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Sensory Pathways and Neural Modulation of Cough

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Cough: Pathophysiology, Diagnosis and Treatment
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Abstract

Cough is induced by mechanical and chemical (irritant) stimuli. The signal is carried out by the vagus nerve A-δ fibers from mechanosensitive cough receptors and/or from nonspecific C-fiber endings in the airways. Cough mechanosensors respond to punctate stimuli and rapid decrease of pH (acidic environment) in the airways providing crucial airway cleaning mechanism. Nonspecific chemosensors provide protection against irritant chemicals reaching lower respiratory tract. These are mostly responsible for upregulated cough response under pathological conditions. Besides primary cough afferent pathways numbers of other (secondary) afferents modulate cough including pulmonary stretch receptors, non-cough-related C-fibers of various origin, baroreceptors, etc. Moreover, several chemicals, neuromediators, and neuromodulators act on cough and other sensors to regulate and affect cough excitability and its motor pattern. Other motor behaviors including breathing, swallowing, sneezing, etc. interact with cough when they compete for the execution. The control neuronal mechanisms ensure under regular conditions that various behaviors order and execute appropriately. Interaction and cooperation of these motor acts may increase or reduce cough.

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Poliacek, I. (2020). Sensory Pathways and Neural Modulation of Cough. In: Zanasi, A., Fontana, G., Mutolo, D. (eds) Cough: Pathophysiology, Diagnosis and Treatment. Springer, Cham. https://doi.org/10.1007/978-3-030-48571-9_2

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