Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

Abstract

PurposeThe present study aimed to examine the age and gender distributions among chronic cough patients referred to a tertiary cough clinic in Korea, and to investigate clinical factors related to the demographic findings.MethodsStudy participants were unselectively recruited from adult chronic cough patients who attended the cough clinic for the first time during one year. To validate their representativeness, their age and gender distributions were compared to the entire chronic cough population, or with those presenting with other chronic disease. Data from the baseline investigations were analyzed to identify clinical factors related to the demographic findings.ResultsA total of 272 chronic cough patients were included. They had a middle-aged female predominant feature (mean age: 52.8±15.7 years and female 69.1%). Their age and gender distributions were almost identical to the entire chronic cough population, but were distinct from patients with hypertension. Among clinical factors, the older female predominance was associated with enhanced capsaicin cough sensitivity, and also with the presence of 'cough by cold air' symptom. Allotussia and laryngeal paresthesia were highly common in chronic cough patients, affecting 94.8% and 86.8% of them, respectively.ConclusionsThe present study demonstrated older female predominance among adult chronic cough patients attending a referral cough clinic in Korea. The demographic features were significantly associated with the capsaicin cough responses and also potentially with allotussia (particularly cold air as the trigger). These findings suggest a role of cough reflex sensitization in the pathophysiology of chronic cough in adults.

Chronic cough in Korean adults: a literature review on common comorbidity

“…The 18 studies published between 1995 and 2014 (Table 1) [52829303132333435363738394041424344] were conducted at referral clinics at the level of single university hospitals. As these studies varied with respect to study period and purposes, they differed widely in both their definition of chronic cough and their inclusion criteria.…”

“…A comparison of two series of analysis performed at the same cough clinic at a single tertiary institution (2007–2011 and 2012–203) revealed a decrease in the prevalence of asthma from 18.5% (2007–2011) to 6.3% (2012–2013) [544]. Whether this decreasing trend at the tertiary clinic was due to an increase in asthma screening activity at primary or secondary clinics is unclear.…”

“…The prevalence of ACE-induced cough was reported as 1.9% in an earlier study of Korean patients (1995–1996) [28]. However, as later studies commonly excluded those receiving ACE inhibitors as the selection criteria [53037383942], its recent prevalence is unclear.…”

“…Although criteria to differentiate between 'normal' and 'abnormal' cough are still not clearly defined, clinical observations suggest that cough in patients seeking medical attention is predominantly 'hypersensitive' in nature [3456]. These patients typically complain that their cough is triggered by trivial or low levels of stimuli, such as perfume, cold air, or talking.…”

Chronic cough hypersensitivity syndrome

“…Причиной тому может быть эволюционная защита от аспирации во время бере менности. Эстрогены не являются единственной причиной кашлевой гиперчувствительности, т. к. у женщин в постменопаузе часто наблюдаются ХК и гиперреактивность к капсаицину [5,19].…”