Cough and Eosinophilia

Diver, Sarah; Russell, Richard J.; Brightling, Christopher

doi:10.1016/j.jaip.2019.04.048

Cited by 31 publications

(30 citation statements)

References 71 publications

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“…It has been confirmed that numbers of active mast cells appear in the bone marrow of HES patients with a positive PDGFRA fusion gene [34]. The mechanisms underlying eosinophilic airway inflammation in chronic cough due to allergic (T helper type 2 cells) and nonallergic (innate lymphoid type 2 cells) pathways had been illustrated in 2 recent outstanding reviews [4,5]. Activated T helper type 2 or innate lymphoid type 2 cells release interleukins, causing eosinophilia inflammation, and bronchial hyperreactivity.…”

Section: Discussionmentioning

confidence: 92%

Cough in hypereosinophilic syndrome: case report and literature review

Xie

Zhang

et al. 2020

BMC Pulm Med

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Background: Cough and airway eosinophilic inflammation has not been highlighted in hypereosinophilic syndrome (HES). Case presentation: We report 2 further cases and reviewed the clinical features and treatment of HES present with cough from the literature. Both cases were middle age male, presenting with chronic cough, airway eosinophilic inflammation and hyper eosinophilia who have been previous misdiagnosed as cough-variant asthma and failed anti-asthma treatment. PDGFRA fusion gene was confirmed in one case, but not in the other case. Both had evidence of myeloproliferative features. The tyrosine kinase inhibitor, imatinib, resulted in complete resolution of eosinophilia and cough. By searching PubMed, we found 8 HES cohorts of 411 cases between 1975 and 2013, where the incidence of cough was 23.11%. Sixteen case reports of HES presented with cough as predominant or sole symptom, with nine male patients with positive PDGFRA fusion gene, who responded well to imatinib. Six of seven patients, who tested negative for the PDGFRA, responded to systemic glucocorticoids. Conclusions: Cough and airway eosinophilic inflammation is common in some HES patients. PDGFRA+ HES patients present with chronic cough respond well to imatinib. Our case reports indicate that PDGFRA negative HES patients may respond to imatinib as well.

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Section: Discussionmentioning

confidence: 92%

Cough in hypereosinophilic syndrome: case report and literature review

Xie

Zhang

et al. 2020

BMC Pulm Med

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“…insufficiently attenuate cough and CRS of asthmatic subjects (19,31,39,42). An anti-IL5 antibody mepolizumab, one of the most potent suppressor of eosinophilic inflammation, did not affect subjective cough of severe asthma patients, despite decrease of eosinophils and improved disease control (2). This fact is likely to be associated with refractoriness of asthmatic cough (19,39,42).…”

Section: Review Article On the 3rd International Cough Conferencementioning

confidence: 91%

“…Chronic cough is a major clinical problem. The causes of chronic cough can be categorized into eosinophilic and noneosinophilic disorders (1), and approximately 30% to 50% of people with chronic cough have eosinophilic airway inflammation (2)(3)(4). Cough variant asthma (CVA) is characterized by eosinophilic inflammation of the whole lower airways (5).…”

Section: Introductionmentioning

confidence: 99%

Narrative Review: how long should patients with cough variant asthma or non-asthmatic eosinophilic bronchitis be treated?

Niimi

2021

J Thorac Dis

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The causes of chronic cough can be categorized into eosinophilic and noneosinophilic disorders, and approximately 30% to 50% of people with chronic cough have eosinophilic airway inflammation, the presence of which can be confirmed by sputum eosinophilia or elevated exhaled nitric-oxide levels. Cough variant asthma (CVA) is a phenotype of asthma which lacks wheezing or dyspnea, and consistently one of the most common causes of chronic cough worldwide. CVA and non-asthmatic eosinophilic bronchitis (NAEB) shares common feature such as chronic dry cough, eosinophilic inflammation, and development of chronic airflow obstruction (CAO) and asthma in a subset of patients. The distinctive characteristic of these conditions is the presence of airway hyperresponsiveness in CVA but not in NAEB. Coughing is responsive to bronchodilators such as beta-agonists in CVA, but such feature has not been clarified in NAEB. Inhaled corticosteroids (ICSs) are the first-line treatment, and leukotriene receptor antagonists are also effective, in patients with both CVA and NAEB. This review will give an outline of clinical and physiological features, and prognosis and its determinants of CVA and EBNA. Further, the rationale and evidence, despite limited, for the need of long-term treatment will be discussed. The development of airway remodeling due to mechanical stress to the airways exerted by long-standing coughing will also be discussed.

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“…Eosinophilic airway inflammation is a common feature of cough variant asthma and a defining characteristic of and eosinophilic bronchitis, which together may comprise up to 50% of chronic cough patients [74]. There is a controversy over direct causal effects of eosinophilic inflammation on cough, as anti-interleukin-5 monoclonal antibody, mepolizumab, did not affect cough while systemic corticosteroids did in patients with severe eosinophilic asthma [75]. However, it is much less arguable that eosinophilic airway inflammation is a treatable trait in chronic cough, because it is measurable in induced sputum and may predict corticosteroid responsiveness.…”

Section: New Concepts To Consider In the Evaluation And Management Ofmentioning

confidence: 99%

“…However, it is much less arguable that eosinophilic airway inflammation is a treatable trait in chronic cough, because it is measurable in induced sputum and may predict corticosteroid responsiveness. Thus, the assessment and management of eosinophilic airway inflammation is recommended during the early stages of diagnostic work-up for chronic cough at specialist clinics [ 6 , 9 , 20 , 75 ]. However, there are practical issues in measuring eosinophilic airway inflammation, as induced sputum analysis is technically demanding and therefore restricted to specialist centers.…”

Section: New Concepts To Consider In the Evaluation And Management Ofmentioning

confidence: 99%

Recent progress in the management of chronic cough

Song

McGarvey

2020

Korean J Intern Med

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Chronic cough is a common clinical condition with significant impact on quality of life and for which effective therapy remains an unmet clinical need. Over the past decade, there has been a major shift in how we approach this problem, driven by better appreciation of the clinical manifestation of chronic cough and an improved understanding of the associated neurobiology. "Cough hypersensitivity syndrome" has been proposed as a new diagnostic term for chronic cough, encompassing different phenotypes of the condition. Accumulating evidence suggests that this new concept is clinically relevant. However, while it is gaining widespread endorsement within the allergy and respiratory community, raising its profile in routine clinical practice is a priority. Thus, the present paper reviews recent progress in our understanding and management of chronic cough, with focus on mechanistic and clinical studies. It also provides detail on knowledge gaps and future research directions.

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Cough and Eosinophilia

Cited by 31 publications

References 71 publications

Cough in hypereosinophilic syndrome: case report and literature review

Cough in hypereosinophilic syndrome: case report and literature review

Narrative Review: how long should patients with cough variant asthma or non-asthmatic eosinophilic bronchitis be treated?

Recent progress in the management of chronic cough

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