The interaction between bronchoconstriction and cough in asthma

Satia, Imran; Badri, Huda; Woodhead, Mark; O'Byrne, Paul M.; Fowler, Stephen J.; Smith, Jaclyn A.

doi:10.1136/thoraxjnl-2016-209625

Cited by 33 publications

(21 citation statements)

References 9 publications

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“…In addition to cough, hypertonic aerosols induce bronchoconstriction. Since bronchoconstriction itself can provoke cough [14][15][16][17], the investigators initially assumed that the cough response was secondary to the induced bronchoconstriction. Indeed, an early study revealed a significant association between the cough response and the bronchoconstrictive response to mannitol [12].…”

Section: The Possible Mechanisms Of Hypertonic Aerosol-provoked Coughmentioning

confidence: 99%

Cough-provocation tests with hypertonic aerosols

2020

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Recent advances in cough research suggest a more widespread use of cough-provocation tests to demonstrate the hypersensitivity of the cough reflex arc. Cough-provocation tests with capsaicin or acidic aerosols have been used for decades in scientific studies. Several factors have hindered their use in everyday clinical work: i.e. lack of standardisation, the need for special equipment and the limited clinical importance of the response. Cough-provocation tests with hypertonic aerosols (CPTHAs) involve provocations with hypertonic saline, hypertonic histamine, mannitol and hyperpnoea. They probably act via different mechanisms than capsaicin and acidic aerosols. They are safe and well tolerated and the response is repeatable. CPTHAs can assess not only the sensitivity of the cough reflex arc but also the tendency of the airway smooth muscles to constrict (airway hyper-responsiveness). They can differentiate between subjects with asthma or chronic cough and healthy subjects. The responsiveness to CPTHAs correlates with the cough-related quality of life among asthmatic subjects. Furthermore, the responsiveness to them decreases during treatment of chronic cough. A severe response to CPTHAs may indicate poor long-term prognosis in chronic cough. The mannitol test has been stringently standardised, is easy to administer with simple equipment, and has regulatory approval for the assessment of airway hyper-responsiveness. Manual counting of coughs during a mannitol challenge would allow the measurement of the function of the cough reflex arc as a part of clinical routine.

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Section: The Possible Mechanisms Of Hypertonic Aerosol-provoked Coughmentioning

confidence: 99%

Cough-provocation tests with hypertonic aerosols

2020

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“…Asthma is characterized by a reversible variable airway obstruction, airway inflammation, and an increased airway responsiveness to stimuli [7,12,36]. While classical asthma is described by the triad of dyspnea, cough, and wheeze, cough alone might be the only manifestation of cough-variant asthma [6,12,13], a leading cause of chronic cough in children [6,7,12,37,38], which can remain undiagnosed. Cough has also been found to signal the onset of asthmatic exacerbation [14].…”

Section: Discussionmentioning

confidence: 99%

Development of Machine Learning for Asthmatic and Healthy Voluntary Cough Sounds: A Proof of Concept Study

et al. 2019

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(1) Background: Cough is a major presentation in childhood asthma. Here, we aim to develop a machine-learning based cough sound classifier for asthmatic and healthy children. (2) Methods: Children less than 16 years old were randomly recruited in a Children’s Hospital, from February 2017 to April 2018, and were divided into 2 cohorts—healthy children and children with acute asthma presenting with cough. Children with other concurrent respiratory conditions were excluded in the asthmatic cohort. Demographic data, duration of cough, and history of respiratory status were obtained. Children were instructed to produce voluntary cough sounds. These clinically labeled cough sounds were randomly divided into training and testing sets. Audio features such as Mel-Frequency Cepstral Coefficients and Constant-Q Cepstral Coefficients were extracted. Using a training set, a classification model was developed with Gaussian Mixture Model–Universal Background Model (GMM-UBM). Its predictive performance was tested using the test set against the physicians’ labels. (3) Results: Asthmatic cough sounds from 89 children (totaling 1192 cough sounds) and healthy coughs from 89 children (totaling 1140 cough sounds) were analyzed. The sensitivity and specificity of the audio-based classification model was 82.81% and 84.76%, respectively, when differentiating coughs from asthmatic children versus coughs from ‘healthy’ children. (4) Conclusion: Audio-based classification using machine learning is a potentially useful technique in assisting the differentiation of asthmatic cough sounds from healthy voluntary cough sounds in children.

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“…We subsequently investigated the interaction between bronchoconstriction and capsaicin-evoked cough and showed that bronchoconstriction induced by inhaling methacholine resulted in an increase in cough responses to inhaled capsaicin, which gradually diminished as airway caliber improved. 12 This suggested that smooth muscle contraction increases neuronal function, as measured based on the cough reflex. An important missing component in these studies was directly assessing the influence of airway inflammation on airway nerves that trigger the cough reflex.…”

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confidence: 99%

Allergen challenge increases capsaicin-evoked cough responses in patients with allergic asthma

Satia

Watson

Scime

et al. 2019

Journal of Allergy and Clinical Immunology

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This study was funded by the British Medical Association James Trust Award. I.S. is funded by a fellowship from the European Respiratory Society/European Union Marie Curie Award. Disclosure of potential conflict of interest: I. Satia reports grant from the BMA James Trust Award and the North West Lung Centre Grant; personal fees from Educational Talks for GPs; and sponsorship to attend conference meetings outside the submitted work. P. D. Mitchell reports grants from the Irish Asthma Society and Teva and personal fees from Educational Talks for GPs and specialists outside the submitted work. P. M. O'Byrne reports personal fees from the Oversight Committee for LABA Safety study; consulting fees from AstraZenca, GlaxoSmithKline, Merck, and Boehringer; and grants from AstraZeneca and Genentech outside the submitted work. J. A. Smith reports grants from the British Medical Association James Trust during the conduct of the study and grants and personal fees from Ario Pharma, GlaxoS-mithKline, NeRRe Pharmaceuticals, Menlo, and Bayer; personal fees from Boehringer Ingleheim, Genentech, and Neomed; grants and personal fees from Merck; nonfinancial support from Vitalograph; personal fees from Cheisi; and grants and personal fees from Afferent outside the submitted work. In addition, J. A. Smith has a patent A method for generating output data licensed. The rest of the authors declare that they have no relevant conflicts of interest. Clinical Trial Registration: www.controlled-trials.com ISRCTN79930571.

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The interaction between bronchoconstriction and cough in asthma

Cited by 33 publications

References 9 publications

Cough-provocation tests with hypertonic aerosols

Cough-provocation tests with hypertonic aerosols

Development of Machine Learning for Asthmatic and Healthy Voluntary Cough Sounds: A Proof of Concept Study

Allergen challenge increases capsaicin-evoked cough responses in patients with allergic asthma

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