Allergy Asthma Respir Dis.
2025 Apr;13(2):48-54. 10.4168/aard.2025.13.2.48.
Neurobiology of chronic cough
- Affiliations
-
- 1Division of Allergy, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- KMID: 2567724
- DOI: http://doi.org/10.4168/aard.2025.13.2.48
Abstract
- Cough is a normal defense mechanism that involves sensory and motor neurons, as well as cognitive functions of the cerebral cortex. Chronic cough, defined as a persistent cough lasting longer than 8 weeks, significantly affects the quality of life, and imposes a considerable socioeconomic burden, including costs for medical consultation and diagnostic testing. Although an anatomical approach to diagnosing chronic cough has been used for over 30 years, many patients are still classified as having “unexplained cough” despite comprehensive evaluation. The concept of cough hypersensitivity syndrome provides a potential explanation for these cases, suggesting that chronic cough may be a neuropathic condition rather than a symptom. Several reports both from animal studies and from human clinical data have elucidated the pathophysiological mechanisms underlying cough hypersensitivity. Additionally, recent advancements in genetic analysis have identified mutations in replication factor C subunit 1 in some patients with chronic cough, which impair neuronal repair mechanisms and increase cough hypersensitivity. This review aims to demonstrate that chronic cough is a neuropathic disorder by reviewing the neuroimmune mechanisms involved in cough hypersensitivity and the neurological manifestations observed in affected patients. Furthermore, treatments for normalizing cough hypersensitivity will be discussed.
