Chronic Cough: Respiratory Pathophysiology, Patient Stratification, and Translational Perspectives

Chronic cough, defined as a cough persisting for over eight weeks, is a prominent and complex respiratory symptom with consequences for quality of life, healthcare resource use, and long-term outcomes. As a multidimensional clinical entity, chronic cough often coexists with or is a manifestation of diverse airway pathologies, such as asthma, chronic airway inflammation, post-infection sequelae, or remodeling. Its persistence highlights the importance of local airway environment, epithelial responses, immune mechanisms, and microenvironmental factors in the development and maintenance of chronic cough. Recent research emphasizes the need to move beyond symptom description and to establish robust models of the underlying biological and physiological processes which distinguish persistent cough from transient or acute forms.Despite guideline-driven management, many patients experience refractory or unexplained chronic cough, signifying poorly defined disease endotypes and incomplete understanding of airway pathobiology. Attention is now focused on detailed patient phenotyping—including structural, inflammatory, and molecular characterization of the airway environment—and their correlation with clinical features and treatment response. In parallel, translational approaches integrating airway imaging, biochemical markers, and cellular profiling are uncovering signatures that may define prognosis, guide therapeutic choices, and inform patient risk stratification. Understanding these pathophysiological determinants is critical to refining diagnostic criteria and realizing the promise of individualized care in chronic cough.This Research Topic aims to advance knowledge of chronic cough by highlighting studies that dissect the pathophysiology of the airway and lung in chronic cough patients, as well as provide new insight into patient phenotypes, biomarkers, and predictors of outcome. Contributions that elucidate the role of airway remodeling, local immunity, microenvironmental stress, tissue injury and repair, or that apply innovative patient stratification strategies and translational tools are especially encouraged. The topic specifically does not focus on cough reflex circuitry, neuro-sensory signal transduction, or airway defense mechanics, but rather on airway structure–function relationships, integrative physiology, and disease heterogeneity relevant to chronic persistent cough.To gather further insights, we welcome articles addressing, but not limited to, the following themes:o Airway, alveolar, and epithelial pathophysiology in chronic cough (e.g., remodeling, fibrosis, inflammation)o Patient phenotyping and stratification based on airway/lung structural and molecular assessmento Local and systemic inflammation and their relationship with clinical features and disease trajectories in chronic cougho Translational or clinical studies on biomarkers, airway imaging, or cellular signatures in persistent cougho Integrated models of disease heterogeneity and proposals for individualized, precision-chronic cough managemento Environmental, occupational, and comorbidity factors impacting chronic cough development and durationo Predictors of prognosis, risk of recurrence, and treatment response linked to airway pathophysiologyWe encourage research that clarifies the biology, pathophysiology, and patient-level variability of chronic cough, aiming to translate mechanistic understanding into improved clinical outcomes and patient-centered management. Topic editors: Fang Yi, Zhe Chen, Mengru Zhang Source: https://www.frontiersin.org/research-topics/79112/chronic-cough-respiratory-pathophysiology-patient-stratification-and-translational-perspectives