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Review Series: Chronic cough: Common causes and current guidelines

Department of Medicine, Queen's University of Belfast, Belfast, UK, l.mcgarvey{at}qub.ac.uk, Regional Respiratory Centre, Belfast City Hospital, Belfast, UK

L. Polley

Department of Medicine, Queen's University of Belfast, Belfast, UK

J. MacMahon

Department of Medicine, Queen's University of Belfast, Belfast, UK, Regional Respiratory Centre, Belfast City Hospital, Belfast, UK

Chronic cough is a common and disabling symptom. Recent guidelines have attempted to provide direction in the clinical management of cough in both primary and secondary care. They have also provided a critical review of the available literature and identified gaps in current knowledge. Despite this they have been criticized for a reliance on a low quality evidence base. In this review, we summarize the current consensus on the clinical management of chronic cough and attempt to rationalize this based on recent evidence. We have also provided an overview of the likely pathophysiological mechanisms responsible for cough and highlighted areas, where knowledge deficits exist and suggest directions for future research. Such progress will be critical in the search for new and effective treatments for cough. Chronic Respiratory Disease 2007; 4: 215—223

Key Words: aetiology • cough • guidelines • treatment

References

• Morice AH, Fontana GA, Sovijarvi AR et al. The diagnosis and management of chronic cough. Eur Respir J 2004; 24(3): 481—92.[Free Full Text]
• Irwin RS Introduction to the diagnosis and management of cough: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(Suppl 1): 25S—27.[Free Full Text]
• Morice AH, McGarvey L., Pavord I., British Thoracic Society Cough Guideline Group. Recommendations for the management of cough in adults. Thorax 2006; 61(Suppl 1): 11—24.
• Woolf SH, Grol R., Hutchinson A., Eccles M., Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ 1999; 318(7182): 527—30.[Free Full Text]
• Dean NC, Silver MP, Bateman KA, James B., Hadlock CJ, Hale D. Decreased mortality after implementation of a treatment guideline for community-acquired pneumonia. Am J Med 2001; 110(6): 451—7.[CrossRef][Medline] [Order article via Infotrieve]
• Nathwani D., Rubinstein E., Barlow G., Davey P. Do guidelines for community-acquired pneumonia improve the cost-effectiveness of hospital care? Clin Infect Dis 2001; 32(5): 728—41.[CrossRef][Medline] [Order article via Infotrieve]
• Dean NC, Bateman KA, Donnelly SM, Silver MP, Snow GL, Hale D. Improved clinical outcomes with utilization of a community-acquired pneumonia guideline. Chest 2006; 130(3): 794—9.[Abstract/Free Full Text]
• Dheda K., Crawford A., Hagan G., Roberts CM Implementation of British thoracic society guidelines for acute exacerbation of chronic obstructive pulmonary disease: impact on quality of life. Postgrad Med J 2004; 80(941): 169—71.[Abstract/Free Full Text]
• Barlow G., Nathwani D., Williams F. et al. Reducing door-to-antibiotic time in community-acquired pneumonia: controlled before-and-after evaluation and cost-effectiveness analysis. Thorax 2007; 62(1): 67—74.[Abstract/Free Full Text]
• Guest JF, Varney SJ, Diggle J. Impact of the British thoracic society chronic obstructive pulmonary disease guidelines on patients' health status, healthcare resource use and health-related quality of life. Prim Care Respir J 2005; 14(5): 242—51.[CrossRef][Medline] [Order article via Infotrieve]
• Committee for the Japanese Respiratory Society Guidelines for Management of Cough, Kohno S., Ishida T. et al. The Japanese respiratory society guidelines for management of cough. Respirology 2006; 11(Suppl 4): S135—86.[CrossRef][Medline] [Order article via Infotrieve]
• Plaza V., Miguel E., Bellido-Casado J., Lozano MP, Rios L., Bolibar I. Usefulness of the guidelines of the Spanish society of pulmonology and thoracic surgery (SEPAR) in identifying the causes of chronic cough. Arch Bronconeumol 2006; 42(2): 68—73.[CrossRef][Medline] [Order article via Infotrieve]
• Hampton T. New guidelines released for managing cough. JAMA 2006; 295(7): 746—7.[Free Full Text]
• Cough guidelines choke on evidence. Lancet 2006; 367(9507): 276.[Medline] [Order article via Infotrieve]
• Niimi A. Geography and cough aetiology. Pulm Pharmacol Ther 2007; 62(6): 491—5.
• Chung KF, McGarvey L., Widdicombe J. American college of chest physicians' cough guidelines. Lancet 2006; 367(9515): 981—2.[Medline] [Order article via Infotrieve]
• Glauser FL Variant asthma. Ann Allergy 1972; 30(8): 457—9.[Medline] [Order article via Infotrieve]
• McGarvey LP, Heaney LG, Lawson JT et al. Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol. Thorax 1998; 53(9): 738—43.[Abstract/Free Full Text]
• Fujimura M., Nishizawa Y., Nishitsuji M., Abo M., Kita T., Nomura S. Longitudinal decline in pulmonary function in atopic cough and cough variant asthma. Clin Exp Allergy 2003; 33(5): 588—94.[CrossRef][Medline] [Order article via Infotrieve]
• Todokoro M., Mochizuki H., Tokuyama K., Morikawa A. Childhood cough variant asthma and its relationship to classic asthma. Ann Allergy Asthma Immunol 2003; 90(6): 652—9.[Medline] [Order article via Infotrieve]
• Matsumoto H., Niimi A., Takemura M. et al. Prognosis of cough variant asthma: a retrospective analysis. J Asthma 2006; 43(2): 131—5.[CrossRef][Medline] [Order article via Infotrieve]
• Fujimura M., Hara J., Myou S. Change in bronchial responsiveness and cough reflex sensitivity in patients with cough variant asthma: effect of inhaled corticosteroids. Cough 2005; 1: 5.[CrossRef][Medline] [Order article via Infotrieve]
• Dicpinigaitis PV Chronic cough due to asthma: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(1 Suppl): 75S—9.[Abstract/Free Full Text]
• Brightling CE, Pavord ID Eosinophilic bronchitis: an important cause of prolonged cough. Ann Med 2000; 32(7): 446—51.[Medline] [Order article via Infotrieve]
• Brightling CE, Bradding P., Symon FA, Holgate ST, Wardlaw AJ, Pavord ID Mast-cell infiltration of airway smooth muscle in asthma. N Engl J Med 2002; 346(22): 1699—705.[Abstract/Free Full Text]
• Park SW, Lee YM, Jang AS et al. Development of chronic airway obstruction in patients with eosinophilic bronchitis: a prospective follow-up study. Chest 2004; 125(6): 1998—2004.[Abstract/Free Full Text]
• Birring SS, Berry M., Brightling CE, Pavord ID Eosinophilic bronchitis: clinical features, management and pathogenesis. Am J Respir Med 2003; 2(2): 169—73.[Medline] [Order article via Infotrieve]
• McGarvey L., Morice AH Atopic cough: little evidence to support a new clinical entity. Thorax 2003; 58(8): 736—7 (author reply 737—8).[Free Full Text]
• Pratter MR Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Chest 2006; 129(Suppl 1): 63S—71.[Abstract/Free Full Text]
• Irwin RS, Curley FJ, French CL Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis 1990; 141(3): 640—7.[Medline] [Order article via Infotrieve]
• O'Hara J., Jones NS `Post-nasal drip syndrome': most patients with purulent nasal secretions do not complain of chronic cough. Rhinology 2006; 44(4): 270—3.[Medline] [Order article via Infotrieve]
• O'Hara J., Jones NS The aetiology of chronic cough: a review of current theories for the otorhinolaryngologist. J Laryngol Otol 2005; 119(7): 507—14.[CrossRef][Medline] [Order article via Infotrieve]
• Pratter MR Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Chest 2006; 129(Suppl 1): 63S—71.[Abstract/Free Full Text]
• Bel A., Labarre JF, Thivolle P., Passot E. Broncho-pulmonary manifestations and gastroesophageal reflux. Poumon Coeur 1977; 33(6): 345—50.[Medline] [Order article via Infotrieve]
• Euler AR, Byrne WJ, Ament ME et al. Recurrent pulmonary disease in children: a complication of gastroesophageal reflux. Pediatrics 1979; 63(1): 47—51.[Abstract/Free Full Text]
• Ford AC, Forman D., Moayyedi P., Morice AH Cough in the community: a cross sectional survey and the relationship to gastrointestinal symptoms. Thorax 2006; 61(11): 975—9.[Abstract/Free Full Text]
• Franco RA, Jr. Laryngopharyngeal reflux. Allergy Asthma Proc 2006; 27(1): 21—5.[Medline] [Order article via Infotrieve]
• Nordenstedt H., Nilsson M., Johansson S. et al. The relation between gastroesophageal reflux and respiratory symptoms in a population-based study: the Nord-Trondelag health survey. Chest 2006; 129(4): 1051—6.[Abstract/Free Full Text]
• Vakil N., van Zanten SV, Kahrilas P., Dent J., Jones R., Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006; 101(8): 1900—20 (quiz 1943).[CrossRef]
• Phua SY, McGarvey LP, Ngu MC, Ing AJ Patients with gastro-oesophageal reflux disease and cough have impaired laryngopharyngeal mechanosensitivity. Thorax 2005; 60(6): 488—91.[Abstract/Free Full Text]
• Ing AJ, Ngu MC, Breslin AB Pathogenesis of chronic persistent cough associated with gastroesophageal reflux. Am J Respir Crit Care Med 1994; 149(1): 160—7.[Abstract]
• Patterson RN, Johnston BT, Ardill JE, Heaney LG, McGarvey LP Elevated tachykinin levels in induced sputum from asthmatics and cough patients with acid reflux. Thorax 2007; 62(6): 491—5.[Abstract/Free Full Text]
• Chang AB, Gibson PG, Ardill J., McGarvey LP Calcitonin gene-related peptide relates with cough sensitivity in children with chronic cough. Eur Respir J 2007; 30(1): 66—72.[Abstract/Free Full Text]
• Kastelik JA, Redington AE, Aziz I. et al. Abnormal oesophageal motility in patients with chronic cough. Thorax 2003; 58(8): 699—702.[Abstract/Free Full Text]
• Patterson RN, Johnston BT, MacMahon J., Heaney LG, McGarvey LP Oesophageal pH monitoring is of limited value in the diagnosis of `reflux-cough'. Eur Respir J 2004; 24(5): 724—7.[Abstract/Free Full Text]
• Chang AB, Lasserson TJ, Kiljander TO, Connor FL, Gaffney JT, Garske LA Systematic review and meta-analysis of randomised controlled trials of gastro-oesophageal reflux interventions for chronic cough associated with gastro-oesophageal reflux. BMJ 2006; 332(7532): 11—7.[Abstract/Free Full Text]
• Chang AB, Lasserson TJ, Gaffney J., Connor FL, Garske LA Gastro-oesophageal reflux treatment for prolonged non-specific cough in children and adults. Cochrane Database Syst Rev 2006; (4): CD004823.
• Ours TM, Kavuru MS, Schilz RJ, Richter JE A prospective evaluation of esophageal testing and a double-blind, randomized study of omeprazole in a diagnostic and therapeutic algorithm for chronic cough. Am J Gastroenterol 1999; 94: 3131—8.[CrossRef][Medline] [Order article via Infotrieve]
• Kiljander TO, Salomaa ER, Hietanen EK, Terho EO Chronic cough and gastro-oesophageal reflux: a double-blind placebo-controlled study with omeprazole. (abstract). Eur Respir J 2000; 16: 633—8.[Abstract]
• Irwin RS Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(Suppl 1): 80S—94.[Abstract/Free Full Text]
• Sifrim D., Dupont L., Blondeau K., Zhang X., Tack J., Janssens J. Weakly acidic reflux in patients with chronic unexplained cough during 24 hour pressure, pH, and impedance monitoring. Gut 2005; 54(4): 449—54.[Abstract/Free Full Text]
• Mainie I., Tutuian R., Shay S. et al. Acid and non-acid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring. Gut 2006; 55(10): 1398—402.[Abstract/Free Full Text]
• Bredenoord AJ, Tutuian R., Smout AJ, Castell DO Technology Review: Esophageal Impedance Monitoring. Am J Gastroenterol 2007; 101(11): 2470—5.
• Swoger J., Ponsky J., Hicks DM et al. Surgical fundoplication in laryngopharyngeal reflux unresponsive to aggressive acid suppression: a controlled study. Clin Gastroenterol Hepatol 2006; 4(4): 433—41.[Medline] [Order article via Infotrieve]
• Kaufman JA, Houghland JE, Quiroga E., Cahill M., Pellegrini CA, Oelschlager BK Long-term outcomes of laparoscopic anti-reflux surgery for gastroesophageal reflux disease (GERD)-related airway disorder. Surg Endosc 2006; 20(12): 1824—30.[Medline] [Order article via Infotrieve]
• Khan AM, Hashmi SR, Elahi F., Tariq M., Ingrams DR Laryngopharyngeal reflux: a literature review. Surgeon 2006; 4(4): 221—5.[Medline] [Order article via Infotrieve]
• Polley L., Cardwell C., Costello R., McGarvey L. Predictors of idiopathic cough: outcome of a retrospective analysis. (abstract). Thorax 2005; 60: 107.
• Haque RA, Usmani OS, Barnes PJ Chronic idiopathic cough: a discrete clinical entity? Chest 2005; 127(5): 1710—3.[Abstract/Free Full Text]
• McGarvey LP Idiopathic chronic cough: a real disease or a failure of diagnosis? Cough 2005; 1: 9.[CrossRef][Medline] [Order article via Infotrieve]
• McGarvey LP, Ing AJ Idiopathic cough, prevalence and underlying mechanisms. Pulm Pharmacol Ther 2004; 17(6): 435—9.[CrossRef][Medline] [Order article via Infotrieve]
• Davenport PW, Bolser DC, Vickroy T. et al. The effect of codeine on the urge-to-cough response to inhaled capsaicin. Pulm Pharmacol Ther 2007; 20(4): 338—46.[CrossRef][Medline] [Order article via Infotrieve]
• Canning BJ Anatomy and neurophysiology of the cough reflex: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(Suppl 1): 33—47S.
• Canning BJ, Farmer DG, Mori N. Mechanistic studies of acid evoked coughing in anesthetized guinea pigs. Am J Physiol Regul Integr Comp Physiol 2006; 291(2): R454—63.[CrossRef]
• Canning BJ, Mazzone SB, Meeker SN, Mori N., Reynolds SM, Undem BJ Identification of the tracheal and laryngeal afferent neurones mediating cough in anaesthetized guinea-pigs. J Physiol 2004; 557(Pt 2): 543—58.[Abstract/Free Full Text]
• Kollarik M., Undem BJ Mechanisms of acid-induced activation of airway afferent nerve fibres in guinea-pig. J Physiol 2002; 543(Pt 2): 591—600.[Abstract/Free Full Text]
• Lalloo UG, Fox AJ, Belvisi MG, Chung KF, Barnes PJ Capsazepine inhibits cough induced by capsaicin and citric acid but not by hypertonic saline in guinea pigs. J Appl Physiol 1995; 79(4): 1082—7.[Abstract/Free Full Text]
• Mitchell JE, Campbell AP, New NE et al. Expression and characterization of the intracellular vanilloid receptor (TRPV1) in bronchi from patients with chronic cough. Exp Lung Res 2005; 31(3): 295—306.[Medline] [Order article via Infotrieve]
• Groneberg DA, Niimi A., Dinh QT et al. Increased expression of transient receptor potential vanilloid-1 in airway nerves of chronic cough. Am J Respir Crit Care Med 2004; 170(12): 1276—80.[Abstract/Free Full Text]
• Krishtal O. The ASICs: signaling molecules? Modulators? Trends Neurosci 2003; 26(9): 477—83.[CrossRef][Medline] [Order article via Infotrieve]
• Choudry NB, Fuller RW Sensitivity of the cough reflex in patients with chronic cough. Eur Respir J 1992; 5(3): 296—300.[Abstract]
• Carr MJ, Lee LY Plasticity of peripheral mechanisms of cough. Respir Physiol Neurobiol 2005; 152(3): 298—311.[Medline] [Order article via Infotrieve]
• Bonham AC, Sekizawa SI, Joad JP Plasticity of central mechanisms for cough. Pulm Pharmacol Ther 2004; 17(6): 453—7 (discussion 469—70).[CrossRef][Medline] [Order article via Infotrieve]
• Carr MJ, Hunter DD, Jacoby DB, Undem BJ Expression of tachykinins in non-nociceptive vagal afferent neurons during respiratory viral infection in guinea pigs. Am J Respir Crit Care Med 2002; 165(8): 1071—5.[Abstract/Free Full Text]
• Piedimonte G., Hegele RG, Auais A. Persistent airway inflammation after resolution of respiratory syncytial virus infection in rats. Pediatr Res 2004; 55(4): 657—65.[CrossRef][Medline] [Order article via Infotrieve]
• Doherty MJ, Mister R., Pearson MG, Calverley PM Capsaicin responsiveness and cough in asthma and chronic obstructive pulmonary disease. Thorax 2000; 55(8): 643—9.[Abstract/Free Full Text]
• Choudry NB, Fuller RW, Pride NB Sensitivity of the human cough reflex: effect of inflammatory mediators prostaglandin E2, bradykinin, and histamine. Am Rev Respir Dis 1989; 140(1): 137—41.[Medline] [Order article via Infotrieve]
• Hargreaves M., Ravi K., Senaratne MP, Kappagoda CT Responses of airway rapidly adapting receptors to bradykinin before and after administration of enalapril in rabbits. Clin Sci (Lond) 1992; 83(4): 399—407.[Medline] [Order article via Infotrieve]
• O'Connell F., Springall DR, Moradoghli-Haftvani A. et al. Abnormal intraepithelial airway nerves in persistent unexplained cough? Am J Respir Crit Care Med 1995; 152(6 Pt 1): 2068—75.[Abstract]
• Basoglu OK, Pelleg A., Essilfie-Quaye S., Brindicci C., Barnes PJ, Kharitonov SA Effects of aerosolized adenosine 5'-triphosphate vs adenosine 5'-monophosphate on dyspnea and airway caliber in healthy nonsmokers and patients with asthma. Chest 2005; 128(4): 1905—9.[Abstract/Free Full Text]
• Crummy F., Livingston M., Ardill JE, Adamson C., Ennis M., Heaney LG Endobronchial adenosine monophosphate challenge causes tachykinin release in the human airway. J Allergy Clin Immunol 2005; 116(2): 312—7.[CrossRef][Medline] [Order article via Infotrieve]
• Dai Y., Moriyama T., Higashi T. et al. Proteinase-activated receptor 2-mediated potentiation of transient receptor potential vanilloid subfamily 1 activity reveals a mechanism for proteinase-induced inflammatory pain. J Neurosci 2004; 24(18): 4293—9.[Abstract/Free Full Text]
• Gatti R., Andre E., Amadesi S. et al. Protease-activated receptor-2 activation exaggerates TRPV1-mediated cough in guinea pigs. J Appl Physiol 2006; 101(2): 506—11.[Abstract/Free Full Text]

Chronic Respiratory Disease, Vol. 4, No. 4, 215-223 (2007)
DOI: 10.1177/1479972307084447


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by McGarvey, L.P.A. Articles by MacMahon, J. Search for Related Content PubMed PubMed Citation Articles by McGarvey, L.P.A. Articles by MacMahon, J. Social Bookmarking                         What's this?