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Related Experiment Video

Updated: Dec 23, 2025

Establishment of a Mouse Model with Cough Hypersensitivity via Inhalation of Citric Acid
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Cough-provocation tests with hypertonic aerosols.

Heikki O Koskela1,2, Hanna M Nurmi1,2, Minna K Purokivi1

  • 1Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland.

ERJ Open Research
|April 28, 2020
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Summary
This summary is machine-generated.

Cough-provocation tests using hypertonic aerosols (CPTHAs) offer a safe and repeatable method to assess cough reflex sensitivity. The standardized mannitol test shows promise for routine clinical use in evaluating chronic cough and airway hyper-responsiveness.

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Area of Science:

  • Respiratory Medicine
  • Clinical Physiology
  • Diagnostic Testing

Background:

  • Cough hypersensitivity is increasingly recognized, necessitating reliable diagnostic tools.
  • Traditional cough-provocation tests (capsaicin, acidic aerosols) face limitations in standardization and clinical utility.
  • Hypertonic aerosol cough provocation tests (CPTHAs) present a potentially more practical alternative.

Purpose of the Study:

  • To evaluate the utility of CPTHAs in assessing cough reflex sensitivity and airway hyper-responsiveness.
  • To explore the clinical relevance of CPTHAs in differentiating patient groups and predicting outcomes.
  • To highlight the potential of standardized CPTHAs, like the mannitol test, for routine clinical application.

Main Methods:

  • Review of existing literature on cough-provocation tests, focusing on hypertonic aerosols.
  • Analysis of mechanisms, safety, repeatability, and clinical differentiation capabilities of CPTHAs.
  • Examination of the standardized mannitol test for airway hyper-responsiveness and its potential for cough reflex assessment.

Main Results:

  • CPTHAs are safe, well-tolerated, and repeatable, acting via distinct mechanisms from capsaicin/acidic aerosols.
  • CPTHAs effectively differentiate between individuals with asthma, chronic cough, and healthy subjects.
  • Responsiveness to CPTHAs correlates with quality of life in asthma and decreases with chronic cough treatment; severe responses may predict poor prognosis.

Conclusions:

  • CPTHAs offer a valuable tool for assessing cough reflex arc sensitivity and airway hyper-responsiveness.
  • The standardized mannitol test is suitable for clinical routine, enabling cough reflex measurement alongside airway hyper-responsiveness.
  • Wider adoption of CPTHAs, particularly the mannitol test, could enhance the clinical management of chronic cough and related respiratory conditions.