Department of Engineering and Architecture, University of Trieste, Via Valerio 6/A, I-34127 Trieste, Italy.
Institute of Polymers, Composites and Biomaterials, National Research Council of Italy, P.le E. Fermi 1, I-80055 Portici, Italy.
Int J Mol Sci. 2024 Feb 5;25(3):1933. doi: 10.3390/ijms25031933.
The respiratory mucus, a viscoelastic gel, effectuates a primary line of the airway defense when operated by the mucociliary clearance. In chronic respiratory diseases (CRDs), such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF), the mucus is overproduced and its solid content augments, changing its structure and viscoelastic properties and determining a derangement of essential defense mechanisms against opportunistic microbial (virus and bacteria) pathogens. This ensues in damaging of the airways, leading to a vicious cycle of obstruction and infection responsible for the harsh clinical evolution of these CRDs. Here, we review the essential features of normal and pathological mucus (i.e., sputum in CF, COPD, and asthma), i.e., mucin content, structure (mesh size), micro/macro-rheology, pH, and osmotic pressure, ending with the awareness that sputum biomarkers (mucins, inflammatory proteins and peptides, and metabolites) might serve to indicate acute exacerbation and response to therapies. There are some indications that old and novel treatments may change the structure, viscoelastic properties, and biomarker content of sputum; however, a wealth of work is still needed to embrace these measures as correlates of disease severity in association with (or even as substitutes of) pulmonary functional tests.
呼吸道黏液是一种黏弹性凝胶，在黏液纤毛清除作用下发挥气道防御的第一道防线。在慢性呼吸系统疾病（CRD），如哮喘、慢性阻塞性肺疾病（COPD）和囊性纤维化（CF）中，黏液过度产生，其固体含量增加，改变了其结构和黏弹性特性，并决定了对机会性微生物（病毒和细菌）病原体的基本防御机制的紊乱。这导致了气道的损伤，导致阻塞和感染的恶性循环，从而导致这些 CRD 的临床恶化。在这里，我们回顾了正常和病理黏液的基本特征（即 CF、COPD 和哮喘中的痰液），即黏蛋白含量、结构（网格大小）、微/宏观流变学、pH 值和渗透压，最后意识到痰液生物标志物（黏蛋白、炎症蛋白和肽以及代谢物）可能用于指示急性加重和对治疗的反应。有一些迹象表明，旧的和新的治疗方法可能会改变痰液的结构、黏弹性特性和生物标志物含量；然而，仍然需要大量的工作来将这些措施作为与（甚至替代）肺功能测试相关的疾病严重程度的指标。
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