Journal of Applied Physiology, Vol 65, Issue 3 1007-1023, Copyright © 1988 by American Physiological Society

ARTICLES

Afferent neural pathways in cough and reflex bronchoconstriction

J. A. Karlsson, G. Sant'Ambrogio and J. Widdicombe
Pharmacological Laboratory, AB Draco, Lund, Sweden.

Cough and bronchoconstriction are airway reflexes that protect the lung from inspired noxious agents. These two reflexes can be evoked both from the larynx and tracheobronchial tree and also from some extrarespiratory sites. Within the airways, certain sites are particularly sensitive to stimulation of cough (larynx and points of proximal airway branching), whereas bronchoconstriction can be triggered from the whole of the tracheobronchial tree. In the larynx, "irritant" receptors with myelinated afferents mediate cough and bronchoconstriction. Little seems to be known about laryngeal nonmyelinated afferents and their reflexes. In the tracheobronchial tree and lung, slowly adapting stretch receptors (SARs) and rapidly adapting stretch receptors (RARs) have opposing effects on airway tone, the former mediating bronchodilation and the latter bronchoconstriction. In cough, on the other hand, they operate concurrently, a mediatory role for RARs and a facilitatory role for SARs. C-fiber endings (bronchial and pulmonary) mediate bronchoconstriction. Inhalation of so-called "selective" C-fiber stimulants induces cough, but excitation of RARs has not been eliminated, and the possibility also exists that the cough is secondary to other lung actions mediated by these nerve endings. Although cough and bronchoconstriction may be mediated by the same type of receptor, they seem to have separate afferent neural pathways.

This article has been cited by other articles:

				A. H. Morice, G. A. Fontana, M. G. Belvisi, S. S. Birring, K. F. Chung, P. V. Dicpinigaitis, J. A. Kastelik, L. P. McGarvey, J. A. Smith, M. Tatar, et al. ERS guidelines on the assessment of cough Eur. Respir. J., June 1, 2007; 29(6): 1256 - 1276. [Full Text] [PDF]

				B. J. Canning Reflex regulation of airway smooth muscle tone J Appl Physiol, September 1, 2006; 101(3): 971 - 985. [Abstract] [Full Text] [PDF]

				T. Oshima, Y. Kasuya, Y. Okumura, T. Murakami, and S. Dohi Identification of independent risk factors for fentanyl-induced cough: [L'identification de facteurs de risque independants pour la toux induite par le fentanyl]. Can J Anesth, August 1, 2006; 53(8): 753 - 758. [Abstract] [Full Text] [PDF]

				J. Widdicombe Reflexes from the lungs and airways: historical perspective J Appl Physiol, August 1, 2006; 101(2): 628 - 634. [Abstract] [Full Text] [PDF]

				A. Johansson, E. Millqvist, S. Nordin, and M. Bende Relationship Between Self-Reported Odor Intolerance and Sensitivity to Inhaled Capsaicin: Proposed Definition of Airway Sensory Hyperreactivity and Estimation of Its Prevalence Chest, June 1, 2006; 129(6): 1623 - 1628. [Abstract] [Full Text] [PDF]

				C.-S. Lin, W.-Z. Sun, W.-H. Chan, C.-J. Lin, H.-M. Yeh, and M. S. Mok Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough: [L'administration iv de lidocaine et d'ephedrine, mais non de propofol, supprime la toux causee par le fentanyl] Can J Anesth, August 1, 2004; 51(7): 654 - 659. [Abstract] [Full Text] [PDF]

				M G Belvisi and P Geppetti Cough * 7: Current and future drugs for the treatment of chronic cough Thorax, May 1, 2004; 59(5): 438 - 440. [Abstract] [Full Text] [PDF]

				V. Brusasco and R. Pellegrino Invited Review: Complexity of factors modulating airway narrowing in vivo: relevance to assessment of airway hyperresponsiveness J Appl Physiol, September 1, 2003; 95(3): 1305 - 1313. [Abstract] [Full Text] [PDF]

				G. Soukhova, Y. Wang, M. Ahmed, J. F. Walker, and J. Yu Bradykinin stimulates respiratory drive by activating pulmonary sympathetic afferents in the rabbit J Appl Physiol, July 1, 2003; 95(1): 241 - 249. [Abstract] [Full Text] [PDF]

				R. D. Andreatta, E. A. Mann, C. J. Poletto, and C. L. Ludlow Mucosal afferents mediate laryngeal adductor responses in the cat J Appl Physiol, November 1, 2002; 93(5): 1622 - 1629. [Abstract] [Full Text] [PDF]

				A.J. Miller ORAL AND PHARYNGEAL REFLEXES IN THE MAMMALIAN NERVOUS SYSTEM: THEIR DIVERSE RANGE IN COMPLEXITY AND THE PIVOTAL ROLE OF THE TONGUE Crit. Rev. Oral. Biol. Med., September 1, 2002; 13(5): 409 - 425. [Abstract] [Full Text] [PDF]

				A. Xiang, Y. Uchida, A. Nomura, H. Iijima, T. Sakamoto, Y. Ishii, Y. Morishima, K. Masuyama, M. Zhang, K. Hirano, et al. Involvement of thromboxane A2 in airway mucous cells in asthma-related cough J Appl Physiol, February 1, 2002; 92(2): 763 - 770. [Abstract] [Full Text] [PDF]

				F. LAVORINI, G. A. FONTANA, T. PANTALEO, G. CAMICIOTTOLI, W. CASTELLANI, N. M. MALUCCIO, and M. PISTOLESI Fog-induced Respiratory Responses Are Attenuated by Nedocromil Sodium in Humans Am. J. Respir. Crit. Care Med., April 1, 2001; 163(5): 1117 - 1120. [Abstract] [Full Text]

				M J Doherty, R Mister, M G Pearson, and P M A Calverley Capsaicin induced cough in cryptogenic fibrosing alveolitis Thorax, December 1, 2000; 55(12): 1028 - 1032. [Abstract] [Full Text]

				J. M. Barkmeier, S. Bielamowicz, N. Takeda, and C. L. Ludlow Modulation of Laryngeal Responses to Superior Laryngeal Nerve Stimulation by Volitional Swallowing in Awake Humans J Neurophysiol, March 1, 2000; 83(3): 1264 - 1272. [Abstract] [Full Text] [PDF]

				G. A. FONTANA, T. PANTALEO, F. LAVORINI, D. MUTOLO, G. POLLI, and M. PISTOLESI Coughing in Laryngectomized Patients Am. J. Respir. Crit. Care Med., November 1, 1999; 160(5): 1578 - 1584. [Abstract] [Full Text]

				K.-H. Lin, Y.-L. Lai, H.-D. Wu, T.-Q. Wang, and Y.-H. Wang Cough Threshold in People With Spinal Cord Injuries Physical Therapy, November 1, 1999; 79(11): 1026 - 1031. [Abstract] [Full Text] [PDF]

				O. E. Suman, K. C. Beck, M. A. Babcock, D. F. Pegelow, and W. G. Reddan Airway obstruction during exercise and isocapnic hyperventilation in asthmatic subjects J Appl Physiol, September 1, 1999; 87(3): 1107 - 1113. [Abstract] [Full Text] [PDF]

				J. YU, J. F. ZHANG, A. M. ROBERTS, L. C. COLLINS, and E. C. FLETCHER Pulmonary Rapidly Adapting Receptor Stimulation Does Not Increase Airway Resistance in Anesthetized Rabbits Am. J. Respir. Crit. Care Med., September 1, 1999; 160(3): 906 - 912. [Abstract] [Full Text]

				W. R. Addington, R. E. Stephens, and K. A. Gilliland Assessing the Laryngeal Cough Reflex and the Risk of Developing Pneumonia After Stroke : An Interhospital Comparison Stroke, June 1, 1999; 30(6): 1203 - 1207. [Abstract] [Full Text] [PDF]

				A. Xiang, Y. Uchida, A. Nomura, H. Iijima, F. Dong, M.-J. Zhang, and S. Hasegawa Effects of airway inflammation on cough response in the guinea pig J Appl Physiol, November 1, 1998; 85(5): 1847 - 1854. [Abstract] [Full Text] [PDF]

				J. Yu, J. F. Zhang, and E. C. Fletcher Stimulation of breathing by activation of pulmonary peripheral afferents in rabbits J Appl Physiol, October 1, 1998; 85(4): 1485 - 1492. [Abstract] [Full Text] [PDF]

				S. Matsumoto, M. Takeda, C. Saiki, T. Takahashi, and K. Ojima Effects of Tachykinins on Rapidly Adapting Pulmonary Stretch Receptors and Total Lung Resistance in Anesthetized, Artificially Ventilated Rabbits J. Pharmacol. Exp. Ther., December 1, 1997; 283(3): 1026 - 1031. [Abstract] [Full Text]