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The Evolving Clinical Practice of Chronic Cough
Sumera R Ahmad1, Vivek N Iyer1
1Division of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic Proceedings
|April 28, 2022
Summary
Chronic cough, lasting over 8 weeks, may stem from cough hypersensitivity syndrome (CHS) when common causes are ruled out. CHS involves laryngeal hypersensitivity and guides new treatment approaches for persistent cough.
Area of Science:
- Pulmonology and Respiratory Medicine
- Clinical Therapeutics
- Neuroscience of Cough
Background:
- Chronic cough (>8 weeks) is a common reason for medical consultations.
- Traditional focus is on gastroesophageal reflux, upper airway cough syndrome, and eosinophilic airway inflammation.
- These approaches are insufficient when cough etiology is unclear or refractory to treatment.
Purpose of the Study:
- To provide an update on the understanding of refractory and unexplained chronic cough.
- To highlight cough hypersensitivity syndrome (CHS) as a key concept in these cases.
- To discuss the pathophysiology and therapeutics for CHS.
Main Methods:
- Review of current literature on chronic cough, laryngeal hypersensitivity, and CHS.
- Analysis of the evolving understanding of cough pathophysiology.
- Discussion of established and emerging therapeutic strategies.
Main Results:
- Chronic cough can manifest as laryngeal hypersensitivity and CHS.
- CHS provides a framework for understanding cough refractory to standard treatments.
- Understanding pathophysiology is crucial for developing novel therapeutics.
Conclusions:
- CHS represents a paradigm shift in understanding unexplained and refractory chronic cough.
- A multidisciplinary approach is essential for systematic evaluation and treatment.
- Further research into CHS pathophysiology will drive innovative therapeutic development.
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