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The Cough Response to Inhaled Mannitol in Healthy Subjects
Hanna M Nurmi1,2, Anne M Lätti2, Heikki O Koskela3,4
1Division of Respiratory Medicine, Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.
Lung
|November 28, 2024
Summary
Healthy adults cough in response to inhaled mannitol, with females exhibiting a greater cough response than males. The cumulative dose-response (CDR) is a reliable measure for assessing cough reactivity to mannitol.
Area of Science:
- Respiratory Medicine
- Clinical Pharmacology
- Pulmonology
Background:
- Inhaled mannitol is known to induce bronchoconstriction and cough.
- Understanding the cough response to mannitol is crucial for its clinical application and interpretation.
Purpose of the Study:
- To characterize the cough response to inhaled mannitol in healthy adult subjects.
- To identify reliable indices for quantifying mannitol-induced cough.
Main Methods:
- 125 healthy adults underwent mannitol testing, with coughs recorded simultaneously and via video.
- Evaluated cumulative dose-response (CDR), provocative dose for 5 coughs, and maximal coughs per dose.
- Assessed repeatability by repeating the test in 26 subjects.
Main Results:
- Cumulative dose-response (CDR) demonstrated excellent repeatability (ICC=0.829).
- Females showed a significantly higher median CDR (2.53 coughs/100mg) compared to males (0.787 coughs/100mg) (p=0.002).
- Simultaneous and video assessments of CDR were highly correlated (ICC=0.985).
Conclusions:
- Females exhibit a greater cough response to mannitol than males.
- CDR is the most suitable index for quantifying mannitol-induced cough responsiveness.
- The mannitol cough response is repeatable, and cut-off limits for normal responses were established.
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