Could cough hypersensitivity symptom profile differentiate phenotypes of chronic cough?
Mi‐Yeong Kim, Ha‐Kyeong Won, Ji-Yoon Oh, Ji‐Hyang Lee, Eun‐Jung Jo, Sung‐Yoon Kang, Ji-Ho Lee, Seung‐Eun Lee, Noeul Kang, Young Chan Kim, Hwa Young Lee, Jin An, Youngsang Yoo, Ji‐Su Shim, So‐Young Park, Han‐Ki Park, Min‐Hye Kim, Sae‐Hoon Kim, Sang‐Heon Kim, Yoon‐Seok Chang, Sang‐Hoon Kim, Byung‐Jae Lee, Surinder S. Birring, Woo‐Jung Song
Abstract
Background: Recently, cough reflex hypersensitivity has been proposed as a common underlying feature of chronic cough in adults. However, symptoms and clinical characteristics of cough hypersensitivity have not been studied amongst phenotypes of chronic cough. This study aimed to compare symptom features, such as cough triggers and associated throat sensations, of cough hypersensitivity in patients with asthmatic chronic cough and those with refractory chronic cough (RCC). Methods: Patients with chronic cough from the Korean Chronic Cough Registry were prospectively evaluated over 6 months. Physicians determined the aetiological diagnosis based on clinical evaluations and responses to treatment at the 6-month follow-up visit. Symptoms of cough hypersensitivity and cough-specific quality of life were assessed using the Cough Hypersensitivity Questionnaire (CHQ) and the Leicester Cough Questionnaire (LCQ), respectively. Results: 8.9±3.9 in RCC; p=0.215, adjusted for age, sex and LCQ score). There were no significant between-group differences in the LCQ and cough severity Visual Analog Scale scores. Both groups showed a similar negative correlation with LCQ scores (asthmatic cough: r=-0.427, p<0.001; RCC: r=-0.306, p<0.001). Conclusions: The symptoms of cough hypersensitivity may not distinguish between asthmatic cough and RCC. This suggests that chronic cough is the primary diagnosis in both phenotypes. It indicates a shared mechanism in their cough pathogenesis, despite having potentially different treatable traits.