title: Chronic Cough as a Female Gender Issue.
abstract: Cough accompanying acute respiratory tract disorders is a self-limiting phenomenon, and it usually does not require sophisticated management. Chronic cough, in contrast, is a bothersome problem, considerably influencing the quality of life of affected individuals. Specialized cough clinics report that substantial proportion of their patients are middle aged-to-postmenopausal females who cough for years in response to otherwise non-tussigenic stimuli, without a clear underlying disease reason. A newly established entity - 'cough hypersensitivity syndrome' explains pathogenesis of this problem. However, the syndrome has not been generally accepted, and the guidelines regarding the diagnostic protocols and treatment are not yet available. The reason why females cough more than males do is unclear, but the analysis of literature and experience with the chronic cough patients allows selecting three main targets of hormonal background which can contribute to the enhanced coughing in females. They are as follows: increased activity of transient receptor potential (TRP) channels expressed on vagal C-fibers mediating cough, laryngeal hypersensitivity and laryngeal dysfunction with paradoxical vocal cord movement, and mast cells which are known to express receptors for female sexual hormones and are frequently found in the bronchoalveolar lavage in chronic cough patients. In this review we analyze the potential contribution of the factors above outlined to excessive cough in female subjects.
authors.affiliation: Jessenius Faculty of Medicine, Department of Pathophysiology, Comenius University, Mala Hora 4C, 036 01, Martin, Slovakia.
authors.forename: N
authors.initials: N
authors.lastname: Kavalcikova-Bogdanova
authors.affiliation: Jessenius Faculty of Medicine, Department of Pathophysiology, Comenius University, Mala Hora 4C, 036 01, Martin, Slovakia.
authors.forename: T
authors.initials: T
authors.lastname: Buday
authors.affiliation: Jessenius Faculty of Medicine, Simulation Education Center, Comenius University, Novomeskeho 7A, 036 01, Martin, Slovakia. plevkova@jfmed.uniba.sk.
authors.forename: J
authors.initials: J
authors.lastname: Plevkova
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: W J
authors.initials: WJ
authors.lastname: Song
mesh_terms: D002908:Chronic Disease; D003371:Cough / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D004967:Estrogens / Q000378:metabolism; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D008407:Mast Cells / Q000276:immunology* / Q000378:metabolism; D036421:Nerve Fibers, Unmyelinated / Q000378:metabolism; D011374:Progesterone / Q000378:metabolism; D012737:Sex Factors; D013577:Syndrome; D050051:Transient Receptor Potential Channels / Q000378:metabolism; D014630:Vagus Nerve / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D004967:Estrogens; D050051:Transient Receptor Potential Channels; D011374:Progesterone
keywords: Cough; Female gender; Laryngeal dysfunction; Mast cells; Respiratory tract; Transient receptor potential channels; Vagus nerve