The respiratory epithelium functions to moisten and protect the airways. It acts as a physical barrier to pathogens, as well as their removal in the mechanism of
mucociliary clearance. The ciliated cells are the primary components in the mucociliary clearance mechanism. Each epithelial cell has around 200
cilia that beat constantly at a rate of between 10 and 20 times per second. The direction of their beat is targeted towards the
pharynx, either upwards from the lower respiratory tract or downwards from the nasal structures.
Goblet cells, so named because they are shaped like a wine goblet, are
columnar epithelial cells that contain membrane-bound mucous granules and secrete
mucus as part of the
airway surface liquid (ASL), also known as the
epithelial lining fluid, the composition of which is tightly regulated; the mucus helps maintain epithelial moisture and traps particulate material and pathogens moving through the airway. and determines how well mucociliary clearance works. The
basal cells are small, nearly
cuboidal that differentiate into the other cell types found within the epithelium. Basal cells respond to injury of the airway epithelium, migrating to cover a site denuded of differentiated epithelial cells, and subsequently differentiating to restore a healthy epithelial cell layer. The differentiated epithelial cells can also dedifferentiate into stem cells and contribute to the repairing of the barrier.
Club cells carry out similar functions in the more distal airways. Certain parts of the
respiratory tract, such as the
oropharynx, are also subject to the abrasive swallowing of food. To prevent the destruction of the epithelium in these areas, it changes to
stratified squamous epithelium, which is better suited to the constant
sloughing and abrasion. The squamous layer of the oropharynx is continuous with the
esophagus. The respiratory epithelium has a further role of immunity for the lungs - that of
glucose homeostasis. The glucose concentration in the airway surface liquid is held at a level of around 12 times lower than that of the blood sugar concentration. However, airway inflammation decreases the effectiveness of the tight junctions making the barrier more permeable to glucose. Higher levels of glucose promote the proliferation of bacteria by providing glucose as a source for carbon for them. Increased levels of glucose in the airway surface liquid is associated with respiratory diseases, and
hyperglycemia. ==Clinical significance==