Gene expression of nociceptors in the esophagus of patients with gastro-esophageal reflux (GER)-associated chronic cough

Background: Activation of afferent nerves in the esophagus is assumedly a major mechanisms of cough associated with GER, which may lead to sensitization of cough reflex. Transient receptor potential vanilloid (TRPV) 1 is one of the nociceptors activated by acid, whose expression is increased in the airways of chronic cough patients (Groneberg 2004) and in the esophagus of GER patients (Guarino 2010). The expression of nociceptors in the esophagus of patients with GER-associated cough is unknown.Method: We prospectively recruited untreated GER patients with (n=32, C+) and without (n=5, C-) cough. Esophageal endoscopy was performed to determine the presence and severity of reflux esophagitis (RE), and to obtain biopsy specimens, which were examined for TRPV1, TRPV4, TRPA1 and P2X3 mRNA expressions by real-time reverse transcription-polymerase chain reaction.Result: Age, sex distribution, smoking history, prevalence/severity of RE, and GER symptom scores did not differ between the C+ and C- groups. The expressions of TRPV1 and TRPV4 were significantly and markedly increased in the C+ group than in the C- group (p
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research

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ConclusionsAlthough semi-solid nutrients have several advantages, including reduced diarrhea and gastroesophageal reflux, evidence on semi-solid nutrients via the nasogastric tube is insufficient. It should be noted that semi-solid nutrient reflux can be more fatal than liquid nutrients.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Publication date: Available online 6 June 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Li Long, Kefang LaiAbstractChronic cough is one of the most common complains for patients seeking medical attention in both general practice and respiratory specialist clinics. Cough variant asthma, eosinophilic bronchitis, upper airway cough syndrome, as well as gastro-esophageal reflux disease are common conditions associated with chronic cough, and cough variant asthma, eosinophilic bronchitis account for a higher proportion of patients with chronic cough in China than in Western countries. An older female predominan...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
Publication date: Available online 14 March 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): David Muccino, Stuart GreenAbstractChronic cough, or cough lasting>8 weeks, is often associated with underlying medical conditions (ie, asthma, gastroesophageal reflux disease, nonasthmatic eosinophilic bronchitis, and upper-airway cough syndrome). In some patients with chronic cough, treatment of these underlying conditions does not resolve the cough (refractory chronic cough [RCC]), or none of these conditions are present (unexplained chronic cough [UCC]). Despite appropriate medical evaluation, patients with RCC...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
Background: The cough reflex in childbearing women has been found to be more sensitive to chemical stimuli than that in other populations. However, the effect of age and sex on the cough reflex threshold (CRT) triggered by mechanical stimuli has not been studied.Aim: Our objective was to explore the association between age and sex, and CRT triggered by mechanical stimuli (air pulses) in childbearing women using a previously validated laryngopharyngeal endoscopic esthesiometer and laser rangefinder (LPEER).Methods: A cohort of 118 subjects, half of whom were female (49%), aged 19-95 years (a mean of 55.7 years), were prospe...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
Authors: Song DJ, Song WJ, Kwon JW, Kim GW, Kim MA, Kim MY, Kim MH, Kim SH, Kim SH, Kim SH, Kim ST, Kim SH, Kim JK, Kim JH, Kim HJ, Kim HB, Park KH, Yoon JK, Lee BJ, Lee SE, Lee YM, Lee YJ, Lim KH, Jeon YH, Jo EJ, Jee YK, Jin HJ, Choi SH, Hur GY, Cho SH, Kim SH, Lim DH Abstract Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. Howe...
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
AbstractIdiopathic pulmonary fibrosis is a peripheral subpleural interstitial lung disorder limited to the lung not involving the airways. It has a poor prognosis (survival less than 5  years) and commonly an interstitial pneumonia radiological pattern. Patients complain of a chronic dry cough in 80% of cases. A cough is often the first symptom of this rare disease, preceding dyspnea by years, and is associated with a poor prognosis, high dyspnea scores and low FVC percentages. T he pathogenetic mechanisms leading to coughing in IPF are unclear. This review focuses on recent evidence of cough pathophysiology in this d...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Publication date: Available online 27 March 2018Source: Respiratory Physiology &NeurobiologyAuthor(s): Martin Duricek, Lenka Nosakova, Tomas Zatko, Renata Pecova, Rudolf Hyrdel, Peter BanovcinAbstractThe sensitization of cough reflex observed in patients with gastroesophageal reflux disease (GERD) is attributed to activation of vagal C-fibers innervating the esophagus by acid, while the heartburn in GERD is mediated by esophageal acid sensitive C-fibers derived from (dorsal root ganglia) DRG. Here we explored the relationship between cough reflex sensitivity (CRS) and esophageal sensitivity to acid. We evaluated CRS to...
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research
Publication date: Available online 27 March 2018 Source:Respiratory Physiology & Neurobiology Author(s): Martin Duricek, Lenka Nosakova, Tomas Zatko, Renata Pecova, Rudolf Hyrdel, Peter Banovcin The sensitization of cough reflex observed in patients with gastroesophageal reflux disease (GERD) is attributed to activation of vagal C-fibers innervating the esophagus by acid, while the heartburn in GERD is mediated by esophageal acid sensitive C-fibers derived from (dorsal root ganglia) DRG. Here we explored the relationship between cough reflex sensitivity (CRS) and esophageal sensitivity to acid. We evaluated CRS to cap...
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research
Chronic cough is one of the most common clinical problems and it may be secondary to different stimuli and diseases, including low-level physical and chemical stimulation of the esophageal –bronchial reflex, suggestive of cough-reflex hyperresponsiveness, in patients with gastroesophageal reflux; however, it is still debated whether gastroesophageal reflux could induce airway inflammation and acidification. The aim of this study was to investigate airway pH and cysteynil-leukotrienes (Cys-LTs) concentration (a marker of airway inflammation) in exhaled breath condensate (EBC). Patients with chronic cough and for...
Source: Journal of Breath Research - Category: Respiratory Medicine Authors: Source Type: research
Conclusion Hyperexcitability of T5 and T6 sympathetic preganglionic fibers appears to be the main etiology of LPR. SNEPI can reduce LES relaxation and improve blood flow to the mucosa, thereby increasing the stability of the vagus reflex and laryngopharyngeal mucosal defense factors. To the best of our knowledge, this case represents the first report of a patient with LPR refractory to PPIs who was successfully treated with SNEPI alone. SNEPI can be considered as an alternative to anti-reflux procedures. References 1. Vakil N, van Zanten SV, Kahrilas P, et al. Global Consensus Group. The Montreal definition and classificat...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue Medical Issues Neurologic Systems and Symptoms Neurology antireflux procedure autonomic regulation laryngopharyngeal reflux refractory Sympathetic nerve entrapment point injection Source Type: research
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