The spatiotemporal organization of cilia activity drives multiscale circular flows of mucus in reconstituted human bronchial epithelium

Chronic respiratory diseases affect hundreds of millions of people worldwide. The bronchial epithelium is the first barrier to protect the respiratory tract via an innate mechanism called mucociliary clearance. It consists in the active transport of a sticky fluid, the mucus, via a myriad of cilia at the epithelial surface of the airways. The mucus traps inhaled pathogens and the protective role of the mucociliary clearance relies on the ability of the cilia to self-organize and coordinate their beating to transport the mucus over the full bronchial tree till its elimination through swallowing or expectoration. Despite a rich corpus of clinical studies, chronic respiratory diseases remain poorly understood and quantitative biophysical studies are still missing. Here we will present the physical mechanisms underlying the mucociliary transport. We will show how the cilia self-organize during the ciliogenesis and how the coordination of their beating direction leads to the formation of fluid flow patterns at the macroscopic scale. Finally, we will discuss the role of long range hydrodynamics interactions in this intricate coupled system.