持续性咳嗽患者的血浆物质P水平
2011/10/13
摘要
背景：动物模型显示物质P（SP）参与了咳嗽的致病过程。然而，这方面的人体试验研究报道较少，而且SP在临床咳嗽中的作用尚不清楚。
目的：阐明持续性咳嗽与患者血浆SP水平的相关性。
方法：对持续咳嗽至少3周的82名患者和15名健康对照者进行研究。患者分为哮喘性咳嗽（咳嗽变异性哮喘和主要症状为咳嗽的哮喘；n = 61）和非哮喘性咳嗽（n = 21：感染后咳嗽：n = 6；胃食管反流病性咳嗽：n = 5；原发性咳嗽：n = 5和其他：n = 5）。血浆SP水平采用ELISA法检测，利用乙酰甲胆碱检测气道高反应性（气道敏感性和气道反应性），以辣椒素检测咳嗽敏感性，检测痰液嗜酸性粒细胞和中性粒细胞水平和肺功能，分析血浆SP水平与气道高反应性、咳嗽敏感性、痰液嗜酸性粒细胞和中性粒细胞水平及肺功能之间的相关性。
结果：哮喘性和非哮喘性咳嗽患者的血浆SP水平均显著高于对照病例[分别为31.1 pg/ml (18.0-52.2)和30.0 pg/ml (15.1-50.3) vs. 15.4 pg/ml (11.3-23.7); p = 0.003和p = 0.038]，但是两个患者组之间无显著差异(p = 0.90)。血浆SP水平与哮喘性咳嗽患者气道敏感性（乙酰甲胆碱阈值剂量）相关(r = -0.37, p = 0.005)，但与两组患者的气道反应性、咳嗽敏感性、FEV1和痰液嗜酸性粒细胞及中性粒细胞计数无关。
结果：哮喘性和非哮喘性咳嗽患者的血浆SP水平均显著高于对照病例[分别为31.1 pg/ml (18.0-52.2)和30.0 pg/ml (15.1-50.3) vs. 15.4 pg/ml (11.3-23.7); p = 0.003和p = 0.038]，但是两个患者组之间无显著差异(p = 0.90)。血浆SP水平与哮喘性咳嗽患者气道敏感性（乙酰甲胆碱阈值剂量）相关(r = -0.37, p = 0.005)，但与两组患者的气道反应性、咳嗽敏感性、FEV1和痰液嗜酸性粒细胞及中性粒细胞计数无关。
Otsuka K, Niimi A, Matsumoto H, Ito I, Yamaguchi M, Matsuoka H, Jinnai M, Oguma T, Takeda T, Nakaji H, Chin K, Sasaki K, Aoyama N, Mishima M.
Source
Department of Respiratory Medicine, Kyoto University, Kyoto, Japan.
Department of Respiratory Medicine, Kyoto University, Kyoto, Japan.
Abstract
BACKGROUND: Substance P (SP) is involved in the pathogenesis of cough in animal models. However, few studies in humans have been reported and the roles of SP in clinical cough remain obscure.
OBJECTIVES: To clarify the relevance of plasma levels of SP in patients with persistent cough.
METHODS: We studied 82 patients with cough persisting for at least 3 weeks and 15 healthy controls. Patients were classified as having asthmatic cough (cough-variant asthma and cough-predominant asthma; n = 61) or nonasthmatic cough (n = 21; postinfectious cough, n = 6; gastroesophageal reflux disease, n = 5; idiopathic cough, n = 5, and others, n = 5). Correlations were evaluated between plasma SP levels as measured with ELISA and methacholine airway hyperresponsiveness (airway sensitivity and airway reactivity), capsaicin cough sensitivity, sputum eosinophil and neutrophil counts, and pulmonary function.
RESULTS: Plasma SP levels were significantly elevated in patients with both asthmatic and nonasthmatic cough compared with controls [31.1 pg/ml (range 18.0-52.2) and 30.0 pg/ml (range 15.1-50.3) vs. 15.4 pg/ml (range 11.3-23.7); p = 0.003 and p = 0.038, respectively] but did not differ between the two patient groups (p = 0.90). Plasma SP levels correlated with airway sensitivity (threshold dose of methacholine) in the patients with asthmatic cough (r = -0.37, p = 0.005) but not with airway reactivity, cough sensitivity, FEV(1) values, or sputum eosinophil and neutrophil counts in either group.
CONCLUSIONS: Increased levels of SP in plasma are associated with persistent cough in humans and might be related to airway sensitivity in asthmatic cough.
BACKGROUND: Substance P (SP) is involved in the pathogenesis of cough in animal models. However, few studies in humans have been reported and the roles of SP in clinical cough remain obscure.
OBJECTIVES: To clarify the relevance of plasma levels of SP in patients with persistent cough.
METHODS: We studied 82 patients with cough persisting for at least 3 weeks and 15 healthy controls. Patients were classified as having asthmatic cough (cough-variant asthma and cough-predominant asthma; n = 61) or nonasthmatic cough (n = 21; postinfectious cough, n = 6; gastroesophageal reflux disease, n = 5; idiopathic cough, n = 5, and others, n = 5). Correlations were evaluated between plasma SP levels as measured with ELISA and methacholine airway hyperresponsiveness (airway sensitivity and airway reactivity), capsaicin cough sensitivity, sputum eosinophil and neutrophil counts, and pulmonary function.
RESULTS: Plasma SP levels were significantly elevated in patients with both asthmatic and nonasthmatic cough compared with controls [31.1 pg/ml (range 18.0-52.2) and 30.0 pg/ml (range 15.1-50.3) vs. 15.4 pg/ml (range 11.3-23.7); p = 0.003 and p = 0.038, respectively] but did not differ between the two patient groups (p = 0.90). Plasma SP levels correlated with airway sensitivity (threshold dose of methacholine) in the patients with asthmatic cough (r = -0.37, p = 0.005) but not with airway reactivity, cough sensitivity, FEV(1) values, or sputum eosinophil and neutrophil counts in either group.
CONCLUSIONS: Increased levels of SP in plasma are associated with persistent cough in humans and might be related to airway sensitivity in asthmatic cough.
Respiration. 2011 Aug 12. [Epub ahead of print]
