Gastroesophageal reflux-induced cough: the positive feedback loop of microaspiration and neurogenic inflammation - PubMed
4 hours ago
- #chronic cough
- #GERC
- #neurogenic inflammation
- Gastroesophageal reflux-related cough (GERC) is a common cause of chronic cough with complex pathogenesis.
- Conventional acid suppression therapy has limited efficacy, indicating mechanisms beyond gastric acid irritation.
- Two core pathways in GERC: 'microaspiration' and 'neurogenic inflammation' interact synergistically.
- Microaspiration involves gastric contents damaging the airway mucosal barrier, activating inflammation and receptors like TRPV1.
- Esophageal reflux triggers vagus nerve-mediated reflex arcs, releasing neuropeptides (e.g., substance P) causing neurogenic inflammation.
- These pathways form a 'injury-sensitization-reinjury' feedback loop: inflammation sensitizes nerves, and cough promotes reflux.
- Understanding this interaction helps explain refractory GERC and supports combined therapies targeting mucosal protection and neural modulation.