Phenotypes and endotypes of cough in asthma

Asthma is a common chronic inflammatory airway disease with diverse clinical manifestations, among which cough is one of the most significant and complex symptoms. Cough not only impacts patients’ quality of life but also significantly influences the diagnosis and management of asthma. In recent years, with advancements in molecular biology and immunology, researchers have progressively uncovered multiple phenotypes of cough in asthma and their corresponding endotypic mechanisms, encompassing the activation of immune cells, the release of inflammatory mediators, and the role of airway neural regulation, among other aspects. However, challenges remain in standardizing the classification of cough phenotypes and establishing precise diagnostic and therapeutic pathways. This article systematically reviews the latest research progress on the phenotypes and endotypes of cough in asthma. It focuses on elucidating the immune-inflammatory and neural regulatory mechanisms, integrating the latest advancements in clinical diagnostic and therapeutic strategies. The aim is to provide theoretical support and practical guidance for the precision medicine of asthmatic cough, thereby promoting in-depth exploration and clinical application in this field.