LAUSR

Cough is a common and frequently debilitating symptom. A persistent cough unresponsive to empirical treatment (chronic refractory cough (CRC)) or unexplained may represent a distinct phenotype [1]. The pathophysiology of CRC is poorly understood. “Cough hypersensitivity syndrome” has recently been the dominant paradigm. Evidence suggests a complex interplay of aberrant vagal afferent pathways [2] and central factors including impaired cough suppression [3]. Cough is more usually associated with an underlying cause (explained cough) and may persist in patients with underlying lung disease even after optimising treatment of the condition. Cough reflex hypersensitivity may be a specific treatable trait in airway disease [4]. Cough is common in asthma; studies demonstrate a link between airway dysfunction and cough hypersensitivity [5]. There are similar findings in bronchiectasis [6] and COPD [7], although the underlying mechanisms may differ. Nonpharmacological cough control therapy (CCT) is effective for refractory chronic cough but there is a significant subgroup of nonresponders. CCT appears to be effective in cough associated with underlying disease such as asthma. http://bit.ly/2uCCwu3