A European team of researchers has found that chronic cough – typically defined as a cough lasting for longer than eight weeks said to affect about one UK adult in 10 – has a neurological basis.
The researchers – who were based in the UK, Denmark, Finland, Denmark and published their findings in the latest edition of the European Respiratory Journal. The first author is Kayesha Coley, a research associate in genetic epidemiology at the National Institute for Health and Care Research Leicester Biomedical Research Centre.
The findings advance the biological understanding of chronic cough, shedding light on potential avenues for new treatments. In many cases the condition has no identifiable cause, and effective treatment options are currently limited.
‘Identifying the association between genetic predisposition to cough with various known comorbidities, including chronic pain, could further advance our understanding of involved biological processes and should be considered in drug discovery and development efforts’ [Kayesha Coley et al]
A ‘debilitating condition’
Chronic cough can severely impact quality of life, often causing fatigue, breathlessness, disturbed sleep and emotional distress. For many, it becomes a debilitating condition that disrupts everyday life and social interactions.
First author Kayesha Coley, from the University of Leicester’s Genetic Epidemiology group, said: ‘We are very excited to publish the first large-scale genetic study of chronic cough. Even though it is a common condition, its genetic basis has remained understudied until now.’
Dr Coley added: ‘Our study represents a major step forward for understanding the biological mechanisms underlying the condition, and we hope it will inform future drug developments. We are incredibly grateful to all the participants across the contributing studies who have made this important research possible.’
New treatments could emerge
The researchers focused on almost 30,000 individuals experiencing chronic cough from multiple population health resources – including the UK Biobank, EXCEED Study, the Copenhagen Hospital Biobank, Genes & Health and the eMERGE Network.
As the largest and most diverse genetic study of chronic cough to date, researchers uncovered genes involved in neuronal signalling and sensory pathways, revealing a neurological basis for the condition.
The findings advance our understanding of cough reflex hypersensitivity as a nervous system-mediated process and open up opportunities for the development of new targeted treatments.
Additionally, the study revealed shared genetics between chronic cough and chronic pain, suggesting shared neurological mechanisms. This insight offers a promising foundation for future research studies and could help inform effective strategies for managing both conditions.
University of Leicester-based Catherine John is the scientific director of the EXCEED Study. Dr John said: ‘We are really pleased that EXCEED has been able to contribute to this study, which provides the first genetic insights into chronic cough with the aim of helping to develop future treatments.’
Conclusions
In their conclusion to the article, Dr Coley and her colleagues note: ‘Our findings expand on the established concept of cough hypersensitivity due to neuronal dysfunction, which in specific cases can be identified as a treatable trait, by showing that this mechanism applies broadly to chronic dry cough at the population-level, and to ACEi [angiotensin-converting enzyme] inhibitors]-induced cough.’
They add: ‘Further, identifying the association between genetic predisposition to cough with various known comorbidities, including chronic pain, could further advance our understanding of involved biological processes and should be considered in drug discovery and development efforts.’
To access a free PDF of the article – titled Genomics of chronic dry cough unravels neurological pathways – see: https://publications.ersnet.org/content/erj/early/2025/05/15/13993003.02341-2024.full.pdf
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