The Clinical Approach to Chronic Cough

Area of Science:

• Respiratory Medicine
• Neurology
• Pharmacology

Background:

• Chronic cough affects 10% of the population, significantly impairing quality of life.
• Refractory chronic cough (RCC) presents a major clinical challenge.
• Cough hypersensitivity syndrome, a neuropathic mechanism, is increasingly recognized in RCC.

Purpose of the Study:

• To review current investigations into the pathophysiology of chronic cough and RCC.
• To summarize emerging management strategies for chronic cough and RCC.
• To highlight the "treatable trait" approach and novel therapeutic targets.

Main Methods:

• Review of current scientific literature on chronic cough and RCC.
• Analysis of emerging treatment modalities, including neuromodulators and receptor antagonists.
• Discussion of the "treatable trait" approach in managing chronic cough.

Main Results:

• The "treatable trait" approach is gaining traction for managing chronic cough.
• Neuropathic mechanisms and cough hypersensitivity are key in RCC.
• New treatments, including P2X3 receptor antagonists, show promise but patient responses vary.

Conclusions:

• Understanding cough hypersensitivity is crucial for managing RCC.
• Targeting neuronal pathways offers new therapeutic avenues.
• Further research is needed to optimize treatment strategies for RCC due to variable patient responses.