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Structural changes in the airways: cause or effect of chronic cough?
1Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan. niimi@kuhp.kyoto-u.ac.jp
Pulmonary Pharmacology & Therapeutics
|February 5, 2011
Summary
Chronic cough, whether asthma-related or unexplained, involves airway inflammation and structural changes. These airway alterations may create a persistent cough cycle, highlighting a complex interplay in chronic cough pathogenesis.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Airway Diseases
Background:
- Chronic cough is often linked to asthma or asthma-related conditions like cough variant asthma and non-asthmatic eosinophilic bronchitis, typically responding to inhaled corticosteroids.
- Unexplained or idiopathic chronic cough cases also exhibit airway inflammation.
- Recent findings indicate structural airway remodeling, previously associated with classic asthma, is present in chronic cough patients regardless of the cause.
Purpose of the Study:
- To review the presence and pathogenesis of structural airway changes in chronic cough.
- To explore the potential consequences of these structural changes on cough persistence.
- To examine the relationship between airway inflammation, structural remodeling, and chronic cough.
Main Methods:
- Literature review focusing on studies investigating airway inflammation and structural changes in chronic cough.
- Analysis of research on the pathogenesis and clinical implications of airway remodeling in various chronic cough etiologies.
- Synthesis of evidence linking asthma-related and non-asthma-related chronic cough to structural airway alterations.
Main Results:
- Airway inflammation is a common feature in both asthma-related and idiopathic chronic cough.
- Structural changes, or airway remodeling, are increasingly recognized in patients with chronic cough, mirroring findings in classic asthma.
- The exact causal relationship between chronic cough and structural changes remains unclear, but their co-occurrence suggests a potential vicious cycle.
Conclusions:
- Structural airway remodeling is a significant finding in chronic cough, irrespective of its underlying cause.
- The interplay between airway inflammation and structural changes may perpetuate chronic cough through a positive feedback mechanism.
- Further research is needed to elucidate the precise mechanisms and therapeutic implications of airway remodeling in chronic cough management.
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