Unravelling vagal hypersensitivity in chronic cough: A distinct disease

Chronic cough (CC) is a common but poorly understood disease that has a negative impact on quality of life. For years, clinicians have been trying to find the underlying diagnosis and using existing disease models to describe the patients' illness. This presents a confusing picture of CC. Most patients with CC present with hypersensitivity of the cough reflex, which is characterised by laryngeal paraesthesia and an increased response to the tussive stimuli or an innocuous stimulus that would not trigger coughing in healthy people. Recently, it has been proposed that CC is a unique disease characterised by vagal hypersensitivity that projects to the central nervous system altering responsiveness. The evidence supports the hypothesis that CC is primarily a neurological disorder, consisting of different phenotypes.image Abstract figure legend Pattern diagram of airway reflux increasing vagal sensitivity.image

Automated summary

Chronic cough is a common and poorly understood disease that negatively affects quality of life. Clinicians have been trying to find the underlying diagnosis and using existing disease models to describe it, resulting in a confusing picture of chronic cough. Most patients with chronic cough present with hypersensitivity of the cough reflex, characterized by abnormal throat sensations and an increased response to stimuli that would not trigger coughing in healthy individuals. Recent studies suggest that chronic cough is a unique disease characterized by vagal hypersensitivity and altered central nervous system responsiveness.