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The interaction between bronchoconstriction and cough in asthma
  1. Imran Satia1,2,
  2. Huda Badri1,
  3. Mark Woodhead1,3,
  4. Paul M O'Byrne1,4,
  5. Stephen J Fowler1,
  6. Jaclyn A Smith1,2
  1. 1Division of Infection, Immunity and Respiratory Medicine, University of Manchester and Manchester Academic Health Science Centre, Manchester, UK
  2. 2University Hospital of South Manchester, Manchester, UK
  3. 3Central Manchester NHS Foundation Trust, Manchester, UK
  4. 4Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Professor Jacky A Smith, Centre for Respiratory and Allergy Research, University of Manchester, University Hospital of South Manchester, Level 2, Education and Research Centre, Manchester M23 9LT, UK; jacky.smith{at}


Variable airflow obstruction is a pathophysiological hallmark of asthma; however, the interactions between acute bronchoconstriction and the cough reflex are poorly understood. We performed a randomised, single-blind, placebo-controlled, crossover study to investigate the interaction between bronchoconstriction and cough in asthma. Capsaicin was administered to evoke coughs and methacholine to induce bronchoconstriction. We demonstrated that acute bronchoconstriction increased capsaicin-evoked coughs, which improved as airway calibre spontaneously resolved. However, capsaicin-evoked coughing had no impact on methacholine-induced bronchoconstriction. This study provides evidence that bronchoconstriction increases the activation of capsaicin-responsive airway nerves, but the precise mechanisms and mediators involved require further evaluation.

Trial registration number ISRCTN14900082.

  • Asthma
  • Asthma Mechanisms
  • Cough/Mechanisms/Pharmacology

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  • Twitter Follow Imran Satia @lung_research

  • Contributors IS, HB, MW, PMO, SJF and JAS: concept and design. IS and HB: data generation. IS and JAS: statistical analysis and modelling. All authors reviewed the manuscript and approved the final draft.

  • Funding National Institute for Health Research, South Manchester Clinical Research Facility.

  • Competing interests JAS is a named inventor on a patent, owned by University Hospital of South Manchester, describing a method for generating output data licensed to Vitalograph; however, no financial benefits have been received.

  • Patient consent Obtained.

  • Ethics approval North West, Liverpool East Ethics Board (15/NW/0052).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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