Effect of codeine on objective measurement of cough in chronic obstructive pulmonary disease

Smith, Jaclyn A.; Owen, Emily; Earis, J. E.; Woodcock, Ashley

doi:10.1016/j.jaci.2005.09.055

Cited by 138 publications

(83 citation statements)

References 28 publications

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“…Qualitative research has suggested that cough and sputum expectoration may be potent triggers for the stigmatization of patients with COPD (29), yet few previous studies have objectively measured cough in COPD (18,30). Our data suggest this novel approach can provide new insights into the mechanisms that may drive coughing.…”

Section: Discussionmentioning

confidence: 76%

Predictors of Objective Cough Frequency in Chronic Obstructive Pulmonary Disease

Sumner

Woodcock

Kolsum

et al. 2013

Am J Respir Crit Care Med

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Rationale: Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood. Objectives: To quantify cough frequency in an unselected group of subjects with COPD and investigate the relationships between cough, reported sputum production, smoking, pulmonary function, and cellular airway inflammation. Methods: We studied 68 subjects with COPD (mean age, 65.6 6 6.7 yr; 67.6% male; 23 smokers; 45 ex-smokers) and 24 healthy volunteers (mean age, 57.5 6 8.9 yr; 37.5% male; 12 smokers; 12 nonsmokers). Subjects reported cough severity, cough-specific quality of life, and sputum expectoration and performed spirometry, sputum induction, cough reflex sensitivity to capsaicin, and 24-hour ambulatory cough monitoring. Measurements and Main Results: COPD current smokers had the highest cough rates (median, 9 coughs/h [interquartile range, 4.3-15.6 coughs/h]), almost double that of COPD ex-smokers (4.9 [2. 3-8.7] coughs/h; P ¼ 0.018) and healthy smokers (5.3 [1.2-8.3] coughs/h; P ¼ 0.03), whereas healthy volunteers coughed the least (0.7 [0.2-1.4] coughs/h). Cough frequency was not influenced by age or sex and only weakly correlated with cough reflex sensitivity to capsaicin (log C5 r ¼ 20.36; P ¼ 0.004). Reported sputum production, smoking history, and current cigarette consumption strongly predicted cough frequency, explaining 45.1% variance in a general linear model (P , 0.001). In subjects producing a sputum sample, cough frequency was related to current cigarette consumption and percentage of sputum neutrophils (P ¼ 0.002). Conclusions: Ambulatory objective monitoring provides novel insights into the determinants of cough in COPD, suggesting sputum production, smoking, and airway inflammation may be more important than sensitivity of the cough reflex.Keywords: cough; smoking; sputum; neutrophils; capsaicin Chronic obstructive pulmonary disease (COPD) is a major public health problem, with a lifetime risk in smokers of 35-50% (1). By 2020, it is estimated that more than 200 million people will have COPD, and it will be the third leading cause of death worldwide. Cough (either with or without sputum) is one of the principle symptoms of COPD, along with breathlessness. Epidemiologic studies have found that the reported presence of chronic cough and mucus hypersecretion in established COPD may be linked to accelerated decline in lung function (2), more frequent exacerbations (3), and hospitalizations (4), yet little is known about the mechanisms underlying coughing (5).The potential drivers for cough in patients with COPD are multifactorial. Excessive airway mucus may provide a mechanical stimulus to coughing, especially in the presence of ciliary dysfunction, airflow obstruction, and airway collapse (caused by destruction of the supporting parenchyma), all of which impair clearance. In addition the inflammation, infection, and in some continuing exposure to cigarette smoke provide chemical stimuli capable of provok...

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Section: Discussionmentioning

confidence: 76%

Predictors of Objective Cough Frequency in Chronic Obstructive Pulmonary Disease

Sumner

Woodcock

Kolsum

et al. 2013

Am J Respir Crit Care Med

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“…The suppression of cough with opiates have long been advocated [97,98]; however, there are few quality trial data to support this recommendation. A recent placebo-controlled crossover trial that used objective and subjective cough measures suggested an antitussive effect similar to that of placebo in COPD patients [99]. …”

Section: Resultsmentioning

confidence: 99%

An update and systematic review on drug therapies for the treatment of refractory chronic cough

Ryan

Vertigan

Birring

2018

Expert Opinion on Pharmacotherapy

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Introduction: Chronic Cough (CC) is common and often associated with significant comorbidity and decreased quality of life. In up to 50% of cases, the cough is refractory despite extensive investigation and treatment trials. It is likely that the key abnormality in refractory CC is dysfunctional, hypersensitive sensory nerves, similar to conditions such as laryngeal hypersensitivity and neuropathic pain.Areas covered: The aim of this systematic review is to assess drug therapies for refractory CC. The authors review the current management of CC and provide discussion of the similarities between neuropathic pain and refractory CC. They review repurposed and new pharmacological treatments. Several meta-analyses were performed to compare the efficacy of treatments where possible.Expert opinion: Repurposed pain medications such as gabapentin and pregabalin reduce the frequency of cough and improve quality of life. Along with speech pathology, they are important and alternate treatments for refractory CC. However, more treatments are needed and the P2X3 ion channel receptor antagonists show the most promise. With a better understanding of neuronal activation and sensitisation and their signal processing in the brain, improved animal models of cough, and the use of validated cough measurement tools, more effective treatments will develop.

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“…the number of seconds containing at least one explosive cough [78,80,81]. This was used to obtain a more encompassing definition of cough rather than just measuring the explosive component that can be heard.…”

Section: Ambulatory Methods Of Cough Recordingmentioning

confidence: 99%

“…This study undertook laborious aural analysis of cough data. More recently, digital cough recorders offer the opportunity for objective cough frequency measurement, which may become the gold standard for such studies in future [73,80,83,160]. Until then, subjective cough scores, VASs and, again more recently, quality-of-life measurements may be used as end-points [8,9].…”

Section: Studies In Patientsmentioning

confidence: 99%

ERS guidelines on the assessment of cough

Morice¹,

Fontana²,

Belvisi³

et al. 2007

Eur Respir J

613

619

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Effect of codeine on objective measurement of cough in chronic obstructive pulmonary disease

Cited by 138 publications

References 28 publications

Predictors of Objective Cough Frequency in Chronic Obstructive Pulmonary Disease

Predictors of Objective Cough Frequency in Chronic Obstructive Pulmonary Disease

An update and systematic review on drug therapies for the treatment of refractory chronic cough

ERS guidelines on the assessment of cough

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