Heterogeneity of cough neurobiology: Clinical implications

Publication date: Available online 11 February 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Stuart B. Mazzone, Michael J. FarrellAbstractCough is an important protective mechanism for clearing the airways but becomes a troublesome, and often difficult to treat, symptom in respiratory disease. Although cough can be produced as a reflex in response to the presence of irritants within the airways, emerging research demonstrates an unappreciated complexity in the peripheral and central neural systems that regulate cough. This complexity includes multiple primary sensory neurons that can induce or facilitate reflex coughing, different ascending central circuits in the brain that contribute to cough sensory discrimination and the perception of the urge-to-cough, and several descending brain systems for inducing, facilitating and inhibiting cough responses. Consequently, the mechanisms responsible for cough becoming dysregulated in disease are not likely homogeneous across all patients with chronic cough. The available data suggests that changes in primary sensory neuron excitability, altered central nervous system integration of sensory inputs and changes in descending control mechanisms may each contribute to the development of cough hypersensitivity.
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research

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We evaluated the effect of gefapixant on cough reflex sensitivity to evoked tussive challenge. In this phase 2, double-blind, two-period study, patients with chronic cough (CC) and healthy volunteers (HV) were randomised to single-dose gefapixant 100 mg or placebo in a crossover fashion. Sequential inhalational challenges with ATP, citric acid, capsaicin and distilled water were performed 1, 3 and 5 h after dosing. Mean concentrations evoking ≥2 coughs (C2) and ≥5 coughs (C5) post dose versus baseline were co-primary endpoints. Objective cough frequency (coughs·h–1) over 24 h and...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory clinical practice Original Articles: Cough Source Type: research
Publication date: July–August 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 6Author(s): Peter G. GibsonPeople with chronic cough can experience significant quality-of-life impairment. New concepts based around cough reflex hypersensitivity are leading to improved management strategies and showing promise in relieving the distress from persistent cough. The clinical cough assessment seeks to classify patients on the basis of symptom duration, and to identify and manage exposures and diseases that activate the afferent limb of the cough reflex. Cough hypersensitivity is also a...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
(Natural News) Coughs make life miserable for the patient and his or her loved ones. Fortunately, there are easy recipes for do-it-yourself cough syrups that effectively relieve the symptoms of cough without costing as much as over-the-counter pharmaceutical drugs. There are two types of syrups used to treat coughs: Antitussives, which suppress coughing by preventing the reflex to cough, and...
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
Duchenne muscular dystrophy (DMD) is one of the most common neuromuscular diseases. It determines a progressive impairment of muscular function that can lead to inability to move, respiratory failure and death [1 –3]. Although improvement in disease management and therapeutic advancements have significantly increased life expectancy [4,5], the progression of the disease and of the functional impairment is not arrested by the present treatment modalities. In older DMD patients, symptoms due to skeletal musc les impairment are prominent, and the severe deterioration of respiratory muscles function causes frequent lung ...
Source: Neuromuscular Disorders - Category: Neurology Authors: Source Type: research
Publication date: Available online 6 June 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Li Long, Kefang LaiAbstractChronic cough is one of the most common complains for patients seeking medical attention in both general practice and respiratory specialist clinics. Cough variant asthma, eosinophilic bronchitis, upper airway cough syndrome, as well as gastro-esophageal reflux disease are common conditions associated with chronic cough, and cough variant asthma, eosinophilic bronchitis account for a higher proportion of patients with chronic cough in China than in Western countries. An older female predominan...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
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Source: Respiratory Research - Category: Respiratory Medicine Authors: Tags: Research Source Type: research
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
(Natural News) As a prepper, it pays to know about various home remedies, especially when SHTF and you can no longer buy supplies from stores and pharmacies. Before disaster strikes, learn know how to make natural cures for common complaints, like coughs. (h/t to ApartmentPrepper.com) Coughing is a normal reflex that protects your lungs and windpipe and it helps...
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
Authors: Skoczyński S, Minarowski Ł, Tobiczyk E, Oraczewska A, Glinka K, Ficek K, Mróz R, Barczyk A Abstract Respiratory failure is one of the most important risk factors for diagnostic bronchofiberoscopy (BF), whereas therapeutic bronchoscopies are typically performed in intubated patients. Only a few published studies analyzed the outcomes of noninvasive mechanical ventilation (NIV)-facilitated BF. In this case series, we present our experiences with NIV-facilitated diagnostic and therapeutic BF performed in patients with respiratory failure that was associated with acute interstitial pulmonary disease, ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
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Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research
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