Nocturnal Cough Research Articles

Dyspnea and nocturnal cough due to esophageal diffuse leiomyomatosis in a girl with hematuria.

A 7-year-old girl with hematuria and clinical suspicion of Alport syndrome (AS) presented with dyspnea and nocturnal cough, initially diagnosed and treated as asthma. Despite inhaled corticosteroid therapy, her symptoms persisted, and spirometry indicated obstructive lung function without bronchodilator response. Chest CT revealed diffuse thickening of the esophageal wall, tracheal compression, with involvement of the gastric cardia, suggestive of diffuse leiomyomatosis. Subsequent genetic reanalysis confirmed the presence of a contiguous deletion of COL4A5 and COL4A6 genes, solidifying the diagnosis of AS. Diffuse leiomyomatosis, a rare benign neoplasm associated with AS, typically manifests as dysphagia, but in this case, it presented initially with asthma-like symptoms. This case emphasizes the importance of imaging when asthma treatment fails, particularly in patients with coexisting conditions of another system.

Role of fractional exhaled nitric oxide in patients with sickle cell disease

IntroductionPatients with sickle cell disease exhibit different patterns in pulmonary function tests. In particular, there is little evidence on the fractional exhaled nitric oxide (FeNO) test, and its value ranges and its interpretation in these patients have been under debate in recent years. MethodsWe conduced a cross-sectional, observational and descriptive study between November 2021 and January 2023 including patients aged 6–18 years with sickle cell disease able to perform the FeNO test. We applied the GLI-2012 reference values and the ERS/ATS standards. We defined statistical significance as P < 0.05. ResultsThe sample included 43 patients with a median age of 12 years (IQR, 10−15). We did not find an association between significantly elevated FeNO (≥25 ppb) and the diagnosis of asthma (P = 0.37), an obstructive pattern in spirometry (P = 0.67), a positive bronchodilator test (P = 0.53), clinical bronchial hyperreactivity in the context of cold or flu-like symptoms (P = 0.48), cough with exercise (P = 0.42) or nocturnal cough (P = 1.0), but found an association with peripheral eosinophilia (P < 0.01). ConclusionsWe found no association between FeNO values and the classic features of asthma (clinical or spirometric) in patients with sickle cell disease. Therefore, airway inflammation mechanisms are probably different in these patients.

Evaluate the Frequency of EosinophilicEsophagitisin Individuals with Refractory GERD

Background: Theeosinophilic infiltrate of the esophagus mucosal distinguishes the esophageal ailment known as Eosinophilicesophagitis (EoE). This study aims to determine the frequency of EoE in patients with gastroesophageal reflux disease (GERD), a gastro esophageal reflux condition that is persistent. Methods: The 248 children in total hadelectiveupper gastrointestinal endoscopy (UGIE) during the study period were separated in tosix groups: individuals without a history of steroid usage and those with outanesophageal biopsyforthrombocytopenia. As a result, 200 people participated in the study total. Results: After an evaluation of 200 children having elective UGIE, A variety of health problems were found during the investigation, including food bolusimpact (2 %), achalasia cardia (5 %), pepticstricture (6 %), congenitalstricture (3 %), post-esophageal atresia repairanastomoticstricture (4 %), and symptoms of gastro esophageal reflux, including vomiting (10 %), regurgitation (2 %), belchingchest (1,5 %), nocturnal cough (2,5 %), pain/heartburn (12,5 %), and feeding refusal (1 %). There were several unusual illnesses that were observed, including Crohn's disease accounted for 2 %, paediatric intestinal pseudo-obstruction (10 %), abdominal discomfort (17,5 %), celiacdisease (16 %), cow's milk protein allergy (3 %), and un classified IBD (7 %). Conclusion: EoEfrequently affects GERD patients who are recalcitrant to treatment. Dysphagia, food impaction, and heartburn are posible symptoms. EGD and esophageal biopsy should be explored for EoEscreening in elderly individuals with strong GERD who are atopy positive and who have not responded to gastric acid inhibitors.

Laparoscopic Heller’s cardiomyotomy as the main method for treatment of achalasia cardia: an evaluation of treatment results

Achalasia is an esophageal motility disorder characterized by symptoms of dysphagia, regurgitation of undigested food, respiratory symptoms (nocturnal cough, recurrent aspiration, and pneumonia), chest pain, and weight loss. The aim: to evaluate the results of surgical treatment for achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy in combination with Dor fundoplication. Materials and methods. To evaluate the treatment results of achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy with Dor fundoplication, we analyzed 30 case histories of patients who were treated in the period from 2011 to 2022. Inclusion criteria were age 18 years or older, diagnosis of stage II, III cardia achalasia confirmed using instrumental examinations. Exclusion criterion was stage I achalasia. The mean age of the patients was 53.0 ± 15.3 years. In terms of sex, this group was almost equal, there were 14 (46.7 %) women and 16 (53.3 %) men. The average duration of the disease was 5.0 ± 1.2 years. To determine the degree of achalasia, we used the radiological classification of the distal esophageal morphology in achalasia and distinguished 4 stages. Based on this classification, stage II achalasia was detected in 24 (80.0 %) patients, and stage III – in 6 (20.0 %), p = 0.0007, U = 180.0. Results. All the patients were operated on as planned. The total duration of preoperative preparation in the hospital was 0.8 ± 0.2 days. The main method of treatment in this group was laparoscopic Heller’s cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller’s cardiomyotomy with fundoplication is currently one of the most effective methods of treatment for achalasia cardia. Minimally invasive surgical treatment methods for achalasia are effective in most patients, however, recurrence of symptoms in the long term occurs in 10.0–20.0 %, leaving open the question of finding new effective methods for the treatment of this pathology.

New medical technologies in cough therapy: results of a double-blind randomized placebo-controlled multicenter clinical trial

To study the efficacy and safety of Eladis® in comparison with placebo in patients with non-productive cough. A phase III clinical trial enrolled 250 patients aged 18-65 years with acute respiratory viral infection with upper respiratory tract involvement or acute bronchitis. Patients were randomized into 2 groups of 125 subjects: group 1 received Eladis® (40 mg tablets), group 2 received a matching placebo. The patients received the study drugs 1 tablet BID for 7-14 days. After the treatment, patients were followed up (day 7±2) to assess the effect of therapy on the frequency of coughing attacks, the frequency and severity of daytime and nocturnal cough, the severity of cough, the duration of clinical cough cure, and the effect on the severity of the main acute respiratory viral infection symptoms. The results of the study demonstrate the overall efficacy and statistically significant superiority of Eladis® over placebo: there were significant differences between the study groups in the proportion of patients who decreased the coughing attack frequency by ≥50% by day 5 (p<0.0001). In addition, the clinical cure of cough in the Eladis® group occurred 2 days earlier: the median time was 6 days, vs 8 days in placebo group. There was a decrease in the frequency of cough attacks and a decrease in its severity by more than 3.5 points by day 5 of treatment. All the effects were associated with high safety of the drug.

Beyond the gut - Atypical presentation of Salmonella spp. infection

Abstract Salmonella is a Gram-negative, non-spore-forming, motile, facultative anaerobic rod. The most studied species are Salmonella typhi and paratyphi (causing typhoid fever) and non-typhi Salmonella species (which can cause different clinical syndromes - gastroenteritis, disseminated infections, etc.). A 61-year-old male patient with multiple comorbidities (including myelofibrosis) presented to the Pulmonology outpatient department, Clinical County Hospital of Târgu Mureș, with a mucopurulent nocturnal cough. Paraclinical examinations showed the presence of a pleural empyema, which was evacuated in local anesthesia. The pleural fluid was sent to the Microbiology Department for bacteriological testing, where a fluoroquinolone-resistant strain of Salmonella spp. was detected. The patient received antibiotic treatment according to the antibiotic susceptibility testing. Due to the persistence of the symptoms, the patient returned two weeks later, when another puncture was performed. Salmonella was isolated again, but the strain showed a higher resistance to antibiotics. The two strains were compared using molecular methods of diagnosis (Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction - ERIC-PCR), the results showing a similarity of 92%. The occurrence of an extra amplicon band in ERIC-PCR suggests an important change in the bacterial genetic material, potentially related to acquisition of antibiotic resistance factors.

INFLAMMATORY MYOFIBROBLASTIC TUMOR OF THE MEDIASTINUM IN A PEDIATRIC PATIENT: A RARE CASE PRESENTATION AND MANAGEMENT REVIEW

Mediastinal tumors in pediatric patients encompass a broad spectrum of pathologies, ranging from benign to malignant entities. We present a case of a 10-year-old boy who initially presented with persistent back pain followed by nocturnal coughing, asthenia, and significant weight loss over a year. Upon admission, physical examination was unremarkable except for a mediastinal opacity noted on radiographic evaluation, leading to further characterization by thoracic CT scan, revealing a sizable right paracardiac mediastinal mass. Surgical excision was performed successfully, with en bloc resection of the mass adherent to the middle and lower lung lobes, and involving regional lymph nodes. Postoperative recovery was uneventful over a two-month follow-up period.Histopathological analysis confirmed the diagnosis of an inflammatory myofibroblastic tumor (IMT), a rare entity within the mediastinum Our case underscores the challenges in diagnosing and managing mediastinal IMTs, emphasizing the importance of a multidisciplinary approach involving clinical suspicion, diagnostic imaging, and definitive histopathological evaluation.Continued reporting and study of such cases contribute to our understanding of this rare pathological entity, guiding optimal management strategies and long-term surveillance protocols for affected pediatric patients. This case report highlights the need for heightened awareness and research efforts to improve diagnostic accuracy and therapeutic outcomes for mediastinal IMTs in pediatric populations.

Efficacy and tolerability of SEDIFLÙ in treating dry or productive cough in the pediatric population (SEPEDIA): A pilot, randomized, double-blind, placebo-controlled, multicenter clinical trial.

The aim of this trial was to assess the effectiveness of Sediflù, a medical device containing active herbal ingredients, on nocturnal and diurnal persistent coughs in children, with a duration of 3 to 7 days. Children with a dry and/or productive cough were enrolled in this prospective, interventional, multicenter, placebo-controlled, double-blind, randomized clinical study. Clinical efficacy was assessed through the evaluation of the soothing action of Sediflù against dry and/or productive coughing, both at night and during the day, and other effects of coughing associated with quality of sleep: frequency, child's quality of sleep, parental quality of sleep and severity. Treatment with Sediflù improved both night-time and day-time cough scores from day 2. The diurnal score also improved significantly in the Sediflù group at days 3 and 7. Sediflù syrup can be considered a valid treatment for cough management in younger children with upper respiratory tract infections, shortening the cough duration.

A tale of noisy airways: Asthma or not?

A young female in her early twenties presented with complaints of sneezing, nocturnal dry cough, chest tightness and occasional nocturnal wheeze. She reported occasional reflux symptoms. She denied loss of weight, loss of appetite or fever.

Adverse Childhood Experiences and Related Events are Associated with Asthma Symptoms in Children

ObjectiveTo examine the association between adverse childhood experiences (ACEs) and related events and asthma symptom burden in children. MethodsThis is a cross-sectional study of baseline data from 147 participants with asthma from a cohort of children enrolled in the Pediatric ACEs Screening and Resiliency Study. Participants completed the PEdiatric ACEs and Related Life Events Screener (PEARLS) tool, a 17-item questionnaire, capturing 3 domains of childhood adversity—child maltreatment, household challenges, and social context. Asthma symptom burden was assessed using the International Study of Asthma and Allergies in Childhood core questionnaire, which asks participants to identify the presence and frequency of severe wheezing that limits speech, wheezing with exercise, nocturnal wheezing, and nocturnal cough in the last 12 months. Using multivariable logistical regression models, we examined the relationship between reported PEARLS and asthma symptoms. ResultsOf children with asthma, 86% reported at least 1 adversity, with 48% reporting 4 or more. The odds of severe wheeze limiting speech increased by 19% with each additional reported adversity captured by the PEARLS tool (95% confidence intervals (CI) 1.01–1.41). Increasing PEARLS scores were also associated with 16% increased odds of reporting wheeze with exercise (95% CI 1.03–1.31). Wheezing with exercise was associated with the household challenges domain (odds ratio (OR) 1.34; 95% CI 1.05–1.72), while severe wheeze limiting speech was associated with the social context domain (OR 1.75; 95%CI 1.02–3.02). ConclusionsChildhood adversities are associated with increased asthma symptom burden, suggesting the tool may be helpful in identifying children at risk for poorly controlled asthma.

Fruit flavors in electronic cigarettes (ECIGs) are associated with nocturnal dry cough: A population longitudinal analysis.

Evidence from in vitro and animal models has identified the pulmonary toxicity of flavors in electronic cigarettes (ECIGs); however, less is known from epidemiological studies about the effects of flavors in the respiratory health. This study examined the longitudinal association between exposure to ECIGs flavors and nocturnal dry cough among ECIGs users. A secondary analysis of data from the Population Assessment of Tobacco and Health Study (2014-2019) was conducted. The study population included adults who provided information (n = 18,925) for a total of 38,638 observations. Weighted-incidence estimates and weighted- generalized estimating equation models were performed to assess unadjusted and adjusted associations. The weighted incidence proportion (WIP) of nocturnal dry cough was significantly higher among current (WIP:16.6%; 95%CI 10.5, 21.2) and former fruit flavored ECIGs users (WIP:16.6%; 95%CI 11.3, 21.9) as compared to non-ECIGs users (WIP:11.1%; 95%CI 10.6, 11.6). Current ECIGs users of fruit flavors showed 40% higher risk of reporting cough than non-ECIGs users (aRR:1.40, 95%CI 1.01, 1.94). Former ECIGs users of multiple flavors and other flavors had 300% and 66% higher risk to develop cough, respectively (aRR:3.33, 95%CI 1.51, 7.34 and aRR:1.66, 95%CI 1.0.9, 2.51), relative to non-ECIGs users. We observed a significantly higher risk of developing nocturnal dry cough in the past 12 months in current and former ECIGs users of fruit flavors and in former ECIGs users of multiple flavors. To the extent that cough may serve as an early indicator of respiratory inflammation and potential disease risk, the association between ECIGs use and cough raises potential concerns.

Индивидуализация подходов к реабилитации детей с хроническим аденоидитом с учетом их конституциональных различий

The purpose — to reveal the features of the development, course and character of clinical manifestations of chronic adenoiditis in 4–7 y. o. children of various constitutional types. Material and methods. Children aged 4–7 years with a verified diagnosis of chronic adenoiditis were examined; they were divided into groups by constitutional types using the scale of mental activity orientation. The children with the expert assessment of mental activity orientation in the 1–3 interval were referred to the subgroup of «introverts», with 4–6 points — to the subgroup of «centroverts», and with 7–9 — to the subgroup of «extroverts». The sample of children was as follows: extroverts made up 35.9% of the total number of children, introverts — 34.1%, centroverts — 30%. The nature of clinical manifestations, development and course of chronic adenoiditis were assessed with the data from the child’s developmental history, additional parental questionnaire, and examination. Results. In introverts, the debut of chronic adenoiditis was at the age of 3–4 years, the disease duration by this age was about one and a half years, the diagnosis was made earlier than in extroverts, but with a later development of exudative otitis. In introverted children, complaints related to snoring and obstructive sleep apnea syndrome, as well as sound pronunciation disorders, came to the forefront. In extroverted children, chronic adenoiditis debuted at the age of 4–5 years, with the disease duration of about six months, with later diagnosis, but with early formation of exudative otitis. Clinical manifestations in extroverted children were associated with postnasal syndrome combined with nocturnal cough, formation of exudative otitis, frequent purulent otitis media and sharp hearing loss. Conclusion. Differences in the clinical and functional course of chronic adenoiditis in preschool children of various constitutional types should be taken into account in the organization of rehabilitation. This will improve the quality of life of these children, increase the bodily reactive capabilities and the levels of success and social adaptation in educational institutions.

Prevalência da asma em regiões do Município do Rio de Janeiro

Introduction: Asthma is the most common chronic disease in childhood. In Brazil, the prevalence of active asthma is high. However, it is known that within the same country this prevalence can vary. Objectives: to describe in the studied sample, the prevalence of asthme, active asthma, asthma diagnosed by a physician, nocturnal cough, cough for more than 10 days after a respiratory infection and respiratory manifestations during physical exertion. Methods: Cross-sectional prospective study in a convenience sample of a pediatric population attending the Clínica da Família Souza Marques, in Rio de Janeiro, using a simplified questionnaire. Results: 34.3% (62/204) had active asthma. 30.4% (62/204) had already received a medical diagnosis of asthma. Among those with active asthma, 40% (28/70) had never received this diagnosis. 46% (95/204) had nocturnal awakening in the last 12 months, 30.4% (62/204) had other respiratory manifestations with exertion in the last 12 months, and 27% (55/204) coughed for more than 10 days when they had a cold in the last 12 months. Conclusion: Asthma is highly prevalent in the evaluated population. Further research is necessary to deepen the study on the evaluation of respiratory symptoms, the communication of the diagnosis to caregivers and to the need to improve clinical recognition, access to diagnostic tests when indicated, and the communication of diagnosis to families.

Mucoactive therapy in community-acquired pneumonia

Aim. To study the clinical efficacy of Bronchipret syrup compared with the standard (real-world practice) mucoactive therapy for patients with viral pneumonia.&#x0D; Materials and methods. The observation study included patients 1870 years old who presented with productive cough and were admitted to the pulmonology department with medically confirmed community-acquired pneumonia (CAP). The study included 60 patients; Group 1 included 30 patients who received Bronchipret syrup 5.4 mL 3 times a day for up to 1014 days. The other 30 patients with CAP were included in Group 2 (control), in which other mucoactive drugs were used at the discretion of the physician: acetylcysteine in 56.7% of patients, ambroxol in 30%, and bromhexine in 13.3%. The duration of therapy was established by a physician for a period of 1014 days.&#x0D; Results. A significant decrease in sputum secretion was observed during treatment with Bronchipret (Group 1) on average on day 4 (after 4.31.2 days) and after 4.50.9 days in group 2. A decrease in the severity of daytime cough in Group 1 was observed after 4.91.2 days vs. 5.11.1 days in Group 2. The nocturnal cough stopped in 2.71.3 days in Group 1 and 2.60.9 days in Group 2.&#x0D; Conclusion. The data support the use of combined products containing ivy and thyme in patients with CAP and mucolytics.

Transmission of Helmithiasis in a community and treatment option

Infections caused by parasitics helminths affect more than a billion people worldwide, causing anemia and with significant social and economic impact. To alleviate this burden, affected population resorts to a massive administration of antiparasitics without worrying about improvements in the factors that aid in spreading helminthosis in the community. In this study we are proposing as objectives, that of going in search of the we used questionnaires, oral interviews and direct observations to determine risk factors and treatment options for the disease in two communities of Kolwezi in Democratic Republic of Congo.by on the one hand a household questionnaire and observation of the investigator and others by a census of antihelminths in the pharmacies of the city of Kolwezi. We received 7,014 responses from households and 283 from pharmacies. It was observed from our analysis that most of the plots were clean and dry although sometimes covered with trees and with grass. On average, four households, six children over the age of fifteen and four children under the age of five, and two toilets were observed per plot. The quality of toilets, the source of water supply, the misuse of toilet pots for children under five years old as well as variations in weather conditions were the major risk factors for parasitosis in Kolwezi Occasional stool examination revealed mainly dominated by the feeling of vomiting, fatigue and a nocturnal cough. a small portion of the population had access to laboratory tests which, moreover, were able to observe more Ascaris lumbricoides eggs. The population resorts to self-medication with Mebendazole® and sometimes herbal teas and palm kernel oils. while on medical prescriptions and on the shelves of pharmacies, Albemedazoles was more present. The elements of transmission having been well identified, the start of an education of the population is a necessity and constitutes the next step.

Impact of thyme drink with Honey on Nocturnal Cough and Sleep Quality for Children

Impact of thyme drink with Honey on Nocturnal Cough and Sleep Quality for Children

Achalasia of the Esophagus at Donka National Hospital: A Case Report

Background: Esophageal achalasia is an esophageal motility disorder of unknown etiology that results in impaired lower esophageal sphincter relaxation and loss of esophageal peristalsis. The aim of our study was to show our experience in the management of esophageal achalasia in a case treated by laparotomy in our service. Case Report: 21-year-old patient, student, admitted to our department for progressive dysphagia to solids accompanied by regurgitation, epigastric pain, nocturnal cough and weight loss, evolving for 5 years. ATCD of pulmonary tuberculosis. The physical examination noted a deterioration in general condition, stage (I) of the WHO; there was hypo coloration of the integuments and conjunctivae, TA=120/80mmHg, Pulse=70/min. The abdomen was symmetrical with presence of sluggish skin folds, supple and painless without a palpable mass, the digital rectal examination did not present any particularity. The thorax was symmetrical with a FR=20 c/mn. The biology showed a normo chrome and normocytic anemia of 8 g/l Group O+. The esogastroduodenal transit was in favor of an amputation (tight stenosis) extended on the cardia with megaesophagus upstream. We performed a cardiomyotomy according to Heller associated with a hemivalve according to Toupet. We performed a followed by preesophageal and subhepatic drainage. The postoperative course was simple, marked by a resumption of food on D6 postoperatively. The control test carried out with gastrographine 10 days after the surgical intervention noted a regression of the signs with passage of the product of contrast in the small intestine. The patient seen again 6 months after the operation showed no particularities. Conclusion: Achalasia is a chronic esophageal motility disorder characterized by the inability of the lower esophageal sphincter to relax. Heller cardiomyotomy by laparotomy associated with Toupet-type fundoplication retains its place in its management in our exercise context.

Prevalence, associated factors, and impact of adolescent asthma in Taiwan: Global Asthma Network phase I survey

BackgroundThe prevalence of asthma in Taiwan was increasing in the past 30 years, causing a great impact on adolescent health. This study aimed to investigate the current prevalence, impact, and associated factors of asthma in Taiwanese adolescents. Material and methodsParents or guardians provided passive consent at home prior to the survey. Adolescents aged 13–14 years completed a questionnaire survey in 2017 in Taipei, Taiwan. The prevalence, impact, and associated factors of asthma were analyzed. We also compared the asthma prevalence with the prevalence in 1995 and 2001. ResultsWe analyzed 3474 validated questionnaires. The prevalence of physician-diagnosed asthma was 12.4%. The prevalence of current wheezing was 9.2% in 2017, which was 5.2% in 1995 and 7.0% in 2001. 3.3% of 13–14-year-old adolescents had severe asthma symptoms. Asthma significantly impacted the lives of adolescents. Of the students with asthma, 10.9% had school absenteeism, 16.5% urgently needed to see a doctor, 9.5% went to the emergency department, and 3.5% were admitted to hospitals within the preceding 12 months. The associated factors for physician-diagnosed asthma in Taiwanese adolescents were male (prevalence ratio [PR], 1.38; 95% confidence interval [CI], 1.05–1.83; p = 0.02), maternal history of asthma (PR, 2.61; 95% CI, 1.69–4.02; p < 0.01), and recent paracetamol use at least once per month (PR, 2.60; 95% CI, 1.24–5.42; p = 0.01). The associated factors for school absenteeism were nocturnal cough (PR, 1.99; 95% CI, 1.16–3.41; p = 0.01), current wheezing (PR, 7.52; 95% CI, 4.39–12.9; p < 0.01), and recent paracetamol use (at least once per month, PR, 3.16; 95% CI, 1.10–9.06; p = 0.03; at least once per year, PR, 2.19; 95% CI, 1.25–3.83; p < 0.01). ConclusionsThe prevalence of physician-diagnosed asthma was 12.4%. Asthma substantially impacted the lives of adolescents. Reducing nocturnal cough, wheezing frequency, and paracetamol usage might help decrease school absenteeism.

34/f-Heartburn and nocturnal cough : Preparation for the medical specialist examination: part 36

34/f-Heartburn and nocturnal cough : Preparation for the medical specialist examination: part 36

Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data

Cough variant asthma (CVA) may respond differently to anti-asthmatic treatment. There is limited data on the heterogeneity of CVA. We aimed to classify patients with CVA using cluster analysis based on clinico-physiological parameters and to unveil the underlying molecular pathways of these phenotypes with transcriptomic data of sputum cells. K-mean clustering was applied to 342 newly physician-diagnosed patients with CVA from a prospective, multicenter, observational cohort using 10 pre-specified baseline clinic-pathophysiological variables. The clusters were compared based on clinical features, treatment response and sputum transcriptomic data. Three stable CVA clusters were identified. Cluster 1 (n= 176) was characterized by female predominance, late-onset, normal lung function, and a low proportion of complete resolution of cough (60.8%) after anti-asthmatic treatment. Cluster 2 (n=105) presented with young, nocturnal cough, atopy, type 2-high inflammation, and a high proportion of complete resolution of cough (73.3%) with highly upregulated co-expression gene network that related to type 2 immunity. Cluster 3 (n= 61) had a high body mass index, long duration, family history of asthma, low lung function, and low proportion of complete resolution of cough (54.1%). Th17 immunity and type 2 immunity co-expression gene networks were both upregulated in clusters 1 and 3. Three clusters of CVA were identified with different clinical, pathophysiological, and transcriptomic features and responses to anti-asthmatics treatment, which may improve our understanding of pathogenesis and develop individualized treatment of cough in asthma.