Neuro-phenotypes in Airway Diseases: insights from translational cough studies.

Maria G Belvisi, Mark A Birrell, Saifudin Khalid, Michael A. Wortley, Rachel Dockry, Julie Coote, Kimberley Holt, Eric Dubuis, Angela Kelsall, Sarah A. Maher, Sara Bonvini, Ashley Woodcock, Jaclyn A Smith

Research output: Contribution to journalArticlepeer-review


Most airway diseases, including chronic obstructive pulmonary disease (COPD), are associated with excessive coughing. The extent to which this may be a consequence of increased activation of vagal afferents by pathology in the airways (e.g., inflammatory mediators, excessive mucus) or an altered neuronal phenotype is unknown. Understanding whether respiratory diseases are associated with dysfunction of airway sensory nerves has the potential to identify novel therapeutic targets.
To assess the changes in cough responses to a range of inhaled irritants in COPD and model these in animals to investigate the underlying mechanisms.
Cough responses to inhaled stimuli in patients with COPD, healthy smokers, refractory chronic cough, asthma, and healthy volunteers were assessed and compared with vagus/airway nerve and cough responses in a cigarette smoke (CS) exposure guinea pig model.
Patients with COPD had heightened cough responses to capsaicin but reduced responses to prostaglandin E2 compared with healthy volunteers. Furthermore, the different patient groups all exhibited different patterns of modulation of cough responses. Consistent with these findings, capsaicin caused a greater number of coughs in CS-exposed guinea pigs than in control animals; similar increased responses were observed in ex vivo vagus nerve and neuron cell bodies in the vagal ganglia. However, responses to prostaglandin E2 were decreased by CS exposure.
CS exposure is capable of inducing responses consistent with phenotypic switching in airway sensory nerves comparable with the cough responses observed in patients with COPD. Moreover, the differing profiles of cough responses support the concept of disease-specific neurophenotypes in airway disease. Clinical trial registered with (NCT 01297790).
Original languageEnglish
Pages (from-to)1364-72
Number of pages9
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number12
Early online date7 Jan 2016
Publication statusPublished - 15 Jun 2016


  • Administration, Inhalation
  • Adult
  • Aged
  • Animals
  • Capsaicin
  • Cough
  • Dinoprostone
  • Disease Models, Animal
  • Female
  • Guinea Pigs
  • Humans
  • Male
  • Middle Aged
  • Phenotype
  • Pulmonary Disease, Chronic Obstructive
  • Respiratory System
  • Smoke
  • Vagus Nerve
  • Journal Article


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