Independent Factors Contributing to Daytime and Nighttime Asthmatic Cough Refractory to Inhaled Corticosteroids.

Independent Factors Contributing to Daytime and Nighttime Asthmatic Cough Refractory to Inhaled Corticosteroids. J Investig Allergol Clin Immunol. 2019;29(1):30-39 Authors: Kanemitsu Y, Matsumoto H, Oguma T, Nagasaki T, Ito I, Izuhara Y, Tajiri T, Iwata T, Mishima M, Niimi A Abstract BACKGROUND: Cough is a common feature of asthma, which is often resistant to inhaled corticosteroids (ICSs). The pathophysiology of this refractoriness may differ between daytime and nighttime asthmatic cough. We sought to identify factors contributing to ICS-refractory daytime and nighttime asthmatic cough. METHODS: Sixty-seven patients with asthma presenting solely or predominantly with chronic cough were prospectively enrolled from April 2012 to December 2014. At baseline and 12 weeks after ICS treatment, the capsaicin cough threshold (C2, C5) and methacholine airway sensitivity and reactivity were examined. A visual analog scale (VAS) and numeric scores were used to evaluate daytime and nighttime cough symptoms separately. The Japanese version of the Leicester Cough Questionnaire was also completed. When either the VAS or numeric scores showed an improvement of ≥50% or ≥2 points, patients were considered responders to ICS treatment. RESULTS: Fifty-five patients were eligible for evaluation. Subjective cough indices improved significantly at 12 weeks after ICS treatment (P
Source: Journal of Investigational Allergology and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: J Investig Allergol Clin Immunol Source Type: research

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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
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Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
Cough is a common and troublesome symptom in patients with asthma, in whom the interactions among airway hyperactivity, bronchospasm, airway wall inflammation, and inevitable environmental exposures (allergens, viruses, and irritants) make effective management of cough a clinical challenge. How then do we understand the etiology of cough, and how can we use that understanding to improve care of patients with asthma? The study by Satia et  al1 in this issue of the Journal suggests that airway inflammation from allergen exposure and consequent bronchospasm are associated with increased sensitivity of the capsaicin-induced cough reflex.
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