Role of ambroxol in therapeutic interaction of mucociliary clearance in the “bronchitic phenotype” of COPD

Česká verzia

Authors: V. Koblížek; T. Dobešová; P. Papoušek; Š. Prachařová
Authors place of work: Přednosta: doc. MUDr. František Salajka, CSc. ; Plicní klinika FN Hradec Králové
Published in the journal: Prakt. Lék. 2009; 89(10): 570-574
Category: Of different specialties

Summary

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in the world. In addition, the prevalence of this syndrome is continually growing. The majority of COPD subjects suffer from the expectoration phenotype of this condition. The cornerstone of the expectoration phenotype is chronic mucus hypersecretion, which is a physiologically protective process that occurs in connection with non-infectious chronic inflammation of the airways and lung parenchyma. This prolonged and excess mucus secretion can usually lead to mucus retention inside the airways. This retention can often contribute to chronic expiratory airflow limitation. Therefore any pharmacotherapy that is able to reduce mucus secretion may play a considerable role in the management of the expectoration (bronchitic) phenotype of COPD.

Mucus over-secretion could be normalized with multiple mucoactive drugs that decrease inflammation, produce antioxidant activity, block secretion, break down the molecular structure of mucus and generally reduce the amount or viscosity of mucus. There are many mucoactive medications on the market and more are being clinically evaluated in the field of COPD. Presently we have several safe and effective drugs, which we can recommend for day-to-day clinical practice (ambroxol, erdosteine, N-acetylcysteine and bromhexine).

This article describes the realistic role of ambroxol in mucoactive therapy of COPD. Overall beneficial effects of mucoactive pharmaceutics appear to be in the treatment of acute exacerbations and presumably during chronic therapy of long-term mucus expectoration (bronchitic phenotype of COPD).

Key words:
mucociliary clearance, mucociliary pathology, COPD, mucoactive substances, ambroxol, treatment.

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