Validity of Fractional Exhaled Nitric Oxide in Diagnosis of Corticosteroid-Responsive Cough

Yi, Fang; Chen, Ruchong; Luo, Wei; Xu, Danyuan; Han, Lina; Liu, Baojuan; Jiang, Siqi; Chen, Qiaoli; Lai, Kefang

doi:10.1016/j.chest.2016.01.006

Cited by 42 publications

(49 citation statements)

References 27 publications

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“…Yi et al, did not report in their study whether a possible occupational cause for chronic cough had been considered (17). Despite published recommendations, both in cough guidelines/protocols and in clinical practice, it is quite frequent that an occupational trigger is not contemplated among the causes of chronic cough (24,25).…”

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confidence: 80%

“…Recently, Yi et al reported the results of a study conducted on the utility of FeNO in diagnosing subjects with corticosteroid-responsive cough (CRC) (17). The authors evaluated 244 patients with chronic cough and 59 healthy subjects, more than half of the patients enrolled had CRC; in these subjects, FeNO is higher than in patients with corticosteroid non-responsive cough and significantly correlated with sputum eosinophils.…”

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confidence: 99%

“…FeNO higher than 22.5 ppb resulted in 74.6% sensitivity and 77.2% specificity to predict sputum eosinophils >2.5%, while with a cut-off value of 33.5 ppb the specificity was adjusted to 95%. In the meantime, a cut-off value of 31.5 ppb has the higher specificity in discriminating CRC (17). Considering such small differences in cut-offs, the inter-individual variability of FeNO evaluation, as measured in each specific setting, should always be checked.…”

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confidence: 99%

“…In the study by Yi et al (17), such a biomarker was not considered, even if it would have been interesting to evaluate its sensitivity and specificity in predicting CRC compared to FeNO levels.…”

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confidence: 99%

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Towards a practical clinical use of fractioned exhaled nitric oxide levels in chronic cough

Pignatti

Spanevello

2016

Ann. Transl. Med.

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confidence: 80%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Towards a practical clinical use of fractioned exhaled nitric oxide levels in chronic cough

Pignatti

Spanevello

2016

Ann. Transl. Med.

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“…In this study, we used oral β 2 ‐agonist not inhaled bronchodilator to avoid some patients being unable to master the inhalation methods. There were some similarities and overlaps between NAEB and CVA in terms of clinical characteristic and airway inflammation, but patients with NAEB do not have airway hyperresponsiveness, while patients with CVA do . Patients with CVA were ruled out mainly according to the bronchial provocation test.…”

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confidence: 99%

Response to bronchodilator and clinical, pathophysiological features in patients with nonasthmatic eosinophilic bronchitis

Lai

Han

et al. 2019

Clinical Respiratory J

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Introduction Whether nonasthmatic eosinophilic bronchitis (NAEB) shows response to bronchodilator (RB) remains unclear. Objectives To investigate the RB and its relationship with clinical and pathophysiological features in NAEB. Methods Fifty‐one patients with NAEB were assigned in a 2:1 ratio to receive oral bambuterol hydrochloride (n = 34, 10 mg, once daily, for 3 days) or matched placebo (n = 17) randomly, of whom 48 patients (32 with bronchodilator and 16 with placebo) completed the study. Sputum induction, spirometry and cough reflex sensitivity were measured. RB was considered when cough Visual analogue scale (VAS) score decreased 30% or more after treatment. Cough reflex sensitivity was defined as the lowest concentration of capsaicin inducing five coughings or more (C5), and presented as Log C5. Results The responsive rate of patients with bronchodilator was significantly higher than that with placebo (34.4% vs 6.3%, P < 0.05). The VAS score decreased significantly in patients with bronchodilator (median: 6.0‐3.0, P < 0.01). There was a significantly higher median Log C5 (2.7 vs 1.3, P < 0.05), and a higher trend of decline in FEV1% predicted and MMEF% predicted after bronchial provocation in patients with RB as compared with patients without RB. No significant differences in baseline percentages of sputum eosinophil were found between patients with RB and that without RB. Conclusions One third of patients with NAEB respond well to bronchodilator treatment, which are related with lower cough reflex sensitivity and increased airway responsiveness. The relationship between NAEB and asthma needs to be investigated further.

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Mechanisms and Rationale for Targeted Therapies in Refractory and Unexplained Chronic Cough

Mazzone

McGarvey

2020

Clin Pharma and Therapeutics

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Chronic cough, defined as a cough lasting > 8 weeks, is a common medical condition that exerts a substantial physical, mental, and social burden on patients. A subset of patients with chronic cough are troubled with a cough that persists despite optimal treatment of presumed associated common and uncommon conditions (refractory chronic cough; RCC) or in which no diagnosable cause for cough can be identified despite extensive assessment (unexplained chronic cough; UCC). Many of these patients exhibit clinical features of cough hypersensitivity, including laryngeal paresthesia, hypertussia, and allotussia. Over-the-counter cough remedies are ineffective and can lead to intolerable side effects when used for RCC/UCC, and the lack of approved treatments indicated for these conditions reflects a major unmet need. An increased understanding of the anatomy and neurophysiology of protective and pathologic cough has fostered a robust clinical development pipeline of several targeted therapies for RCC/UCC. This manuscript reviews the mechanisms presumed to underly RCC/UCC together with the rationale and clinical evidence for several targeted therapies currently under clinical investigation, including transient receptor potential channel antagonists, P2X3-receptor antagonists, voltage-gated sodium channel blockers, neuromodulators, and neurokinin-1-receptor antagonists. Finally, we provide an overview of targets that have been investigated in preclinical models of cough and other airway diseases that may hold future promise for clinical studies in RCC/UCC. Development of targeted therapies with different sites of action may foster a precision medicine approach to treat this heterogeneous, underserved patient population.

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Validity of Fractional Exhaled Nitric Oxide in Diagnosis of Corticosteroid-Responsive Cough

Cited by 42 publications

References 27 publications

Towards a practical clinical use of fractioned exhaled nitric oxide levels in chronic cough

Towards a practical clinical use of fractioned exhaled nitric oxide levels in chronic cough

Response to bronchodilator and clinical, pathophysiological features in patients with nonasthmatic eosinophilic bronchitis

Mechanisms and Rationale for Targeted Therapies in Refractory and Unexplained Chronic Cough

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