喉頭アレルギーにおける咳に関する一考察

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  • Cough in Laryngeal Allergy : A Review

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Cough in Laryngeal Allergy : A Review Cough is common in patients with laryngeal allergy. It is well known that irritant receptors and C-fiber endings participate in the cough reflex caused by mechanical and chemical stimulation of the laryngeal mucosa. Intraepithelial nerve fibers corresponding to the irritant receptors or C-fiber endings are observed in the laryngeal mucosa. These fibers are very dense in the arytenoid region, which is considered to be a primary site for the allergic reaction. Supposedly, susceptibility to the cough reflex is enhanced in patients with laryngeal allergy.The inflammatory mediators may stimulate or sensitize the sensory receptors related to cough reflex. Laryngeal C-fiber endings are stimulated by histamine, and applying histamine to the laryngeal mucosa elicits continual cough. Prostaglandin is likely to stimulate the irritant receptors and to trigger the cough reflex. There is controversy concerning the participation of leukotriene in cough reflex. Thromboxane is likely to participate in the cough reflex. Bradykinin stimulates airway C-fiber endings, which in turn invokes the cough reflex. Further investigations are needed to clarify the neural mechanism causing coughing in laryngeal allergy.

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