%0 Journal Article
%T The utility of the mannitol challenge in the assessment of chronic cough: a pilot study
%A Amisha Singapuri
%A Susan McKenna
%A Christopher E Brightling
%J Cough
%D 2008
%I BioMed Central
%R 10.1186/1745-9974-4-10
%X Chronic cough is the most common presenting symptom in primary care; is a significant cause of morbidity and a considerable health economic burden [1]. The need for objective outcome measures for cough has lead to the development of cough challenge tests to assess cough sensitivity [2], health status questionnaires [3] and most recently the development of cough monitors [4,5]. However, there remains debate over the clinical utility of these tests. Asthma is one of the commonest causes of cough [6] and therefore bronchial challenge is often included in the clinical investigations of patients with chronic cough. The mannitol challenge is a novel indirect bronchial challenge [7,8], which exerts an osmotic effect on the airway and consequently has the potential to lead to mast cell activation [9]. One of the early observations in the development of the mannitol challenge was that it has a tussive effect as has been reported for methacholine and histamine challenge tests [10]. Indeed asthmatics cough more than controls in response to manntiol and this effect is independent of bronchoconstriction [11]. Therefore the mannitol challenge has the potential to be used both to assess airway hyperrresponsiveness and cough sensitivity. We hypothesised that subjects with non-asthmatic chronic cough also have a heightened cough in response to mannitol and that this test may be a valid outcome measure in chronic cough. To test our hypothesis we examined the number of coughs induced by mannitol during a challenge and assessed the 1-week repeatability of this test in a group of healthy controls and subjects with non-asthmatic chronic cough.Subjects were recruited from hospital staff or from the respiratory clinics at Glenfield Hospital, Leicester, UK. Chronic cough was defined as a cough > 8 weeks as per American College of Chest Physician Guideline (ACCP) [12]. Healthy volunteers had no respiratory symptoms. All subjects had normal spirometry, were non-smokers and had < 10 pack year
%U http://www.coughjournal.com/content/4/1/10