Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study

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• 作者：Hisako Matsumoto (1)
  Akio Niimi (1)
  Masaya Takemura (1) (2)
  Tetsuya Ueda (1) (2)
  Masafumi Yamaguchi (1)
  Hirofumi Matsuoka (1)
  Makiko Jinnai (1)
  Kazuo Chin (3)
  Michiaki Mishima (1)
  
• 刊名：Cough
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：5
• 期：1
• 全文大小：177KB
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• 作者单位：Hisako Matsumoto (1)
  Akio Niimi (1)
  Masaya Takemura (1) (2)
  Tetsuya Ueda (1) (2)
  Masafumi Yamaguchi (1)
  Hirofumi Matsuoka (1)
  Makiko Jinnai (1)
  Kazuo Chin (3)
  Michiaki Mishima (1)
  
  1. Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
  2. Department of Respiratory Medicine, Kitano Hospital, Osaka, Japan
  3. Department of Respiratory Care and Sleep Control Medicine, Kyoto University, Kyoto, Japan
  

文摘

Background Little is known regarding mechanistic and phenotypic differences between cough variant asthma (CVA), presenting with a chronic cough as the sole symptom that responds to bronchodilators, and classic asthma with wheezing during methacholine inhalation. Here we reported airway sensitivity, airway reactivity, and as the main concern, the appearance of cough and wheezes during methacholine inhalation in patients with CVA or classic asthma. Methods We cross-sectionally examined the degrees of airway sensitivity, the point where resistance started to increase, and reactivity, the slope of the methacholine-resistance curve, and the appearance of cough and wheezes in steroid-na?ve adult patients with classic asthma (n = 58) or CVA (n = 55) while they were continuously inhaling methacholine during simultaneous measurement of respiratory resistance. Results Patients with CVA were less sensitive and less reactive to inhaled methacholine and wheezed less frequently but coughed more frequently during methacholine-induced bronchoconstriction than did patients with classic asthma. Multivariate analysis revealed that airway hypersensitivity and lower baseline FEV1/FVC were associated with the appearance of wheezes, whereas a diagnosis of CVA was associated with coughing. Conclusion There are mechanistic and phenotypic differences between CVA and classic asthma during methacholine inhalation. Frequent coughing during bronchoconstriction may be a distinctive feature of CVA.