Effect of inhaled corticosteroids on symptom severity and sputum mediator levels in chronic persistent cough

Chaudhuri, Rekha; McMahon, Alex D.; Thomson, L.; MacLeod, Kirsten J; McSharry, Charles; Livingston, Eric W.; McKay, Anne; Thomson, Neil C.

doi:10.1016/j.jaci.2004.03.019

Cited by 81 publications

(62 citation statements)

References 45 publications

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“…Tussive inflammatory mediators, which may activate afferent sensory nerve endings, have been implicated in the pathogenesis of cough [7,38,39]. Inhalation studies in healthy individuals [9,10] and inhibition studies of the specific antagonists of inflammatory mediators in asthmatic patients [11] have shown that prostanoids such as PGE 2 , PGF 2 α and TXA 2 are associated with the cough reflex.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Physiological and Anti-Inflammatory Effect of Montelukast in Patients with Cough Variant Asthma

Takemura¹,

Niimi²,

Matsumoto³

et al. 2011

Respiration

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Background: Cough variant asthma (CVA) is a phenotype of asthma presenting solely with coughing, characterized by airway hyperresponsiveness, eosinophilic inflammation and a cough response to bronchodilators. Leukotriene receptor antagonists (LTRAs) are antiasthma medications with anti-inflammatory and bronchodilatory properties. Although LTRAs exert antitussive effects in CVA, the mechanisms involved are unknown. Objectives: This study aimed to clarify the antitussive mechanisms of LTRAs in CVA patients. Methods: We prospectively observed the effect of montelukast (10 mg) daily for 4 weeks in 23 consecutive nonsmoking adults with anti-inflammatory treatment-naive CVA. We evaluated, before and after treatment, the cough visual analogue scale (VAS), pulmonary function (spirometry and impulse oscillation), methacholine airway responsiveness, cough receptor sensitivity, expressed by the concentration of capsaicin inducing 2 or more (C2) and 5 or more (C5) coughs, sputum eosinophil counts and levels of inflammatory mediators, including cysteinyl leukotrienes, leukotriene B₄, prostaglandin (PG) D₂, PGE₂, PGF₂_α and thromboxane B₂. We compared the baseline characteristics of the patients based on the symptomatic response to montelukast, defined as a decrease in the cough VAS of >25% (n = 15) or ≤25% (n = 8). Results: Montelukast significantly decreased the cough VAS (p = 0.0008), sputum eosinophil count (p = 0.013) and cough sensitivity (C2: p = 0.007; C5: p = 0.039), whereas pulmonary function, airway responsiveness and sputum mediator levels remained unchanged. Multivariate analysis showed that a better response to montelukast was associated solely with younger age (p = 0.032). Conclusion: The antitussive effect of montelukast in CVA may be attributed to the attenuation of eosinophilic inflammation rather than its bronchodilatory properties.

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Section: Discussionmentioning

confidence: 99%

Clinical, Physiological and Anti-Inflammatory Effect of Montelukast in Patients with Cough Variant Asthma

Takemura¹,

Niimi²,

Matsumoto³

et al. 2011

Respiration

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show abstract

“…In a randomized, placebo-controlled 2-week trial of inhaled FP (500 mg twice a day) in patients with normal spirometry and cough for more than 1 year, significant improvement in cough symptoms and in the levels of airway inflammatory mediators was observed (Chaudhuri et al, 2004). However, a randomized, placebo-controlled crossover study of lower dose ICS (200 mg of BDP twice daily) given for a shorter period of time (2 weeks) did not appear to be effective (Evald et al, 1989).…”

Section: Glucocorticosteroidsmentioning

confidence: 99%

Antitussive Drugs—Past, Present, and Future

et al. 2014

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“…Histamin, prostoglandin E 2 ve substance P, bradikinin artışı da öksürük refleksini aktive eder. Bu durum ACE inhibitörlerinin kullanımına bağlı kronik öksürük hastaların yanı sıra idiyopatik öksürük olgularında da ortaya konulmuştur [48][49][50].…”

Section: öKsürük Refleksi Aşırı Duyarlılığıunclassified

Management Modalities of Chronic Cough in Adults

Erkekol¹

2017

Turk Thorac J

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Effect of inhaled corticosteroids on symptom severity and sputum mediator levels in chronic persistent cough

Cited by 81 publications

References 45 publications

Clinical, Physiological and Anti-Inflammatory Effect of Montelukast in Patients with Cough Variant Asthma

Clinical, Physiological and Anti-Inflammatory Effect of Montelukast in Patients with Cough Variant Asthma

Antitussive Drugs—Past, Present, and Future

Management Modalities of Chronic Cough in Adults

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