EXPECTORANTES Y MUCOLITICOS PDF

Mucociliary clearance system in lung defense. Vargas M. Becario Conicyt. Becaria Conicyt.

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Mucociliary clearance system in lung defense. Vargas M. Becario Conicyt. Becaria Conicyt. Correspondencia a :. The first line of defense to maintain the sterility of the intrapulmonary airways is the mucociliary clearance system. This rapidly responding, non-specific, immune defensive system is challenged by approximately 12, liters of air filtered by the lungs each day, containing millions of particles like spores, environmental and eventually toxic pollutants.

The main components of this system are the floating mucus "blanket", the underlying mucus propelling cilia with periciliary fluid, and the airway epithelium with secretory and ciliated type of cells.

The fine and coordinated regulation of these three components is critical for an effective performance. Deregulation resulting from continuous insults, inherited ion channel disease, infections or abnormal immune response may lead to mucus alterations, goblet cell hyperplasia and metaplasia, airway obstruction, air trapping and chronic lung disease.

Options for treatment are limited. Understanding this system may reveal new targets for treatment of lung disease. Key words: Expectorants; Lung diseases; Mucociliary clearance; Mucus. Al menos Figura 1. Posteriormente, la capa mucosa es barrida fuera del aparato respiratorio. Componentes del barrido mucociliar. Figura 2. Dos mecanismos regulan el grosor del LS. Figura 3. Epitelio respiratorio. Barrido mucociliar en enfermedades respiratorias.

La eficacia del barrido mucociliar disminuye especialmente durante exacerbaciones de la enfermedad 31, Su principal causa es el tabaquismo Diskinesia ciliar primaria DCP. Tabla 1. El beneficio de otras alternativas como los broncodilatadores en pacientes con FQ es controversial Sin embargo, no se sabe si alteraciones en sus proporciones relativas cambia o no las propiedades del moco Las alteraciones del barrido mucociliar contribuyen a la morbilidad de enfermedades respiratorias como asma y EPOC, y pueden favorecer infecciones.

Rogers DF. The airway goblet cell. Int J Biochem Cell Biol ; Thomas R. Innate Immunity in the Lungs. Proc Am Thorac Soc ; 2: Local mucociliary defence mechanisms. Paediatr Respir Rev ; 1: Respiratory tract mucin genes and mucin glycoproteins in health and disease. Physiol Rev ; Clin Microbiol Rev ; Mucins, Mucus, and Sputum. Chest ; 2. Hiemstra P. Epithelial antimicrobial peptides and proteins: their role in host defence and inflammation.

Paediatr Respir Rev ; 2: Airway Mucus Function and Dysfunction. N Engl J Med ; Boucher RC. Cystic fibrosis: a disease of vulnerability to airway surface dehydration. Trends Mol Med ; Structure and function of the cell surface tethered mucins.

Annu Rev Physiol ; Regulation of airway mucin gene expression. Airway mucus obstruction: mucin glycoproteins, MUC gene regulation and goblet cell hyperplasia.

Verdugo P. Mucin exocytosis. Submucosal glands and airway defense. Proc Am Thorac Soc ; 1: Wine JJ. Parasympathetic control of airway submucosal glands: central reflexes and the airway intrinsic nervous system. Auton Neurosci ; Mucociliary clearance in the airways.

Activity of abundant antimicrobials of the human airway. Liquid movement across the surface epithelium of large airways. Respir Physiol Neurobiol ; The propulsion of mucus by cilia. Am Rev Respir Dis ; Regulation of airway surface liquid volume by human airway epithelia.

Pfugers Arch ; The relative roles of passive surface forces and active ion transport in the modulation of airway surface liquid volume and composition.

J Gen Physiol ; Estimation of tracheal mucous velocity by bronchofiberscopy. J Appl Physiol ; Analysis of ciliary beat pattern and beat frequency using digital high speed imaging: comparison with the photomultiplier and photodiode methods. Thorax ; Nakahari T. Regulation of ciliary beat frequency in airways: shear stress, ATP action, and its modulation.

Cone RA. Barrier properties of mucus. Adv Drug Deliv Rev ; Pulmonary mucus: Pediatric perspective. Pediatr Pulmonol ; Airway remodeling in asthma: New mechanisms and potential for pharmacological intervention.

Pharmacol Ther ; 3 : Regulation of mucociliary clearance in health and disease. Eur Respir J ; 13 5 : Efect of salmeterol xinafoate on lung mucociliary clearance in patients with asthma. Respir Med ; The role of mucus in fatal asthma. Am J Med ; Characterization of airway plugging in fatal asthma. Mucin expression in peripheral airways of patients with chronic obstructive pulmonary disease.

Histopathology ; 45 5 : A nonredundant role for mouse Serpinb3a in the induction of mucus production in asthma. J Allergy Clin Immunol ; Curr Med Chem ; Lai H, Rogers DF. Improving mucociliary clearance in chronic obstructive pulmonary disease. Respir Med ; 4 :

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