Diagnosis and treatment of chronic cough in China: an insight into the status quo

In the clinical setting, chronic cough is defined as cough being sole or predominant symptom and lasting for more than 8 weeks with normal chest X-ray. Chronic cough is a common complaint in China, as it is in Europe, America and Japan. An epidemiological study demonstrated a 3.3% incidence of chronic cough among college students in Guangzhou [1]. It is also estimated that patients who seek medical attention for chronic cough account for 30-40% of the visits to respiratory clinics in China. However, this condition has frequently been misdiagnosed and inappropriately treated. In a clinical survey of chronic cough patients, Lai et al. showed that 81% of patients with chronic cough had been misdiagnosed with chronic bronchitis, pharyngitis, or laryngitis, and 93% had been treated with antibiotics and/or antitussives [2]. Misdiagnosis and inappropriate treatment of chronic cough substantially interferes with quality of life in the majority of patients. For example, nearly 50% of female patients were found to have urinary incontinence [3].Since the description of an anatomy-based diagnostic protocol for chronic cough in 1977 by Irwin and colleagues, many studies have been undertaken in America, Europe and Japan, concerning the pathogenesis, etiologic diagnosis and management of chronic cough with the subsequent development of national guidelines [4-6]. Since 2005, similar studies on local populations in China have yielded promising findings. Here we describe these research efforts in particular the findings on the pathogenesis, etiology, diagnosis and treatment of cough in China together with cough guideline development and dissemination.Airway inflammation in EB shares some similarities to asthma regarding the recruitment of inflammatory cells such as eosinophils (Eos), T lymphocytes and mast cells, as detected using the induced sputum test, bronchoalveolar lavage fluid (BALF) cytology and airway mucosal biopsy. In addition, airway inflammation is attributable to the pr