Ohkura Noriyuki, Hara Johsuke, Sakai Tamami, Okazaki Akihito, Abo Miki, Kasahara Kazuo, Fujimura Masaki
a Department of Respiratory Medicine and Cellular Transplantation Biology , Graduate School of Medical Sciences, Kanazawa University , Kanazawa , Ishikawa , Japan.
Exp Lung Res. 2016 Jun;42(5):227-31. doi: 10.1080/01902148.2016.1195460. Epub 2016 Jun 23.
Atopic cough (AC) and cough variant asthma (CVA) were identified as major causes of chronic non-productive cough in a Japanese study. A characteristic feature of CVA is the presence of a heightened cough response to bronchoconstriction. On the other hand, the cough response to bronchoconstriction in AC remains unclear.
Methacholine (Mch)-induced cough in AC was measured and compared with that in CVA. Diagnoses of AC and CVA were made based on patient history, physical examination, response to bronchodilator therapy, cough reflex sensitivity to capsaicin, spirometry, and airway responsiveness to methacholine.
Thirteen AC patients and 12 CVA patients in whom the criteria were met were recruited to the study. After inhalation of Mch at PC35-PEF40 that means milder bronchoconstriction than PC20-FEV1, cough was triggered a few times in AC. [cough number: 1/ 32 min (0-40)]. Conversely, significantly greater number of coughs was provoked in CVA, compared with AC [cough number: 35.5/ 32 min (25-125), p < 0.05].
The cough response to bronchoconstriction is reduced in AC compared to CVA. This feature may be useful in the diagnosis of chronic cough.
在一项日本研究中，过敏性咳嗽（AC）和咳嗽变异性哮喘（CVA）被确定为慢性干咳的主要原因。CVA的一个特征是对支气管收缩的咳嗽反应增强。另一方面，AC对支气管收缩的咳嗽反应尚不清楚。
测量AC患者中乙酰甲胆碱（Mch）诱发的咳嗽，并与CVA患者进行比较。AC和CVA的诊断基于患者病史、体格检查、支气管扩张剂治疗反应、对辣椒素的咳嗽反射敏感性、肺活量测定以及对乙酰甲胆碱的气道反应性。
13例符合标准的AC患者和12例CVA患者被纳入研究。在PC35-PEF40（意味着比PC20-FEV1更轻的支气管收缩）吸入Mch后，AC患者咳嗽几次。[咳嗽次数：1/32分钟（0-40）]。相反，与AC相比，CVA引发的咳嗽次数明显更多[咳嗽次数：35.5/32分钟（25-125），p<0.05]。
与CVA相比，AC对支气管收缩的咳嗽反应降低。这一特征可能有助于慢性咳嗽的诊断。
