[Ambroxol: mechanisms of action and efficacy for inhaled therapy in the treatment of respiratory diseases].

There is growing recognition that mucus and mucin biology have a considerable impact on respiratory health, and subsequent global morbidity and mortality. Mucins play a critical role in chronic lung disease, not only by providing a physical barrier and clearing pathogens, but also in immune homeostasis. Mucoactive drugs are commonly used to clear the airway in mucus hypersecretory diseases, which can alleviate mucus hypersecretion and increase the efficiency of expectoration. Theoretically, inhaled medications can be directly and rapidly delivered to the lower respiratory tract and exert therapeutic effects, with fewer systemic adverse effects. Ambroxol is a widely used mucoactive drug to treat respiratory diseases associated with abnormal mucus secretion and impaired mucus transport. Moreover, ambroxol stimulates the synthesis of pulmonary surfactant, which, in addition to increasing lung compliance, preventing end-expiratory atelectasis, and facilitating the recruitment of collapsed airways, has anti-inflammatory, anti-infective, and immunoregulatory properties. Ambroxol inhalation represents an efficient way to reduce sputum viscosity, increase expectoration without increasing adverse events.