Abstract
Cough is a common and troublesome symptom in people with asthma and is often associated with poorer asthma control and exacerbations. Apart from asthma, other causes or comorbidities might underlie cough in asthma, such as rhinosinusitis and bronchiectasis. Eosinophilic inflammation and bronchoconstriction can lead to an acute episode of cough or worsen chronic cough. Cough hypersensitivity with laryngeal paraesthesia, allotussia, and hypertussia might underlie the cough of asthma through augmented sensory nerve excitability of upper-airway vagal sensory nerves. Cough associated with bronchoconstriction and type 2 inflammation should respond to inhaled corticosteroids and long-acting β-adrenoceptor agonist therapy. For cough hypersensitivity in adults, speech and language therapy and neuromodulators (eg, gabapentin) could be considered. In children, there is no consistent association of asthma with cough sensitivity or between cough and asthma severity. Further research is needed to realise the potential of cough as a measure of asthma control, to understand the mechanisms of cough in asthma, and to develop safe, effective treatments and a precision-medicine approach to the management of cough in asthma in children and adults.
Original language | English |
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Pages (from-to) | 650-662 |
Number of pages | 13 |
Journal | The Lancet Respiratory Medicine |
Volume | 11 |
Issue number | 7 |
DOIs | |
Publication status | Published - Jul 2023 |
Bibliographical note
Funding Information:No funding was provided for the writing of this Personal View. KFC is an Emeritus Senior Investigator of the UK National Institute for Health research and receives research funding from UK Research and Innovation.
Publisher Copyright:
© 2023 Elsevier Ltd