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Characteristics of different asthma phenotypes associated with cough: a prospective, multicenter survey in China

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机构: [1]Guangzhou Med Univ, Guangzhou Inst Resp Hlth, Natl Ctr Resp Med,Affiliated Hosp 1, Natl Clin Res Ctr Resp Dis,State Key Lab Resp Dis, 151 Yanjiang Rd, Guangzhou 510120, Peoples R China [2]Guangzhou Med Univ, Huizhou Peoples Hosp 3, Dept Pulm & Crit Care Med, Huizhou, Peoples R China [3]Guangzhou Med Univ, Affiliated Hosp 2, Guangzhou, Peoples R China [4]Dongguan Third Peoples Hosp, Dongguan, Peoples R China [5]Zhejiang Univ, Sch Med, Hosp 2, Hangzhou, Peoples R China [6]Guangzhou Univ Chinese Med, Clin Coll 2, Guangdong Prov Hosp Chinese Med, Guangdong Prov Acad Chinese Med Sci, Guangzhou, Peoples R China [7]First Peoples Hosp Yunnan Prov, Kunming, Yunnan, Peoples R China [8]Henan Univ Chinese Med, Affiliated Hosp 1, Zhengzhou, Peoples R China [9]Fourth Mil Med Univ, Xijing Hosp, Xian, Peoples R China [10]Hebei Med Univ, Hosp 2, Shijiazhuang, Hebei, Peoples R China [11]Sichuan Univ, West China Hosp, West China Sch Med, Chengdu, Peoples R China [12]Guizhou Prov Peoples Hosp, Dept Pulm & Crit Care Med, Guiyang, Peoples R China [13]Dongguan Peoples Hosp, Dongguan, Peoples R China [14]Qingdao Municipal Hosp, Qingdao, Peoples R China [15]Third Mil Med Univ Army, Army Med Univ, Xingiao Hosp, Chongqing, Peoples R China [16]Peoples Hosp Jiangmen, Jiangmen, Peoples R China [17]Tongji Univ, Sch Med, Tongji Hosp, Dept Pulm & Crit Care Med, Shanghai, Peoples R China [18]Second Peoples Hosp Shenzhen, Shenzhen, Peoples R China [19]Shenzhen Peoples Hosp, Shenzhen, Peoples R China [20]Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Shanghai, Peoples R China [21]Imperial Coll London, Natl Heart & Lung Inst, London, England [22]Royal Brompton & Harefield Fdn NHS Trust, London, England
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关键词: Asthma Cough predominant asthma Cough Cough sensitivity Airway inflammation

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Background Asthma is a heterogeneous disease with variable symptoms, which presents with cough either as the sole or predominant symptom with or without wheezing. We compared the clinical and pathophysiological characteristics of cough predominant asthma (CPA), cough variant asthma (CVA) and classic asthma (CA) in order to determine any differential phenotypic traits. Methods In 20 clinics across China, a total of 2088 patients were finally recruited, including 327 CVA, 1041 CPA and 720 CA patients. We recorded cough and wheezing visual analogue scale, Leicester cough questionnaire (LCQ) and asthma control test scores. Fractional exhaled nitric oxide (FeNO), induced sputum cell counts, and capsaicin cough challenge were also measured and compared. Results CPA patients more frequently presented with cough as the initial symptom, and laryngeal symptoms (p < 0.001), had less symptoms related with rhinitis/sinusitis and gastroesophageal reflux (p < 0.05) than CA patients. Comorbidities including rhinitis and gastroesophageal reflux were similar, while the proportion of COPD and bronchiectasis was higher in CA patients. There were no differences in FeNO levels, sputum eosinophil and neutrophil counts, FEV1 (%pred) decreased from CVA to CPA to CA patients (p < 0.001). Cough sensitivity was higher in CVA and CPA compared to CA (p < 0.001), and was positively correlated with LCQ scores. Conclusions CVA, CPA and CA can be distinguished by the presence of laryngeal symptoms, cough sensitivity and airflow obstruction. Asthma-associated chronic cough was not associated with airway inflammation or comorbidities in our cohort. Trial registration The Chinese Clinical Trial Registration Center, ChiCTR-POC-17011646, 13 June 2017

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大类 | 2 区 医学
小类 | 2 区 呼吸系统
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大类 | 2 区 医学
小类 | 2 区 呼吸系统
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第一作者机构: [1]Guangzhou Med Univ, Guangzhou Inst Resp Hlth, Natl Ctr Resp Med,Affiliated Hosp 1, Natl Clin Res Ctr Resp Dis,State Key Lab Resp Dis, 151 Yanjiang Rd, Guangzhou 510120, Peoples R China
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