Bronchial sensitivity and bronchial reactivity in children with cough variant asthma

被引:59
作者
Mochizuki, H [1 ]
Arakawa, H [1 ]
Tokuyama, K [1 ]
Morikawa, A [1 ]
机构
[1] Gunma Univ, Grad Sch Med, Dept Pediat & Dev Med, Maebashi, Gumma 371, Japan
关键词
allergy; pediatrics; pulmonary;
D O I
10.1378/chest.128.4.2427
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Cough variant asthma (CVA) is diagnosed in some children with chronic cough who do not have wheezing. However, the precise mechanism of CVA in children is unclear. Objective: To evaluate the physiologic differences in the airways of children with classic asthma and CVA, the methacholine dose-response curves of respiratory resistance (Rrs) were studied. Patients and methods: CVA was diagnosed in 31 children with chronic cough (age range, 5 to 14 years; 19 boys and 12 girls; mean age, 8.5 years) on the basis of methacholine inhalation challenge using an oscillation method. For comparison, the study included 86 age-matched children with classic asthma (age range, 5 to 15 years; 42 boys and 44 girls; mean age,. 9.5 years), 25 age-matched children with cough (age range, 5 to 15 years; 17 boys and 8 girls; mean age, 8.8 years), and 23 age-matched control subjects (8 boys and 15 girls; mean age, 9.2 years). Consecutive doses of methacholine were doubled until a 200% increase in Rrs from baseline was reached. The cumulative dose of methacholine at the inflection point of Rrs was considered to represent the bronchial sensitivity to inhaled methacholine (minimum dose of methacholine [Dmin]). The slope of the methacholine dose-response curve (SRrs), which was considered to represent bronchial reactivity, was measured from the increasing Rrs curve. Results: The values of Dmin in classic asthma patients and in CVA patients were significantly lower than those for cough patients and control subjects. There was no significant difference in the values of Dmin between the classic asthma and CVA patients. The value of SRrs in CVA patients was significantly lower than that in classic asthma patients, cough patients, and control subjects (p < 0.05, p < 0.01, and p < 0.01, respectively). There was no significant difference in the value of SRrs between classic asthma patients, cough patients, and control subjects. Conclusions: These data show that bronchial reactivity in the children with CVA was significantly lower than that in the children with classic asthma, and this specificity has an effect on prolonged cough without wheezing in children with CVA.
引用
收藏
页码:2427 / 2434
页数:8
相关论文
共 41 条
[1]   THE EXPERIMENTAL PRODUCTION OF COUGH IN HUMAN SUBJECTS INDUCED BY CITRIC ACID AEROSOLS - PRELIMINARY STUDIES ON THE EVALUATION OF ANTITUSSIVE AGENTS [J].
BICKERMAN, HA ;
BARACH, AL .
AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 1954, 228 (02) :156-163
[2]   AIRWAY INFLAMMATION IN NONASTHMATIC SUBJECTS WITH CHRONIC COUGH [J].
BOULET, LP ;
MILOT, J ;
BOUTET, M ;
STGEORGES, F ;
LAVIOLETTE, M .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 149 (02) :482-489
[3]   Airway hyperresponsiveness and cough-receptor sensitivity in children with recurrent cough [J].
Chang, AB ;
Phelan, PD ;
Sawyer, SM ;
Robertson, CF .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1997, 155 (06) :1935-1939
[4]   PREVALENCE OF ATOPY AND RANGE OF BRONCHIAL RESPONSE TO METHACHOLINE IN 7-YEAR-OLD AND 11-YEAR-OLD SCHOOLCHILDREN [J].
CLIFFORD, RD ;
RADFORD, M ;
HOWELL, JB ;
HOLGATE, ST .
ARCHIVES OF DISEASE IN CHILDHOOD, 1989, 64 (08) :1126-1132
[5]   BRONCHIAL REACTIVITY TO INHALED HISTAMINE - METHOD AND CLINICAL SURVEY [J].
COCKCROFT, DW ;
KILLIAN, DN ;
MELLON, JJA ;
HARGREAVE, FE .
CLINICAL ALLERGY, 1977, 7 (03) :235-243
[6]   CAPSAICIN INHALATION IN MAN AND THE EFFECTS OF SODIUM CROMOGLYCATE [J].
COLLIER, JG ;
FULLER, RW .
BRITISH JOURNAL OF PHARMACOLOGY, 1984, 81 (01) :113-117
[7]   CHRONIC COUGH AS THE SOLE PRESENTING MANIFESTATION OF BRONCHIAL-ASTHMA [J].
CORRAO, WM ;
BRAMAN, SS ;
IRWIN, RS .
NEW ENGLAND JOURNAL OF MEDICINE, 1979, 300 (12) :633-637
[8]   A longitudinal evaluation of bronchial responsiveness to methacholine in children: Role of baseline lung function, gender, and change in atopic status [J].
Forastiere, F ;
Corbo, CM ;
DellOrco, V ;
Pistelli, R ;
Agabiti, N ;
Kriebel, D .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1996, 153 (03) :1098-1104
[9]   Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma? [J].
Fujimura, M ;
Ogawa, H ;
Nishizawa, Y ;
Nishi, K .
THORAX, 2003, 58 (01) :14-18
[10]   THE ROLE OF THE METHACHOLINE CHALLENGE IN CHILDREN WITH CHRONIC COUGH [J].
GALVEZ, RA ;
MCLAUGHLIN, FJ ;
LEVISON, H .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1987, 79 (02) :331-335