Sex difference in the inhaled tartaric acid cough threshold in non-atopic healthy subjects.

Fujimura, Masaki; Sakamoto, Sayuri; Kamio, Yumie; Matsuda, Tamotsu

doi:10.1136/thx.45.8.633

Cited by 83 publications

(64 citation statements)

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“…Twice as many females as males develop a cough on angiotensin-converting-enzyme inhibitor therapy [16]. Females have a heightened sensitivity of the cough reflex as revealed by inhalational challenge with citric acid [17,18], tartaric acid [19], and capsaicin [20]. This increased sensitivity of the cough reflex is also demonstrable in patients attending the cough clinic [21] where objectively recorded cough in females is twice that of males [18].…”

Section: Discussionmentioning

confidence: 94%

A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response

et al. 2014

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Reports from individual centres suggest a preponderance of females with chronic cough. Females also have heightened cough reflex sensitivity. Here we have reviewed the age and sex of unselected referrals to 11 cough clinics. To investigate the cause of any observed sex dimorphism, functional magnetic resonance imaging of putative cough centres was analysed in normal volunteers.The demographic profile of consecutive patients presenting with chronic cough was evaluated. Cough challenge with capsaicin was undertaken in normal volunteers to construct a concentration-response curve. Subsequent functional magnetic resonance imaging during repeated inhalation of sub-tussive concentrations of capsaicin observed areas of activation within the brain and differences in the sexes identified.Of the 10 032 patients presenting with chronic cough, two-thirds (6591) were female (mean age 55 years). The patient profile was largely uniform across centres. The most common age for presentation was 60-69 years. The maximum tolerable dose of inhaled capsaicin was lower in females; however, a significantly greater activation of the somatosensory cortex was observed.Patients presenting with chronic cough from diverse racial and geographic backgrounds have a strikingly homogeneous demographic profile, suggesting a distinct clinical entity. The preponderance of females may be explained by sex-related differences in the central processing of cough sensation. @ERSpublications Chronic cough in specialist clinics have homogenous demographic profiles, suggesting single clinical entity

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Section: Discussionmentioning

confidence: 94%

A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response

et al. 2014

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“…As some factors, such as sex [1,2], menopause [2], cigarette smoking [1,[20][21][22] and ACE genotype [23], have been proposed to influence cough sensitivity, only nonsmoking, young females were examined to avoid the factors likely to influence cough sensitivity in the present study, whereas we did not examine the ACE genotype. In the results, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…age, height, weight, pulmonary function [2], bronchomotor tone [15] and nonspecific bronchial responsiveness [26]. The independent factors that have been proven to exert an influence are sex, menopause [2], smoking history [1,[20][21][22] and angiotensin-converting enzyme genotype [23].…”

Section: Discussionmentioning

confidence: 99%

“…It has previously been reported that cough sensitivity to a chemostimulant, tartaric acid, which may produce cough by stimulating irritant receptors, is greater in young females than in young males [1]. In addition, it was shown recently that cough reflexing to capsaicin was more hypersensitive in females than in males, regardless of age, height, weight and pulmonary function [2].…”

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confidence: 99%

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Atopy in cough sensitivity to capsaicin and bronchial responsiveness in young females

Fujimura

Kondo²,

Yasui³

et al. 1998

Eur Respir J

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We have shown previously that female sex is a determinant of cough sensitivity to inhaled capsaicin, but the relationship between atopy and the cough sensitivity has not been examined. The capsaicin cough threshold, defined as the lowest concentration of capsaicin causing five or more coughs, nonspecific bronchial responsiveness, defined as the provocative concentration of methacholine causing a 20% fall in the forced expiratory volume in one second (PC20), total immunoglobulin E (IgE) and specific IgEs to eight common aeroallergens (house dust 1, 2 and 6, Dermatophagoides pteronyssinus and D. farinae, Japanese cedar, ragweed and orchard grass) in the serum were measured in 71 nonsmoking, healthy young women aged 20.6+/-0.1 yrs (mean+/-EM). A structured interviewer-led questionnaire on allergic diseases revealed that one and six subjects had mild current and past asthma, respectively. These seven subjects were excluded from the data analysis. PC20 was significantly lower in 42 subjects showing a positive specific IgE than in 22 subjects showing a negative specific IgE to any of the eight allergens (p<0.05), while the capsaicin cough threshold was not significantly different between the subgroups. PC20 was significantly lower in subjects with positive specific IgE to Dermatophagoides and house dust, but not to the three kinds of pollen examined. It was confirmed that atopy indicated by specific immunoglobulin E to mite-related antigens, but not to pollen antigens, is associated with nonspecific bronchial responsiveness, and it is suggested that atopy is not a determinant of airway cough sensitivity in healthy, nonasthmatic subjects.

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“…In a study by KAUFFMANN et al [27], females were found to report more shortness of breath than males for any given forced expiratory volume in one second deficit. Females have been found also to have a more sensitive cough reflex, given an equal cough stimulant [28,29]. Furthermore, it has been argued that females are more perceptive to breathlessness than males, due to cyclical hormonal variations [26].…”

Section: Discussionmentioning

confidence: 99%

Incidence of asthma and respiratory symptoms by sex, age and smoking in a community study

Eagan

Bakke²,

Eide³

et al. 2002

Eur Respir J

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The purpose of this study was to establish incidence rates for a wide range of respiratory symptoms and asthma, and relate them to sex, age, and smoking habits.A cohort established in 1985 as a random sample from the population of Western Norway, aged 15-70 yrs, was followed-up in 1996-1997. Of the initial cohort of 3,786 subjects, a total of 2,819 replied to mailed questionnaires at both baseline and follow-up.The 11-yrs cumulative incidence of asthma was 4.0% in males and 3.5% in females. For respiratory symptoms, the cumulative incidences for both sexes varied between 2.0% (dyspnoea grade 4) and 25.8% (wheezing), being higher in females than males for most symptoms. For calculation of odds ratios (ORs) multivariate logistic regression analyses were used. The sex and smoking-adjusted incidences increased by age for all symptoms except wheezing and attacks of dyspnoea. Those starting to smoke within the follow-up had ORs of 1.9-2.2 for the cough symotoms compared to never-smokers, after adjusting for sex, age, and pack-yrs.To conclude, the 11-yrs incidence of dyspnoea increased with increasing pack-yrs, after adjusting for sex, age, and changes in smoking habits. This indicated that when analysing other risk factors, adjustment has to be made for the risks posed by smoking, sex and age.

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Sex difference in the inhaled tartaric acid cough threshold in non-atopic healthy subjects.

Cited by 83 publications

References 10 publications

A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response

A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response

Atopy in cough sensitivity to capsaicin and bronchial responsiveness in young females

Incidence of asthma and respiratory symptoms by sex, age and smoking in a community study

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