Breathing hot humid air induces airway irritation and cough in patients with allergic rhinitis

Khosravi, Mehdi; Collins, Paul B.; Lin, Ruei Lung; Hayes, Don; Smith, Jaclyn A.; Lee, Lu-Yuan

doi:10.1016/j.resp.2014.03.013

Cited by 15 publications

(13 citation statements)

References 27 publications

(42 reference statements)

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“…NP2 DRG neurons are dedicated itch-transducing neurons ( Han et al., 2013 ), whereas NP3 neurons are general chemosensitive, including also itch compounds. JG4 represents PEP1 in DRG—a polymodal, high-threshold, mechano-heat sensitive C-fiber contributing to inflammatory pain, sensation of noxious heat ( Vandewauw et al., 2018 ), and low pH ( Tominaga et al., 1998 ), consistent with heat and low pH activation of C-fibers in the airways ( Gu and Lee, 2006 , Hayes et al., 2012 , Khosravi et al., 2014 , Kollarik and Undem, 2002 ). JG5 is similar to essentially all myelinated DRG sensory neurons and is the only clearly myelinated jugular cluster.…”

Section: Discussionmentioning

confidence: 99%

An Atlas of Vagal Sensory Neurons and Their Molecular Specialization

Kupari¹,

Häring²,

Agirre³

et al. 2019

Cell Reports

272

321

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Section: Discussionmentioning

confidence: 99%

An Atlas of Vagal Sensory Neurons and Their Molecular Specialization

Kupari¹,

Häring²,

Agirre³

et al. 2019

Cell Reports

272

321

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“…Previous studies have also reported larger magnitudes of associations between temperature and asthma/wheeze compared to other respiratory outcomes (Anderson et al, 2013; Li et al, 2014a; Winquist et al, 2016). Studies exploring the mechanistic causes of temperature-related respiratory morbidity suggest that inhalation of hot air activates airway sensory nerves, the cholinergic reflex pathway, and transient bronchoconstriction (Hayes et al, 2012; Khosravi et al, 2014); therefore, it is possible that asthma/wheeze and related cough disorders may have a more direct relationship with high temperature compared to other respiratory illnesses such as upper and lower respiratory infections.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of individual and area-level factors as modifiers of the association between warm-season temperature and pediatric asthma morbidity in Atlanta, GA

O’Lenick

Winquist

Chang

et al. 2017

Environmental Research

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Introduction Previous studies have found associations between respiratory morbidity and high temperatures; however, few studies have explored associations in potentially sensitive sub-populations. Methods We evaluated individual and area-level factors as modifiers of the association between warm-season (May–Sept.) temperature and pediatric respiratory morbidity in Atlanta. Emergency department (ED) visit data were obtained for children, 5–18 years old, with primary diagnoses of asthma or respiratory disease (diagnoses of upper respiratory infections, bronchiolitis, pneumonia, chronic obstructive pulmonary disease, asthma, or wheeze) in 20-county Atlanta during 1993–2012. Daily maximum temperature (Tmax) was acquired from the automated surface observing station at Atlanta Hartsfield International Airport. Poisson generalized linear models were used to estimate rate ratios (RR) between daily Tmax and asthma or respiratory disease ED visits, controlling for time and meteorology. Tmax effects were estimated for single-day lags of 0–6 days, for 3-, 5-, and 7-day moving averages and modeled with cubic terms to allow for non-linear relationships. Effect modification by individual factors (sex, race, insurance status) and area-level socioeconomic status (SES; ZIP code levels of poverty, education, and the neighborhood deprivation index) was examined via stratification. Results Estimated RRs for Tmax and pediatric asthma ED visits were positive and significant for lag days 1–5, with the strongest single day association observed on lag day 2 (RR=1.06, 95% CI: 1.03, 1.09) for a change in Tmax from 27 °C to 32 °C (25th to 75th percentile). For the moving average exposure periods, associations increased as moving average periods increased. We observed stronger RRs between Tmax and asthma among males compared to females, non-white children compared to white children, children with private insurance compared to children with Medicaid, and among children living in high compared to low SES areas. Associations between Tmax and respiratory disease ED visits were weak and non-significant (p-value > 0.05). Conclusions Results suggest socio-demographic factors (race/ethnicity, insurance status, and area-level SES) may confer vulnerability to temperature-related pediatric asthma morbidity. Our findings of weaker associations among children with Medicaid compared to other health insurance types and among children living in low compared to high SES areas run counter to our belief that children from disadvantaged households or ZIP codes would be more vulnerable to the respiratory effects of temperature. The potential reasons for these unexpected results are explored in the discussion.

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“…This finding explains, at least in part, the observation that breathing hot humid air-triggered coughs and reflex bronchoconstriction in patients with asthma (15) and vigorous cough responses in patients with allergic rhinitis (21). It should be noted that several recent epidemiological and environmental studies have reported a close link of high ambient air temperature to acute asthma exacerbation and airway dysfunction (2,28,33).…”

Section: Discussionmentioning

confidence: 60%

Hypersensitivity of vagal pulmonary C-fibers induced by increasing airway temperature in ovalbumin-sensitized rats

Lin¹,

Lin²,

Khosravi

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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Our recent study has shown that hyperventilation of humidified warm air (HWA) triggered cough and reflex bronchoconstriction in patients with mild asthma. We suggested that a sensitizing effect on bronchopulmonary C-fibers by increasing airway temperature was involved, but direct evidence was lacking. This study was carried out to test the hypothesis that HWA enhances the pulmonary C-fiber sensitivity in Brown-Norway rats sensitized with ovalbumin (Ova). In anesthetized rats, isocapnic hyperventilation of HWA for 3 min rapidly elevated airway temperature to a steady state of 41.7°C. Immediately after the HWA challenge, the baseline fiber activity (FA) of pulmonary C-fibers was markedly elevated in sensitized rats, but not in control rats. Furthermore, the response of pulmonary C-fibers to right atrial injection of capsaicin in sensitized rats was significantly higher than control rats before the HWA challenge, and the response to capsaicin was further amplified after HWA in sensitized rats (ΔFA = 4.51 ± 1.02 imp/s before, and 9.26 ± 1.74 imp/s after the HWA challenge). A similar pattern of the HWA-induced potentiation of the FA response to phenylbiguanide, another chemical stimulant of C-fibers, was also found in sensitized rats. These results clearly demonstrated that increasing airway temperature significantly elevated both the baseline activity and responses to chemical stimuli of pulmonary C-fibers in Ova-sensitized rats. In conclusion, this study supports the hypothesis that the increased excitability of these afferents may have contributed to the cough and reflex bronchoconstriction evoked by hyperventilation of HWA in patients with asthma.

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Breathing hot humid air induces airway irritation and cough in patients with allergic rhinitis

Cited by 15 publications

References 27 publications

An Atlas of Vagal Sensory Neurons and Their Molecular Specialization

An Atlas of Vagal Sensory Neurons and Their Molecular Specialization

Evaluation of individual and area-level factors as modifiers of the association between warm-season temperature and pediatric asthma morbidity in Atlanta, GA

Hypersensitivity of vagal pulmonary C-fibers induced by increasing airway temperature in ovalbumin-sensitized rats

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