Patients with the 'IL-5, IL-17A, IL-25-high' airway inflammatory pattern are often uncontrolled asthmatics, despite daily treatment. It seems worthwhile to evaluate whether measuring sputum cytokine levels might be used to assess the response to increased doses of steroids in patients with asthma.

One of the theories which explain, why gastroesophageal reflux disease (GORD) may provoke cough, is the occurrence of aspiration of gastric content into the airways. The aim of the study was to assess the presence of aspiration markers: pepsin and bile acids (BA) in induced sputum in gastroesophageal reflux-related (GOR-related) chronic cough (CC) patients. Forty-one CC patients and 20 healthy controls were enrolled in the study. GORD as cause of CC was diagnosed by presence of GORD-related symptoms, gastroscopy and/or improvement of cough upon treatment with proton pump inhibitors (PPI). Patients were divided into two groups based on the response to PPI treatment. In all patients and healthy controls induced sputum was obtained and differential cell counts were calculated. Levels of pepsin and BA were measured in sputum supernatants. Pepsin was detectable in 48.8% samples in CC patients and in 60% healthy controls (p = NS). In pepsin positive samples no significant difference in pepsin concentration could be found between CC patients and control subjects. Pepsin levels in pepsin positive samples were significantly decreased in patients treated with PPI compared to non-treated patients. BA were detectable in 56% samples of CC patients and in 70% healthy controls (p = NS). BA concentration in BA positive samples in CC group was not different from healthy controls. There was also no difference when comparing patients who took PPI and those who did not. Patients characterized as PPI-responders and PPI-non-responders had similar pepsin and BA concentrations. Airway cellularity was not significantly different between groups of patients with or without pepsin or BA in induced sputum. Our results demonstrated the lack of differences in gastric content aspiration between patients with probable GOR-related CC and healthy control subjects. This might imply that the reflex cough theory may be more relevant than the reflux-associated aspiration theory in the pathophysiology of GORinduced chronic cough.

Clinical presentation, treatment, and long-term outcomes... 231 INTROduCTION Takotsubo cardiomyopathy (TTC), also known as stress cardiomyopathy or apical ballooning syndrome, is defined as a temporary left ventricular dysfunction caused mainly by stress, with left ventricular regional wall hypokinesis extending beyond a single coronary artery distribution and without any significant coronary lesions (FIGuRE 1). 1,2 Clinical presentation of this severe cardiac disorder is indistinguishable from acute coronary syndrome (ACS), 3,4 but due to TTC pathophysiology, the American Heart Association classified this stress syndrome as a primary acquired cardiomyopathy. 5 To diagnose TTC and to differentiate it from ACS, Prasad et al. 1 proposed the modified Mayo Clinic criteria for the diagnosis of TTC: 1 transient hypokinesis, akinesis, or dyskinesis in the left ventricular mid segments with or

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