Asthmatic coughing
Pro Research Analysisby 
Searched over 200M research papers for "asthmatic coughing"
Consensus Meter
Understanding Asthmatic Coughing: Causes, Diagnosis, and Treatment
Asthmatic Coughing: A Common Symptom
Asthma is a prevalent cause of chronic cough, particularly in adult nonsmokers. Coughing in asthma can occur alongside other symptoms like wheezing and dyspnea, or it may present as the sole symptom, a condition known as cough-variant asthma (CVA) . This type of asthma is characterized by bronchial hyperresponsiveness and can be challenging to diagnose due to the absence of typical asthmatic symptoms.
Diagnostic Challenges and Methods
Diagnosing cough due to asthma, especially CVA, can be difficult because physical examinations and spirometry results may appear normal. Methacholine inhalation challenge testing is often used to demonstrate bronchial hyperresponsiveness, but the diagnosis is confirmed only after the cough resolves with antiasthmatic therapy. Non-invasive measurements of airway inflammation, such as induced sputum and fractional exhaled nitric oxide (FeNO), have been explored, but their specific benefit in chronic cough due to asthma remains weak.
Mechanisms Behind Asthmatic Cough
The mechanisms of cough in asthma are complex and multifactorial. Research indicates that asthmatic coughing may result from bronchial hyperresponsiveness, inflammation, and possibly airway neuronal dysfunction. Capsaicin-evoked cough responses in asthmatic patients suggest that neuronal dysfunction might play a significant role, particularly in nonatopic asthma phenotypes. Additionally, the preservation of bronchodilating and bronchoprotective effects of deep inspirations is a distinguishing feature of CVA.
Treatment Approaches
The therapeutic approach to managing asthmatic cough generally mirrors that of typical asthma. Most patients respond well to inhaled bronchodilators and corticosteroids. In some cases, leukotriene receptor antagonists and short courses of oral corticosteroids may be necessary . Both asthma and non-asthmatic eosinophilic bronchitis (NAEB) show improvement with inhaled corticosteroids, highlighting the role of airway eosinophilia in these conditions.
Impact of Cough on Asthma Patients
Coughing in asthma can have varying effects on patients. Some find relief through expectoration, while others experience exacerbation of symptoms like breathlessness and wheezing. Chronic cough is associated with poor asthma control, diminished quality of life, and an increased risk of future exacerbations. Therefore, addressing cough as a treatable trait in asthma is crucial for precision medicine and improving patient outcomes.
Conclusion
Asthmatic coughing, whether as part of classic asthma or CVA, is a significant symptom that requires careful diagnosis and management. Understanding the underlying mechanisms, utilizing appropriate diagnostic tools, and tailoring treatment to individual patient needs are essential steps in effectively managing this condition. By recognizing cough as a critical component of asthma, healthcare providers can better address the heterogeneity of asthma and improve patient care.
Sources and full results
Most relevant research papers on this topic