Cough and Asthma

Akio      Niimi

Abstract

Cough is the most common complaint for which patients seek medical attention. Cough variant asthma (CVA) is a form of asthma, which presents solely with cough. CVA is one of the most common causes of chronic cough. More importantly, 30 to 40% of adult patients with CVA, unless adequately treated, may progress to classic asthma. CVA shares a number of pathophysiological features with classic asthma such as atopy, airway hyper-responsiveness, eosinophilic airway inflammation and various features of airway remodeling. Inhaled corticosteroids remain the most important form of treatment of CVA as they improve cough and reduce the risk of progression to classic asthma most likely through their prevention of airway remodeling and chronic airflow obstruction.

Keywords: Chronic cough, eosinophils, asthma, cough variant asthma, airway inflammation, inhaled corticosteroid, airway hyper-responsiveness, chronic airflow obstruction, classic asthma (CA), non-asthmatic eosinophilic bronchitis (NAEB), atopic cough, bronchodilators, dyspnea, cough-predominant asthma, beta-agonists, leukotriene receptor antagonists, histamine H1 receptor antagonists, thromboxane synthesis inhibitors, cough-reflux selfperpetuating positive feedback cycle, goblet cell hyperplasia, Sinobronchial syndrome (SBS), neutrophilic inflammation, ELISA method, productive cough, Sputum mucin, methacholine, theophyllines, IgE, skin test, aeroallergens, peak expiratory flow (PEF), bronchoconstriction, capsaicin, bronchoalveolar lavage (BAL), bronchial mucosal tissue, lung parenchyma, Mast cells, fibrogenic mediators, goblet cell, hyperplasia, vascular proliferation, histamine, prostaglandins D2, leukotrienes C4, D4 and E4, computed tomography (CT), biopsy, leukocytes, sputum eosinophilia, bronchodilator-resistant dry cough, eosinophilic tracheobronchitis