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Physiological and pathophysiological down-regulation of cough
1University of London, 116 Pepys Road, London, SW20 8NY, UK. johnwiddicombej@aol.com
Respiratory Physiology & Neurobiology
|May 10, 2005
Summary
Coughing can be suppressed in various situations, including altered breathing conditions and central nervous system disorders. Further research is needed to understand the nervous mechanisms behind cough suppression and its implications.
Area of Science:
- Respiratory physiology
- Neuroscience
Background:
- Clinical studies highlight increased cough sensitivity in airway diseases.
- Conversely, numerous conditions can lead to the down-regulation or suppression of cough reflexes.
Purpose of the Study:
- To review known situations where cough sensitivity is reduced.
- To identify gaps in understanding the neural mechanisms of cough suppression.
- To emphasize the need for further research into cough regulation.
Main Methods:
- Literature review of clinical and experimental studies on cough reflex modulation.
- Analysis of conditions associated with cough down-regulation.
Main Results:
- Cough can be suppressed by factors including hypercapnia/hypoxia, voluntary inhibition, placebo effects, sleep, anesthesia, central nervous disorders, visceral afferent input, and certain bronchopulmonary conditions.
- The nervous mechanisms underlying these cough suppressive effects are poorly understood.
- Situations like exercise, coitus, talking, and singing, and their impact on cough, remain largely uninvestigated.
Conclusions:
- Cough regulation involves complex mechanisms of both sensitization and down-regulation.
- Significant gaps exist in our knowledge of the neural basis for cough suppression.
- More research, particularly in human subjects, is crucial for understanding and potentially modulating cough reflexes for better health outcomes.