Non‐asthmatic eosinophilic bronchitis is characterized by proximal airway eosinophilic inflammation as compared with classic asthma and cough variant asthma

2021 ◽  
Author(s):  
Qingling Zhang ◽  
Wei Luo ◽  
Wenzhi Zhan ◽  
Jiaxing Xie ◽  
Hui Wang ◽  
...  
Keyword(s):  
Eosinophilic Inflammation ◽  
Cough Variant Asthma ◽  
Eosinophilic Bronchitis

European Respiratory Society guidelines on the diagnosis and treatment of chronic cough in adults and children

2021 ◽  
Vol 31 (4) ◽  
pp. 418-438
Author(s):  
A. H. Morice ◽  
E. Millqvist ◽  
K. Bieksiene ◽  
S. S. Birring ◽  
P. Dicpinigaitis ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Acid Reflux ◽  
Drug Dose ◽  
Diagnosis And Treatment ◽  
European Respiratory Society ◽  
Cough Variant Asthma ◽  
Eosinophilic Bronchitis ◽  
Highly Effective ◽  
Adults And Children ◽  
External Stimuli

These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus, adults with chronic cough now have a firm physical explanation for their symptoms based on vagal afferent hypersensitivity. Different treatable traits exist with cough variant asthma (CVA)/eosinophilic bronchitis responding to anti-inflammatory treatment and non-acid reflux being treated with promotility agents rather the anti-acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low-dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated, but in clinical experience they are limited by adverse events. Perhaps the most promising future developments in pharmacotherapy are drugs which tackle neuronal hypersensitivity by blocking excitability of afferent nerves by inhibiting targets such as the ATP receptor (P2X3). Finally, cough suppression therapy when performed by competent practitioners can be highly effective. Children are not small adults and a pursuit of an underlying cause for cough is advocated. Thus, in toddlers, inhalation of a foreign body is common. Persistent bacterial bronchitis is a common and previously unrecognised cause of wet cough in children. Antibiotics (drug, dose and duration need to be determined) can be curative. A paediatric-specific algorithm should be used.

Comparison of Clinical Characteristics and Responsiveness to Bronchodilator Between Cough Variant Asthma and Eosinophilic Bronchitis

CHEST Journal ◽  
2016 ◽  
Vol 149 (4) ◽  
pp. A550
Author(s):  
Fang Yi ◽  
Lina Han ◽  
Baojuan Liu ◽  
Wei Luo ◽  
Qiaoli Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cough Variant Asthma ◽  
Eosinophilic Bronchitis

scholarly journals Eosinophilic inflammation in cough variant asthma

1998 ◽  
Vol 11 (5) ◽  
pp. 1064-1069 ◽  
Author(s):  
A. Niimi ◽  
R. Amitani ◽  
K. Suzuki ◽  
E. Tanaka ◽  
T. Murayama ◽  
...  
Keyword(s):  
Eosinophilic Inflammation ◽  
Cough Variant Asthma

Cough Due to Asthma, Cough-Variant Asthma and Non-Asthmatic Eosinophilic Bronchitis

2010 ◽  
Vol 43 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Dhan Desai ◽  
Chris Brightling
Keyword(s):  
Cough Variant Asthma ◽  
Eosinophilic Bronchitis

scholarly journals The cough variant asthma

2020 ◽  
Vol 92 (3) ◽  
pp. 98-101
Author(s):  
M. O. Uryasjev ◽  
I. V. Ponomareva ◽  
M. F. Bhar ◽  
S. I. Glotov
Keyword(s):  
Chronic Cough ◽  
Airway Hyperresponsiveness ◽  
Airway Remodeling ◽  
Eosinophilic Inflammation ◽  
Cough Variant Asthma ◽  
Common Features ◽  
Variant Type

Cough variant asthma (CVA) was first described by W. Corrao. CVA was described as the isolated chronic cough as the only presenting symptom responsive to bronchodilator therapy.This phenotype of asthma is present with airway hyperresponsiveness, eosinophilic inflammation airways and bronchodilator responsive coughing without typical manifestation of asthma such as wheezing or dyspnea. CVA shares common features with classic asthma such as eosinophilic inflammation and airway remodeling. Because of that, CVA is clinically considered as a variant type of asthma.

scholarly journals ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

2019 ◽  
Vol 55 (1) ◽  
pp. 1901136 ◽  
Author(s):  
Alyn H. Morice ◽  
Eva Millqvist ◽  
Kristina Bieksiene ◽  
Surinder S. Birring ◽  
Peter Dicpinigaitis ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Acid Reflux ◽  
Drug Dose ◽  
Diagnosis And Treatment ◽  
Cough Variant Asthma ◽  
Eosinophilic Bronchitis ◽  
Highly Effective ◽  
Adults And Children ◽  
Wet Cough ◽  
External Stimuli

These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus, adults with chronic cough now have a firm physical explanation for their symptoms based on vagal afferent hypersensitivity. Different treatable traits exist with cough variant asthma (CVA)/eosinophilic bronchitis responding to anti-inflammatory treatment and non-acid reflux being treated with promotility agents rather the anti-acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low-dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated, but in clinical experience they are limited by adverse events. Perhaps the most promising future developments in pharmacotherapy are drugs which tackle neuronal hypersensitivity by blocking excitability of afferent nerves by inhibiting targets such as the ATP receptor (P2X3). Finally, cough suppression therapy when performed by competent practitioners can be highly effective. Children are not small adults and a pursuit of an underlying cause for cough is advocated. Thus, in toddlers, inhalation of a foreign body is common. Persistent bacterial bronchitis is a common and previously unrecognised cause of wet cough in children. Antibiotics (drug, dose and duration need to be determined) can be curative. A paediatric-specific algorithm should be used.

Toxocariasis associated with chronic cough in childhood: a longitudinal study in Hungary

2008 ◽  
Vol 82 (4) ◽  
pp. 357-363 ◽  
Author(s):  
O. Bede ◽  
Z. Szénási ◽  
J. Danka ◽  
K. Gyurkovits ◽  
D. Nagy
Keyword(s):  
Chronic Cough ◽  
Toxocara Canis ◽  
Inhaled Corticosteroid ◽  
Cough Variant Asthma ◽  
Eosinophilic Bronchitis ◽  
Eosinophil Cell ◽  
Airway Symptoms ◽  
Intractable Problem ◽  
Positive Effect

AbstractChronic cough lasting 8 weeks or more often seems to be an intractable problem in childhood. Toxocara infection is associated with an increased prevalence of airway symptoms and may be the possible aetiological agent of chronic cough. Of 425 children aged 2–17 years with chronic cough who were investigated for toxocariasis and the distribution of bronchial asthma (BA), cough variant asthma (CVA) and non-asthmatic eosinophilic bronchitis (NAEB), 136 (32%) were seropositive for Toxocara canis antigens. Ninety-three of the 136 were adequately assessed, diagnosed and followed up during 1 year. BA was diagnosed in 40%, CVA in 27% and NAEB in 33% of the children. The eosinophil cell count, serum T. canis IgG levels and symptoms are predictors of the improvement or the decline of the condition. Presuming the aetiopathogenetic role of T. canis in the inflammatory process of chronic cough, we treated the children not only with inhaled corticosteroid (ICS), but also with a 1-week course of anthelminthics. We could significantly decrease the dose of ICS in 23 (62%) of the 37 with BA. The administration of anthelminthics and the avoidance of sensitizers were sufficient for those with NAEB; none needed ICS. ICS therapy could be stopped 2–3 months later in 17 (68%) of the 25 with CVA. We found that 8 of the 25 with CVA (32%) presented asthmatic symptoms at the end of the 1-year period. In Hungary, T. canis may be a potential sensitizer for chronic cough in seropositive children. Deworming therapy will then alleviate the airway symptoms without exacerbation in patients with BA, and have a positive effect on those with NAEB and the majority of those with CVA.

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