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Editorial
. 2024 Feb 15;209(4):347-349.
doi: 10.1164/rccm.202312-2275ED.

Small Airways in Non-Cystic Fibrosis Bronchiectasis

John D Dickinson  1 , Christopher M Evans  2 , Burton F Dickey  3
Affiliations
Editorial

Small Airways in Non-Cystic Fibrosis Bronchiectasis

John D Dickinson et al. Am J Respir Crit Care Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
Feed-forward cycle driving the pathogenesis of muco-obstructive lung diseases. Hyperconcentrated mucus has increased viscoelasticity and adhesivity, preventing clearance by ciliary beating or cough. This results in the formation of mucus plaques and plugs that cause hypoxia in the underlying epithelium, which derive most of their oxygen from the airway lumen rather than the vasculature. Hypoxic airway epithelium upregulates the production of MUC5B, the major macromolecular constituent of mucus, and ENaC, the apical sodium channel that allows movement of sodium and water out of the airway lumen. Both of these result in a further increase of mucus concentration, driving the cycle forward (solid arrows). In addition to this central cycle, two amplification loops further drive the cycle and also cause airway remodeling. First, impaired mucus clearance leads to microbial infection, which in turn causes inflammation and airway damage (dashed arrows, right side). Second, epithelial hypoxia itself results in the release of inflammatory mediators that increase mucin production as well as degradative enzymes and proliferative signals (dashed arrows, left side).
See this image and copyright information in PMC

Comment on

  • Proximal and Distal Bronchioles Contribute to the Pathogenesis of Non-Cystic Fibrosis Bronchiectasis.
    Asakura T, Okuda K, Chen G, Dang H, Kato T, Mikami Y, Schworer SA, Gilmore RC, Radicioni G, Hawkins P, Barbosa Cardenas SM, Saito M, Cawley AM, De la Cruz G, Chua M, Alexis NE, Masugi Y, Noone PG, Ribeiro CMP, Kesimer M, Olivier KN, Hasegawa N, Randell SH, O'Neal WK, Boucher RC. Asakura T, et al. Am J Respir Crit Care Med. 2024 Feb 15;209(4):374-389. doi: 10.1164/rccm.202306-1093OC. Am J Respir Crit Care Med. 2024. PMID: 38016030 Free PMC article.

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