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This dysregulation can lead to an increased sensitivity of the cough reflex such that the coughing becomes, at times, \u201cnonproductive\u201d or inappropriate. Vagal dysregulation can also lead to an increase in the activity of the parasympathetic reflex control of the airways, which contributes to greater mucus secretion and bronchial smooth muscle contraction. Indirect evidence indicates that lung disease is accompanied by substantive changes to the entire reflex pathways, including enhanced activity of the primary afferent nerves, increases in synaptic efficacy at secondary nerves in the central nervous system, and changes in the autonomic nerve pathways. Drugs aimed at normalizing neuronal activity may, therefore, be beneficial in chronic obstructive pulmonary disease.<\/jats:p>","DOI":"10.1513\/pats.200504-033sr","type":"journal-article","created":{"date-parts":[[2005,11,2]],"date-time":"2005-11-02T19:47:33Z","timestamp":1130960853000},"page":"355-360","source":"Crossref","is-referenced-by-count":98,"title":["The Role of Vagal Afferent Nerves in Chronic Obstructive Pulmonary Disease"],"prefix":"10.1093","volume":"2","author":[{"given":"Bradley J.","family":"Undem","sequence":"first","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Kollarik","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, 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