Mechanisms and management of cough in interstitial lung disease.

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-12-30 DOI:10.1080/17476348.2023.2299751
Ameer Z Rasheed, Mark L Metersky, Fatima Ghazal
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Abstract

Introduction: Many patients with interstitial lung diseases (ILDs), especially fibrotic ILDs, experience chronic cough. It negatively impacts both physical and psychological well-being. Effective treatment options are limited.

Areas covered: The pathophysiology of chronic cough in IPF is complex and involves multiple mechanisms, including mechanical distortion of airways, parenchyma, and nerve fibers. The pathophysiology of cough in other fibrosing ILDs is poorly understood and involves various pathways. The purpose of this review is to highlight mechanisms of chronic cough and to present therapeutic evidence for its management in the most commonly occurring diffuse fibrosing lung diseases including idiopathic pulmonary fibrosis (IPF), connective tissue disease-related interstitial lung disease (CTD-ILD), sarcoidosis-related ILD (Sc-ILD), chronic hypersensitivity pneumonitis-related ILD (CHP-ILD), and post-COVID-19-related interstitial lung disease (PC-ILD).

Expert opinion: This review guides the management of chronic cough in fibrosing ILDs. In this era of precision medicine, chronic cough management should be individualized in each interstitial lung disease.

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间质性肺病咳嗽的机理和治疗。
导言:许多间质性肺病(ILDs)患者,尤其是纤维化间质性肺病患者,都有慢性咳嗽的经历。它对患者的身心健康都有负面影响。有效的治疗方案有限:IPF 慢性咳嗽的病理生理学非常复杂,涉及多种机制,包括气道、肺实质和神经纤维的机械变形。其他纤维化 ILD 咳嗽的病理生理学尚不十分清楚,涉及多种途径。本综述旨在强调慢性咳嗽的发病机制,并介绍治疗最常见的弥漫性纤维化肺部疾病(包括特发性肺纤维化(IPF)、结缔组织病相关性间质性肺病(CTD-ILD)、肉样瘤病相关性间质性肺病(Sc-ILD)、慢性超敏性肺炎相关性间质性肺病(CHP-ILD)和 COVID-19 后相关性间质性肺病(PC-ILD))的治疗证据:本综述为纤维化 ILD 中慢性咳嗽的治疗提供了指导。在这个精准医疗的时代,慢性咳嗽的治疗应针对每种间质性肺病进行个体化治疗。
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