COUGH

Capsaicin cough sensitivity in bronchiectasis

A Torrego, R A Haque, L T Nguyen, M Hew, D H Carr, R Wilson, K F Chung

National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London, UK

Correspondence to:
Professor K F Chung
National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK; f.chung{at}imperial.ac.uk

Background: Bronchiectasis is a suppurative airway disease characterised by persistent cough and sputum production associated with bronchial dilatation. A study was undertaken to determine whether cough sensitivity is increased in bronchiectatic patients.

Methods: Twenty two patients with bronchiectasis and 20 healthy non-smoking controls matched for age and sex were recruited into the study. Quality of life (Leicester Cough Questionnaire score), total cough symptom score, and extent of bronchiectasis on HRCT scans were recorded. Cough sensitivity was assessed using incremental inhalation of capsaicin concentrations; the concentration at which 5 or more coughs occurred (C5) was recorded.

Results: Patients with bronchiectasis had increased sensitivity to capsaicin compared with controls (mean (SE) log₁₀ C5 1.22 (0.20) v 1.89 (0.21); p<0.03). Capsaicin sensitivity correlated positively with the Leicester Cough Questionnaire score (r = 0.64; p = 0.005) and inversely with the total cough symptom score (r = –0.58; p = 0.004), but not with the extent of the disease. It also correlated with forced expiratory volume in 1 second (FEV₁) in litres (r = 0.58; p = 0.005) but not with FEV₁ % predicted. Capsaicin sensitivity was not related to the presence of infected sputum or to corticosteroid or bronchodilator use.

Conclusions: : Patients with bronchiectasis have a sensitive cough reflex which reflects the severity of cough symptoms. A measure of cough severity could be part of health assessment for patients with bronchiectasis.

Abbreviations: C5, concentration of capsaicin required to induce 5 coughs; FEV₁, forced expiratory volume in 1 second; LCQ, Leicester Cough Questionnaire

Keywords: bronchiectasis; cough; capsaicin

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