Advanced Search

Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 2001 April;67(4) > Minerva Anestesiologica 2001 April;67(4):206-9



A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2001 April;67(4):206-9

SMART 2001 


Pathophysiology and treatment of airway mucociliary clearance. A moving tale

Cole P.

From the Roy­al Bromp­ton Hos­pi­tal Lon­don, UK, UK

Air­way ­hygiene ­depends large­ly on muco­cil­iary clear­ance (MCC) ­which in ­turn ­depends ­upon the move­ment of vis­coe­las­tic ­mucus ­along the air­way by the beat­ing of the cil­iary append­ag­es of air­way epi­the­lial ­cells. Fail­ure to ­keep the air­ways ster­ile by MCC ­results in a ­host inflam­ma­to­ry ­response to the per­sis­tent micro­or­gan­isms ­which, if it ­becomes chron­ic, caus­es dam­age to the air­way ­wall and upreg­u­la­tion of ­mucus pro­duc­tion man­i­fest clin­i­cal­ly as bron­chiec­ta­sis, sinus­itis and ­otitis. ­There are ­three prin­ci­pal dis­or­ders of MCC. First­ly, pri­mary cil­iary dys­ki­ne­sia (PCD), a ­rare genet­ic defi­cien­cy of the ultra­struc­tu­ral appa­ra­tus ­required to pro­pel the cil­i­um, in ­which ­nasal ­nitric ­oxide is ­very low due to a defi­cien­cy of indu­cible ­nitric ­oxide syn­thase. Sec­ond­ly, sec­on­dary cil­iary dys­ki­ne­sia due prin­ci­pal­ly to micro­bi­al tox­in-­induced dys­func­tion of the ener­gy path­ways ­required for cil­iary beat­ing. Third­ly, abnor­mal­ities in the phy­sic­o­chem­i­cal prop­er­ties of ­mucus, includ­ing ­reduced ­salt con­tent/osmo­lal­ity ­which ­results in it ­being unsuit­able in qual­ity for cil­ia to ­move it. Meth­ods of rec­ti­fy­ing ­this ­defect prom­ise to ­restore MCC to nor­mal and inter­fere in the ­vicious cir­cle of inflam­ma­to­ry ­lung dam­age.

language: English


top of page