Document Detail

Development of wheezing in patients with cough variant asthma during an increase in airway responsiveness.
MedLine Citation:
PMID:  10515405     Owner:  NLM     Status:  MEDLINE    
Two theories explaining the mechanism for the manifestation of cough without wheeze in patients with cough variant asthma (CVA) are either a higher wheezing threshold or a milder degree of airway hyperresponsiveness. A significant proportion of patients diagnosed as having CVA eventually develop wheezing. The aim of this study was to investigate whether this change in the manifestation of asthma was associated with a decrease in wheezing threshold and/or an increase in airway hyperresponsiveness. Thirty-six children (7-15 yrs) with CVA were prospectively studied for 4 yrs. Bronchial provocation tests with methacholine using the stepwise increasing concentration technique were performed annually to measure the provocative cumulative dose producing a 20% fall in forced expiratory volume in one second (PD20). Wheezing thresholds were additionally determined at the initiation of and the end of the study (development of wheezing, or after 4 yrs). Sixteen (Group 1) of 29 patients available for the follow-up developed clinical wheezing during the period; 13 patients (Group 2) stayed as CVA or their cough resolved. There was no significant change in wheezing thresholds from the initiation to the end of the study (Group 1: 40.9+/-8.2% versus 40.2+/-8.3%; Group 2: 41.4+/-7.1% versus 40.1+/-7.3%). Methacholine PD20 (geometric mean, range of 1 SD), expressed as breath unit (BU), significantly decreased in Group 1 patients as they developed wheezing (initial versus wheezing year: 60.8 BU, 29.2-126.5 versus 32.8 BU, 11.5-93.3; p<0.01), whereas the value did not change in Group 2 patients (initial versus after 4 yrs: 85.3 BU, 45.2-161.1 versus 84.3 BU, 39.7-179.1; NS). The results suggest that an increase in airway hyperresponsiveness, but not a decrease in wheezing threshold, may have a pathogenetic role in the development of wheezing during the course of cough variant asthma in childhood.
Y Y Koh; J H Jeong; Y Park; C K Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European respiratory journal     Volume:  14     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-11-19     Completed Date:  1999-11-19     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  302-8     Citation Subset:  IM    
Dept of Pediatrics, Seoul National University College of Medicine, Korea.
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MeSH Terms
Airway Resistance / physiology
Asthma / diagnosis,  physiopathology*
Bronchial Hyperreactivity / physiopathology*
Bronchial Provocation Tests
Cough / physiopathology*
Follow-Up Studies
Forced Expiratory Volume / physiology
Methacholine Chloride / diagnostic use
Prospective Studies
Respiratory Sounds / physiopathology*
Reg. No./Substance:
62-51-1/Methacholine Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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