Mucolytic and secretory pathways

The mucolytic and secretory pathways represent a coordinated network of cellular processes involved in the production, transport, and clearance of mucus, primarily within the respiratory system [1]. These pathways are centered around the synthesis and secretion of gel-forming mucins, such as MUC5AC and MUC5B, by goblet cells and submucosal glands [2]. Proper functioning of these pathways is essential for mucociliary clearance, a primary innate defense mechanism that traps and removes inhaled pathogens and debris [3]. Dysregulation of these pathways is a hallmark of chronic inflammatory airway diseases, including cystic fibrosis, chronic obstructive pulmonary disease (COPD), and asthma, where mucus hypersecretion and dehydration lead to airway obstruction and recurrent infections [1, 2]. Therapeutic strategies targeting these pathways include mucolytic agents that reduce mucus viscosity (e.g., N-acetylcysteine), secretagogues that enhance fluid secretion, and ion channel modulators (e.g., CFTR potentiators) that improve airway surface liquid hydration [3, 4]. These interventions aim to restore the rheological properties of mucus and facilitate its removal from the airways to improve lung function and reduce exacerbations [1]. Citations: [1] StatPearls, Mucolytics (https://www.ncbi.nlm.nih.gov/books/NBK559163/); [2] Fahy, J. V., & Dickey, B. F. (2010). Airway mucus function and dysfunction. NEJM; [3] Rogers, D. F. (2007). Mucoactive agents for airway mucus hypersecretory diseases. Paediatric Respiratory Reviews; [4] PubChem, Acetylcysteine (https://pubchem.ncbi.nlm.nih.gov/compound/Acetylcysteine).

Other names

Mucus clearance pathwaysAirway secretory pathwaysMucociliary clearance systemMucoactive pathwaysMucus hypersecretion pathways

Drugs targeting these pathways function as mucolytics (reducing mucus viscosity by breaking disulfide bonds or degrading extracellular DNA), secretolytics (stimulating the secretion of airway surface liquid), or mucoregulators (inhibiting mucus hypersecretion by targeting underlying inflammatory signaling or ion transport) [1, 3].