RT Journal Article
SR Electronic
T1 Reduced pH and chloride levels in exhaled breath condensate of patients with chronic cough
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 608
OP 612
DO 10.1136/thx.2003.012906
VO 59
IS 7
A1 A Niimi
A1 L T Nguyen
A1 O Usmani
A1 B Mann
A1 K F Chung
YR 2004
UL http://thorax.bmj.com/content/59/7/608.abstract
AB Background: Increased hydrogen and reduced chloride ionic environments of the airways are conducive to the stimulation of cough. However, the constituents of the local milieu of the airways of patients with chronic cough are unknown.Methods: The pH and chloride levels in exhaled breath condensate and capsaicin cough threshold (C5) were measured in 50 patients with chronic cough and in 16 healthy controls. pH and chloride measurements were repeated after capsaicin challenge in those with cough. The cause of cough was asthma (n = 13), postnasal drip/rhinitis (n = 7), gastro-oesophageal reflux (n = 5), bronchiectasis (n = 5), but remained unidentified in 20.Results: Compared with controls, patients with chronic cough had lower pH (mean 7.9 v 8.3, 95% CI of difference −0.5 to −0.2, p<0.0001), chloride levels (median 4 v 6 mmol/l, 95% CI −3.1 to −0.2, p = 0.007), and C5 (median 3.9 v 125 μM, 95% CI −270.0 to −17.6, p = 0.002). The pH levels were different in the six subgroups including controls, and were reduced in all diagnostic subgroups of patients with cough compared with controls but did not differ between them. Chloride levels were significantly different in the six subgroups but were lower than controls in only the gastro-oesophageal reflux subgroup. There was a weak but significant correlation between chloride levels and C5 when all participants were analysed together, but not between pH and C5 or chloride levels. pH and chloride levels did not change after capsaicin challenge.Conclusions: The epithelial lining fluid of patients with chronic cough has a reduced pH and reduced chloride levels which could contribute to the enhanced cough reflex.