video: Chronic cough is undergoing a pivotal shift—from being viewed merely as a symptom to being recognized as a distinct disease entity. From December 4 to 6, 2025, the 5th International Cough Conference (ICC) was successfully held in Guangzhou, China. This event focused on the theme of “refractory chronic cough,” bringing together more than 400 experts, researchers, and industry representatives worldwide from China, the United Kingdom, the United States, Australia, Canada, Japan, the Republic of Korea, and other countries and regions, to discuss the latest advances and future directions in chronic cough. On the occasion of this conference, the editorial team of the Journal of Thoracic Disease (JTD), together with Nanshan Respiratory, invited leading experts to discuss major international cough conferences, review research progress, and share perspectives on the future of cough research and clinical practice. Participants included: Academician Zhong Nanshan (ICC Chair and Editor-in-Chief of JTD); Professor Kian Fan Chung, Chair of the London International Cough Symposium (LICS) (Co-Chair of ICC, and Deputy Editor-in-Chief of JTD); and Professor Lai Kefang, ICC Co-Chair (JTD Editorial Board Member). The London International Cough Symposium (LICS) was initiated by Professor John Widdicombe, a pioneer in cough research. During the 13th LICS meeting in 2024, Professor Kian Fan Chung introduced, experts focused on defining chronic cough as a disease rather than simply a symptom. Discussions were focused on “cough hypersensitivity,” a distinctive feature of chronic cough, and its underlying mechanisms. Prof. Chung also highlighted that the 2026 LICS event (now named ERS Cough Conference 2026), will be co-hosted with the European Respiratory Society (ERS) , and registration is now open at https://channel.ersnet.org/event-390-ers-cough-conference-2026. The International Cough Conference (ICC) in China was first held in Guangzhou in 2013. Professor Lai Kefang explained that while ICC and LICS share common goals, they differ in emphasis. LICS focuses more on basic research and cutting-edge developments. In China, due to regional disparities in healthcare capacity, misdiagnosis and inappropriate treatment are still common, so that ICC emphasis more on standardized diagnosis, treatment, and management of chronic cough—in a hope to improve and normalize clinical practice. In recent years, ICC has increasingly focused on refractory chronic cough, and recognizing cough as an independent disease is also critical for the development of new therapies. Professor Chung emphasized that China has made substantial progress in basic research on chronic cough in recent years. He noted that it is especially encouraging—and deeply meaningful—that a growing number of Chinese pharmaceutical companies are showing strong interest in developing new drugs for chronic cough. In his view, this signals significant progress toward alignment of the broader goals of ICC and LICS. Beyond research, both conferences should increasingly take on responsibilities in physician education—improving awareness and management capabilities among general practitioners and primary/community healthcare providers. Academician Zhong Nanshan spoke highly of ICC, noting that it has grown into one of the world’s largest academic conferences dedicated to cough research. Together with LICS and the American Cough Conference (ACC), ICC is now among the most influential international academic meetings in the cough field. He also recognized the sustained efforts of Professor Kian Fan Chung, Professor Lai Kefang, and other experts in building a high-quality bridge for international academic exchange between LICS and ICC. Academician Zhong highlighted rapid progress in China’s chronic cough research, with a series of major advances in recent years: Diagnostics and assessment: The development of an AI-based automated identification technique for eosinophils in induced sputum, achieving an accuracy of over 95%; and the completion of initial prototype development for a portable cough monitoring device. Mechanistic research: Using animal models, novel insights have emerged regarding central nervous system nuclei, peripheral lymphocytes, and cytokines involved in regulating cough hypersensitivity, along with explorations of the relationship between anxiety, depression, and cough hypersensitivity. Therapeutic innovation: To address refractory chronic cough—a global clinical challenge—China is pursuing diversified approaches in novel drug development. Domestic next-generation P2X3 receptor antagonists are entering clinical trial evaluation, alongside the development and efficacy exploration of multi-target traditional Chinese medicine compound formulations. Discipline development and standardization: China has launched a chronic cough subspecialty development program involving 223 hospitals nationwide to improve consistency and quality of care. Through continuous guideline updates and the nationwide educational initiative “China Cough Guideline Promotion Tour,” nearly 40,000 healthcare professionals have been trained, significantly improving the standardization of chronic cough diagnosis and treatment. Academician Zhong emphasized that these achievements are inseparable from international academic exchange and cooperation. Leveraging platforms such as ICC and LICS, China will deepen cross-border collaboration and continue to advance the field. Looking ahead, Professor Kian Fan Chung mentioned that much work remains in the fundamental mechanisms of chronic cough—particularly the central and peripheral regulatory pathways of cough hypersensitivity. He stressed that chronic cough should be recognized as a disease with heterogeneity under different phenotypes and endotypes. Future research and clinical practice should focus on identifying individual drivers of cough to enable personalized and precision treatment. Professor Lai Kefang agreed with Prof. Chung, and Prof. Lai mentioned that cough hypersensitivity may be heterogeneous and present as distinct phenotypes. Such differences may be linked to environmental exposures and genetic factors. He shared that a nationwide chronic cough cohort study is currently underway in China, which is expected to provide additional Chinese data and evidence to support further exploration of phenotypes and endotypes. Professor Lai also expressed hope for expanded China–Europe collaboration to jointly advance mechanistic research and classification studies in chronic cough.Two Major International Cough Conferences: LICS and ICC
Major Advances and Steady Progress Achieved in Chronic Cough in China
Future Directions in Chronic Cough: Advancing Insights in Mechanisms and Phenotyping through Global Collaboration
Credit: Journal of Thoracic Disease (JTD) & Nanshan Respiration, © 2025.
From December 4 to 6, 2025, the 5th International Cough Conference (ICC) was successfully held in Guangzhou, China. This event focused on the theme of "refractory chronic cough", bringing together more than 400 experts, researchers, and industry representatives worldwide from China, the United Kingdom, the United States, Australia, Canada, Japan, the Republic of Korea, and other countries and regions, to discuss the latest advances and future directions in chronic cough.
Chronic cough is undergoing a pivotal shift—from being viewed merely as a symptom to being recognized as a distinct disease entity. On the occasion of this conference, the editorial team of the Journal of Thoracic Disease (JTD), together with Nanshan Respiration, invited leading experts to discuss major international cough conferences, review research progress, and share perspectives on the future of cough research and clinical practice. Participants included: Academician Zhong Nanshan (ICC Chair and Editor-in-Chief of JTD); Professor Kian Fan Chung, Chair of the London International Cough Symposium (LICS) (Co-Chair of ICC, and Deputy Editor-in-Chief of JTD); and Professor Lai Kefang, ICC Co-Chair (JTD Editorial Board Member).
Two Major International Cough Conferences: LICS and ICC
The London International Cough Symposium (LICS) was initiated by Professor John Widdicombe, a pioneer in cough research. During the 13th LICS meeting in 2024, Professor Kian Fan Chung introduced, experts focused on defining chronic cough as a disease rather than simply a symptom. Discussions were focused on “cough hypersensitivity,” a distinctive feature of chronic cough, and its underlying mechanisms. Prof. Chung also highlighted that the 2026 LICS event (now named ERS Cough Conference 2026), will be co-hosted with the European Respiratory Society (ERS) , and registration is now open at https://channel.ersnet.org/event-390-ers-cough-conference-2026.
The International Cough Conference (ICC) in China was first held in Guangzhou in 2013. Professor Lai Kefang explained that while ICC and LICS share common goals, they differ in emphasis. LICS focuses more on basic research and cutting-edge developments. In China, due to regional disparities in healthcare capacity, misdiagnosis and inappropriate treatment are still common, so that ICC emphasis more on standardized diagnosis, treatment, and management of chronic cough—in a hope to improve and normalize clinical practice. In recent years, ICC has increasingly focused on refractory chronic cough, and recognizing cough as an independent disease is also critical for the development of new therapies.
Professor Chung emphasized that China has made substantial progress in basic research on chronic cough in recent years. He noted that it is especially encouraging—and deeply meaningful—that a growing number of Chinese pharmaceutical companies are showing strong interest in developing new drugs for chronic cough. In his view, this signals significant progress toward alignment of the broader goals of ICC and LICS. Beyond research, both conferences should increasingly take on responsibilities in physician education—improving awareness and management capabilities among general practitioners and primary/community healthcare providers.
Major Advances and Steady Progress Achieved in Chronic Cough in China
Academician Zhong Nanshan spoke highly of ICC, noting that it has grown into one of the world’s largest academic conferences dedicated to cough research. Together with LICS and the American Cough Conference (ACC), ICC is now among the most influential international academic meetings in the cough field. He also recognized the sustained efforts of Professor Kian Fan Chung, Professor Lai Kefang, and other experts in building a high-quality bridge for international academic exchange between LICS and ICC.
Academician Zhong highlighted rapid progress in China's chronic cough research, with a series of major advances in recent years:
- Diagnostics and assessment: The development of an AI-based automated identification technique for eosinophils in induced sputum, achieving an accuracy of over 95%; and the completion of initial prototype development for a portable cough monitoring device.
- Mechanistic research: Using animal models, novel insights have emerged regarding central nervous system nuclei, peripheral lymphocytes, and cytokines involved in regulating cough hypersensitivity, along with explorations of the relationship between anxiety, depression, and cough hypersensitivity.
- Therapeutic innovation: To address refractory chronic cough—a global clinical challenge—China is pursuing diversified approaches in novel drug development. Domestic next-generation P2X3 receptor antagonists are entering clinical trial evaluation, alongside the development and efficacy exploration of multi-target traditional Chinese medicine compound formulations.
- Discipline development and standardization: China has launched a chronic cough subspecialty development program involving 223 hospitals nationwide to improve consistency and quality of care. Through continuous guideline updates and the nationwide educational initiative "China Cough Guideline Promotion Tour", nearly 40,000 healthcare professionals have been trained, significantly improving the standardization of chronic cough diagnosis and treatment.
Academician Zhong emphasized that these achievements are inseparable from international academic exchange and cooperation. Leveraging platforms such as ICC and LICS, China will deepen cross-border collaboration and continue to advance the field.
Future Directions in Chronic Cough: Advancing Insights in Mechanisms and Phenotyping through Global Collaboration
Looking ahead, Professor Kian Fan Chung mentioned that much work remains in the fundamental mechanisms of chronic cough—particularly the central and peripheral regulatory pathways of cough hypersensitivity. He stressed that chronic cough should be recognized as a disease with heterogeneity under different phenotypes and endotypes. Future research and clinical practice should focus on identifying individual drivers of cough to enable personalized and precision treatment.
Professor Lai Kefang agreed with Prof. Chung, and Prof. Lai mentioned that cough hypersensitivity may be heterogeneous and present as distinct phenotypes. Such differences may be linked to environmental exposures and genetic factors. He shared that a nationwide chronic cough cohort study is currently underway in China, which is expected to provide additional Chinese data and evidence to support further exploration of phenotypes and endotypes. Professor Lai also expressed hope for expanded China–Europe collaboration to jointly advance mechanistic research and classification studies in chronic cough.