Aggiornamento
Sindrome da ipersensibilitŕ dei recettori della tosse (SIRT): “la tosse che fa tosse”
Cough receptors hypersensitivity syndrome: the cough that makes cough
Giorgio Longo
IRCCS Marteno-Infantile “Burlo Garofolo”, Trieste
Settembre 2023 - pagg. 427 -436 | DOI: 10.53126/MEB42427
Abstract
Dry cough usually accompanies the first few days of each “cold” (Upper Respiratory Tract Infection: URTI), but in some children, it always recurs with a particular intensity that “prevents sleep” and puts the whole family to the test. This cough is recognized to have an etiopathogenetic factor of an exaggerated sensitivity of cough sensory receptors. In the year 2000, the “Medico e Bambino” journal coined the acronym SIRT (Sindrome da Ipersensibilitŕ dei recettori della Tosse - Cough Receptors Hypersensitivity Syndrome) to label this phenotype of cough. Today, this diagnosis is made more frequently especially by Italian family paediatricians who have learned to understand and recognize it. However, in the paediatric literature, SIRT still lacks recognition and an adequate description of its peculiar clinical characteristics. It is conceivable that SIRT corresponds to the persistent cough during the most acute phase of URTIs. The mechanisms by which viral infections induce the dysregulation of the cough reflex are now well understood, but why it remains unchanged over time in only certain individuals is still unknown. In adulthood, cough due to cough receptor hypersensitivity (Cough Receptor Hypersensitivity, CRH) has received much more attention, becoming an “umbrella” diagnosis for all “chronic” coughs of undefined cause. CRH recognizes the same mechanisms and causes at all ages, but there is a significant clinical difference that, in children, due to the high frequency of URTIs, it is characterized by recurrent episodes of acute cough, while in adults, CRH primarily manifests as a “chronic” cough induced by micro environmental stimuli (thermal, mechanical, chemical).
Riassunto
La tosse secca auto amplificante (“la tosse che fa tosse”) e ricorrente ad ogni “common cold”, definita piů di vent’anni fa con l’acronimo SIRT su Medico e Bambino, si identifica probabilmente con quella che in letteratura č stata etichettata come tosse da “post-nasal drip”, termine oggi abbandonato e sostituito da “upper airway cough syndrome” (UACS) . Di questo importante fenotipo di tosse dell’etŕ pediatrica rimane perň del tutto carente nella letteratura pediatrica internazionale una trattazione che ne descriva compiutamente le peculiari caratteristiche cliniche. Come pure ancora incerto il riconoscimento della “Cough Receptor Hypersensibility” (CRH) come meccanismo patogenetico fondamentale. Infine non sono stati ancora chiariti quali siano l’evoluzione attesa di questo fenotipo di tosse pediatrica e i rapporti con la piů gettonata tosse “cronica” da CRH dell’etŕ adulta.
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Bibliografia
1. Longo G, Barbi E. La tosse (o le tossi). Medico e Bambino 2000;19:631-5.
2. Ferrara D, Vella MC. Le infezioni respiratorie ricorrenti. Medico e Bambino 2020;39 (2):85-91.
3. Hay AD, Wilson AD. The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review. Br J Gen Pract 2002;52(478):401-9.
4. Murgia V, Manti S, Licari A, De Filippo M, Ciprandi G, Marseglia GL. Upper respiratory tract infection-associated acute cough and the urge to cough: new insights for clinical practice. Pediatr Allergy Immunol Pulmonol 2020;33(1):3-11. doi: 10.1089/ped.2019.1135.
5. McGovern AE, Short KR, Kywe Moe AA, Mazzone SB. Translational review: Neuroimmune mechanisms in cough and emerging therapeutic targets. J Allergy Clin Immunol 2018;142(5):1392-402. doi: 10.1016/j.jaci. 2018.09.004.
6. Dicpinigaitis PV. Effect of viral upper respiratory tract infection on cough reflex sensitivity. J Thorac Dis 2014;6(Suppl 7):S708-11. doi: 10.3978/j.issn.2072-1439.2013.12.02.
7. Curley FJ, Irwin RS, Pratter MR, et al. Cough and the common cold. Am Rev Respir Dis 1988;138(2):305-11. doi: 10.1164/ajrccm/138.2.305.
8. O’Grady KF, Drescher BJ, Goyal V, et al. Chronic cough postacute respiratory illness in children: a cohort study. Arch Dis Child 2017;102(11):1044-8. doi: 10.1136/archdischild-2017-312848.
9. Hay AD, Wilson AD. The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review. Br J Gen Pract 2002;52(478):401-9.
10. Smith SM, Schroeder K, Fahey T. Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2008;(1): CD001831. doi: 10.1002/14651858.CD 001831.pub3. Update in: Cochrane Database Syst Rev 2012;8:CD001831.
11. Brodlie M, Graham C, McKean MC. Childhood cough. BMJ 2012;344:e1177. doi: 10.1136/bmj.e1177.
12. Ghezzi M, Silvestri M, Sacco O, et al. Mild tracheal compression by aberrant innominate artery and chronic dry cough in children. Pediatr Pulmonol 2016;51(3):286-94. doi: 10.1002/ppul.23231.
13. Bibalo C, Bibalo C, Tubaro M, Ventura A, Longo G. Bronchite batterica protratta; dai casi clinici alla messa a fuoco di una entitŕ poco conosciuta e “maltrattata”. Medico e Bambino 2015;34(9):565-72.
14. Chang AB, Phelan PD, Roberts RG, Robertson CF. Capsaicin cough receptor sensitivity test in children. Eur Respir J 1996;9(11):2220-3. doi: 10.1183/09031936. 96.09112220.
15. O’Connell F, Thomas VE, Studham JM, Pride NB, Fuller RW. Capsaicin cough sensitivity increases during upper respiratory infection. Respir Med 1996;90(5):279-86. doi: 10.1016/s0954-6111(96)90099-2.
16. Chang AB, Phelan PD, Sawyer SM, Robertson CF. Airway hyperresponsiveness and cough-receptor sensitivity in children with recurrent cough. Am J Respir Crit Care Med 1997;155(6):1935-9. doi: 10.1164/ajrccm.155.6.9196099.
17. Chang AB. Cough, cough receptors, and asthma in children. Pediatr Pulmonol 1999;28(1):59-70. doi: 10.1002/(sici)1099-0496(199907)28:1<59::aid-ppul10>3.0.co;2-y.
18. Song WJ, Morice AH. Cough hypersensitivity syndrome: a few more steps forward. Allergy Asthma Immunol Res 2017;9(5):394-402. doi: 10.4168/aair.2017.9.5.394.
19. Dicpinigaitis PV, Bhat R, Rhoton WA, Tibb AS, Negassa A. Effect of viral upper respiratory tract infection on the urge-to-cough sensation. Respir Med 2011;105(4):615-8. doi: 10.1016/j.rmed.2010.12.002.
20. Chung KF. Approach to chronic cough: the neuropathic basis for cough hypersensitivity syndrome. J Thorac Dis 2014;6(Suppl 7):S699-707. doi: 10.3978/j.issn.2072 1439.2014.08.41.
21. Morice AH, Millqvist E, Belvisi MG, et al. Expert opinion on the cough hypersensitivity syndrome in respiratory medicine. Eur Respir J 2014;44(5):1132-48. doi: 10.1183/ 09031936.00218613.
22. Mazzone SB, Chung KF, McGarvey L. The heterogeneity of chronic cough: a case for endotypes of cough hypersensitivity. Lancet Respir Med 2018;6(8):636-46. doi: 10.1016/S2213-2600(18)30150-4.
23. Gupta A, McKean M, Chang AB. Management of chronic non-specific cough in childhood: an evidence-based review. Arch Dis Child Educ Pract Ed 2007;92(2):33-9. doi: 10.1136/adc.2005.090753.
24. Shields MD, Bush A, Everard ML, McKenzie S, Primhak R; British Thoracic Society Cough Guideline Group. BTS guidelines: recommendations for the assessment and management of cough in children. Thorax 2008;63 Suppl 3:iii1-iii15. doi: 10.1136/ thx.2007.077370.
25. Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest 2006;129(1 Suppl):1S-23S. doi: 10.1378/chest.129.1_suppl. 1S.
26. Morgan WJ, Taussig LM. The child with persistent cough. Pediatr Rev 1987;8(8):249-53. doi: 10.1542/pir.8-8-249.
27. Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J 2020;55(1):1901136. doi: 10.1183/13993003.01136-2019. Erratum in: Eur Respir J 2020;56(5).
28. Sanu A, Eccles R. Postnasal drip syndrome. Two hundred years of controversy between UK and USA. Rhinology 2008; 46(2):86-91.
29. Kemp A. Does post-nasal drip cause cough in childhood? Paediatr Respir Rev 2006;7(1):31-5. doi: 10.1016/j.prrv.2005. 11.005.
30. Morice AH. Post-nasal drip syndrome - a symptom to be sniffed at? Pulm Pharmacol Ther 2004;343-5. doi: 10.1016/j.pupt.2004 .09.005.
31. Morice AH, McGarvey LP, Dicpinigaitis PV. Cough hypersensitivity syndrome is an important clinical concept: a pro/con debate. Lung 2012;190(1):3-9. doi: 10.1007/s00408-011-9351-y.
32. Chung KF. Chronic ‘cough hypersensitivity syndrome’: a more precise label for chronic cough. Pulm Pharmacol Ther 2011; 24(3):267-71. doi: 10.1016/j.pupt.2011.01.012.
33. Pratter MR. Cough and the common cold: ACCP evidence-based clinical practice guidelines. Chest 2006;129(1 Suppl):72S-74S. doi: 10.1378/chest.129.1_suppl.72S.
34. Davies MJ, Fuller P, Picciotto A, McKenzie SA. Persistent nocturnal cough: randomised controlled trial of high dose inhaled corticosteroid. Arch Dis Child 1999;81(1):38-44.
35. Bernard DW, Goepp JG, Duggan AK, Serwint JR, Rowe PC. Is oral albuterol effective for acute cough in non asthmatic children? Acta Paediatr 1999;88(4):465.
36. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev 2014; 2014(11):CD001831. doi: 10.1002/14651858. CD001831.pub5.
37. Dicpinigaitis PV, Morice AH, Birring SS, McGarvey L, Smith JA, Canning BJ, Page CP. Antitussive drugs-past, present, and future. Pharmacol Rev 2014;66(2):468-512. doi: 10.1124/pr.111.005116.
38. Marseglia GL, Manti S, Chiappini E, et al. Acute cough in children and adolescents: a systematic review and a practical algorithm by the Italian Society of Pediatric Allergy and Immunology. Allergol Immunopathol (Madr) 2021;49(2):155-69. doi: 10.15586/aei.v49i2.45.
39. Dicpinigaitis PV, Morice AH, Birring SS, et al. Antitussive drugs - past, present, and future. Pharmacol Rev 2014;66(2):468-512. doi: 10.1124/pr.111.005116.
40. Fiocchi A, Zuccotti GV, Vignati B, Pogliani L, Sala M, Riva E. Valutazione del trattamento con levodropropizina nelle affezioni respiratorie del bambino [Evaluation of the treatment with levodropropizine of respiratory diseases in children]. Pediatr Med Chir 1989;11(5):519-22.
41. Eccles R, Mallefet P. Soothing properties of glycerol in cough syrups for acute cough due to common cold. Pharmacy (Basel) 2017;5(1):4. doi: 10.3390/pharmacy5010004.
42. Miceli Sopo S, Monaco S, Greco M, Varrasi G, Simeone G. Tosse acuta e miele Medico e Bambino 2014;33(1):41-6.
43. De Blasio F, Dicpinigaitis PV, Rubin BK, De Danieli G, Lanata L, Zanasi A. An observational study on cough in children: epidemiology, impact on quality of sleep and treatment outcome. Cough 2012;8(1):1. doi: 10.1186/1745-9974-8-1.
44. Curley FJ, Irwin RS, Pratter MR, et al. Cough and the common cold. Am Rev Respir Dis 1988;138(2):305-11. doi: 10.1164/ajrccm/138.2.305.
45. Dicpinigaitis PV, Morice AH, Birring SS, et al. Antitussive drugs - past, present, and future. Pharmacol Rev 2014;66(2):468-512.
46. Freestone C, Eccles R. Assessment of the antitussive efficacy of codeine in cough associated with common cold. J Pharm Pharmacol 1997;49(10):1045-9. doi: 10.1111/j.2042-7158.1997.tb06039.x.
47. Keller JA, McGovern AE, Mazzone SB. Translating cough mechanisms into better cough suppressants. Chest 2017;152(4):833-41. doi: 10.1016/j.chest.2017.05.016.
48. Zhang M, Wang S, Yu L, Xu X, Qiu Z. The role of ATP in cough hypersensitivity syndrome: new targets for treatment. J Thorac Dis 2020;12(5):2781-90. doi: 10.21037/jtd-20-cough-001.
49. Fisher JA. A new approach to delivering cold, moist air to children with cough or wheezing: open the freezer door. J Pediatr 2002;141(4):596-7.
Corrispondenza: giorgio.longo@burlo.trieste.it