COUGH REFLEX INDUCED BY TUSSIEGENIC AGENT (CAPSAICIN AND CITRIC ACID)

 
 
BY
 
 
UBA CYNTHIA ONYEKA
BMS1600493
 
 
 
 
 
 
 
 

 
 

DEPARTMENT OF PHYSIOLOGY
SCHOOL OF BASIC MEDICAL SCIENCES
UNIVERSITY OF BENIN
BENIN CITY

19th May, 2021

 INTRODUCTION
• Coughing is an important defensive reflex that enhances clearance
of secretions and particulates from the airways and protects from
aspiration of foreign materials occurring as a consequence of
aspiration or inhalation of particulate matter, pathogens,
accumulated secretions, postnasal drip, inflammation, and
mediators associated with inflammation (Polverino et al., 2012).

• Cough serves as an important protective role in the airways and

lungs, but in some conditions it may become excessive,
nonproductive and harmful to the airway mucosa. These
contrasting consequences of coughing can be attributed to the
parallel afferent pathways regulating this important defensive
reflex of the airways (Hague et al., 2005; Kelsall et al., 2009)..
COUGH REFLEX ARC

Figure 1: Schema on cough reflex Arc

 CAPSAICIN AND CITRIC ACID

• Capsaicin or Citric acid induces coughing (Forsberg and

Karlsson, 1986; Xiang et al., 1998; kotzer et al., 2000;
Morista et al., 2002).

• Capsaicin primarily evokes the cough reflex through

stimulation of neuropeptide containing, non-myelinated,
chemosensitive C-fiber afferents (Karlsson, 1996).
• Citric acid stimulates not only C-fibers but also A-fiber
terminals (Takahama et al., 1993).

• Inhalation of capsaicin or citric acid stimulates all the

respiratory tract systems from the nasal cavity to the
bronchi and therefore induces not only coughing but also
sneezing.

• The larynx is well established as a favorite site for inducing

coughs (Karlson, 1996), although it is difficult to apply
chemical stimulation to this organ (Takahama et al., 1997).
• capsaicin and citric acid induce coughs by a similar mechanism
(Yagi et al., 2001). .

• citric acid stimulates afferent fibers other than C-fibers in the

larynx (possibly Aδ-fibers).

• Canning et al. identified the tracheal and laryngeal afferent

nerves regulating coughs in anesthetized guinea pigs, and
designated them ‘cough receptor’ Aδ-fibers (Canning et al.,
2004).

• These afferent nerves are unresponsive to capsaicin and are

distinct from the well-defined rapidly or slowly adapting stretch
receptors innervating the airways or lungs (Canning et al., 2004).
 Citric acid

Capsaicin

Figure 2: Schema on capsaicin and citric acid cough

reflex Arc