Sputum eosinophilia and bronchial responsiveness in patients with chronic non‐productive cough responsive to anti‐asthma therapy

Yamaguchi, Shinjiro; Urushibata, Kazuhisa; Koizumi, Tomonobu; Kubo, Keishi

doi:10.1046/j.1440-1843.2003.00448.x

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…And the percentages of EOS and T lymphocytes in induced sputum were significantly decreased in post-treated asthmatic patients, and with the increase of the inflammatory cells, the FEV1% was increased accordingly. The result was consistent with the findings of other studies [15,16 ] , suggesting that the sputum induction can reliably reflect the severity of airway inflammation.…”

Section: Discussionsupporting

confidence: 92%

The effect of Ginkgo Biloba Extract on the expression of PKCα in the inflammatory cells and the level of IL-5 in induced sputum of asthmatic patients

Tang

Xiong

et al. 2007

J. Huazhong Univ. Sc. Technol.

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To investigate the effect of the Ginkgo Biloba Extract (GBE) on the asthma and examine its possible mechanisms, 75 asthma patients were divided into 4 groups and the patients were respectively treated with fluticasone propionate for 2 weeks or 4 weeks, or treated with fluticasone propionate plus GBE for 2 weeks or 4 weeks. Fifteen healthy volunteers served as healthy controls. Sputum inhalation with inhaling hypertonic saline (4%-5%) was performed. Lung ventilatory function and forced expiratory volume in one second (FEV1) were measured. The numbers of different cells in induced sputum were calculated. The expression of PKCalpha in the cells was immunocytochemically detected and the percentages of positive cells in different cells were counted. Interleukin-5 (IL-5) in sputum supernatants was detected with enzyme-linked immunosorbent assay. The percentage of eosinophils, lymphocytes, PKCalpha positive inflammatory cells and the concentration of IL-5 in asthmatic patients were higher than those in the controls (P<0.05), and the eosinophils, lymphocytes, positive expression of PKCalpha and the level of IL-5 were significantly decreased in asthmatic patients after they were treated with fluticasone propionate or fluticasone propionate plus GBE. However, they were still significantly higher than those of the controls. Compared to the group treated with glucocorticosteroid for 2 weeks, no significant decrease was found in the percentage of eosinophils, lymphocytes, PKCalpha positive inflammatory cells and the IL-5 in the supernatant of induced sputum. Compared with the group treated with glucocorticosteroid for 2 or 4 weeks, significant decrease in the same parameters was observed in the group treated with fluticasone propionate and GBE for 4 weeks. The IL-5 level in the supernatant of induced sputum was positively correlated with the percentage of PKCalpha-positive inflammatory cells and the percentage of eosinophils in the induced sputum in asthma patient groups respectively (n=150, r= 0.83, P<0.01; n=150, r=0.76, P<0.01). The FEV1 was negatively correlated with the percentage of PKCalpha-positive inflammatory cells and the IL-5 levels in supernatant of induced sputum in asthma patients respectively (n=150, r=-0.77, P<0.01; n=150, r= -0.64, P<0.01). It is concluded that GBE could significantly decrease the infiltration of inflammatory cells such as eosinophils and lymphocytes in the asthmatic airway and relieve the airway inflammation. GBE may decrease the activation of the PKCalpha in the inflammatory cells and thereby decrease the IL-5 level in induced sputum. GBE may be used as a complement to the glucocorticosteroid therapy for asthma.

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Section: Discussionsupporting

confidence: 92%

The effect of Ginkgo Biloba Extract on the expression of PKCα in the inflammatory cells and the level of IL-5 in induced sputum of asthmatic patients

Tang

Xiong

et al. 2007

J. Huazhong Univ. Sc. Technol.

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“…They experienced relief of their coughing with bronchodilator therapy, but in most cases their cough did not disappear completely and they only obtained complete recovery after being treated with inhaled corticosteroids for 2 weeks. Others have reported similar findings, 8,9 and if improvement occurs only with inhaled corticosteroids, it may be problematic to classify whether the patients have CVA or atopic cough. A few patients with PNDS or GERD show hyperresponsiveness to methacholine and no relief of cough following treatment with antiasthma therapy 8,22 .…”

Section: Discussionmentioning

confidence: 82%

“…Others have reported similar findings, 8,9 and if improvement occurs only with inhaled corticosteroids, it may be problematic to classify whether the patients have CVA or atopic cough. A few patients with PNDS or GERD show hyperresponsiveness to methacholine and no relief of cough following treatment with antiasthma therapy 8,22 . However, no such patients were included in our study population.…”

Section: Discussionmentioning

confidence: 82%

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Prevalence and clinical features of cough variant asthma in a general internal medicine outpatient clinic in Japan

et al. 2005

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“…We named this condition NHBRC, and it consisted of a significantly large part of BRC (30%) with a higher prevalence in women (Table 1). Fujimoto et al reported a similar phenomenon in a limited number of patients who responded to a beta agonist without airway hyperresponsiveness [18]. Although the airway reversibility test estimated by the change in FEV 1 was not positive in all BRC patients, there was a difference in the flow volume parameters among BA, CVA and NHBRC.…”

Section: Discussionmentioning

confidence: 81%

Classification of chronic cough by systematic treatment cascade trial starting with beta agonist

Shimizu

Hayashi

Saito

et al. 2013

Cough

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BackgroundChronic cough is one of the most challenging symptoms to diagnose and treat, not only because of the variety of underlying disorders but also its varying susceptibility to treatments. Etiological studies of chronic cough vary depending on the clinical settings and the particular interests of investigators.ObjectivesThe purposes of this study were first to categorize the etiology of chronic cough by its response to systematic diagnostic treatments starting from the β2 agonist and second to sub-categorize β2 agonist responsive cough (BRC) by the airway hyperresponsiveness.MethodsOne hundred and eighty-four never-smokers received the maximal dose of procaterol to diagnose BRC. BRC was sub-categorized into two groups with or without airway hyperresponsiveness measured by the methacholine challenge test. Sinobronchial syndrome (SBS) was diagnosed by postnasal drip symptoms and by the response to clarythromycin and carbocysteine. Atopic cough (AC) was diagnosed by the evidence of atopy and the response to cetirizine hydrochloride. Gastroesophageal reflux disease (GERD) was diagnosed by the response to rabeprazole sodium. Since we did not investigate eosinophil counts in the tissue or in the induced sputum, no diagnosis of eosinophilic bronchitis was made.ResultsOne hundred and nine patients had BRC. Twenty-three of them had bronchial asthma (BA), 53 had cough variant asthma (CVA) and 33 had non-hyperresponsive BRC (NHBRC). Thirty-one patients had GERD, 27 had AC and 14 had SBS. Twenty-five patients had more than one diagnosis in combination, while 6 had other miscellaneous diseases. Twelve patients were undiagnosed and 11 dropped out of the study.ConclusionsThe majority of chronic cough was BRC. NHBRC was a new chronic cough entity. GERD is a common cause of chronic cough in Japan, as in Western countries. AC and SBS are also causes of chronic cough in Japan.Trial registrationUniversity hospital medical information network (UMIN 000007483)

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Sputum eosinophilia and bronchial responsiveness in patients with chronic non‐productive cough responsive to anti‐asthma therapy

Cited by 9 publications

References 24 publications

The effect of Ginkgo Biloba Extract on the expression of PKCα in the inflammatory cells and the level of IL-5 in induced sputum of asthmatic patients

The effect of Ginkgo Biloba Extract on the expression of PKCα in the inflammatory cells and the level of IL-5 in induced sputum of asthmatic patients

Prevalence and clinical features of cough variant asthma in a general internal medicine outpatient clinic in Japan

Classification of chronic cough by systematic treatment cascade trial starting with beta agonist

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