Assessment and Management of Cough in Idiopathic Pulmonary Fibrosis: A Narrative Review.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM Lung Pub Date : 2023-12-01 Epub Date: 2023-11-07 DOI:10.1007/s00408-023-00653-3
Shangxiang Liu, Xu Ye
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Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal disease with an unknown cause. It is characterized by symptoms such as cough and breathlessness, which significantly impact patients' quality of life. Cough, in particular, has emerged as a burdensome symptom for individuals with IPF. The etiology of cough in IPF patients is believed to be complex, involving factors related to the disease itself, such as increased sensitivity of cough nerves, lung structural changes, inflammation, and genetic factors, as well as comorbidities and medication effects. Unfortunately, effective treatment options for cough in IPF remain limited, often relying on empirical approaches based on studies involving chronic cough patients in general and the personal experience of physicians. Medications such as opioids and neuromodulators are commonly prescribed but have shown suboptimal efficacy, imposing significant physical, psychological, and economic burdens on patients. However, there is hope on the horizon, as specific purinergic P2 receptor ligand-gated ion channel (P2X3) inhibitors have demonstrated promising antitussive effects in ongoing clinical trials. This review aims to provide a comprehensive overview of the evaluation and management of cough in IPF patients, as well as highlight emerging pharmacological and non-pharmacological approaches that target the cough reflex and are currently being investigated in clinical settings.

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特发性肺纤维化咳嗽的评估和治疗:叙述性综述。
特发性肺纤维化(IPF)是一种病因不明的慢性、进行性和致命性疾病。其特征是咳嗽和呼吸困难等症状,这些症状会显著影响患者的生活质量。尤其是咳嗽,已经成为IPF患者的一种负担性症状。IPF患者咳嗽的病因被认为是复杂的,涉及与疾病本身相关的因素,如咳嗽神经敏感性增加、肺部结构变化、炎症和遗传因素,以及合并症和药物作用。不幸的是,IPF咳嗽的有效治疗选择仍然有限,通常依赖于基于对慢性咳嗽患者的研究和医生的个人经验的经验方法。阿片类药物和神经调节剂等药物通常是处方药,但疗效不佳,给患者带来了巨大的身体、心理和经济负担。然而,随着特异性嘌呤能P2受体配体门控离子通道(P2X3)抑制剂在正在进行的临床试验中显示出有希望的镇咳作用,希望就在眼前。这篇综述旨在全面概述IPF患者咳嗽的评估和管理,并强调针对咳嗽反射的新兴药理学和非药理学方法,这些方法目前正在临床环境中进行研究。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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