title: Changing the paradigm for cough: does 'cough hypersensitivity' aid our understanding?
abstract: Chronic cough is a common reason for patients to seek medication attention. Over the last few decades, we have experienced significant clinical success by applying the paradigm of 'evaluating and treating the causes for chronic cough'. However, we still ask ourselves 'what underlies chronic cough. Indeed in a considerable proportion of patients cough is idiopathic, or unexplained despite vigorous evaluation. Commonly associated conditions such as rhinitis, eosinophilic bronchitis, asthma, or gastroesophageal acidic reflux may not be fundamental to cough, and thus may be triggers rather than causes. The cardinal feature of chronic cough is persistent upregulation the cough reflex, which may be driven by complex interactions between biologic, neurologic, immunologic, genetic, comorbid, and environmental factors. We suggest the new paradigm 'cough hypersensitivity syndrome' should finally bring us further advances in understanding and management of chronic cough.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea.
authors: Woo-Jung
authors: WJ
authors: Song
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 110-799, Korea. ; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
authors: Yoon-Seok
authors: 0000-0003-3157-0447
authors: YS
authors: Chang
authors: Cardiovascular and Respiratory Studies, Castle Hill Hospital, University of Hull, Hull York Medical School, Cottingham HU16 5JQ, UK.
authors: Alyn H
authors: AH
authors: Morice
keywords: Cough; Etiology; Pathophysiology; Respiratory hypersensitivity