Mucoactive drugs
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Abstract
The production of mucus is the first-line defense against inhaled harmful agents damaging the airway epithelium. The process in which airway mucus together with microbes, viruses and other particles trapped within is moved out of the respiratory tract, is termed mucociliary clearance. The effective ciliary movement and biophysical properties of mucus, especially its two features; viscosity and elasticity, affect on efficiency of this process. Under normal conditions airway mucus protects the lower respiratory tract against inhaled irritants. On the other hand, excessive production of airway mucus in respiratory diseases, such as chronic obstructive pulmonary disease, asthma or cystic fibrosis, is associated with number of complications. Mucus hypersecretion, related with changes in its biophysical properties, can weaken mucociliary clearance as well as favour accumulation of mucus in upper and lower airways. Mucoactive drugs, stimulating airway clearance, are one of the therapeutic options in these cases. According to the putative mechanism of action, these compounds are categorized to four main groups, as expectorants (induce cough), mucolytics (increase mucus viscosity), mucokinetics (facilitate ciliary movement) and mucoregulators (act on hypersecretion). It is noteworthy, that many of them have other beneficial effects besides influence on mucus and mucociliary clearance. For example, the experimental and clinical studies on erdosteine indicate its antioxidant, anti-inflammatory, antibacterial and mucolytic pharmacological activities. Although over 50 compounds have potentially profitable effect on airway mucus, the mechanism of action of numerous of it is imprecisely characterized or absolutely unknown. The accessible data does not interchangeably confirm benefits from use of mucoactive drugs, that is why the further studies on efficacy of its action should be carrying out.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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