Abstract
Bronchial hyperresponsiveness is a typical, but non-specific feature of cough variant asthma (CVA). This study aimed to determine whether bronchial hyperresponsiveness may be considered as a predictor of CVA in non-smoking adults with chronic cough (CC). The study included 55 patients with CC and bronchial hyperresponsiveness confirmed in the methacholine provocation test, in whom an anti-asthmatic, gradually intensified treatment was introduced. The diagnosis of CVA was established if the improvement in cough severity and cough-related quality of life in LCQ were noted.The study showed a high positive predictive value of bronchial hyperresponsiveness in this population. Cough severity and cough related quality of life were not related to the severity of bronchial hyperresponsiveness in CVA patients. A poor treatment outcome was related to a low baseline capsaicin threshold and the occurrence of gastroesophageal reflux-related symptoms. In conclusion, bronchial hyperresponsiveness could be considered as a predictor of cough variant asthma in non-smoking adults with CC.
Highlights
Bronchial hyperresponsiveness is a typical, but non-specific feature of cough variant asthma (CVA)
Treatment effects As 43/49 (87.8%) patients with chronic cough (CC) and bronchial hyperresponsiveness (BHR) responded to anti-asthmatic therapy, the positive predictive value (PPV) of BHR in establishing the diagnosis of CVA was 87.8%
CVA cough variant asthma, BMI body mass index, PC20 provocative concentration of methacholine causing 20% fall in FEV1, Fractional exhaled nitric oxide (FeNO) fractional exhaled nitric oxide, Upper airway cough syndrome (UACS) upper airway cough syndrome, Gastroesophageal reflux (GER) gastroesophageal reflux, C2 the lowest capsaicin concentrations of capsaicin evoking two coughs, C5 the lowest capsaicin concentrations of capsaicin evoking five coughs, LCQ Leicester Cough Questionnaire, VAS visual analogue scale a Difference between final and baseline C2/C5 threshold
Summary
Bronchial hyperresponsiveness is a typical, but non-specific feature of cough variant asthma (CVA). This study aimed to determine whether bronchial hyperresponsiveness may be considered as a predictor of CVA in non-smoking adults with chronic cough (CC). The diagnosis of CVA was established if the improvement in cough severity and cough-related quality of life in LCQ were noted.The study showed a high positive predictive value of bronchial hyperresponsiveness in this population. Cough severity and cough related quality of life were not related to the severity of bronchial hyperresponsiveness in CVA patients. Bronchial hyperresponsiveness could be considered as a predictor of cough variant asthma in non-smoking adults with CC. Cough variant asthma (CVA) is a phenotype of asthma, characterized by bronchial hyperresponsiveness (BHR) and cough as a sole symptom [1, 2]. Albeit BHR is a hallmark of CVA, its significance as a predictor of the response to classic anti-asthmatic therapy in adults with CC has not
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