Title:Bronchial Asthma and Mucociliary Clearance - A Bidirectional Relationship
Volume: 20
Issue: 4
Author(s): Daša Oppova, Peter Bánovčin, Peter Ďurdík, Michaela Babničová and Miloš Jeseňák*
Affiliation:
- Department of Paediatrics, Jessenius Faculty of Medicine of Comenius University in Bratislava, Martin University
Hospital, Martin, Slovakia Republic
- Department of Clinical Immunology and Allergology, Martin University Hospital, Martin, Slovakia Republic
- Department of Pulmonology and Phtiseology, Jessenius Faculty of Medicine in Martin, Comenius
University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia
Keywords:
Bronchial asthma, mucociliary clearance, cilia, interleukin IL-13, interleukin IL-4, mucin.
Abstract: The integrity of the airway epithelium plays an important role in the defence against
pathogens and various immunogenic stimuli from the external environment. Properly functioning
mucociliary clearance is an indispensable part of the respiratory system defence and it relies on adequate
viscoelastic properties of mucus, as well as the intact function of a significant number of
healthy ciliated cells. The movement of the cilia can be affected by many endogenous and exogenous
factors. Complex mucociliary clearance dysfunction can be seen as a part of the respiratory
system inflammation. Bronchial asthma is one of the most common inflammatory diseases of the
respiratory system. It is characterised by structural and functional changes in the airways. The last
decades of bronchial asthma research point to asthmatic inflammation as the cause of airway remodelling
with subsequent impairment of mucociliary transport function. Changes in the respiratory
epithelium in patients with bronchial asthma include hypertrophy of secretory cells, overproduction
of mucus, increase in mucus viscosity, decline of ciliated cells, decrease of ciliary beat frequency,
and more. Cytokines of T2-high type of asthmatic inflammation, such as interleukin
IL-13 and IL-4, have been shown to contribute to these changes in the airway epithelium significantly.
There is strong evidence of cytokine-induced overexpression of important transcription factors,
which results in hyper- and metaplasia of secretory cells and also transdifferentiation of
ciliary cells. Impaired mucociliary clearance increases the risk of airway infection and contributes
to the worsening of bronchial asthma control.
