Mucus Dynamics in Severe Asthma
Summary
Severe asthma is characterised by the overproduction and altered properties of airway mucus, which plays a central role in airflow obstruction and disease exacerbations. In health, mucus traps inhaled particles and facilitates their removal through coordinated ciliary motion. In severe asthma, however, goblet cell hyperplasia and submucosal gland enlargement drive excessive secretion of gel-forming mucins, notably MUC5AC and MUC5B. The physical properties of this mucus are transformed, acquiring increased viscoelasticity and resistance to clearance. Immune cells, including eosinophils and neutrophils, can infiltrate the mucus gel, releasing enzymes and reactive species that further modify mucin structure and promote cross-linking. Such changes give rise to persistent mucus plugs that occlude proximal airways, amplify local inflammation and impair gas exchange. Advanced imaging modalities, such as computed tomography and magnetic resonance, have revealed heterogeneity in plug size, shape and distribution along airway generations, and have highlighted the dynamic balance between plug formation and resolution over time. A deeper understanding of mucus rheology, epithelial–immune interactions and the molecular drivers of mucin cross-linking underpins emerging muco-active and anti-inflammatory therapies designed to restore mucociliary clearance and improve clinical outcomes.
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Mucus Dynamics in Severe Asthma publication trend
The graph below shows the total number of articles in mucus dynamics in severe asthma across all publications each year (not limited to Nature Index journals).
Technical terms
Mucus plug: A matrix of gel-forming mucins and trapped cells that occludes an airway lumen.
Mucin: High-molecular-weight glycoprotein secreted by goblet cells and submucosal glands.
Viscoelasticity: Combined viscous and elastic response of mucus that determines its flow and deformation.
Eosinophil degranulation: Release of cytotoxic proteins and enzymes from eosinophils into mucus.
Airway generation: Sequential branching levels of the bronchial tree from central to peripheral airways.
References
- Cellular and molecular features of asthma mucus plugs provide clues about their formation and persistence. Journal of Clinical Investigation (2025).
- Persistent mucus plugs in proximal airways are consequential for airflow limitation in asthma. JCI Insight (2023).
- Comparison of hyperpolarized 3He-MRI, CT based parametric response mapping, and mucus scores in asthmatics. Frontiers in Physiology (2023).
- Peroxidase-mediated mucin cross-linking drives pathologic mucus gel formation in IL-13-stimulated airway epithelial cells. JCI Insight (2024).
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