%0 Journal Article
%T Cough and dyspnea during bronchoconstriction: comparison of different stimuli
%A Thais R Suguikawa
%A Clecia A Garcia
%A Edson Z Martinez
%A Elcio O Vianna
%J Cough
%D 2009
%I BioMed Central
%R 10.1186/1745-9974-5-6
%X Twenty asthmatic patients underwent challenge tests with methacholine, bradykinin and exercise. Cough was counted during challenge tests. Dyspnea was assessed by modified Borg scale and visual analogue scale. Statistical comparisons were performed by linear mixed-effects model.For cough evaluation, bradykinin was the most potent trigger (p < 0.01). In terms of dyspnea measured by Borg scale, there were no differences among stimuli (p > 0.05). By visual analogue scale, bradykinin induced more dyspnea than other stimuli (p ¡Ü 0.04).Bradykinin seems to be the most suitable stimulus for bronchial challenge tests intended for measuring cough in association with bronchoconstriction.Cough is one of the most common symptoms in asthma patients, although little attention has been paid to its role in asthma diagnosis and follow-up. Some recent studies from Europe have suggested that cough provoked by inhalation challenges may be useful in diagnosing asthma [1,2], and also in evaluating the response to asthma treatment [3]. These studies support the concept that cough could be utilized as a surrogate for bronchoconstriction when studying patients likely to be unable to perform spirometry. However, the relationship between intensity of coughing and level of bronchoconstriction is still a matter of debate.Sheppard et al studied the relationship between cough and bronchoconstriction caused by inhaled distilled water aerosol in subjects with asthma. Atropine caused inhibition of the water-induced bronchoconstriction, but did not inhibit cough. Their data suggest that water-induced bronchoconstriction involves cholinergic nerves and that water-induced cough is not dependent on bronchoconstriction[4]. On the other hand, Koskela et al showed that direct, indirect, and combined airway challenges are able to provoke cough, but the significance of the cough response differs considerably among the challenge stimuli[2].Therefore, the utility of cough during bronchial challenges in diagnosin
%U http://www.coughjournal.com/content/5/1/6