[Mechanisms and progress of airway mucus retention in bronchial asthma]

This review summarizes the mechanisms and research progress of airway mucus retention in bronchial asthma. Abnormal mucus accumulation in the asthmatic airway is mainly driven by mucus hypersecretion and impaired mucociliary clearance. Inflammatory cytokines, allergens, and pathogens stimulate the airway epithelium, inducing overexpression of mucin genes, particularly MUC5AC, which promotes goblet cell hyperplasia and mucus hypersecretion This leads to highly viscous mucus that can obstruct the airways. Meanwhile, impairment of ciliary structure and function, together with oxidative stress and inflammation, reduces mucus clearance efficiency and exacerbates mucus retention. Multiple signaling pathways including IL-13/STAT6, EGFR, and Notch participate in regulating mucus production and secretion. Clinically, airway mucus can be assessed by induced sputum analysis, imaging techniques, and biomarker detection. For treatment, beyond conventional anti-inflammatory and bronchodilator therapies, mucoregulatory drugs and targeted biologics are emerging as research hotspots. Overall, a deeper understanding of the mechanisms underlying the imbalance between mucus secretion and clearance will help optimize asthma treatment strategies and improve patient outcomes.