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Cough in non-cystic fibrosis bronchiectasis
Ahmad Kantar1,2, Woo-Jung Song3, Andrew Bush4
1Paediatric Asthma and Cough Centre, Instituti Ospedalieri Bergamaschi, Bergamo, Italy.
ERJ Open Research
|December 3, 2024
Summary
Non-cystic fibrosis bronchiectasis (NCFBE) involves airway dilation and mucus issues. Coughing is vital for mucus clearance, and targeting mucus viscosity may be a key treatment strategy.
Area of Science:
- Pulmonology
- Respiratory Medicine
Background:
- Non-cystic fibrosis bronchiectasis (NCFBE) is a chronic suppurative lung disease characterized by persistent cough and airway dilation.
- Airway changes in NCFBE impair mucus transport and reduce cough's effectiveness.
- Mucus hyperviscosity is a key factor in NCFBE pathogenesis, compromising ciliary activity.
Purpose of the Study:
- To review the role of cough in mucus clearance in NCFBE.
- To highlight mucus hyperviscosity as a potential therapeutic target.
- To discuss physiotherapy goals for managing NCFBE.
Main Methods:
- Mini-review of existing literature on NCFBE, cough, and mucus clearance.
- Analysis of the interplay between airflow, mucus properties, and cough efficiency.
- Examination of physiotherapy approaches for NCFBE.
Main Results:
- Cough serves as a crucial backup mechanism for mucus clearance when ciliary and breathing-induced transport are compromised.
- Mucus hyperviscosity significantly impairs mucus clearance in NCFBE.
- Physiotherapy aims to hydrate mucus and optimize expiratory airflow for effective mucus removal.
Conclusions:
- Targeting mucus rheology and enhancing mucus transport are essential for preventing NCFBE progression and exacerbations.
- Early intervention focusing on mucus modification and clearance can potentially reverse early-stage bronchiectasis.
- Effective management of NCFBE involves optimizing cough function and physiotherapy interventions.
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