Noxious cold stimulation: pro–con perspectives on the hypothermic effect on experimentally evoked cough

Abstract

We read with great interest in the recent article by HILTON et al. [1] published in the European Respiratory Journal, about the effect of pain conditioning on experimentally evoked cough; the hypothesis and protocol are well thought out. The study showed that noxious cold-water-induced pain significantly reduced capsaicin-evoked cough; however, it was less effective in refractory chronic cough (RCC) patients than healthy volunteers. The results indicated that endogenous inhibitory control mechanisms, especially those activated by noxious stimuli-inducing pain (conditioned pain modulation, CPM), can modulate cough response evoked by capsaicin. Impairment of such mechanisms may contribute to persistent coughing in RCC patients.