Reviews and feature articleA comparison of objective and subjective measures of cough in asthma
Section snippets
Subjects
To study a wide range of asthma severity, we recruited subjects from 2 sources at a regional respiratory unit (North West Lung Centre, Manchester, United Kingdom): a database of asthma volunteers and respiratory outpatient clinics (including a severe asthma clinic). Inclusion criteria were the diagnosis of asthma by a specialist pulmonologist and a positive methacholine challenge test (except in those with severe asthma). Healthy volunteers were also recruited to allow for comparisons of cough
Subjects
We studied 56 subjects with asthma (median age, 42.0 years [range, 28.5-71], 34 [60.7%] female; Table II). Eleven (19.6%) subjects were exsmokers with a median smoking history of 1.5 pack-years (range, 0.3-6.0). Inhaled corticosteroids (ICSs) were taken by 32 (57.1%) subjects, and 3 (5.4%) were taking oral corticosteroids (median dose, 20 mg [7-30]). One subject was maintained with 8-weekly intramuscular triamcinolone injections. Bronchial hyperreactivity to methacholine was demonstrated in 49
Discussion
This study is the first to examine the relationships between objective and subjective measures of cough in subjects with classic asthma, not selected for the symptom of cough. The correlations between objective cough frequency and subjective measures of cough in asthma are at best moderate, and the relationship with citric acid cough reflex sensitivity is only weak for the less commonly used C2 endpoint. The best relationship with objective cough rates was seen for cough-related quality of
References (28)
- et al.
Relationship between airway obstruction and respiratory symptoms in adult asthmatics
Chest
(1998) - et al.
Prognostic factors of asthma severity: a 9-year international prospective cohort study
J Allergy Clin Immunol
(2006) - et al.
Impact of cough across different chronic respiratory diseases: comparison of two cough specific health related quality of life questionnaires
Chest
(2008) - et al.
Evaluation of a cough-specific quality-of-life questionnaire
Chest
(2002) - et al.
Cough in COPD: correlation of objective monitoring with cough challenge and subjective assessments
Chest
(2006) - et al.
Relationship among pulmonary function, bronchial reactivity, and exhaled nitric oxide in a large group of asthmatic patients
Ann Allergy Asthma Immunol
(2003) - et al.
Effect of codeine on objective measurement of cough in chronic obstructive pulmonary disease
J Allergy Clin Immunol
(2006) - et al.
Effects of inhaled corticosteroids on cough threshold in patients with bronchial asthma
Pulm Pharmacol Ther
(2001) - et al.
Cough throughout life: children, adults and the senile
Pulm Pharmacol Ther
(2007) Global Strategy for Asthma Management and Prevention
Global Initiative for Asthma (GINA)
(2007)
Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol
Thorax
Determinants of cough in young adults participating in the European Community Respiratory Health Survey
Eur Respir J
Prevalence of asthma symptoms among adults aged 20-44 years in Canada
CMAJ
Patient weighting of importance of asthma symptoms
Thorax
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Supported by the North West Lung Research Centre Endowment Fund.
Disclosure of potential conflict of interest: J. A. Smith is a consultant for Schering- Plough, receives grant support from Schering-Plough, and is an inventor on a cough-monitoring patent owned by the University Hospital of South Manchester Trust, patent licensed to Vitalograph Ltd. A. A. Woodcock is a consultant for GlaxoSmithKline, Chiesi, and Schering-Plough; receives grant support from Schering-Plough and AstraZeneca; and is a co-inventor of an ambulatory cough monitor patent owned by the University Hospital of South Manchester and licensed by Vitalograph Ltd. The rest of the authors have declared that they have no conflict of interest.