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Translating Basic Research Into Clinical Practice |

Mucins, Mucus, and Sputum

Judith A. Voynow, MD; Bruce K. Rubin, MEngr, MD, MBA, FCCP
Author and Funding Information

*From the Department of Pediatrics (Dr. Voynow), Duke University School of Medicine, Durham; and Department of Pediatrics (Dr. Rubin), Wake Forest University School of Medicine, Winston-Salem, NC.

Correspondence to: Judith A. Voynow, MD, Division of Pediatric Pulmonary Diseases, Box 2994, Duke University Medical Center, Durham, NC 27710; e-mail: voyno001@mc.duke.edu


This work was supported by National Institutes of Health grants HL65611 (J.A.V.), the Duke Children's Miracle Network (J.A.V.), and the Cystic Fibrosis Foundation (J.A.V.).

Dr. Voynow is a consultant for BioMarcks. Dr. Rubin holds patents on the use of aerosol surfactant for airway clearance and increasing mucin secretion to protect the CF airway; he also has grant support from GlaxoSmithKline/PLIVA, Hill-Rom, and Bayer for mucus clearance therapies and consults for Boehringer and GlaxoSmithKline.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(2):505-512. doi:10.1378/chest.08-0412
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Normal airway mucus lines the epithelial surface and provides an important innate immune function by detoxifying noxious molecules and by trapping and removing pathogens and particulates from the airway via mucociliary clearance. The major macromolecular constituents of normal mucus, the mucin glycoproteins, are large, heavily glycosylated proteins with a defining feature of tandemly repeating sequences of amino acids rich in serine and threonine, the linkage sites for large carbohydrate structures. The mucins are composed of two major families: secreted mucins and membrane-associated mucins. Membrane-associated mucins have been reported to function as cell surface receptors for pathogens and to activate intracellular signaling pathways. The biochemical and cellular functions for secreted mucin glycoproteins have not been definitively assigned. In contrast to normal mucus, sputum production is the hallmark of chronic inflammatory airway diseases such as asthma, chronic bronchitis, and cystic fibrosis (CF). Sputum has altered macromolecular composition and biophysical properties which vary with disease, but unifying features are failure of mucociliary clearance, resulting in airway obstruction, and failure of innate immune properties. Mucin glycoprotein overproduction and hypersecretion are common features of chronic inflammatory airway disease, and this has been the underlying rationale to investigate the mechanisms of mucin gene regulation and mucin secretion. However, in some pathologic conditions such as CF, airway sputum contains little intact mucin and has increased content of several macromolecules including DNA, filamentous actin, lipids, and proteoglycans. This review will highlight the most recent insights on mucus biology in health and disease.

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