Abstract
Chronic cough can be a troublesome clinical problem. Current thinking is that increased activity and/or enhanced sensitivity of the peripheral and central neural pathways mediates chronic cough via processes similar to those associated with the development of chronic pain. While inflammation is widely thought to be involved in the development of chronic cough, the true mechanisms causing altered neural activity and sensitisation remain largely unknown. In this back-to-basics perspective article we explore evidence that inflammation in chronic cough may, at least in part, involve neuroinflammation orchestrated by glial cells of the nervous system. We summarise the extensive evidence for the role of both peripheral and central glial cells in chronic pain, and hypothesise that the commonalities between pain and cough pathogenesis and clinical presentation warrant investigations into the neuroinflammatory mechanisms that contribute to chronic cough. We open the debate that glial cells may represent an underappreciated therapeutic target for controlling troublesome cough in disease.
Abstract
The mechanisms causing altered neural activity and sensitisation in chronic cough remain largely unknown. Neuroinflammation involving glial cells may contribute to cough pathogenesis, representing a potential novel therapeutic target. https://bit.ly/3fdbko4
Footnotes
Author contributions: Article concept: L.P. McGarvey, S.B. Mazzone and F.T. Lundy; drafting of manuscript: all authors; critical revision of manuscript for important content: all authors.
Conflict of interest: A-C. Devlin has nothing to disclose.
Conflict of interest: F.T. Lundy has nothing to disclose.
Conflict of interest: S.L. Martin has nothing to disclose.
Conflict of interest: G.P. Sergeant has nothing to disclose.
Conflict of interest: S.B. Mazzone reports grants and personal fees for consultancy from Merck, personal fees for consultancy from NeRRe, outside the submitted work.
Conflict of interest: L.P. McGarvey reports grants and personal fees from Merck, personal fees from NeRRe, Chiesi, GSK and Shionogi, outside the submitted work.
Conflict of interest: A.K. Driessen has nothing to disclose.
Support statement: This work was part of the BREATH project by the European Union under the Interreg VA Health and Life Science Programme. The views and opinions expressed in this paper do not necessarily reflect those of the European Commission or the Special European Union Programmes Body.
- Received March 19, 2020.
- Accepted June 30, 2020.
- Copyright ©ERS 2020