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Unexplained chronic cough and vitamin B-12 deficiency
Caterina B Bucca1, Beatrice Culla, Giuseppe Guida
1Department of Clinical Pathophysiology, University of Turin, Turin, Italy. caterina.bucca@unito.it
The American Journal of Clinical Nutrition
|January 21, 2011
Summary
Vitamin B-12 (cobalamin) deficiency contributes to chronic cough by causing sensory neuropathy. Supplementation improved cough symptoms and nerve function in deficient patients.
Area of Science:
- Neurology
- Pulmonology
- Nutritional Science
Background:
- Chronic cough is often linked to sensory neuropathy.
- Vitamin B-12 (cobalamin) deficiency (Cbl-D) is known to cause nervous system damage, potentially affecting sensory pathways.
Purpose of the Study:
- To investigate the potential role of Vitamin B-12 deficiency in chronic, unexplained cough.
- To assess if cobalamin supplementation can alleviate symptoms in patients with chronic cough and Cbl-D.
Main Methods:
- Assessed laryngeal, bronchial, and cough hypersensitivity to histamine in 42 patients with chronic cough (27 Cbl-D, 15 Cbl-N).
- Evaluated oropharyngeal biopsies for epithelial thickness and nerve fiber density before and after 2 months of cobalamin treatment.
- Measured nerve growth factor (NGF) expression in biopsies.
Main Results:
- Cbl-D patients exhibited higher laryngeal hyperresponsiveness (92.6% vs. 66.7%) and thinner oropharyngeal epithelium compared to Cbl-N patients.
- Cbl-D patients showed reduced myelinated nerve fibers and increased NGF expression in pharyngeal biopsies.
- Cobalamin supplementation significantly improved cough symptoms and airway hyperresponsiveness in Cbl-D patients, but not in Cbl-N patients.
Conclusions:
- Vitamin B-12 deficiency may contribute to chronic cough by promoting sensory neuropathy, evidenced by laryngeal hyperresponsiveness and elevated NGF.
- Cbl-D should be considered a contributing factor in chronic cough, especially when underlying triggers are unclear.
- Cobalamin therapy shows promise for managing chronic cough associated with Vitamin B-12 deficiency.
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