Abstract
Chronic bronchitis (CB) is defined by cough and sputum production. The pathologic correlate of CB is mucus hypersecretion, defined as mucus cell metaplasia. Sputum production in CB results from cigarette smoke-induced increases in airway mucus concentration. Increased mucus concentrations in CB osmotically compress the cell surface mucin layer, resulting in cessation of clearance and mucus accumulation, particularly in the bronchioles. Mucus accumulation produces airflow obstruction, inflammation, zones of hypoxia, and bacterial infection. Mucus concentrations are associated with CB disease severity and may be diagnostic of CB. Therapies that normalize mucus concentrations are rational for CB.
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