Department of Anatomy and Neuroscience, The University of Melbourne, Australia.
School of Biomedical Sciences, The University of Queensland, Australia.
Pulm Pharmacol Ther. 2017 Dec;47:9-15. doi: 10.1016/j.pupt.2017.01.010. Epub 2017 Jan 27.
The airway sensory nervous system is composed of two anatomically distinct processing pathways that allow for the production of respiratory reflexes and voluntary evoked respiratory behaviours in response to sensing an airway irritation. Disordered sensory processing is a hallmark feature of many pulmonary disorders and results in the development of cough hypersensitivity syndrome, characterised by chronic cough and a persistent urge-to-cough in affected individuals. However, the mechanism underpinning how the airway sensory circuits become disordered, especially at the level of the central nervous system, is not well understood. In this mini-review we present well-defined mechanisms that lead to the development of chronic pain as a framework to explore the evidence that cough disorders may manifest due to neuroplasticity and sensitisation of important components of the airway sensory circuitry in the brain. We highlight recent discoveries of how airway sensory processing occurs in the brain in health and disease and additionally suggest areas where gaps exist in our current knowledge on the topic, with the goal of providing a better understanding of how airway circuits become dysfunctional in disease. This may in turn help identify novel therapeutic targets for restoring normal airway sensory processing and alleviating excessive cough.
气道感觉神经系统由两个解剖上不同的处理途径组成，这使得能够在感觉到气道刺激时产生呼吸反射和自愿诱发的呼吸行为。感觉处理障碍是许多肺部疾病的一个显著特征，导致咳嗽高敏综合征的发展，其特征为慢性咳嗽和受影响个体持续的咳嗽冲动。然而，气道感觉回路如何变得紊乱的机制，特别是在中枢神经系统水平，尚不清楚。在这篇迷你综述中，我们提出了明确的机制，这些机制导致慢性疼痛的发展，作为探索咳嗽障碍可能由于大脑中气道感觉回路的重要组成部分的神经可塑性和致敏而表现出来的证据的框架。我们强调了在健康和疾病中大脑中气道感觉处理发生的最新发现，并另外提出了我们目前在该主题上的知识空白领域，目的是更好地了解气道回路在疾病中如何变得功能失调。这反过来可能有助于确定恢复正常气道感觉处理和缓解过度咳嗽的新治疗靶点。
