title: Expert opinion on the cough hypersensitivity syndrome in respiratory medicine.
abstract: In 2011, a European Respiratory Society Task Force embarked on a process to determine the position and clinical relevance of the cough hypersensitivity syndrome, a disorder characterised by troublesome coughing often triggered by low levels of thermal, mechanical or chemical exposure, in the management of patients with chronic cough. A 21-component questionnaire was developed by an iterative process supported by a literature review. 44 key opinion leaders in respiratory medicine were selected and interviewed as to their opinions. There was a high degree of unanimity in the responses obtained, with all opinion leaders supporting the concept of cough hypersensitivity as a clinically useful paradigm. The classic stratification of cough into asthmatic, rhinitic and reflux-related phenotypes was supported. Significant disparity of opinion was seen in the response to two questions concerning the therapy of chronic cough. First, the role of acid suppression in reflux cough was questioned. Secondly, the opinion leaders were split as to whether a trial of oral steroids was indicated to establish a diagnosis of eosinophilic cough. The cough hypersensitivity syndrome was clearly endorsed by the opinion leaders as a valid and useful concept. They considered that support of patients with chronic cough was inadequate and the Task Force recommends that further work is urgently required in this neglected area.
authors.affiliation: Centre for Cardiovascular and Metabolic Research, Respiratory Medicine, Hull York Medical School, University of Hull, Cottingham, UK a.h.morice@hull.ac.uk.
authors.forename: Alyn H
authors.initials: AH
authors.lastname: Morice
authors.affiliation: Dept of Internal Medicine/Respiratory Medicine and Allergology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Millqvist
authors.affiliation: Respiratory Pharmacology Group, Pharmacology and Toxicology Section, National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Belvisi
authors.affiliation: Dept of Pulmonology and Immunology, Lithuanian University of Health Science, Kaunas, Lithuania.
authors.forename: Kristina
authors.initials: K
authors.lastname: Bieksiene
authors.affiliation: Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Birring
authors.affiliation: National Heart and Lung Institute, Imperial College London and Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK.
authors.forename: Kian Fan
authors.initials: KF
authors.lastname: Chung
authors.affiliation: Centro Nazionale Studi di Farmacoeconomia e Farmacoepidemiologua Respiratoria CESFAR, Verona, Italy.
authors.forename: Roberto W
authors.initials: RW
authors.lastname: Dal Negro
authors.affiliation: Einstein Division/Montefiore Medical Center, Albert Einstein College of Medicine, New York, , NY, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Dicpinigaitis
authors.affiliation: Paediatric Cough and Asthma Centre, Istituti Ospedalieri Bergamaschi, Bergamo, Italy.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kantar
authors.affiliation: Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK.
authors.forename: Lorcan P
authors.initials: LP
authors.lastname: McGarvey
authors.affiliation: Chronic Cough Unit, Pneumology Service, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Adalberto
authors.initials: A
authors.lastname: Pacheco
authors.affiliation: Dept of Pulmonology and Immunology, Lithuanian University of Health Science, Kaunas, Lithuania.
authors.forename: Raimundas
authors.initials: R
authors.lastname: Sakalauskas
authors.affiliation: Centre for Respiratory and Allergy, University of Manchester, University Hospital of South Manchester, Manchester, UK.
authors.forename: Jaclyn A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D001991:Bronchitis / Q000175:diagnosis; D002908:Chronic Disease; D003226:Congresses as Topic; D003371:Cough / Q000175:diagnosis* / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000175:diagnosis; D005060:Europe; D006801:Humans; D006967:Hypersensitivity; D007249:Inflammation; D015272:Pulmonary Medicine / Q000379:methods*; D012137:Respiratory System / Q000294:innervation; D012955:Societies, Medical; D013256:Steroids / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
chemical_list: D013256:Steroids