Kaliner M, Shelhamer J H, Borson B, Nadel J, Patow C, Marom Z
Am Rev Respir Dis. 1986 Sep;134(3):612-21. doi: 10.1164/arrd.1986.134.3.612.
Respiratory mucous glycoproteins may serve a number of protective functions for the airways; however, excessive secretions contribute to the morbidity of a variety of diseases including asthma, chronic bronchitis, and cystic fibrosis. Respiratory secretions are a mixture of cells, fluid, transudated and locally produced proteins, and mucous glycoproteins. The mucous glycoproteins give these secretions their characteristic viscosity and elasticity. While the physiologic control of mucous glycoprotein secretion is not completely understood, cholinergic, alpha-adrenergic, and beta-adrenergic stimuli may all contribute. Respiratory mucus hypersecretion seen in immediate hypersensitivity or inflammatory states may be due to reflex hypersecretion, to a variety of mediators (including histamine and cyclooxygenase or lipoxygenase pathway metabolites of arachidonic acid), or to substances released from phagocytic cells (such as macrophages, monocytes, or neutrophils). The limited number of specific approaches currently available for treating respiratory mucus hypersecretion include therapy of any underlying or intercurrent disease, improving clearance of secretions, and reducing mucus secretion with the use of glucocorticosteroids or anticholinergic drugs.
呼吸道黏液糖蛋白可能对气道起到多种保护作用;然而,分泌物过多会导致包括哮喘、慢性支气管炎和囊性纤维化在内的多种疾病的发病。呼吸道分泌物是细胞、液体、渗出液和局部产生的蛋白质以及黏液糖蛋白的混合物。黏液糖蛋白赋予这些分泌物特有的黏性和弹性。虽然黏液糖蛋白分泌的生理控制尚未完全明确,但胆碱能、α-肾上腺素能和β-肾上腺素能刺激可能都有作用。在速发型超敏反应或炎症状态下出现的呼吸道黏液分泌过多可能是由于反射性分泌过多、多种介质(包括组胺以及花生四烯酸的环氧化酶或脂氧化酶途径代谢产物),或吞噬细胞(如巨噬细胞、单核细胞或中性粒细胞)释放的物质所致。目前可用于治疗呼吸道黏液分泌过多的特定方法数量有限,包括治疗任何潜在或并发疾病、改善分泌物清除以及使用糖皮质激素或抗胆碱能药物减少黏液分泌。