HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (15) Citing Articles via Google Scholar Google Scholar Articles by Lee, S. Y. Articles by In, K. H. Search for Related Content PubMed PubMed Citation Articles by Lee, S. Y. Articles by In, K. H.

Airway Inflammation as an Assessment of Chronic Nonproductive Cough^*

Sang Yeub Lee, MD; Jae Youn Cho, MD; Jae Jeong Shim, MD; Han Kyeom Kim, MD; Kyung Ho Kang, MD, FCCP; Se Hwa Yoo, MD and Kwang Ho In, MD

^* From the Pulmonary Division (Dr. Lee), the Department of Internal Medicine, College of Medicine, Konkuk University, Chungju, Korea; Korea University (Drs. Cho, Shim, Kang, Yoo, and In), Seoul, Korea; and the Department of Pathology (Dr. Kim), College of Medicine, Korea University, Seoul, Korea. Dr. Lee is currently at the Department of Internal Medicine, Pulmonary Division, Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Kyonggi-do, Korea.

Correspondence to: Kwang Ho In, MD, The Pulmonary Division, The Department of Internal Medicine, Korea University Anam Hospital 126–1, 5Ka, Anam-Dong, Sungbuk-Ku, Seoul, Korea, 136–075; e-mail: khin{at}ns.kumc.or.kr

Objectives: The possibility that a bronchial inflammatory process could be involved with a chronic nonproductive cough without other potential causes such as postnasal drip syndrome, bronchial asthma, gastroesophageal reflux, chronic bronchitis, bronchiectasis, or the use of angiotensin-converting enzyme inhibitors has not been clearly described. We investigated the possibility that a chronic nonproductive cough without other potential causes is associated with airway inflammation, and if this is so, what the relationship might be between this inflammation and the possible etiology of the cough.

Subjects: Twenty-five adults with chronic nonproductive cough as an isolated symptom over a 3-week period, and 5 healthy control subjects were studied.

Measurements and results: Clinical assessments, cough scores, methacholine challenges, allergy skin prick tests, and bronchoscopies for bronchial biopsies were performed. In the bronchial biopsies, the patients were divided into the following two subgroups: 21 patients who were infiltrated with eosinophils vs the healthy control group (median, 12.0 vs 0.0 cells/mm², respectively; p < 0.01); and 4 patients who were infiltrated with lymphocytes vs the healthy control group (median, 84.5 vs 22.0 cells/mm², respectively; p < 0.01). With the methacholine challenge test, 5 of the 21 eosinophil-infiltrated patients received diagnoses of cough-variant asthma, and the other 16 patients received diagnoses of eosinophilic bronchitis. In the lymphocyte-infiltrated group, all four patients received diagnoses of lymphocytic bronchitis.

Conclusions: These results suggest that a chronic nonproductive cough as an isolated symptom is associated with airway inflammation due to eosinophil and lymphocyte infiltration. The causes of the chronic nonproductive cough were eosinophilic bronchitis, cough-variant asthma, and lymphocytic bronchitis.

Key Words: airway inflammation • cough • cough-variant asthma • eosinophilic bronchitis • lymphocytic bronchitis

This article has been cited by other articles:

				R. S. Irwin, R. Ownbey, P. T. Cagle, S. Baker, and A. E. Fraire Interpreting the histopathology of chronic cough: a prospective, controlled, comparative study. Chest, August 1, 2006; 130(2): 362 - 370. [Abstract] [Full Text] [PDF]

				M. R. Pratter Unexplained (Idiopathic) Cough: ACCP Evidence-Based Clinical Practice Guidelines Chest, January 1, 2006; 129(1_suppl): 220S - 221S. [Abstract] [Full Text] [PDF]

				E. Mund, B. Christensson, R. Gronneberg, and K. Larsson Noneosinophilic CD4 Lymphocytic Airway Inflammation in Menopausal Women With Chronic Dry Cough Chest, May 1, 2005; 127(5): 1714 - 1721. [Abstract] [Full Text] [PDF]

				I. D. Pavord Chronic cough: a rational approach to investigation and management Eur. Respir. J., February 1, 2005; 25(2): 213 - 215. [Full Text] [PDF]

				S. S. Birring, D. Parker, C. E. Brightling, P. Bradding, A. J. Wardlaw, and I. D. Pavord Induced Sputum Inflammatory Mediator Concentrations in Chronic Cough Am. J. Respir. Crit. Care Med., January 1, 2004; 169(1): 15 - 19. [Abstract] [Full Text] [PDF]

				S S Birring, C E Brightling, F A Symon, S G Barlow, A J Wardlaw, and I D Pavord Idiopathic chronic cough: association with organ specific autoimmune disease and bronchoalveolar lymphocytosis Thorax, December 1, 2003; 58(12): 1066 - 1070. [Abstract] [Full Text] [PDF]