Cough Variant Asthma and Airway Inflammation Dynamics
Summary
Cough variant asthma (CVA) is an atypical form of asthma in which chronic cough is the predominant or sole symptom, often in the absence of wheezing or dyspnoea. Underlying this cough is a spectrum of airway inflammation—most commonly eosinophilic—together with heightened bronchial responsiveness to nonspecific stimuli. Subclinical changes in airway structure and function, including peribronchial remodelling and increased mucus production, contribute to persistent cough and occasional progression to classic asthma. Diagnosis frequently relies on a combination of normal spirometric measures, positive bronchial provocation tests, assessment of fractional exhaled nitric oxide (FeNO) and induced sputum cytometry. Management revolves around inhaled corticosteroids to reduce inflammation, leukotriene receptor antagonists for adjunctive control, and close monitoring of cough severity and inflammation biomarkers. A better understanding of the dynamic interplay between cough reflex sensitivity, inflammatory mediators such as interleukin-5 and transforming growth factor-β, and structural airway changes is crucial for optimising personalised interventions and preventing disease evolution.
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Cough Variant Asthma and Airway Inflammation Dynamics publication trend
The graph below shows the total number of articles in cough variant asthma and airway inflammation dynamics across all publications each year (not limited to Nature Index journals).
Technical terms
Cough variant asthma (CVA): A form of asthma where chronic cough is the principal symptom, often lacking wheeze.
Airway hyperresponsiveness (AHR): Exaggerated bronchoconstriction response to stimuli such as methacholine or histamine.
Eosinophilic airway inflammation: Infiltration of the bronchial mucosa by eosinophils, driving Th2-type inflammatory responses.
Fractional exhaled nitric oxide (FeNO): A non-invasive biomarker of airway inflammation, elevated in eosinophilic asthma phenotypes.
Bronchial provocation test: A diagnostic procedure that measures airway responsiveness by inhalation of a known bronchoconstrictor agent.
References
- Inflammatory Mediators in Induced Sputum and Airway Hyperresponsiveness in Cough Variant Asthma during Long‐Term Inhaled Corticosteroid Treatment. Mediators of Inflammation (2012).
- Effects of treatment with montelukast alone, budesonide/formoterol alone and a combination of both in cough variant asthma. Respiratory Research (2022).
- Clinical and Inflammatory Characteristics of the Chinese APAC Cough Variant Asthma Cohort. Frontiers in Medicine (2022).
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