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| Chronic cough affects 10% of people, significantly impacting quality of life and productivity. Linked to cough hypersensitivity syndrome, its mechanisms remain unclear. Evidence suggests sensory nerve upregulation, altered airway proteins, and genetic factors like the RFC1 gene, present in 25% of refractory chronic cough cases versus 0.7% of the general population. |
| New Insights into Heritability: A Two-Generation Study |
| A recent two-generation study, leveraging data from the RHINE and RHINESSA cohorts, sought to understand the heritability of chronic cough. The study analyzed data from over 7,000 parents and more than 8,000 offspring, all of whom were over 20 years old. It aimed to assess the prevalence of chronic cough across generations and whether different cough types-nonproductive (dry) or productive (with phlegm)—showed distinct patterns of inheritance. |
| Key Findings: A Strong Familial Link |
| Chronic cough in parents was significantly associated with chronic cough in their adult offspring. The prevalence of chronic cough increased with the persistence of the condition in parents—offspring of parents with persistent chronic cough were 29% more likely to suffer from chronic cough themselves, compared to just 18% in offspring whose parents had no cough. Importantly, the type of cough in parents appeared to influence the type in offspring. |
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| Nonproductive cough in parents was linked to a 11% prevalence of nonproductive cough in offspring (OR 1.59), |
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| Productive cough was associated with a 14% prevalence in offspring (OR 1.34). |
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| The findings highlight a genetic or familial link in chronic cough, with smoking playing a key role in productive cases. |
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| Heritability was notably stronger in female offspring, especially with parental chronic cough linked to daughters. |
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| The Role of Sex Differences and Environmental Factors |
| The genetic basis of chronic cough is unclear, but heritable patterns may involve genetic factors like cough reflex sensitivity or CFTR gene variants predisposing smokers to chronic bronchitis. Environmental factors, such as air pollution and shared behaviours, also contribute. This highlights the need for a multifaceted approach to understanding and managing chronic cough. |
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| Clinical Implications: Targeting Cough Mechanisms |
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| Clinicians should consider family history when evaluating chronic cough, as it may indicate higher risk. |
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| Differentiating between productive and nonproductive cough can guide management, such as prioritizing smoking cessation for productive cough or exploring genetic and environmental factors for nonproductive types. |
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| Advances in understanding genetic variants and sensory nerve upregulation offer potential for targeted therapies, providing hope for more personalized treatment options. |
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| Conclusion |
| While this study provides compelling evidence for the heritability of chronic cough, much remains to be understood. Further research is needed to explore the genetic underpinnings of this condition and to identify specific variants that may predispose individuals to chronic cough. Additionally, understanding how environmental factors, such as air pollution and shared family behaviours, contribute to chronic cough will be crucial in developing comprehensive prevention and treatment strategies. |
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| GGI-CO-A1-AQS-300033085-DVC-B25-0246 |
| For the use of a Registered Medical Practitioner, Hospital or Laboratory only. |
| Reference: |
| Emilsson ÖI, Johansson H, Johannessen A, Janson C, Palm A, Franklin KA, Oudin A, Gómez Real F, Holm M, Gislason T, Lindberg E, Jõgi R, Schlünssen V, Callejas-González FJ, Zhang J, Malinovschi A, Svanes C, Ekström M. Heritability of cough across two generations: the RHINESSA study. ERJ Open Res. 2024 Aug 5;10(4):00071-2024. doi: 10.1183/23120541.00071-2024. PMID: 39104957; PMCID: PMC11299003. Click here to view the original article |
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