Potential Benefits of Adhesive Airway Mucus

Abstract What possible benefit could there be to sticky respiratory mucus? Most of the clinical efforts of respiratory therapy are aimed at thinning thick mucus and decreasing its adhesivity to the airway walls. Yet evidence has accumulated that thinning airway mucus may contribute to dependent atelectasis and may worsen respiratory failure in ventilated patients. We speculate that mucus adhesivity benefits cough clearance by keeping mucus in central airways where cough velocity can clear it, rather than allowing backsliding of mucus due to gravity that would result in distal plugging. It follows that mucus in central airways would benefit from increased adhesivity while mucus in distal airways would not.