Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study

doi:10.1186/1745-9974-5-3

Cough

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Matsumoto H
Niimi A
Takemura M
Ueda T
Yamaguchi M
Matsuoka H
Jinnai M
Chin K
Mishima M

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Niimi A
Takemura M
Ueda T
Yamaguchi M
Matsuoka H
Jinnai M
Chin K
Mishima M
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Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study

Hisako Matsumoto¹ , Akio Niimi¹ , Masaya Takemura¹^,2 , Tetsuya Ueda¹^,2 , Masafumi Yamaguchi¹ , Hirofumi Matsuoka¹ , Makiko Jinnai¹ , Kazuo Chin³ and Michiaki Mishima¹

¹Department of Respiratory Medicine, Kyoto University, Kyoto, Japan

²Department of Respiratory Medicine, Kitano Hospital, Osaka, Japan

³Department of Respiratory Care and Sleep Control Medicine, Kyoto University, Kyoto, Japan

author email corresponding author email

Cough 2009, 5:3doi:10.1186/1745-9974-5-3


Published:	9 March 2009

Abstract

Background

Little is known regarding mechanistic and phenotypic differences between cough variant asthma (CVA), presenting with a chronic cough as the sole symptom that responds to bronchodilators, and classic asthma with wheezing during methacholine inhalation. Here we reported airway sensitivity, airway reactivity, and as the main concern, the appearance of cough and wheezes during methacholine inhalation in patients with CVA or classic asthma.

Methods

We cross-sectionally examined the degrees of airway sensitivity, the point where resistance started to increase, and reactivity, the slope of the methacholine-resistance curve, and the appearance of cough and wheezes in steroid-naïve adult patients with classic asthma (n = 58) or CVA (n = 55) while they were continuously inhaling methacholine during simultaneous measurement of respiratory resistance.

Results

Patients with CVA were less sensitive and less reactive to inhaled methacholine and wheezed less frequently but coughed more frequently during methacholine-induced bronchoconstriction than did patients with classic asthma. Multivariate analysis revealed that airway hypersensitivity and lower baseline FEV₁/FVC were associated with the appearance of wheezes, whereas a diagnosis of CVA was associated with coughing.

Conclusion

There are mechanistic and phenotypic differences between CVA and classic asthma during methacholine inhalation. Frequent coughing during bronchoconstriction may be a distinctive feature of CVA.