Mechanisms of hypersecretion in acute asthma, proposed cause of death, and novel therapy.

Neutrophil chemoattractants cause neutrophil-dependent goblet cell degranulation in guinea pig and human airways through a novel mechanism involving close contact between neutrophils and goblet cells, mediated by neutrophil elastase. The chemoattractant plays various roles in the response: It causes neutrophil recruitment and mobilizes elastase to the surface of the neutrophil. In addition, it induces surface expression of adhesion molecules, which allow the neutrophil to interact with the goblet cell surface, resulting in goblet cell secretion.