Press Release
Pain and cough, what do they have in common?
A symposium in Florence answers this question.
Florence, 20 March 2015– How does our body react to pain? And to a cough? Are there any similarities, common channels of perception, brain mechanisms that can explain how they work?
Attempts to answer these, and other equally challenging questions, are made by the experts currently meeting in Florence to take part in the symposium “Pain and cough”. This event has been organised by the Department of Health Sciences of the University of Florence, by the Department of Geriatrics of the University Hospital of Careggi in Florence, and promoted by the Fondazione Internazionale Menarini.
“These are two very common, and apparently far removed conditions in the life of everyone. Even still, certain molecular mechanisms may be closely associated in both these conditions. In fact, the sensitisation processes, and therefore the chronicity processes may share the same pathway”, explains Pierangelo Geppetti, Director of the Department of Health Sciences of the University of Florence. “Pain may have a protective action and the coughing reflex is also normally also a symptom and therefore it must be maintained. What we need to avoid, is that the pain, an extremely important phenomenon for the survival of the individual, degenerates into a condition in which a normal symptom, such as the cough, strongly limits the person’s quality of life. It’s the same thing with pain: the painful sensation may be useful, and therefore it should not necessarily be eliminated, but what we want to do is to reduce, and if possible, abolish this condition in which even a normal everyday gesture becomes a painful and unbearable condition. For some people, a usually normal movement, or simple contact of the skin with an object, may be painful: our aim is to study these processes to transform these conditions of suffering into normal conditions”.
In order to achieve this goal, Geppetti and his staff have conducted various research projects, in particular, on the ionic channels, the trans-receptor potential channels, some of which are well known. For example, the TRPA1, which is the channel activated by natural hot, spicy substances like chilli pepper and wasabi, a sauce used in Japanese cuisine.
“Our target is to create and develop new drugs against chronic, untreatable pain”, continues Geppetti. “The basis of the project is the study of this pain transmitting channel, mediated by a specific molecular mechanism. During this study we have observed how various natural substances of vegetable origin are able to produce a pronounced pain reliever effect. The aim of our programme is to identify and develop original molecules which, by acting precisely on this pain transmission channel, are able to form the basis of new, more effective and safer drugs compared to current treatments, especially in the case of cancer, neuropathic and acute migraine pain”.
Studies have recently been conducted at the University of Florence for locating and defining the function of the TRPA1 ionic channel in the airway passages and for testing the ability of the TRPA1 receptor antagonists to sedate a cough. “That’s why pain and cough have many similarities, more so in physiopathological than in clinical terms: the mechanisms at the basis of the genesis of the two phenomena are extremely similar”, adds Giovanni Fontana, Professor Respiratory Medicine of the University of Florence.“Chronic cough is a totally different clinical entity from the cough as we commonly understand it. It is not a mere extension in time of the phenomena that generate acute seasonal cough all of us have had as a consequence of the flu or a cold, instead it is a completely different phenomenon that has a far greater impact on the quality of life. Acute, seasonal cough clears up spontaneously and often no intervention by the physician is necessary, whereas chronic cough is never self-limiting and it may conceal underlying diseases, therefore requiring intervention by a specialist. With the progress of knowledge in the clinical field, we have observed how a significant number, probably amounting to approximately 25-30 percent of patients with chronic cough, in actual fact suffer from a new nosological disease known as the reflex cough hypersensitivity syndrome, in which there is no other disease underlying the cough, rather, the cough itself is the disease. Something similar – and here we return again to the similarities between pain and cough – happens in neuropathic pain, migraine, headache, and irritable bowel: all conditions that do not have a triggering cause, and yet they exist. To conclude, pain and cough still have many obscure aspects that need to be evaluated and analysed. This congress in Florence is probably the first in the world to have combined these two very different, yet very similar nosologies, and we hope we will be able to contribute to the knowledge of pain and cough, and in this way find new therapies capable of combating them».
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