Heightened cough response to bronchoconstriction in cough variant asthma.

Published on Aug 1, 2012in Respirology4.88
· DOI :10.1111/J.1440-1843.2012.02208.X
Noriyuki Ohkura15
Estimated H-index: 15
,
Masaki Fujimura53
Estimated H-index: 53
+ 2 AuthorsNobuyuki Katayama13
Estimated H-index: 13
Sources
Abstract
Background and objective:  The pathophysiology of cough variant asthma (CVA) is poorly understood. We compared bronchoconstriction-triggered cough between CVA patients and normal control (NC) subjects. Methods:  There were two protocols in the study. We measured bronchial responsiveness to methacholine (MCh) and counted the number of coughs in nine CVA patients and seven NC subjects (Study A). Using partial and full flow–volume curves, expiratory flow of the partial flow–volume curve at 40% above residual volume level (PEF40) and FEV1 were used to measure bronchoconstriction. Mild bronchoconstriction was defined as a 35% fall in PEF40 (PC35-PEF40), and more severe bronchoconstriction as a 20% fall in FEV1 (PC20-FEV1). In study B, the same measurements were obtained in six CVA patients before and after therapy. Results:  In study A, more coughs were provoked at PC35-PEF40 in CVA patients (median, 60 coughs/32 min post challenge; range, 12–135) than in NC subjects (median, 0/32 min; range, 0–13; P < 0.05). At PC20-FEV1, more coughs were provoked in CVA patients (median, 60/32 min; range, 12–150) than in NC subjects (median, 20/32 min; range, 0–54; P < 0.05). In study B, the six CVA patients who underwent re-examination after treatment had less coughs at PC35-PEF40 (median, 3/32 min; range, 0–14) and PC20-FEV1 (median, 13/32 min; range, 3–26) after therapy than before therapy (median, 54/32 min; range, 33–125 and 52/32 min, 45–96, respectively; P < 0.05). Conclusions:  We identified heightened cough response to bronchoconstriction as a feature of CVA.
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#2M. Diane Lougheed (Queen's University)H-Index: 22
Asthma is one of the most common causes of chronic cough, and cough may be the sole or predominant symptom of asthma. The mechanisms of cough in asthma are complex and presumbably multi-factorial. In particular, the pathophysiologic basis of cough variant versus classic asthma is poorly understood. Recent research utilizing various inhalation challenge tests suggests that preservation of the bronchodilating and bronchoprotective effects of deep inspirations is a distinguishing feature of cough v...
15 CitationsSource
#1Noriyuki Ohkura (Kanazawa University)H-Index: 15
#2Masaki Fujimura (Kanazawa University)H-Index: 53
Last. Nobuyuki Katayama (Kanazawa University)H-Index: 13
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Background and objective. Cough is an essential innate protective behavior, which is experienced by even healthy individuals. The mechanism of cough triggered by bronchoconstriction is not yet clear. The aim of this study was to investigate the relation between bronchoconstriction and cough caused by methacholine (Mch) inhalation in typical asthmatics and normal healthy subjects. Methods. We measured bronchial responsiveness to Mch and counted the number of coughs induced by Mch inhalation in 15...
18 CitationsSource
#1Noriyuki Ohkura (Kanazawa University)H-Index: 15
#2Masaki Fujimura (Kanazawa University)H-Index: 53
Last. Shinji Nakao (Kanazawa University)H-Index: 59
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The aim of the present study was to investigate the relation between bronchoconstriction and cough induced by methacholine (Mch) inhalation and to elucidate the role of C-fibers and rapidly adapting irritant receptors (RARs) in these reactions in conscious guinea pigs. The authors measured enhanced pause (Penh) as an index of bronchoconstriction and also measured the number of coughs induced by Mch inhalation in conscious guinea pigs. The authors also examined the effects of pretreatment with pr...
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#1Hisako Matsumoto (Kyoto University)H-Index: 48
#2Akio Niimi (Kyoto University)H-Index: 54
Last. Michiaki Mishima (Kyoto University)H-Index: 76
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Background Little is known regarding mechanistic and phenotypic differences between cough variant asthma (CVA), presenting with a chronic cough as the sole symptom that responds to bronchodilators, and classic asthma with wheezing during methacholine inhalation. Here we reported airway sensitivity, airway reactivity, and as the main concern, the appearance of cough and wheezes during methacholine inhalation in patients with CVA or classic asthma.
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#2Shigeru KohnoH-Index: 94
#3Tadashi IshidaH-Index: 6
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#1Hisako Matsumoto (Kyoto University)H-Index: 48
#2Akio Niimi (Kyoto University)H-Index: 54
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Patients with cough variant asthma, a common cause of chronic cough, may develop wheezing. We examined the determinants of this phenomenon and achievement of remission in 42 patients. During 4 years after diagnosis, wheezing developed in 13 of the patients. Early inhaled corticosteroid treatment was inhibitory against the development of wheezing by univariate analysis and by multivariate analysis with an odds ratio of 0.12 (95% confidence interval, 0.02 to 0.87, p = 0.037). Remission was achieve...
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#1Stuart B. Mazzone (University of Melbourne)H-Index: 39
The cough reflex represents a primary defensive mechanism for airway protection in a variety of mammalian species. However, excessive and inappropriate coughing can emerge as a primary presenting symptom of many airway diseases. Cough disorders are characterized by a reduction in the threshold for reflex initiation and, as a consequence, the occurrence of cough in response to stimuli that are normally innocuous in nature. The current therapeutic strategies for the treatment of cough disorders ar...
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#1Ahmed Z. El-Hashim (Kuniv: Kuwait University)H-Index: 14
#2Sanaa A. Amine (Kuniv: Kuwait University)H-Index: 1
Abstract In this study we investigated the ability of aerosolized substance P to induce either cough or bronchoconstriction in guinea-pigs. We have also examined whether pre-treatment, by the inhaled route, of animals with a combination of the neutral endopeptidase inhibitor, phosphoramidon (10 −3 M), and the diaminopeptidase IV inhibitor, diprotin A (10 −3 M), enhances the airway response to substance P. Moreover, we also assessed whether aerosol pre-treatment of guinea-pigs with either substan...
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#1Masaki FujimuraH-Index: 53
#2Miki AboH-Index: 14
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Objective: A prospective multicentre study was conducted to elucidate the causes of chronic cough in Japan. Methodology: All consecutive and unselected patients complaining of cough lasting 8 weeks or more, who visited our clinics from 1 June to 31 December 2001, were registered. The causes of chronic cough were diagnosed based on the criteria for definite and probable causes of cough as recommended by the Japanese Cough Research Society. Results: Of the 248 patients enrolled, 72 patients (29.0%...
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We have identified the tracheal and laryngeal afferent nerves regulating cough in anaesthetized guinea-pigs. Cough was evoked by electrical or mechanical stimulation of the tracheal or laryngeal mucosa, or by citric acid applied topically to the trachea or larynx. By contrast, neither capsaicin nor bradykinin challenges to the trachea or larynx evoked cough. Bradykinin and histamine administered intravenously also failed to evoke cough. Electrophysiological studies revealed that the majority of ...
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Introduction The pathophysiologic differences between methacholine-induced cough but normal airway sensitivity (COUGH) and healthy individuals (CONTROL) are incompletely understood and may be due to differences in the bronchodilating effect of deep inspirations (DIs). The purpose of this study is to compare the bronchodilating effect of DIs in individuals with classic asthma (CA), cough variant asthma (CVA), and COUGH with CONTROL and to assess impulse oscillometry (IOS) measures as predictors o...
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Abstract Background Cough variant asthma (CVA) is the most common cause of chronic cough and responds well to bronchodilator therapy. Previous studies on methacholine -induced cough have shown that heightened cough response due to bronchoconstriction is a feature of CVA. The aim of this study was to assess Mch-induced cough as an indicator of bronchodilator-responsive cough (BRC). Methods This was a single-center retrospective study of prolonged/chronic cough cases who underwent evaluation via s...
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