Dilated intercellular space diameter as marker of reflux-related mucosal injury in children with chronic cough and gastro-oesophageal reflux disease

Although the aetiology of chronic cough in guidelines is clearly stated as asthma and related syndromes, gastro-oesophageal reflux disease (GORD), and upper airways disease, the inflammatory mechanisms underlying these conditions differ. Recent studies on asthma have increasingly focused on its molecular phenotypes instead of clinical characteristics. Here, we proposed the hypothesis that divides cough into two groups; the eosinophilic and neutrophilic. This division will enhance our ability to recognise the type of airway inflammation which, as a consequence will lead us to more targeted and personalized treatment approaches.

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Persistence of chronic cough in a community-based population

ERJ Open Research ◽

10.1183/23120541.00229-2019 ◽

2020 ◽

Vol 6 (2) ◽

pp. 00229-2019

Author(s):

Anne M. Lätti ◽

Juha Pekkanen ◽

Heikki O. Koskela

Keyword(s):

Reflux Disease ◽

Chronic Cough ◽

Mail Survey ◽

Oesophageal Reflux ◽

Community Based ◽

Oesophageal Reflux Disease ◽

Significant Impairment ◽

Baseline Factors ◽

E Mail

Chronic cough causes significant impairment in the quality of life and is often immune to treatment. Previous studies about its persistence have focused on patients managed in special cough clinics. Little is known about the persistence of chronic cough in unselected populations. In this prospective follow-up study, we investigated factors that predict the persistence of cough at 12-month follow-up in a community-based study of subjects with chronic cough.The first e-mail survey in 2017 included a questionnaire about current cough and its risk factors. The 264 subjects who reported chronic cough were sent a follow-up questionnaire 12 months later.The response rate was 77.7% (205 subjects), of whom 165 subjects (80.5%) still had cough in 2018. In multivariate analysis, the following baseline factors predicted the persistence of cough at 12 months; gastro-oesophageal reflux disease (adjusted OR (aOR) 5.02 (95% CI 1.10–22.83)), presence of a chemical trigger (aOR 2.88 (95% CI (1.20–7.00)), duration of cough more than 1 year (aOR 2.80 (95% CI 1.27–6.22)), frequent somatic symptoms (aOR 1.31 (95% CI 1.07–1.59)), and low number of family members (aOR 0.71 (95% CI 0.52–0.98)).In conclusion, most patients with chronic cough still suffer from cough 1 year later. The presence of gastro-oesophageal reflux disease is the main predictor for the persistence of cough.

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Defining the risk factors for acute, subacute and chronic cough: a cross-sectional study in a Finnish adult employee population

BMJ Open ◽

10.1136/bmjopen-2018-022950 ◽

2018 ◽

Vol 8 (7) ◽

pp. e022950 ◽

Cited By ~ 17

Author(s):

Anne M Lätti ◽

Juha Pekkanen ◽

Heikki O Koskela

Keyword(s):

Risk Factors ◽

Family History ◽

Reflux Disease ◽

Chronic Cough ◽

Respiratory Infections ◽

Oesophageal Reflux ◽

Acute Respiratory Infections ◽

Chronic Rhinitis ◽

Oesophageal Reflux Disease ◽

History Of

ObjectivesChronic cough is linked to various long-standing risk factors like asthma, chronic rhinitis and oesophageal reflux disease. On the contrary, acute and subacute cough are usually considered to be caused by acute respiratory infections. Little is known about the possible long-standing risk factors for acute and subacute cough. In this study, we have identified the long-standing risk factors for acute, subacute and chronic cough in order to identify the risk factors specifically associated with chronic cough.DesignA comprehensive 80-item questionnaire was sent via email to the participants.SettingA community-based study to all public service employees of two towns in central Finland.ParticipantsThere were 13 980 employees, of them 3697 responded (26.4%). Among the responders, there were 199 subjects with current daily acute cough (duration <3 weeks, prevalence 5.4%), 126 subjects with current daily subacute cough (duration 3–8 weeks, prevalence 3.4%) and 267 subjects with current daily chronic cough (duration >8 weeks, prevalence 7.2%).Primary outcome measuresThe risk factors that associated with each cough subtype. The subjects without any cough formed the reference group.ResultsSeveral risk factors were associated with both short and long cough subtypes namely family history of chronic cough, moisture damage exposure and number of reported somatic symptoms. Furthermore, allergy was associated with acute and subacute cough. Current asthma and chronic rhinitis were associated with subacute and chronic cough. Oesophageal reflux disease and advanced age were associated with chronic cough.ConclusionsThe specific risk factors for chronic cough were oesophageal reflux disease and advanced age. Acute and subacute cough should not be regarded merely as symptoms of acute respiratory infections but possible manifestations of long-standing risk factors. A new risk factor for all cough types was family history of chronic cough.

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