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Cough

, 8:5

First Online: 14 September 2012Received: 15 May 2012Accepted: 07 September 2012

Abstract

BackgroundViral respiratory tract infection is the most frequent cause of acute cough and is reported at onset in about one third of patients with chronic cough. Persistent infection is therefore one possible explanation for the cough reflex hypersensitivity and pulmonary inflammation reported in chronic cough patients.

MethodsBronchoscopic endobronchial biopsies and bronchoalveolar lavage cell counts were obtained from ten healthy volunteers and twenty treatment resistant chronic cough patients 10 selected for lavage lymphocytosis. A screen for known respiratory pathogens was performed on biopsy tissue. Chronic cough patients also underwent cough reflex sensitivity testing using citric acid.

ResultsThere was no significant difference in incidence of infection between healthy volunteers and chronic cough patients p = 0.115 or non-lymphocytic and lymphocytic groups p = 0.404. BAL cell percentages were not significantly different between healthy volunteers and chronic cough patients without lymphocytosis. Lymphocytic patients however had a significantly raised percentage of lymphocytes p < 0.01, neutrophils p < 0.05, eosinophils p < 0.05 and decreased macrophages p < 0.001 verses healthy volunteers. There was no significant difference in the cough reflex sensitivity between non-lymphocytic and lymphocytic patients p = 0.536.

ConclusionsThis study indicates latent infection in the lung is unlikely to play an important role in chronic cough, but a role for undetected or undetectable pathogens in either the lung or a distal site could not be ruled out.

Trials registrationCurrent Controlled Trials ISRCTN62337037 and ISRCTN40147207

KeywordsBiopsy Bronchoalveolar lavage Bronchoscopy Cough Infection PCR Virus AbbreviationsANOVAAnalysis of variance

BALBronchoalveolar lavage

COPDChronic obstructive pulmonary disease

EBVEpstein-barr virus

HBoVHuman bocavirus

HCoVHuman coronovirus

hMPVHuman metapneumovirus

IBDInflammatory bowel disease

LRECLocal research ethics committee

NK1RNeurokinin-1 receptor

PHNPost herpetic neuralgia

PIVParainfluenza virus

RSVRespiratory syncytial virus

SEMStandard error of the mean

TGF-βTransforming growth factor beta

TRPV1Transient receptor potential cation channel subfamily V vanilloid 1

URTIUpper respiratory tract infection

VZVVaricella zoster virus.

Electronic supplementary materialThe online version of this article doi:10.1186-1745-9974-8-5 contains supplementary material, which is available to authorized users.

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Autor: Peter W West - Angela Kelsall - Samantha Decalmer - Winifred Dove - Paul W Bishop - James P Stewart - Ashley A Woodcock

Fuente: https://link.springer.com/



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