Moinard J, Manier G
Centre de Pneumologie, Bordeaux.
Rev Mal Respir. 2000 Feb;17(1):23-8.
Cough is a reflex phenomenon occurring when sensitive receptors located in the larynx and upper airways are activated. These receptors generate information which reaches the central nervous system. The central organization of the cough reflex loop is poorly understood. The afferent pathways originate in receptors situated under and between airway epithelial cells. Most are rapidly adapting receptors (RAR) linked to myelinized fibers of the vagus nerve which can be directly stimulated by cough-inducing agents. Other receptors generate information carried by non-myelinized C fibers. When activated, these receptors release neuropeptides leading to neurogenic inflammation which can also activate RARs. The threshold of the cough reflex and its expression thus depends on a complex interaction between RARs and C fiber receptors with peripheral and central components. A better understanding of the mechanisms triggering cough and its control would be most useful for optimal management of patients with cough problems.
咳嗽是一种反射现象，当位于喉部和上呼吸道的敏感感受器被激活时就会发生。这些感受器产生的信息会传至中枢神经系统。咳嗽反射环路的中枢机制目前还了解甚少。传入通路起源于气道上皮细胞下方和之间的感受器。大多数是与迷走神经的有髓纤维相连的快速适应感受器（RAR），咳嗽诱导剂可直接刺激这些感受器。其他感受器产生由无髓C纤维携带的信息。这些感受器被激活时会释放神经肽，导致神经源性炎症，进而也能激活RAR。因此，咳嗽反射的阈值及其表现取决于RAR与具有外周和中枢成分的C纤维感受器之间的复杂相互作用。更好地了解引发咳嗽及其控制的机制，对于咳嗽问题患者的最佳管理最为有用。
