Assume that the patient have atrophic nasal membranes after long chronic rhinitis. He is having frequent dry coughs through reflex arch
- induced by exercise,
- allergies, and
You normally heal this by corticosteroids. Assume that the patient have a special glue-gene that creates protein layer (DNA of lymphocytes in small bronchial tree) onto the nasal membranes. The creation of this membrane is continuous so you cannot stop it. I think this would inhibit the functioning of the steroids. So the component of the medication should involve something lipid soluble that either
- allows steroids to affect the membrane or
- prevents the spreading of nasal bacteria through sympathetic fibers into the brain and causing the cough
which affect the cough trough reflex arch. Each time these sympathetic fibers are stimulated, the dry cough results (exercise, stress, allergies, ...). Codeine affects the cough center so it cannot prevent this cough happening.
How can you design a drug that prevents the activation of these sympathetic fibers or spreading of more bacteria into the fibers?
I think once you have those bacteria in the sympathetic fibers you cannot prevent the cough through reflex arch happening. The only way is to limit the presence of these fibers in the nasal region or to heal the nasal mucosa.
The recovery of the atrophic nasal mucosa takes about 2 months. Risk factors for rhinitis are
- irritating factors like dust,
- too dry or too moist air,
- huge temperature changes.
so prevention should include oiling of nose early in the January. Or throughout the year. I think there exists no lipid secretion glands near by nasal region. So the main method should be prophylactics. I could not find any existing method to heal the atrophic mucosa faster. Corticosteroids or anything else that has been used only worsen the situation.