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Cough hypersensitivity and suppression in COPD.

Peter S P Cho1,2, Hannah V Fletcher2, Irem S Patel2

  • 1Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, King's College London, London, UK.

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|December 11, 2020
PubMed
Summary
This summary is machine-generated.

Patients with chronic obstructive pulmonary disease (COPD) and chronic refractory cough (CRC) show heightened cough reflex sensitivity. However, only CRC patients struggle to suppress coughs, indicating different underlying mechanisms and the need for tailored management strategies.

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Area of Science:

  • Respiratory Medicine
  • Clinical Physiology
  • Pulmonology

Background:

  • Chronic refractory cough (CRC) is characterized by cough reflex hypersensitivity and impaired cough suppression.
  • The mechanisms of cough suppression and reflex hypersensitivity in chronic obstructive pulmonary disease (COPD) remain poorly understood.

Purpose of the Study:

  • To investigate cough suppression abilities in COPD patients during a cough challenge test.
  • To compare cough suppression and reflex hypersensitivity in COPD patients versus CRC patients and healthy individuals.
  • To determine if cough reflex hypersensitivity is linked to chronic cough in COPD.

Main Methods:

  • Capsaicin challenge tests were performed on COPD patients (n=27), CRC patients (n=11), and healthy subjects (n=13).
  • Participants attempted to self-suppress coughs during the tests, conducted over two visits.
  • Objective 24-h cough frequency was measured for COPD patients.

Main Results:

  • COPD patients with chronic cough exhibited heightened cough reflex sensitivity compared to those without chronic cough (p=0.003).
  • CRC patients also showed heightened cough reflex sensitivity versus healthy subjects (p<0.001).
  • COPD and healthy participants could suppress coughs, unlike CRC patients (p=0.922).

Conclusions:

  • Both COPD-chronic cough and CRC involve heightened cough reflex sensitivity.
  • Impaired cough suppression is specific to CRC, suggesting distinct pathophysiological mechanisms.
  • Disease-specific management strategies are necessary for different chronic cough conditions.