Comparison of Clinical Characteristics and Pathophysiology of Cough Predominate Asthma and Noncough Predominate Asthma
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Kefang Lai
Rationale: Cough is a predominant symptom in some asthmatic patients (cough predominate asthma, CPA), while in the others ,wheeze is a predominant symptoms(non-cough predominate asthma, NCPA).It is little known about difference in clinical feature and pathophysiology of CPA and NCPA.We compare the difference in the clinical characteristics and pathophsiology between CPA and NCPA.

Methods: Asthmatic patients were enrolled and divided into CPA and NCPA. Questionnaires, spirometry, capsaicn cough challenge test, induced sputum test were performed in all patients. Cough severity was evaluated with visual analogue scale (VAS) and symptom score.

Results: A total of 227 patients with asthma were enrolled, with 131 CPA and 96 NCPA. The major troublesome symptoms were dyspnea (43.6%), wheeze (41.9%), cough (60.4%), chest distress (7.8%). The initial symptoms ranging from highest to lowest proportions were cough (57%), dyspnea (17.3%), wheeze (14.3%), chest distress (3.7%). Compared with NCPA, patients with CPA had higher VAS score (p<0.001) and Neu% (p=0.03) in sputum. However, There were no significant differences in Eos% (P=0.46), age, gender, duration and comorbidities  (AR, ST, GER and bronchiectasis) between CPA and NCPA. FEV1%pred, FEV1/FVC% and MMEF%pred were similar between two groups. There was a higher trend of cough hypersensitivity in CPA patients as compared with NCPA (64% vs. 36.4%, p=0.059).

Conclusions: Cough is the most common and disturbing symptom in asthmatic patients, and mostly presented as the initial symptom. Cough hypersensitivity and neutrophilic airway inflammation may contribute to the development of CPA. Further studies are needed for the mechanisms of CPA.