Breathing Movement of Asthmatic Airways

Abstract

Airway narrowing is the primary pathophysiological abnormality in asthma. Mucus plugs within the lumen remain a critical and prevalent cause of airway obstruction and contain inflammatory secretions that must be removed and drained. Therefore, the clearance of mucus plugs is vital for effective treatment and disrupts the vicious cycle of chronic airway remodeling in my clinical practice. Mucus retention and subsequent obstruction occur both in patients with reduced or restricted ventilation and those experiencing respiratory arrest. To investigate the mechanical forces driving mucus transport, I conducted experiments using custom-built tube-balloon models to observe the dynamics of air movement and mucus displacement within the tubes and balloons during various cycles of breathing and coughing. Clinical application of these experimental findings suggests: their efficacy in asthma management; airway respiratory movement is the primary force driving secretion transport; targeted respiratory maneuvers facilitate the clearance of trapped air and mucus plugs, particularly within the distal small airways. This approach allows for the gradual reduction and discontinuation of bronchodilators while preventing acute relapses and chronic exacerbations. Furthermore, a subtle wheezing detected during gentle, prolonged expiration between attacks and immediately following the subsidence of the acute episode is identified as a key clinical indicator of distal mucus blockage. In addition, suppression of the pharyngeal cough reflex promotes continuous cephalad displacement of secretions. Finally, the use of acupuncture or acupoint injection as an adjunct therapy significantly enhances the therapeutic effects of the breathing exercises.