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Coughing during mannitol challenge is associated with asthma.
Heikki O Koskela1, Liisa Hyvärinen, John D Brannan
1Department of Respiratory Medicine (Drs. Koskela and Hyvärinen), Kuopio University Hospital, Kuopio, Finland. heikki.koskela@kuh.fi
Chest
|June 11, 2004
Summary
Coughing during mannitol challenges is linked to asthma, not just a side effect. This finding helps in diagnosing asthma and assessing anti-inflammatory treatment effectiveness.
Area of Science:
- Respiratory Medicine
- Clinical Immunology
- Pulmonology
Background:
- Coughing is a common symptom in asthma.
- The mannitol challenge is used to assess bronchial hyperresponsiveness.
- The cause of coughing during mannitol challenges is not fully understood.
Purpose of the Study:
- To determine if coughing during a mannitol challenge is a nonspecific side effect or indicative of asthma.
- To investigate the association between coughing during mannitol challenge and asthma, independent of bronchoconstriction.
- To explore the utility of mannitol-induced cough in asthma diagnosis and treatment assessment.
Main Methods:
- Prospective study involving 37 steroid-naive asthmatic subjects and 10 healthy controls.
- Participants underwent spirometry, bronchial provocation tests (mannitol, histamine, cold air), and symptom questionnaires.
- Asthmatic subjects received budesonide treatment, with repeated measurements after 3 and 6 months to assess cough sensitivity and treatment effects.
Main Results:
- Asthmatic subjects exhibited significantly more coughing during mannitol challenge compared to healthy subjects (p < 0.0001).
- Coughing occurred even in asthmatic subjects who did not show bronchoconstriction, indicating an association independent of airway narrowing.
- Budesonide treatment reduced cough sensitivity and was linked to improvements in asthma symptoms, lung function (FEV1), and bronchial hyperresponsiveness.
Conclusions:
- Coughing during mannitol challenge is a specific indicator associated with asthma, not a general side effect.
- Mannitol-induced cough can serve as a tool to study asthmatic cough mechanisms.
- Measuring mannitol-provoked coughing may aid in asthma diagnosis and evaluating anti-inflammatory therapy efficacy.