Abstract

BackgroundThe mechanisms of chronic cough are unclear. Many reactive oxygen species affect airway sensory C-fibres which are capable to induce cough. Several chronic lung diseases are characterised by cough and oxidative stress. In asthma, an association between the cough severity and airway oxidative stress has been demonstrated. The present study was conducted to investigate whether airway oxidative stress is associated with chronic cough in subjects without chronic lung diseases.MethodsExhaled breath condensate samples were obtained in 43 non-smoking patients with chronic cough and 15 healthy subjects. Exclusion criteria included a doctor’s diagnosis of any lung disorders and any abnormality in lung x-ray. The concentration of 8-isoprostane was measured. In addition, the patients filled in Leicester Cough Questionnaire and underwent hypertonic saline cough provocation test, spirometry, ambulatory peak flow monitoring, nitric oxide measurement, and histamine airway challenge. In a subgroup of patients the measurements were repeated during 12 weeks’ treatment with inhaled budesonide, 800 ug/day.ResultsThe 8-isoprostane concentrations were higher in the cough patients than in the healthy subjects (24.6 ± 1.2 pg/ml vs. 10.1 ± 1.7 pg/ml, p = 0.045). The 8-isoprostane concentration was associated with the Leicester Cough Questionnaire total score (p = 0.044) but not with the cough sensitivity to saline or other tests. Budesonide treatment did not affect the 8-isoprostane concentrations.ConclusionsChronic cough seems to be associated with airway oxidative stress in subjects with chronic cough but without chronic lung diseases. This finding may help to develop novel antitussive drugs.Trial registrationThe study was registered in ClinicalTrials.gov database (KUH5801112), identifier NCT00859274.

Highlights

  • The mechanisms of chronic cough are unclear

  • A suggestive association between the baseline exhaled breath condensate (EBC) 8-isoprostane concentration and the Leicester Cough Questionnaire (LCQ) total score was found in the bivariate analysis (Rp = −0.29, p = 0.06, Figure 3)

  • When sex was included in the multivariate analysis, the association between baseline EBC 8-isoprostane concentration and the LCQ total score was statistically significant within the whole group of cough patients (p = 0.044)

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Summary

Introduction

The mechanisms of chronic cough are unclear. Several chronic lung diseases are characterised by cough and oxidative stress. An association between the cough severity and airway oxidative stress has been demonstrated. The present study was conducted to investigate whether airway oxidative stress is associated with chronic cough in subjects without chronic lung diseases. Chronic cough is reported by 10 – 20% of general population [1]. It is the most common condition for which patients seek consultation from a doctor [2]. The mechanisms of chronic cough are poorly understood. During the recent years the concept of chronic cough as a sensory neuropathy has been widely accepted [4]. Cfibres represent one of the two main sensory pathways to initiate cough reflex and are often thought to be the principal fibres mediating cough in pathological conditions [5]

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