Thermo sensitive TRPM8 channel and its role in cold induced airway symptoms

It is generally accepted that environmental factors can significantly influence respiratory system. Cold is one of these factors. Understanding of the reaction of airways to cold air is very important tool leading to improvement in management of cold induced rhinitis, cold induced asthma, exercise induced asthma, and exacerbation of chronic airway diseases induced by cold exposure. Despite the airways are protected against cold air by powerful heat and moisture exchanging counter current system within the nose, they are still at the risk of onset and development of cold induced symptoms mainly if this mechanism is insufficient, exposed person hyperventilates or is breathing subfreezing air. Some of the mechanisms involved in cold air induced reactions are understood quite well, but some of them are still discussed as they have not been satisfactorily explained, yet. Most discussed mechanisms by which cold air may induce respiratory symptoms include direct cooling and exsiccation of mucosal surface with subsequent hypertonicity of superficial fluid layer and interactions between the trigeminal and the vagus nerve at the central level. Molecular background for such a reaction may rely on the presence of thermo sensitive channels, mainly TRPM8, expressed on airway afferent nerves, which initiate response to cold air, giving a rise to autonomic responses like bronchoconstriction, cough, dyspnoea, chest tightness, mucus secretion and mucosal swelling. Identification of targets for cold action in the airway may help to identify potent antagonists which may prevent or reverse cold induced reactions sharing possibility for clinical application.