Published ahead of print on August 13, 2003, doi:10.1164/rccm.200304-597OC
American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 995-1002, (2003)
© 2003 American Thoracic Society
A Study of the Cough Reflex in Idiopathic Pulmonary Fibrosis
Benjamin D. M. Hope-Gill,
Simon Hilldrup,
Christine Davies,
Russell P. Newton and
Nicholas K. Harrison
Respiratory Unit and Pathology Department, Morriston Hospital; and Biological Sciences, University of Wales, Swansea, United Kingdom
Correspondence and requests for reprints should be addressed to Nicholas K. Harrison, M.D., F.R.C.P., Respiratory Unit, Morriston Hospital, Swansea, SA6 6NL UK. E-mail: resp.unit{at}swansea-tr.wales.nhs.uk
Little is known about the pathogenesis of cough in idiopathic pulmonary fibrosis (IPF). We hypothesized that abnormalities of respiratory tract tachykinin-containing sensory nerves may be implicated. We studied cough response to capsaicin, substance P (SP), and bradykinin in 10 healthy control subjects and 10 patients with IPF. Six patients were tested before and after steroid therapy. Induced sputum cell counts and neurotrophic factor levels were also measured in 13 patients and 13 control subjects. The results show that cough sensitivity to capsaicin was greater in patients (p < 0.01). Neither SP nor bradykinin induced cough in normal subjects. SP and bradykinin induced cough in 7/10 patients (p < 0.002) and 2/10 patients (not significant) with IPF, respectively. Prednisolone caused a reduction in cough sensitivity to capsaicin (p < 0.05) and SP (p < 0.05) in all six patients treated. There were significantly more neutrophils (p = 0.001) and higher levels of nerve growth factor (p < 0.01) and brain-derived neurotrophic factor (p < 0.01) in patient's sputa. These findings suggest functional upregulation of lung sensory neurones in IPF. The cough response to inhaled SP in most patients may reflect disrupted respiratory epithelium. The response to corticosteroids demonstrates that the cough is amenable to therapy.
Key Words: idiopathic pulmonary fibrosis • cough • neurotrophins
This article has been cited by other articles:
|
|
|
|
 
A U Wells, N Hirani, and on behalf of the BTS Interstitial Lung Disease Gui
Interstitial lung disease guideline
Thorax,
September 1, 2008;
63(Suppl_5):
v1 - v58.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M R Horton, S K Danoff, and N Lechtzin
Thalidomide inhibits the intractable cough of idiopathic pulmonary fibrosis
Thorax,
August 1, 2008;
63(8):
749 - 749.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A H Morice, L McGarvey, I Pavord, and on behalf of the British Thoracic Society Cough Gu
Recommendations for the management of cough in adults
Thorax,
September 1, 2006;
61(suppl_1):
i1 - i24.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A Torrego, R A Haque, L T Nguyen, M Hew, D H Carr, R Wilson, and K F Chung
Capsaicin cough sensitivity in bronchiectasis
Thorax,
August 1, 2006;
61(8):
706 - 709.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. P. McSharry, I. Fraser, R. Chaudhuri, K. Anderson, S. J. Bourke, N. C. Thomson, and G. Boyd
Nerve growth factor in serum and lymphocyte culture in pigeon fanciers' acute hypersensitivity pneumonitis.
Chest,
July 1, 2006;
130(1):
37 - 42.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. K. Brown
Chronic Cough Due to Chronic Interstitial Pulmonary Diseases: ACCP Evidence-Based Clinical Practice Guidelines
Chest,
January 1, 2006;
129(1_suppl):
180S - 185S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Tobin
Tuberculosis, Lung Infections, Interstitial Lung Disease, Social Issues and Journalology in AJRCCM 2003
Am. J. Respir. Crit. Care Med.,
January 15, 2004;
169(2):
288 - 300.
[Full Text]
[PDF]
|
|
|
Copyright © 2003 American Thoracic Society
|
|
|
