scholarly journals Tussive challenge with ATP and AMP: does it reveal cough hypersensitivity?

2017 ◽  
Vol 49 (2) ◽  
pp. 1601452 ◽  
Author(s):  
Helen Elizabeth Fowles ◽  
Tim Rowland ◽  
Caroline Wright ◽  
Alyn Morice
Keyword(s):  
Healthy Volunteers ◽  
Chronic Cough ◽  
Purinergic Receptor ◽  
Hypersensitivity Syndrome ◽  
Acute Effect ◽  
Atp Receptors ◽  
Cough Response ◽  
Study Population ◽  
Cough Hypersensitivity Syndrome ◽  
Receptor Family

Recent studies have demonstrated that blockade of P2X3 ATP receptors can profoundly inhibit chronic cough. We have considered whether inhaled ATP produces a tussive response and whether chronic cough patients are hypersensitive to inhaled ATP compared to healthy volunteers.A standardised inhalational cough challenge was performed with ATP and AMP. We randomised 20 healthy volunteers and 20 chronic cough patients as to the order of challenges. The concentration of challenge solution causing at least five coughs (C5) was compared for ATP and AMP.The study population consisted of six male and 14 female volunteers in each group. Two out of 19 healthy volunteers coughed with AMP (one volunteer could not take part in this challenge) and none reached C5. Eight out of 20 chronic cough patients coughed with AMP and two reached C5. Of the 20 healthy volunteers, 18 coughed with ATP, with 15 reaching C5. All 19 chronic cough patients completing the ATP challenge coughed with ATP and 18 reached C5. The chronic cough patients had a greater cough response at lower concentrations of ATP.The greater potency of ATP versus AMP in the inhalational challenge suggests that tussive responses are mediated through members of the P2X purinergic receptor family. This acute effect was, however, not sufficient to explain cough hypersensitivity syndrome.

scholarly journals Cough Hypersensitivity Syndrome – A Major Advance in the Understanding of Chronic Cough

2018 ◽  
Vol 4 (1) ◽  
pp. 19
Author(s):  
Kian Fan Chung ◽  
Keyword(s):  
Chronic Cough ◽  
Hypersensitivity Syndrome ◽  
Common Mechanism ◽  
Major Advance ◽  
Difficult Condition ◽  
Cough Response ◽  
Expert Interview ◽  
Number Of Patients ◽  
Cough Hypersensitivity Syndrome ◽  
Definition Of

Cough is a common complaint that often necessitates a visit to a primary care provider,1 but tpically resolves spontaneously within a few weeks. Chronic cough, which is a cough that has lasted for more than 8 weeks, is a more difficult condition to manage and satisfactory control is not achieved in a substantial number of patients.2 It has been suggested that many cases of chronic cough may share a common mechanism: that of a hypersensitive cough response.3 This has led to the definition of a new disease entity: cough hypersensitivity syndrome (CHS).4–6 In an expert interview, Professor Kian Fan Chung of the National Heart & Lung Institute, Imperial College and the Royal Brompton & Harefield NHS Trust, London, UK, discusses CHS and the recent advances in our understanding of this condition that is leading to the development of novel treatment approaches.

scholarly journals Novel approach to chronic cough

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Laima Kondratavičienė ◽  
Kristina Biekšienė ◽  
Skaidrius Miliauskas
Keyword(s):  
Chronic Cough ◽  
Hypersensitivity Syndrome ◽  
Medical Advice ◽  
Common Symptom ◽  
P2x3 Receptor ◽  
P2x3 Receptors ◽  
Important Target ◽  
Novel Approach ◽  
Cough Hypersensitivity Syndrome ◽  
New Treatment

Cough is the most common symptom for which people seek medical advice. A multitude of reasons can cause it. In clinical practice, a new term “Cough hypersensitivity syndrome“ was proposed, which defines unaccountable reasons forcough and different groups of patients with chronic cough. Adenosine triphosphate (ATP) as a driver of chronic cough is the most important target in nowadays clinical trials. Extracellular ATP activates P2X purinoreceptor 3 (P2X3) receptor channels, which are expressed in sensory neurons. New treatment methods that block P2X3 receptors are being developed.

scholarly journals Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

2014 ◽  
Vol 44 (5) ◽  
pp. 1132-1148 ◽  
Author(s):  
Alyn H. Morice ◽  
Eva Millqvist ◽  
Maria G. Belvisi ◽  
Kristina Bieksiene ◽  
Surinder S. Birring ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Task Force ◽  
Chemical Exposure ◽  
Hypersensitivity Syndrome ◽  
Opinion Leaders ◽  
Respiratory Medicine ◽  
European Respiratory Society ◽  
Oral Steroids ◽  
Cough Hypersensitivity Syndrome ◽  
High Degree

In 2011, a European Respiratory Society Task Force embarked on a process to determine the position and clinical relevance of the cough hypersensitivity syndrome, a disorder characterised by troublesome coughing often triggered by low levels of thermal, mechanical or chemical exposure, in the management of patients with chronic cough. A 21-component questionnaire was developed by an iterative process supported by a literature review. 44 key opinion leaders in respiratory medicine were selected and interviewed as to their opinions.There was a high degree of unanimity in the responses obtained, with all opinion leaders supporting the concept of cough hypersensitivity as a clinically useful paradigm. The classic stratification of cough into asthmatic, rhinitic and reflux-related phenotypes was supported. Significant disparity of opinion was seen in the response to two questions concerning the therapy of chronic cough. First, the role of acid suppression in reflux cough was questioned. Secondly, the opinion leaders were split as to whether a trial of oral steroids was indicated to establish a diagnosis of eosinophilic cough.The cough hypersensitivity syndrome was clearly endorsed by the opinion leaders as a valid and useful concept. They considered that support of patients with chronic cough was inadequate and the Task Force recommends that further work is urgently required in this neglected area.

Chronic cough and cough hypersensitivity syndrome

2016 ◽  
Vol 4 (12) ◽  
pp. 934-935 ◽  
Author(s):  
Kian Fan Chung ◽  
Lorcan McGarvey ◽  
Stuart Mazzone
Keyword(s):  
Chronic Cough ◽  
Hypersensitivity Syndrome ◽  
Cough Hypersensitivity Syndrome
Sign in / Sign up

Export Citation Format

Share Document