respiratory tract diseases Bicarbonates 030104 developmental biology medicine.anatomical_structure Cough Mucociliary Clearance Biophysics Respiratory Physiological Phenomena medicine.symptom 0210 nano-technology Rheology Mucus clearance Clearance |
| Zdroj: | Proceedings of the National Academy of Sciences of the United States of America. 115(49) |
| ISSN: | 1091-6490 |
| Popis: | Clearance of intrapulmonary mucus by the high-velocity airflow generated by cough is the major rescue clearance mechanism in subjects with mucoobstructive diseases and failed cilial-dependent mucus clearance, e.g., subjects with cystic fibrosis (CF) or chronic obstructive pulmonary disease (COPD). Previous studies have investigated the mechanical forces generated at airway surfaces by cough but have not considered the effects of mucus biophysical properties on cough efficacy. Theoretically, mucus can be cleared by cough from the lung by an adhesive failure, i.e., breaking mucus-cell surface adhesive bonds and/or by cohesive failure, i.e., directly fracturing mucus. Utilizing peel-testing technologies, mucus-epithelial surface adhesive and mucus cohesive strengths were measured. Because both mucus concentration and pH have been reported to alter mucus biophysical properties in disease, the effects of mucus concentration and pH on adhesion and cohesion were compared. Both adhesive and cohesive strengths depended on mucus concentration, but neither on physiologically relevant changes in pH nor bicarbonate concentration. Mucus from bronchial epithelial cultures and patient sputum samples exhibited similar adhesive and cohesive properties. Notably, the magnitudes of both adhesive and cohesive strength exhibited similar velocity and concentration dependencies, suggesting that viscous dissipation of energy within mucus during cough determines the efficiency of cough clearance of diseased, hyperconcentrated, mucus. Calculations of airflow-induced shear forces on airway mucus related to mucus concentration predicted substantially reduced cough clearance in small versus large airways. Studies designed to improve cough clearance in subjects with mucoobstructive diseases identified reductions of mucus concentration and viscous dissipation as key therapeutic strategies. |
| Databáze: | OpenAIRE |
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