Traditional Chinese Medicine for Cough Variant Asthma: Bridging TCM Syndrome Differentiation with Modern Immunological Mechanisms and Clinical Translation - A Narrative Review.
- 1Clinical Medical College, Chengdu University of TCM, Chengdu, Sichuan, 611137, People's Republic of China.
- 2Department of Pediatrics, Hospital of Chengdu University of TCM, Chengdu, Sichuan, 610075, People's Republic of China.
Abstract
Background
Cough variant asthma (CVA) constitutes a diagnostically challenging phenotype of asthma, predominantly characterized by chronic cough without overt wheezing. Its pathogenesis involves airway inflammation, immune dysregulation, airway hyperresponsiveness, and cough hypersensitivity, yet therapeutic optimization remains an unmet need.Objective
This review aims to systematically synthesize current evidence on the role of traditional Chinese medicine (TCM) in CVA, bridging TCM syndrome-differentiation theory, molecular immunological mechanisms, and real-world clinical applications.Findings
In TCM theory, CVA is conceptualized as a disorder arising from external triggers (notably wind), internal viscera dysfunction (lung, spleen, kidney), phlegm retention, and blood stasis. Syndrome differentiation guides individualized treatment. Experimentally, TCM interventions modulate Th1/Th2 and Th17/Treg immune axes, inhibit key inflammatory pathways (TLR4/NF-κB, IL-6/STAT3), attenuate airway remodeling, and regulate gut microbiota. Clinically, meta-analyses and randomized trials indicate that TCM, alone or as adjunctive therapy, may improve cough control, reduce recurrence, and enhance quality of life. Nevertheless, substantial heterogeneity across study designs, TCM syndrome classification criteria, and selected outcome measures fundamentally restricts the generalizability and robustness of existing clinical evidence.Future directions
Advancing the field requires phenotype-stratified trials, integration of biomarkers and TCM syndromes, exploration of the gut-lung axis, and application of AI-driven compound screening and microfluidic models. International standardization and inclusion in global guidelines are essential for translational impact.Conclusion
TCM offers a mechanistically plausible and clinically relevant integrative approach to CVA. Rigorous, multicenter, and mechanism-based research is urgently needed to establish its definitive role in global respiratory medicine.
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BibTeX
@article{luo2026traditional,
title = {{Traditional Chinese Medicine for Cough Variant Asthma: Bridging TCM Syndrome Differentiation with Modern Immunological Mechanisms and Clinical Translation - A Narrative Review.}},
author = {Dan Luo and Yingling Yang and Jinna Tian and Jianbao Li},
journal = {Therapeutics and clinical risk management},
year = {2026},
month = oct,
doi = {10.2147/tcrm.s631539},
url = {https://europepmc.org/article/MED/42928898},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Traditional Chinese Medicine for Cough Variant Asthma: Bridging TCM Syndrome Differentiation with Modern Immunological Mechanisms and Clinical Translation - A Narrative Review.
AU - Dan Luo
AU - Yingling Yang
AU - Jinna Tian
AU - Jianbao Li
PY - 2026
DA - 2026/10/21
JO - Therapeutics and clinical risk management
DO - 10.2147/tcrm.s631539
UR - https://europepmc.org/article/MED/42928898
AB - Background Cough variant asthma (CVA) constitutes a diagnostically challenging phenotype of asthma, predominantly characterized by chronic cough without overt wheezing. Its pathogenesis involves airway inflammation, immune dysregulation, airway hyperresponsiveness, and cough hypersensitivity, yet therapeutic optimization remains an unmet need.Objective This review aims to systematically synthesize current evidence on the role of traditional Chinese medicine (TCM) in CVA, bridging TCM syndrome-differentiation theory, molecular immunological mechanisms, and real-world clinical applications.Findings In TCM theory, CVA is conceptualized as a disorder arising from external triggers (notably wind), internal viscera dysfunction (lung, spleen, kidney), phlegm retention, and blood stasis. Syndrome differentiation guides individualized treatment. Experimentally, TCM interventions modulate Th1/Th2 and Th17/Treg immune axes, inhibit key inflammatory pathways (TLR4/NF-κB, IL-6/STAT3), attenuate airway remodeling, and regulate gut microbiota. Clinically, meta-analyses and randomized trials indicate that TCM, alone or as adjunctive therapy, may improve cough control, reduce recurrence, and enhance quality of life. Nevertheless, substantial heterogeneity across study designs, TCM syndrome classification criteria, and selected outcome measures fundamentally restricts the generalizability and robustness of existing clinical evidence.Future directions Advancing the field requires phenotype-stratified trials, integration of biomarkers and TCM syndromes, exploration of the gut-lung axis, and application of AI-driven compound screening and microfluidic models. International standardization and inclusion in global guidelines are essential for translational impact.Conclusion TCM offers a mechanistically plausible and clinically relevant integrative approach to CVA. Rigorous, multicenter, and mechanism-based research is urgently needed to establish its definitive role in global respiratory medicine.
SN - 1176-6336
SN - 1178-203X
ER -