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Tiotropium bromide(136310-93-5) is a long-acting, specific anticholinergic drug used primarily for chronic treatment of chronic obstructive pulmonary disease and asthma. In recent clinical trials and animal experiments have found that it has the role of regulation of cough reflex sensitivity. In 2008 Dicpinigaitis, etc. in a randomized, double-blind prospective clinical trial study reported that tiotropium can inhibit capsaicin-induced upper respiratory tract infection in patients with high cough reflex sensitivity. 2009 Bouyssou and other reports in the guinea pig asthma model, tiotropium can inhibit acid-mediated cough reflex sensitivity, and dose-dependent. Birrell et al. Applied the guinea pig model in 2014 to separate the vagus nerve, airway-associated ganglia, and to assess the effect of tiotropium bromide(136310-93-5) on airway sensory nerve activity and cough reflex sensitivity by recording the function of C fibers using electrophysiological methods. In this experiment, capsaicin was used to stimulate TRPV1, induce cough and activate C fiber, and were treated with tiotropium bromide, ipratropium bromide and atropine. The results show that the first two can block the capsaicin-induced vagal reflex, and the latter two have no effect. Tiotropium bromide(136310-93-5) also inhibits capsaicin-mediated Ca 2+ ion movement and voltage changes in airway-specific ganglia. This is the first time that tiotropium has been shown to inhibit the neuronal TRPV1-mediated cough reflex, and this effect is not associated with tiotropium anticholinergic activity. So anticholinergic drugs may become a treatment of chronic cough choice.

There is a class of patients with chronic cough can not clear the cause of the crowd, the treatment is poor, has been called unexplainedchroniccough, refractorychroniccough, isolatedchroniccough, idiopathicchroniccough and so on, cough reflex sensitivity may be its important pathogenesis. Some scholars in 2010 proposed chroniccoughhypersensitivitysyndrome, CCHS concept, it is estimated that the prevalence of CCHS 6% or more.

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