Asthma, Rhinitis, Other Respiratory DiseasesElevated substance P levels in nasal lavage fluids from patients with chronic nonproductive cough and increased cough sensitivity to inhaled capsaicin
Section snippets
Subjects
Patients with a chronic nonproductive cough lasting more than 1 month as the sole presenting symptom were recruited from the outpatient department of our institution. All patients were nonsmokers, without any typical PND symptoms or signs, such as purulent sputum, rhinorrhea, sneezing, and nasal stuffiness, or any GER symptoms, including substernal pain and acid regurgitation. Each patient underwent a simple chest radiograph, Waters (occipitomental) view radiography, allergen skin prick testing
Clinical characteristics and distribution of cough sensitivity of patients and control subjects
We analyzed the distribution of the C5 and the CC64 values obtained from the patients and control subjects and found a close negative correlation between them (r = −0.662, P < .0001, Fig 2). In this analysis, 6 normal control subjects and 6 patients with chronic cough were excluded because their C5 values could not be determined exactly, as fewer than 4 coughs were induced during the capsaicin challenge test. The C5 values for all the control subjects were >32 μmol/L, so we divided the patients
Discussion
The results of this study demonstrated that local SP content of the upper airway was elevated in some patients with chronic nonproductive cough showing ICS without bronchial hyperresponsiveness. This indicates that a neurochemical alteration of the upper airway may be related to the mechanism of ICS and may ultimately develop into a chronic cough.
Although ICS has been regarded as a distinctive feature in some patients with chronic cough, the exact mechanism has not been well defined. In our
References (35)
- et al.
Chronic cough: eosinophilic bronchitis without asthma
Lancet
(1989) - et al.
Chronic persistent cough: experience in diagnosis and outcome using an anatomic diagnostic protocol
Chest
(1989) - et al.
Are asthma like symptoms due to bronchial or extrathoracic airway dysfunction?
Lancet
(1995) - et al.
Capsaicin cough sensitivity is decreased in smokers
Respir Med
(2001) - et al.
An algorithmic approach to chronic cough
Ann Intern Med.
(1993) - et al.
Chronic cough: the spectrum and frequency of causes, key component of diagnostic evaluation and outcomes of specific therapy
Am Rev Respir Dis
(1990) - et al.
Eosinophilic bronchitis is an important cause of chronic cough
Am J Respir Crit Care Med
(1999) - et al.
Abnormal intraepithelial airway nerves in persistent unexplained cough
Am J Respir Crit Care Med
(1995) - et al.
Airway inflammation as an assessment of chronic nonproductive cough
Chest
(2001) - et al.
Airway inflammation in non-asthmatic subjects with chronic cough
Am J Respir Crit Care Med
(1994)
Increased neutrophils and cytokines, TNF-a and IL-8, in induced sputum of non-asthmatic patients with chronic dry cough
Thorax
Airway inflammation, airway responsiveness and cough before and after inhaled budesonide in patients with eosinophilic bronchitis
Eur Respir J
Sensitivity of the cough reflex in patients with chronic cough
Eur Respir J
Capsaicin cough sensitivity decreases with successful treatment of chronic cough
Am J Respir Crit Care Med
Effect of loratadine, an H1 antihistamine on induced cough in non-asthmatic patients with chronic cough
Thorax
Increased cough reflex associated with angiotensin converting enzyme inhibitor cough
Br Med J
Tussive effect of capsaicin in patients with gastroeosphageal reflux without cough
Am J Respir Crit Care Med
Cited by (36)
Neurokinin 1 and 2 receptors are involved in PGE<inf>2</inf>- and citric acid-induced cough and ventilatory responses
2022, Respiratory Physiology and NeurobiologyCitation Excerpt :For example, plasma or sputum SP levels were markedly elevated in patients with both asthmatic and nonasthmatic cough (Otsuka et al., 2011; Patterson et al., 2007). Moreover, SP levels in nasal lavage fluids were enhanced in patients with chronic nonproductive cough and oversensitized cough response to inhalion of CAP (Cho et al., 2003). SP aerosols given to healthy subjects or to patients with asthma did not cause cough, but evoked a sensation of tightness in the asthmatic chest, indicating that some peripheral sensory nerves were being stimulated (Joos et al., 1987).
The research of the possible mechanism and the treatment for capsaicin-induced cough
2018, Pulmonary Pharmacology and TherapeuticsCitation Excerpt :In addition, TRPV1 can mediate airway neurogenic inflammation caused by SP, CGRP, NKA (released by sensory nerve terminals), which may also play an important role in the enhancement of cough sensitivity [12,36,37]. Cho et al. observed in nasal fluids that were rinsed from chronic cough patients, that the SP levels were significantly higher in the increased cough sensitivity group than in the normal cough sensitivity group [38]. The consequences of airway neurogenic inflammation include an increase in vascular permeability, excess mucus production, plasma exosmosis and edema in the mucosa.
Antitussive activity of the Schisandra chinensis fruit polysaccharide (SCFP-1) in guinea pigs models
2016, Journal of EthnopharmacologyCitation Excerpt :CHS is characterized by cough reflux hypersensitivity, which can be evaluated by cough challenge test with protussive agents such as capsaicin or ally isothiocyanate (Morice, 2011). The pathogenesis of CHS is related with the activation of transient receptor potential vaniloid 1 (TRPV1), transient receptor potential ankyrin 1 (TRPA1) in airway (Groneberg et al., 2004; Birrell et al., 2009; Andrè et al., 2009), airway inflammation (Jatakanon et al.,1999; Cho et al., 2003), immune dysfunction (Birring et al., 2003; Mund et al., 2005; Grace et al., 2012), submucosa injury mediated by oxidative stress (Koskela and Purokivi, 2013; Rahman and MacNee, 2000) and mucus hypersecretion (Niimi et al., 2005; Thai et al., 2008; Jackson, 2001) etc. Currently available drugs are ineffective for patients with CHS.
Neuropeptide levels in nasal secretions from patients with and without chronic cough
2011, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :A previous study measured SP in nasal lavage fluid in subjects with dry cough and used capsaicin sensitivity to divide subjects into increased cough sensitivity and normal cough sensitivity.7 Subjects with higher cough sensitivity had higher mean SP levels.7 Our study further supports a role for neuropeptides in patients with chronic cough by demonstrating that elevated neuropeptide levels are not simply a reflection of increased posterior nasal drainage, but rather appear to be specific to cough.
Immunoassay-based measurement of clinical biomarkers for monitoring changes in nasal cavity
2009, Journal of Pharmaceutical and Biomedical Analysis