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J Appl Physiol 104: 902, 2008; doi:10.1152/japplphysiol.01263.2007
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LETTER TO THE EDITOR

A further comment on Point:Counterpoint "Airway smooth muscle is/is not useful"

TO THE EDITOR: Dr. Mead (3, 5) is to be congratulated for his persistence in seeking out possible functions for airway smooth muscle. Perhaps he feels his illustrious career will not be complete without winning the Mitzner prize (4). This whole situation is somewhat analogous to the 19th Century physicists seeking increasingly creative ways to show the existence of something (the ether) that was thought to have an essential function. Here we have the inverse, where we know airway smooth muscle exists, but has no essential function. To many physiologists this seems to be as distressing as the lack of an ether was to those classical physicists. Although this latest explanation that airway narrowing might improve the effectiveness of coughing has superficial plausibility, it makes the implicit assumption that coughs are preceded by smooth muscle contraction. Where is the evidence for this? In fact, the big breaths that precede large coughs would only serve to dilate the airways. The proposed experiment of comparing cough effectiveness before and after a bronchodilator would be almost impossible to interpret, since if the airways were dilated and more patent, there will be a lesser urgency to cough. The fact of the matter is that, in those humans and animals who have had a significant fraction of their conducting airway smooth muscle destroyed by thermoplasty, there have been no adverse consequences (1, 2). If even more of the smooth muscle could be destroyed it seems quite unlikely that some functional abnormality would suddenly appear.

REFERENCES

  1. Cox G, Miller JD, McWilliams A, Fitzgerald JM, Lam S. Bronchial thermoplasty for asthma. Am J Respir Crit Care Med 173: 965–909, 2006.[Abstract/Free Full Text]
  2. Danek CJ, Lombard CM, Dungworth DL, Cox PG, Miller JD, Biggs MJ, Keast TM, Loomas BE, Wizeman WJ, Hogg JC, Leff AR. Reduction in airway hyperresponsiveness to methacholine by the application of RF energy in Dogs. J Appl Physiol 97: 1946–1953, 2004.[Abstract/Free Full Text]
  3. Mead J. A further comment on Point:Counterpoint "Airway smooth muscle is/is not useful". J Appl Physiol 103: 412, 2007.[Free Full Text]
  4. Mead J. Last Word on Point:Counterpoint "Airway smooth muscle is/is not useful". J Appl Physiol 102: 1723, 2007.[Free Full Text]
  5. Mead J, Fredberg JJ. Point:Counterpoint Airway smooth muscle is/is not useful. J Appl Physiol 102: 1708–1711, 2007; doi:10.1152/japplphysiol.01419.2006.[Free Full Text]

Wayne Mitzner
 Division of Physiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland





This Article
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