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[Mechanisms of chronic cough pathophysiology]
H Allain1, D Bentue-Ferrer, G Daval
1Laboratoire de Pharmacologie Expérimentale et Clinique, Faculté de Médecine, Université de Rennes I, Rennes, France. Herve.Allain@univ-rennes1.fr
Revue Des Maladies Respiratoires
|November 13, 2004
Summary
Chronic cough can stem from central nervous system (CNS) issues, not local inflammation. Targeting NMDA receptors in the brainstem offers a potential pharmacological approach to manage this persistent cough reflex.
Area of Science:
- Neuroscience
- Respiratory Medicine
- Pharmacology
Context:
- Subacute or chronic cough can persist after infections like viruses or whooping cough.
- This cough syndrome, termed 'cough disease,' originates from the central nervous system (CNS) and its autonomic outputs.
- Functional disturbances and neosynaptogenesis within the CNS, involving NMDA-type glutamatergic receptors, are implicated.
Purpose:
- To review the central nervous system mechanisms underlying chronic cough.
- To identify pharmacological targets for managing cough reflex hypersensitivity.
- To explore the role of NMDA receptors and 5-HT4 receptors in cough pathophysiology.
Summary:
- Neurons in the brainstem's expiratory center exhibit exaggerated responses due to NMDA receptor stimulation, akin to long-term potentiation.
- This amplification leads to a rapidly chronic cough reflex, suggesting NMDA receptors as a viable pharmacological target.
- Emerging evidence implicates 5-HT4 receptors in respiratory control, with potential overexpression contributing to increased cough reflex.
Impact:
- Provides a rationale for developing novel therapeutics targeting CNS pathways for chronic cough.
- Highlights the importance of understanding neuroplasticity in the development of persistent cough.
- Suggests potential therapeutic strategies focusing on receptor modulation within the brainstem's respiratory centers.
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