Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?

Fujimura, Masaki; Ogawa, Haruhiko; Nishizawa, Yoriko; Nishi, Kiyoto

doi:10.1136/thorax.58.1.14

Cited by 164 publications

(214 citation statements)

References 22 publications

(19 reference statements)

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“…The authors of CVA studies agree that the criteria proposed by the Japanese Cough Research Society are adequate for diagnosing CVA [6,8,13]. The above criteria are as follows [13]:…”

Section: Biomarkers and Diagnostic Criteriamentioning

confidence: 91%

“…Bronchial hyperreactivity plays a significant role in the pathophysiology of CVA development. Cough reflex sensitivity does not change in patients with CVA, and it is not essential in pathophysiology in CVA [7,8].…”

Section: Pathological Mechanism Underlying Cvamentioning

confidence: 98%

“…A smaller number, about 10% of patients with CVA and with adequate therapy (bronchodilator, ICS or Montelukast) develop classic asthma. A good response of chronic cough to the therapy with ICS cannot be used to distinguish other cough present diseases (atopic cough, non-asthmatic eosinophilic bronchitis) from CVA [2,8].…”

Section: Introductionmentioning

confidence: 99%

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Cough Variant Asthma as a Phenotype of Classic Asthma

Vujnović¹,

Domuz²,

Petrovic³

2018

Asthma Diagnosis and Management - Approach Based on Phenotype and Endotype

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Cough variant asthma (CVA) was first described by Glauser. CVA was described as the isolated chronic cough as the only presenting symptom responsive to bronchodilator therapy. The authors now suggest that CVA is present with airway hyperresponsiveness, eosinophilic inflammation of central and peripheral airways and bronchodilator responsive coughing without typical manifestation of asthma such as wheezing or dyspnea. Pathologically, CVA shares common features such as eosinophilic inflammation and remodeling changes with classic asthma. Because of that, CVA is clinically considered as a variant type of asthma, a phase at the beginning of asthma pathogenesis or as a precursor of classic asthma. Nearly 30% of patients with CVA eventually develop intermittent wheezing, an average of 3-5 years. It is clinically very important to recognize CVA because long-term inhaled corticosteroids can significantly decrease the development of classic asthma in these patients.

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“…The authors of CVA studies agree that the criteria proposed by the Japanese Cough Research Society are adequate for diagnosing CVA [6,8,13]. The above criteria are as follows [13]:…”

Section: Biomarkers and Diagnostic Criteriamentioning

confidence: 91%

Section: Pathological Mechanism Underlying Cvamentioning

confidence: 98%

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Cough Variant Asthma as a Phenotype of Classic Asthma

Vujnović¹,

Domuz²,

Petrovic³

2018

Asthma Diagnosis and Management - Approach Based on Phenotype and Endotype

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“…Two days later, the animals were immunized with 2.0 mg of OA and 100 mg of aluminum hydroxide [Al(OH) 3 ]. A booster injection of 0.01 mg of OA and 100 mg of Al(OH) 3 was then carried out three weeks after the primary immunization. The naïve guinea pigs that were kept in the same surroundings as the active sensitization animals that were used for NC.…”

Section: Active Sensitizationmentioning

confidence: 99%

“…One of the most representative airway disorders responsible for chronic cough is eosinophilic bronchitis [1], including bronchial asthma, non-asthmatic eosinophilic bronchitis (NAEB) [2], atopic cough (AC) [3], and cough variant asthma (CVA) [4]. Coughs are caused by cough reflex hypersensitivity in NAEB and AC.…”

Section: Introductionmentioning

confidence: 99%

Effects of macrolides on antigen-induced increases in cough reflex sensitivity in guinea pigs

Tokuda¹,

Ohkura²,

Fujimura³

et al. 2010

Pulmonary Pharmacology & Therapeutics

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Hence, they are used for both acute and chronic inflammatory airway diseases.However, the effects of these agents on allergic airway disorders presenting with an isolated chronic cough, such as non-asthmatic eosinophilic bronchitis and eosinophilic tracheobronchitis with cough hypersensitivity (atopic cough), still remain to be elucidated.Objective: To determine if macrolides are effective in the management of chronic cough caused by eosinophilic airway inflammation. Methods:The cough reflex sensitivity to inhaled capsaicin was measured at 48 h after challenge with an aerosolized antigen in actively sensitized guinea pigs.The 14-, 15-or 16-membered macrolides (erythromycin, azythromycin, or josamycin, respectively) were given intraperitoneally every 12 h after the antigen challenge. Bronchoalveolar lavage and the resection of the tracheal tissue were performed immediately after the measurement of the cough response to capsaicin. Results:The antigen-induced increase in the number of coughs elicited by capsaicin inhalation was significantly reduced by treatments with erythromycin and azythromycin, but not with josamycin. Erythromycin dose-dependently inhibited the increases in the substance P, prostaglandin E 2 and leukotriene B 4 levels, but not the histamine levels, in the bronchoalveolar lavage fluid. However, erythromycin did not influence the antigen-induced decrease in the neutral endopeptidase (NEP) activity in the tracheal tissue.Conclusions: Both 14-and 15-membered, but not 16-membered, macrolides 3 could reduce the antigen-induced cough reflex hypersensitivity by inhibiting the antigen-induced release of the afferent sensory nerve sensitizers. These macrolides may be therapeutically useful for the treatment of isolated chronic cough based on cough reflex hypersensitivity in allergic airway diseases such as non-asthmatic eosinophilic bronchitis and atopic cough.

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Retrospective, observational study of different medication regimens and outcome in children with cough variant asthma

Lou,

Ma,

Luo

et al. 2024

Immunity Inflam & Disease

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ObjectiveThis retrospective longitudinal cohort study aimed to explore the best therapeutic regimen and treatment duration of cough variant asthma (CVA) in children.MethodsA total of 314 children with CVA were divided into receive inhaled corticosteroids (ICS) combined with long‐acting beta2‐agonist (LABA) group, ICS combined with leukotriene receptor antagonists (LTRA) group, ICS monotherapy group and LTRA monotherapy group. All clinical data were statistically analyzed. Logistic regression model was used to compare the advantages and disadvantages of different treatment schemes at each follow‐up time point and the best treatment scheme. The Cox proportional hazard regression model based on inverse probability weighting was used to compare the effects of different medication regimens on adverse outcomes with asthma recurrence or progression as the end point.Results(1) After comprehensive analysis, ICS + LABA group was the preferred control regimen for CVA within 8 weeks. After 8 weeks of diagnosis, the efficacy of ICS group or LTRA group was comparable to that of ICS + LABA group and ICS + LTRA group. (2) The ICS + LABA group showed a significant improvement in cough at an early stage, particularly at 4 weeks; the symptoms of ICS + LTRA and ICS groups were significantly improved at 36 weeks. The LTRA group alone showed significant improvement at 20 weeks.ConclusionICS + LABA, ICS + LTRA, ICS alone and LTRA alone can effectively treat CVA. ICS + LABA could improve the symptoms most quickly within 8 weeks after CVA diagnosis, followed by ICS + LATR group. After 8 weeks, it can be reduced to ICS alone to control CVA for at least 36 weeks based on the remission of symptoms in children.

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Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?

Cited by 164 publications

References 22 publications

Cough Variant Asthma as a Phenotype of Classic Asthma

Cough Variant Asthma as a Phenotype of Classic Asthma

Effects of macrolides on antigen-induced increases in cough reflex sensitivity in guinea pigs

Retrospective, observational study of different medication regimens and outcome in children with cough variant asthma

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