Cough in asthma

Asthma is one of the most common causes of chronic cough, and cough may be the sole or predominant symptom of asthma. The mechanisms of cough in asthma are complex and presumbably multi-factorial. In particular, the pathophysiologic basis of cough variant versus classic asthma is poorly understood. Recent research utilizing various inhalation challenge tests suggests that preservation of the bronchodilating and bronchoprotective effects of deep inspirations is a distinguishing feature of cough variant asthma. This review outlines the tussive agents used in cough research (including tussive and direct, indirect and combined bronchoconstrictive stimuli), their mechanisms of action, the receptors involved in eliciting cough, and characteristic responses in classic asthma and cough variant asthma.

► This review summarizes current understanding of the mechanisms of cough in asthma. ► Various tussive stimuli elicit cough through different pathways and receptors. ► Responses to tussive challenges are providing insight into cough pathophysiology. ► Effects of deep inspirations may discern asthma from related airway conditions.