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These mucus plugs persist in the same airways for years and often occur in patients without symptoms of cough and sputum production. Mucus plugs associate strongly with measures of airflow obstruction and disease morbidity in both asthma and COPD, and they occur and persist despite treatment with high doses of inhaled and oral corticosteroids. Thus, airway mucus plugs have emerged as an underappreciated airway pathology in asthma and COPD and a cause of persistent airflow obstruction and disease morbidity that can be specifically targeted for treatment. 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