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Cough Update: Chronic cough: future directions, mechanisms and antitussives

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eMediNexus    04 February 2021

An essential cautious reflex of the respiratory tract is cough, required to clear and protect the upper airways. Cough might become inflated and also inhibit with the quality of life. Even though chronic cough can be treated successfully when it is related with the common causes like eosinophilic bronchitis, asthma, GERD, post-nasal drip syndrome or rhinosinusitis. Gradually, cough with no related cause or idiopathic cough is recognized.

 

Every so often, the chronic cough is related with an increased response to tussive agents for instance capsaicin, which is used as an index for the cough reflex. Few airway receptors intercede or influence the cough through activation of vagal afferent pathways that unite on brain stem respiratory networks and on supra-medullary centres. Pliable changes in intrinsic and synaptic excitability at the brain stem, at spinal or ganglionic level might be the mechanism through which the cough reflex is improved in chronic cough. Objective and subjective measurements of cough in the clinic are available, however a major unmet requirement in chronic cough is the accessibility of effective antitussives. Future guidelines in chronic cough consist of the pathophysiological mechanisms of the heightened cough reflex. The finding of effective antitussives can successfully ease the chronic cough.

Source: Chron Respir Dis. 2007;4(3):159-65.

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