Prognosis of Cough Variant Asthma: A Retrospective Analysis

Matsumoto, Hisako; Niimi, Akio; Takemura, Masashi; Ueda, Tetsuya; Tabuena, Rollin P.; Yamaguchi, Masafumi; Matsuoka, Hiroaki; Hirai, Toyohiro; Muro, Shigeo; Ito, Yutaka; Mio, Tadashi; Chin, Kazuo; Nishiyama, Hideki; Mishima, Michiaki

doi:10.1080/02770900500498477

Cited by 60 publications

(57 citation statements)

References 25 publications

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“…In fact, the decreased MMP9 to TIMP1 ratio in the bronchial secretion of asthmatic patients has been clearly shown to be associated with chronic airflow obstruction (Bossé et al, 1999;Matsumoto et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Chlamydophila pneumoniae inhibits corticosteroid-induced suppression of metalloproteinase-9 and tissue inhibitor metalloproteinase-1 secretion by human peripheral blood mononuclear cells

Park

Lee

Kwon

et al. 2012

Journal of Medical Microbiology

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Chlamydophila pneumoniae infection has been suggested to be associated with severe asthma characterized by persistent airway limitation, which may be related to airway remodelling. We investigated whether C. pneumoniae infection affected the secretion of metalloproteinase-9 (MMP9) and tissue inhibitor metalloproteinase-1 (TIMP1), and altered the responsiveness of inflammatory cells to corticosteroids. Human peripheral blood mononuclear cells (PBMCs) were cultured in vitro in the presence or absence of C. pneumoniae. Secretion of both MMP9 and TIMP1 was strongly suppressed by dexamethasone treatment in uninfected cells. MMP9 secretion was also significantly inhibited by dexamethasone in C. pneumoniae-infected cells, but TIMP1 secretion was not; hence the MMP9 to TIMP1 ratio decreased. Interestingly, expression of human glucocorticoid receptor b, which is believed to confer resistance to corticosteroids, was enhanced by dexamethasone treatment in C. pneumoniae-infected PBMCs. We conclude that C. pneumoniae infection may promote airway remodelling by decreasing the ratio of MMP9 to TIMP1 secreted by inflammatory cells, and by altering cellular responsiveness to corticosteroids.

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Section: Discussionmentioning

confidence: 99%

Chlamydophila pneumoniae inhibits corticosteroid-induced suppression of metalloproteinase-9 and tissue inhibitor metalloproteinase-1 secretion by human peripheral blood mononuclear cells

Park

Lee

Kwon

et al. 2012

Journal of Medical Microbiology

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“…The results of the studies show that early application of ICS therapy reduces the risk of progression of CVA to classical asthma [8,12,21]. Namely, an average of 30% of patients with CVA without treatment develop classic asthma with wheezing in the future [3,7].…”

Section: Therapymentioning

confidence: 83%

“…Improvement of chronic cough with bronchodilators is the essential diagnostic feature of CVA [12,13,21].…”

Section: Biomarkers and Diagnostic Criteriamentioning

confidence: 99%

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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“…In contrast, atopic cough was thought to progress to classic asthma less frequently, especially with early introduction of treatment with ICSs [Fujimura et al 2003]. Similarly, Matsumo and colleagues revealed that treatment with ICSs prevent progression from cough-variant asthma to classic asthma [Matsumoto et al 2006]. Fujimura and colleagues examined the effects of ICSs on changes in AHR and cough reflex sensitivity in patients with cough-variant asthma [Fujimura et al 2005a[Fujimura et al , 2005b.…”

Section: Treatment Of Atypical Asthmamentioning

confidence: 99%

Unusual asthma syndromes and their management

Morjaria

Kastelik

2011

Therapeutic Advances in Chronic Disease

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Asthma usually presents with symptoms of wheeze, dyspnoea and cough. However, clinicians should be aware of atypical presentation of this disorder when cough is the main or only symptom in conditions such as cough-variant asthma, nonasthmatic eosinophilic bronchitis and atopic cough. Early diagnosis and treatment of these conditions with inhaled corticosteroids improves symptoms in the majority of patients. Up to 10% of patients with asthma remain poorly controlled in spite of optimal standard therapy. These patients have been encompassed under the term 'treatment-refractory asthma' (TRA), have the greatest morbidity and are responsible for more than 50% of healthcare costs. In this review we discuss investigations, management and pathophysiology of the various phenotypes of atypical presentations of asthma as well as novel biological agents licensed and those that have been reported in clinical trials in terms of their efficacy and safety in TRA.

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Prognosis of Cough Variant Asthma: A Retrospective Analysis

Cited by 60 publications

References 25 publications

Chlamydophila pneumoniae inhibits corticosteroid-induced suppression of metalloproteinase-9 and tissue inhibitor metalloproteinase-1 secretion by human peripheral blood mononuclear cells

Chlamydophila pneumoniae inhibits corticosteroid-induced suppression of metalloproteinase-9 and tissue inhibitor metalloproteinase-1 secretion by human peripheral blood mononuclear cells

Cough Variant Asthma as a Phenotype of Classic Asthma

Unusual asthma syndromes and their management

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