H-P Hauber, SC Foley, Q Hamid. Mucin overproduction in chronic inflammatory lung disease. Can Respir J 2006;13(6):327-335.Mucus overproduction and hypersecretion are commonly observed in chronic inflammatory lung disease. Mucins are gel-forming glycoproteins that can be stimulated by a variety of mediators. The present review addresses the mechanisms involved in the upregulation of secreted mucins. Mucin induction by neutrophil elastase, bacteria, cytokines, growth factors, smoke and cystic fibrosis transmembrane conductance regulator malfunction are also discussed.Key Words: Bacteria; Cytokine; Lung; Mucin; Neutrophil elastase; Overproduction; Smoke La surproduction de mucine dans la pneumopathie inflammatoire chronique La surproduction de mucus et l'hypersécrétion sont courantes en présence d'une pneumopathie inflammatoire chronique. Les mucines sont des glycoprotéines gélifiantes qui peuvent être stimulées par divers médiateurs. La présente analyse traite des mécanismes de régulation positive des mucines sécrétées. Est également exposée l'induction des mucines par l'élastase des neutrophiles, les bactéries, les cytokines, les facteurs de croissance, la fumée et la défaillance du régulateur de conductance transmembraneuse de la fibrose kystique. M ucus is an important component of both the physiological and pathological processes in airways. It protects, moisturizes and lubricates mucosal surfaces, and traps bacteria and other inhaled irritants for removal by mucociliary clearance. However, excessive production of airway mucus is a feature of chronic inflammatory lung diseases such as bronchial asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cystic fibrosis (CF). Mucus hypersecretion results from hyperplasia and metaplasia of mucous cells, which lead to greater numbers of these cells being found throughout the airways, including the distal airways, where they are normally absent (1). The presence of neutrophil elastase, certain bacterial pathogens and altered cytokine patterns all contribute to excess airway mucus production. This overproduction and hypersecretion of mucus, in turn, contributes to airway obstruction and impairment of mucociliary clearance.An understanding of the mechanisms that lead to mucus overproduction and secretion is therefore of great clinical interest. The present review provides insight into the mechanisms by which excessive mucus production is stimulated in chronic inflammatory lung disease, focusing mainly on enhanced gene expression and protein production of secretory mucins in the airways.
MUCINSMucus is formed within the airways by a polymeric matrix of large, oligomeric, gel-forming glycoproteins, called mucins. These gel-forming mucins are primarily responsible for the rheological properties of airway mucus (2). However, in disease states such as CF and chronic bronchitis, polymeric DNA and filamentous actin, two products of leukocyte lysis, contribute greatly to, and are the principal determinants of, the viscoelastic properties of the purulent sputum...