Capsaicin cough sensitivity in bronchiectasis

Alfonso Torrego ¹, Rubaiyat A Haque ¹, Lan-Tien Nguyen ¹, Mark Hew ², Denis H Carr ³, Robert Wilson ³ and Kian Fan Chung ^1*

¹ Imperial College, United Kingdom
² imperial College, United Kingdom
³ Royal Brompton Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: f.chung{at}imperial.ac.uk.

Accepted 15 March 2006

Abstract

Background: Bronchiectasis is a suppurative airway disease characterised by persistent cough and sputum production associated with bronchial dilatation. We determined whether cough sensitivity is increased in bronchiectatic patients.

Methods: We recruited 22 patients with bronchiectasis and 20 healthy non-smoking controls matched for age and gender and recorded quality of life using the Leicester cough score, total cough symptom score and extent of bronchiectasis from high resolution computed tomograms (HRCT). 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 demonstrated increased sensitivity to capsaicin compared to controls (mean log10 C5 1.22 ± 0.20 vs. 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 total cough symptom score (r=-0.58; p=0.004), but not with the extent of the disease. It also correlated with FEV1 (L) (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: A sensitive cough reflex is present in patients with bronchiectasis reflecting the severity of cough symptoms. A measure of cough severity could be part of health assessment for bronchiectasis.

Keywords: bronchiectasis, capsaicin, cough, quality of life

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