Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease

  1. Derek Chadwick Organizer and
  2. Jamie A. Goode
  1. Duncan F. Rogers

Published Online: 7 OCT 2008

DOI: 10.1002/0470868678.ch5

Chronic Obstructive Pulmonary Disease: Pathogenesis to Treatment: Novartis Foundation Symposium 234

Chronic Obstructive Pulmonary Disease: Pathogenesis to Treatment: Novartis Foundation Symposium 234

How to Cite

Rogers, D. F. (2000) Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease, in Chronic Obstructive Pulmonary Disease: Pathogenesis to Treatment: Novartis Foundation Symposium 234 (eds D. Chadwick and J. A. Goode), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470868678.ch5

Author Information

  1. Department of Thoracic Medicine, National Heart and Lung Institute (Imperial College), Dovehouse Street, London SW3 6LY, UK

Publication History

  1. Published Online: 7 OCT 2008
  2. Published Print: 28 NOV 2000

Book Series:

  1. Novartis Foundation Symposia

Book Series Editors:

  1. Novartis Foundation

ISBN Information

Print ISBN: 9780471494379

Online ISBN: 9780470868676

SEARCH

Summary

Most patients with chronic obstructive pulmonary disease (COPD) exhibit characteristics of airway mucus hypersecretion, namely sputum production, increased luminal mucus, submucosal gland hypertrophy and goblet cell hyperplasia. The clinical consequences of hypersecretion are impaired gas exchange and compromised mucociliary clearance, which encourages bacterial colonization and associated exacerbations. However, the extent of the contribution of mucus to pathophysiology of COPD is controversial. Early epidemiological studies found little evidence for the involvement of mucus in the age-related decline in lung function and mortality associated with COPD and concluded that chronic airflow obstruction and mucus hypersecretion were independent processes. Later studies found positive associations between phlegm production and decline in lung function, hospitalization and death. Thus, although not diagnostic for the condition, mucus hypersecretion contributes to morbidity and mortality in certain groups of patients with COPD. This suggests that it is important to develop drugs that inhibit mucus hypersecretion in these patients. Unfortunately, ambiguity in clinical studies of mucoactive drugs means that mucolytics are not recommended in clinical management. Future research should determine whether there is an intrinsic abnormality in mucus in COPD, which will determine development of appropriate inhibitors, which in turn can be used in ‘proof of concept’ and in treatment.