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Methods for Detecting Cough and Airway Inflammation in Mice
Published on: August 2, 2024
Children with chronic nonspecific isolated cough
Ozlem Yilmaz1, Arzu Bakirtas1, Hacer Ilbilge Ertoy Karagol1
1Department of Pediatric Allergy and Asthma, School of Medicine, Gazi University, Ankara, Turkey.
Insights
Most children with chronic nonspecific isolated cough (NIC) recover. However, a history of aeroallergen sensitization or chronic cough increases asthma risk. Inhaled corticosteroid (ICS) trials may guide treatment for these children.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Chronic nonspecific isolated cough (NIC) is common in children.
- Distinguishing between spontaneous resolution and the development of asthma is crucial.
- Understanding treatment responses in children who develop asthma is important.
Purpose of the Study:
- To identify clinical differences between children with NIC who spontaneously recover versus those who develop asthma.
- To explore differences in response to inhaled corticosteroids (ICS) among children who develop asthma.
Main Methods:
- Children with chronic NIC were managed with either a wait-and-review approach or a 2-week trial of inhaled budesonide.
- Responses were assessed using a validated cough score, with treatment extended to 8 weeks for partial responders.
- All children were followed up for a mean of 21 months.
Main Results:
- 71% of children experienced spontaneous cough resolution; 28% relapsed and responded to ICS, indicating asthma development.
- Aeroallergen sensitization and a history of chronic cough significantly increased asthma risk.
- Cough duration, cough score, family history of asthma, and serum eosinophilia did not predict the final diagnosis.
Conclusions:
- The majority of chronic NIC cases do not recur.
- Initial ICS response can be misleading; however, ICS trials are beneficial for children with atopic sensitization or a history of chronic cough.
- No significant differences were observed in treatment response duration between 2-week and 8-week ICS trials in children who developed asthma.
Background:
This study observed children with chronic nonspecific isolated cough (NIC) to investigate clinical differences between children whose symptoms resolved spontaneously and those who eventually developed asthma and then explored the differences among the children who eventually developed asthma in terms of their time of response to a trial of inhaled corticosteroid (ICS).
Methods:
Children with chronic NIC were managed either with a wait-and-review approach or with a 2-week trial with 400 μg/d inhaled budesonide according to the preference of their parents. Responses were monitored with a validated cough score. Treatment was prolonged to 8 weeks in the case of partial responders. All children were followed up at 3-month intervals.
Results:
A total of 109 children (median [interquartile range] age, 5 [3.5-9] years; cough duration, [8-16] weeks]) were followed for a mean (± SD) time of 21(± 5) months. Cough did not recur in 71% (spontaneous resolution) but relapsed in 28% of the children who later responded to ICS treatment again (asthma). Aeroallergen sensitization (relative risk, 2.86; 95% CI, 1.17-6.99) and previous history of chronic cough (relative risk, 2.68; 95% CI, 1.10-6.49) increased the risk of asthma. Cough duration, the cough score, the family history of asthma, and serum eosinophilia were not found discriminative for the final diagnosis. There were no differences among children who eventually developed asthma and responded to either the 2-week or 8-week trial in terms of the study parameters.
Conclusions:
Chronic NIC does not recur in the majority of children. Initial response to the ICS trial may be misleading but the trial may be preferred for children who have atopic sensitization, a previous history of chronic cough, or both .
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Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...