title: Towards understanding and managing chronic cough.
abstract: Chronic cough is a common and troublesome condition affecting approximately 12% of the general population. It is associated with poor quality of life with psychological, social and physical consequences. Patients typically complain of a dry irritating cough, driven by a strong urge to cough associated with a sensation or irritation located in the throat. Treatment of potential 'causes', ie asthma, gastro-oesophageal reflux disease and rhino-sinusitis, may produce a complete or partial response, but the response of some patients to opiates and alpha-2-delta ligand antagonists (gabapentin and pregabalin) supports the concept that this is primarily a neurological disorder, characterised by hyper-responsiveness of the nerves. Novel and highly effective neuronal treatments are in development and offer hope of better symptom control with fewer side effects within a few years. This review focuses on understanding the mechanism of chronic cough, current management approaches and research that may lead to novel therapies.
authors.affiliation: Division of Infection, Immunity and Respiratory Medicine, University of Manchester, and Manchester Academic Health Sciences Centre. University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
authors.forename: Imran
authors.initials: I
authors.lastname: Satia
authors.affiliation: Division of Infection, Immunity and Respiratory Medicine, University of Manchester, and Manchester Academic Health Sciences Centre. University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
authors.forename: Huda
authors.initials: H
authors.lastname: Badri
authors.affiliation: Division of Infection, Immunity and Respiratory Medicine, University of Manchester, and Manchester Academic Health Sciences Centre. University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
authors.forename: Bashar
authors.initials: B
authors.lastname: Al-Sheklly
authors.affiliation: Division of Infection, Immunity and Respiratory Medicine, University of Manchester, and Manchester Academic Health Sciences Centre. University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
authors.forename: Jaclyn Ann
authors.initials: JA
authors.lastname: Smith
authors.affiliation: Division of Infection, Immunity and Respiratory Medicine, University of Manchester, and Manchester Academic Health Sciences Centre. University Hospital of South Manchester NHS Foundation Trust, Manchester, UK ashley.woodcock@manchester.ac.uk.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Woodcock
mesh_terms: D002908:Chronic Disease; D003371:Cough / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D017410:Practice Guidelines as Topic
keywords: Capsaicin; P2X3; chronic cough; cough hypersensitivity syndrome; vagus nerve