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The influence of purulence on ciliary and cough transport in bronchiectasis
Joana Tambascio1, Hugo Celso Dutra de Souza, José Antonio Baddini Martinez
1Physiotherapy Department, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Background:
Individuals with bronchiectasis exhibit colonization and infection of the respiratory system, with a consequent alteration of the macroscopic appearance of secretions, which ranges from mucoid to purulent. Purulence is related to the structural conformation, rheological profile, and transport indexes of mucus. We analyzed and compared the transport properties of respiratory secretions with mucoid appearance versus those with purulent appearance in patients with bronchiectasis and in subjects without lung disease.
Methods:
In a simulated cough machine we assessed the mucociliary transport and contact angle of 32 mucoid and 19 purulent samples from subjects with bronchiectasis, and 21 samples from subjects without lung disease.
Results:
Mucociliary transport was lower in the mucoid samples (0.78 ± 0.22) and in the purulent samples (0.73 ± 0.22) than in the samples from subjects without lung disease (1 ± 0.19). The purulent samples had less displacement in the simulated cough machine (7.57 ± 3 cm) than did the mucoid samples (23 ± 15 cm) or the samples from subjects without lung disease (34 ± 8.4 cm), as did the mucoid samples compared to the samples from subjects without lung disease. The purulent samples had a higher contact angle (25 ± 6.1°) than the mucoid samples (17 ± 7.8°) or the samples from subjects without lung disease (10 ± 2.5°), as did the mucoid samples compared to the samples from subjects without lung disease.
Conclusions:
Respiratory secretions in individuals with bronchiectasis have poor transport properties, which manifest as reduced mucociliary transport, reduced mucus transport by cough, and higher contact angle. These features were more accentuated in the purulent samples. This simple classification can be used by therapists to plan treatments, and by researchers to obtain more homogeneity between groups of subjects.
Insights
Respiratory secretions in bronchiectasis patients show impaired mucus transport and higher contact angles, especially in purulent samples. These findings highlight poor mucus clearance in lung disease, aiding treatment planning.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Biomaterials Science
Background:
- Bronchiectasis is characterized by respiratory colonization and infection, altering mucus from mucoid to purulent.
- Mucus purulence correlates with structural, rheological, and transport properties.
- Understanding mucus transport is crucial for managing bronchiectasis.
Purpose of the Study:
- To compare the transport properties of mucoid and purulent respiratory secretions in bronchiectasis patients.
- To evaluate mucus transport in bronchiectasis patients versus healthy individuals.
- To identify key differences in mucus properties related to appearance and disease state.
Main Methods:
- Utilized a simulated cough machine to assess mucociliary transport and contact angle.
- Analyzed 32 mucoid and 19 purulent samples from bronchiectasis patients.
- Included 21 control samples from subjects without lung disease.
Main Results:
- Mucociliary transport was significantly lower in bronchiectasis patients (mucoid and purulent) compared to controls.
- Purulent samples exhibited reduced mucus displacement during simulated cough (7.57 cm) versus mucoid (23 cm) and control (34 cm) samples.
- Purulent secretions had a higher contact angle (25°) than mucoid (17°) and control (10°) samples, indicating poorer wetting properties.
Conclusions:
- Respiratory secretions in bronchiectasis patients demonstrate impaired mucociliary transport, reduced cough clearance, and increased contact angles.
- These transport deficits are more pronounced in purulent secretions.
- This classification aids therapists in treatment planning and researchers in subject group homogeneity.
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