Cough and Mucociliary Transport of Airway Particulate in Chronic Obstructive Lung Disease

Although the pathophysiology of persistent cough remains obscure, cough can be a manifestation of obstructive airway disease. We evaluated mucociliary function of the airway in elderly subjects with obstructive lung disease to determine if spontaneous cough was essential to clearance of secretions and particulate from the tracheobronchial airways. In severe airway obstruction, failure or delayed clearance of particulate from tracheobronchial airways may be a contributing factor to the increased mortality of respiratory patients found in urban centres of the U.S. (Dockery and Pope, 1993). Voluntary cough has been demonstrated to assist mucociliary clearance of airway mucus in health and severe airway disease (Bennett et al., 1990, 1993). However, the significance of involuntary or spontaneous cough or its frequency to the kinetics of mucus and particulate clearance from tracheobronchial airways in patients with chronic airflow obstruction is not well described (Camner et al., 1973; Puchelle et al., 1980).