The University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom.
The University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom; M(c)Master University and Firestone Institute for Respiratory Health.
Neurosci Lett. 2023 Jan 1;792:136934. doi: 10.1016/j.neulet.2022.136934. Epub 2022 Oct 26.
In recent years our understanding of the neurophysiological basis of cough has increased substantially. In conjunction, concepts around the drivers of chronic coughing in patients have also significantly evolved. Increasingly it is recognised that dysregulation of the neuronal pathways mediating cough play an important role in certain phenotypes of chronic cough and therefore pathological processes affecting the nervous system are likely to represent key endotypes in patients. Taking inspiration from the study of neuropathic pain, the term hypertussia has been employed to describe the phenomenon of abnormal excessive coughing in response to airway irritation and allotussia to describe coughing in response to stimuli not normally provoking cough. This review aims to summarise current clinical evidence supporting a role for the hyperexcitability of neuronal pathways contributing to chronic coughing and suggest how these might align with the clinical features observed in patients.
近年来，我们对咳嗽的神经生理学基础的理解有了很大的提高。同时，围绕患者慢性咳嗽驱动因素的概念也发生了重大变化。越来越多的人认识到，介导咳嗽的神经元通路的失调在某些慢性咳嗽表型中起着重要作用，因此影响神经系统的病理过程可能代表患者的关键内型。受神经病性疼痛研究的启发，人们使用“过度咳嗽”一词来描述对气道刺激异常过度咳嗽的现象，并用“减敏性咳嗽”来描述对通常不会引起咳嗽的刺激的咳嗽。本综述旨在总结目前支持参与慢性咳嗽的神经元通路过度兴奋的临床证据，并提出这些证据如何与患者观察到的临床特征相一致。
