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PURPOSE: An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients. METHODS: We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers. RESULTS: The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years. CONCLUSIONS: In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02591550
Subject(s)
Female , Humans , Male , Age Distribution , Asian People , Asthma , Capsaicin , China , Cough , Healthy Volunteers , Reflex , Sex DistributionABSTRACT
Objective To assess the effects of two different methods on differential cell count and the detection on inflammatory mediators in the process of induced sputum. Methods Induced sputum samples from outpatients with respiratory diseases were collected. Each sample was equally divided into two parts. One portion was processed at a regular way by incubation at 37 ℃ for 15 min in 0.1% dithiothreitol (DTT). Another was processed at 0 ℃ for 60 min in 0.1% DTT. The cell pellet was used for the cytology analysis by HE staining. The levels of IL-4,IL-5 and IL-8 were measured by Elisa Kit. Results Induced sputum was successfully collected from 20 subjects with chronic airway diseases ,including 7 males and 13 females . Total cell counts was lower in 0 ℃-incubated group than in 37 ℃-incubated group(P < 0.05). However,there was no difference in differential cell counts between two groups ,as well as the levels of IL-4 ,IL-5 and IL-8 in sputum supernatants(all P >0.05). Conclusions Except a difference in the total cell number ,there was no difference between two methods on the differential cell count and levels of certain inflammatory mediators.
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Objective To assess the effects of two different methods on differential cell count and the detection on inflammatory mediators in the process of induced sputum. Methods Induced sputum samples from outpatients with respiratory diseases were collected. Each sample was equally divided into two parts. One portion was processed at a regular way by incubation at 37 ℃ for 15 min in 0.1% dithiothreitol (DTT). Another was processed at 0 ℃ for 60 min in 0.1% DTT. The cell pellet was used for the cytology analysis by HE staining. The levels of IL-4,IL-5 and IL-8 were measured by Elisa Kit. Results Induced sputum was successfully collected from 20 subjects with chronic airway diseases ,including 7 males and 13 females . Total cell counts was lower in 0 ℃-incubated group than in 37 ℃-incubated group(P < 0.05). However,there was no difference in differential cell counts between two groups ,as well as the levels of IL-4 ,IL-5 and IL-8 in sputum supernatants(all P >0.05). Conclusions Except a difference in the total cell number ,there was no difference between two methods on the differential cell count and levels of certain inflammatory mediators.
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Objective To investigated the difference in induced sputum concentrations of mucin between the patients with eosinophilic bronchitis (EB) and classic asthma, and found out the difference in mechanism. Methods 20 patients with eosinophilic bronchitis (EB), 20 patients with classic asthma and 10 healthy controls were enrolled. Induced sputum levels of MUC5AC, MUC5B, LTC4 and PGE2 were measured by enzyme immunoassay in patients and healthy control. Results In patients with asthma, sputum MUC5A (26.8 ± 8.5)μg/mL and LTC4 (700.8 ± 172.3)pg/mL were significantly elevated whereas MUC5B levels (1.1 ± 0.5)μg/mL were reduced compared with patients with EB MUC5AC:( 17 . 6 ± 7 . 0 )μg/mL , LTC4:( 320 . 9 ± 89 . 4 ) pg/mL , MUC5B:(2.6 ± 0.5)μg/mL and healthy controls MUC5AC:(12.5 ± 4.3)μg/mL, LTC4:(91.2 ± 16.1)pg/mL, MUC5B:(2.6 ± 0.4)μg/mL (P < 0.01). PGE2 levels were higher in patients with EB (433.8 ± 118.1)pg/mL than in asthma(172.7 ± 74.5)pg/mL and controls(113.3 ± 18.3)pg/mL(P < 0.01), but results did not differ between asthma and controls. The LTC4 showed a significant positive correlation with MUC5AC (r = 0.785,P < 0.01), and a significant negative correlation with MUC5B (r = -0.703,P < 0.01). Conclusion A significant difference in MUC5AC/MUC5B ratio was founded in proximal airway between EB and asthma. The unbalance level between LTC4 and PGE2 would be involved in the pathogenesis of airway mucus hypersecretion.
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Cough is one of the most common symptoms of many respiratory diseases; the characteristics of intensity and frequency of cough sound offer important clinical messages. When using these messages, we have need to differentiate the cough sound from the other sounds such as speech voice, throat clearing sound and nose clearing sound. In this paper, based on Empirical Mode Decomposition (EMD) and Hidden Markov Model (HMM), we proposed a novel method to analyze and detect cough sound. Employing the property of adaptive dyadic filter banks of EMD, we gained the mean energy distribution in the frequency domain of the signals in order to analyze the statistical characteristics of cough sound and of other sounds not accompanied by cough, and then we found the optimal characteristics for the recognition using HMM. The experiments on clinical date showed that this optimal characteristic method effectively improved the detective rate of cough sound.
Subject(s)
Humans , Cough , Diagnosis , Diagnosis, Computer-Assisted , Methods , Markov Chains , Monitoring, Physiologic , Methods , Pattern Recognition, Automated , Methods , Sound , Sound Spectrography , MethodsABSTRACT
Objective To investigate the severity of cough in patients with different etiology of chronic cough and its related factors. Methods One hundred and fifty patients with chronic cough were recruited. The diagnosis of the patients was as follows: 24 cases with post nasal drip syndrome (PNDs), 26 cough variant asthma (CVA), 20 gastroesophageal reflux-induced cough (GERC), 31 eosinophilic bronchitis (EB), 30 atopic cough (AC) and 19 cough post infection (CPI). The severity of cough at daytime and night-time were scored by the doctor and the patient at the first visit. The correlation between cough score and age, gender and course duration of patients was analyzed. Results There was no significantly difference of cough score at daytime among different groups. Cough score at night in CVA group was significantly higher than that of other five groups (all P <0.01). Regression analysis showed that cough score at daytime was significantly correlated with age of patients (P < 0.05), while cough score at night was correlated significantly with gender (P < 0.01). Conclusion Cough severity at daytime in different etiology of chronic cough is similar, while that at night in patient with CVA is higher than that with other etiology.
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Objective To investigate the role of the cough reflex sensitivity and airway neurogenic inflammation in the pathogenesis of cough post infectious(CPI).Methods Capsaicin provocation test and sputum inducing were performed in 10 patients with CPI(CPI group)and 10 healthy subjects(normal control group)to detect the cough reflex sensitivity and neurokinin of sputum.Total and differential cells count of induced sputum was performed.Substance P(SP),neurokinin A(NKA),neurokinin B(NKB)and calcitonin gene-related peptide(CGRP)in the supernatant of induced sputum were measured.The expression of SP,neurokinin 1 receptor and NKA in sputum cells was detected.Results The cough threshold(lg C5)of CPI was significantly lower than normal(1.16?0.61 vs 2.64?0.28,P
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AIM: To explore the pathological features of airway inflammation in patients with eosinophilic bronchitis(EB) and compared to those with cough variant asthma(CVA).METHODS: Flexible fibre optic bronchoscopy was performed in 11 patients with EB,10 with CVA,14 with bronchial asthma and 10 normal controls.The mean thickness of the basement membrane was measured by light microscopy.Using immunohistochemical and special staining,the localization and density of inflammatory cells(eosinophils,mast cells,T lymphocytes) were detected in bronchial submucosa in EB and CVA patients.RESULTS: The mean thickness of the basement membrane was significantly increased in the subjects with EB [2.92 ?m(2.10-6.50 ?m)],CVA [5.64 ?m(3.23-8.48 ?m)] and bronchial asthma [9.08 ?m(6.61-11.99 ?m)] rather than that in the normal controls [2.08 ?m(1.62-3.40 ?m)].There were also significant differences among the three groups.The number of mast cells and eosinophils in the bronchial submucosal from subjects with EB [75 cells/mm~2(35-112 cells/mm~2),7 cells/mm~2(0-31(cells/mm~2))] was substantially decreased than those in subjects with CVA [148 cells/mm~2(34-200 cells/mm~2),114 cells/mm~2((1-768 cells/mm~2));P