Kaiser G. Lim, M.D.

The Division of Pulmaonray & Critical Care Medicine sees a large amount of patients presenting with chronic cough. Since chronic cough can be induced by otolaryngological as well as pulmonary causes, an interdisciplinary approach is necessary There is an active collaoration between the Departments of Otolaryngology, Division of Allergy & Immunology, Gastroenterology and Pulmonary & Critical Care Medicine regarding the care of patients with Chronic Cough.

There is clinical research ongoing regarding the diagnosis and management of chronic cough. These include understanding the mechanism of cough associated with postnasal drip, the differentiation and medical management of chronic sinusitis associated with cough, the use of exhaled nitric oxide in chronic cough, management of refractory cough and gastroesophageal reflux disease in chronic cough. There is clincal interest in the nonnarcotic management of chronic cough as well as in Laryngopharyngeal (LPR) reflux as a cause of cough.

There is currently a funded study to evaluate neurogenic inflammation as a contributing factor in chronic cough associated with postnasal drip. The study will evaluate the use of a capsaicin inhalation challenge test as a clinical test to detect the presence of neurogenic inflammation. Inflammatory neuropeptides have been detected in the postnasal drip secretions of patients with chronic cough. These inflammatory neuropeptides can trigger a cough reflex. These neuropeptides may also be involved in the upregulation of the cough receptor in the laryngotracheobronchial tree. Neurogenic inflammation may provide the linkage between the upper airways and the lower airways. This translational research will evaluate the role of neurogenic inflammation in cough associated with postnasal drip.