Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • For authors
    • Instructions for authors
    • Submit a manuscript
    • Author FAQs
    • Open access
    • COVID-19 submission information
  • Alerts
  • Podcasts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • For authors
    • Instructions for authors
    • Submit a manuscript
    • Author FAQs
    • Open access
    • COVID-19 submission information
  • Alerts
  • Podcasts
  • Subscriptions

From the authors

B. P. Ponsioen, P. N. R. Dekhuijzen, A. M. Bohnen, N. A. Vermue
European Respiratory Journal 2005 26: 181-182; DOI: 10.1183/09031936.05.00034605
B. P. Ponsioen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
P. N. R. Dekhuijzen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A. M. Bohnen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
N. A. Vermue
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

We would like to thank F. Hargreave and K. Parameswaran for their suggestion that sputum eosinophils and the provocative dose causing a 20% fall in forced expiratory volume in one second (PD20) might reflect partially distinct pathophysiological phenomena 1.

In our study, we did not find a relationship between bronchial hyperresponsiveness (PD20) and the change from baseline of the cough score. This applied to smokers as well as nonsmokers (both p>0.80) 2.

The “increasing evidence” regarding the mechanism of eosinophilic bronchitis refers to small uncontrolled studies 3, 4 or studies in severely obstructive patients 5, 6. In the study by Pizzichine et al. 7, 44 adults (32 nonsmokers), with a daily bothersome cough for ≥1 yr, were included. None of the patients had sputum eosinophilia, and no effect was found of a 2-week treatment with budesonide compared with placebo.

Eosinophilic bronchitis occurs in 10–30% of patients referred to a specialist for chronic cough 8–10, and in 14 out of 82 (17%) primary care patients with cough (mean (range) duration 11 months (1–96)) 11. However, in a subset of 36 patients who responded to budesonide only, seven out of 34 (thus, not more than in the studies mentioned previously) fulfilled the criterion for sputum eosinophilia (>3%) 12.

Interestingly, in our study 2, as well as the study of Rytila et al. 12, cough appears to be at least as sensitive to anti-inflammatory therapy compared with other lower respiratory tract infection symptoms like wheeze and dyspnoea. Nevertheless, we agree with F. Hargreave and K. Parameswaran that the measurement of airway inflammation may help to clarify the mechanism of action of anti-inflammatory medications.

Cough may be a target symptom in studies of the mechanisms of anti-inflammatory treatment for lower respiratory tract symptoms in healthy subjects. The recent literature and the results of our study 2 suggest that investigation of sputum in nonsmoking patients, who present with unexplained cough to their doctor, is feasible and worthwhile.

    • © ERS Journals Ltd

    References

    1. ↵
      van Rensen ELJ, Straathof KCM, Veselic-Charvat MA, Zwinderman AH, Bel EH, Sterk PJ. Effect on inhaled steroids on airway hyperresponsiveness, sputum eosinophils, and exhaled nitric oxide levels in patients with asthma. Thorax 1999;54:403–408.
      OpenUrlAbstract/FREE Full Text
    2. ↵
      Ponsioen BP, Hop WC, Vermue NA, Dekhuijzen PN, Bohnen AM. Efficacy of fluticasone on cough: a randomised controlled trial. Eur Respir J 2005;25:147–152.
      OpenUrlAbstract/FREE Full Text
    3. ↵
      Gibson PG, Dolovich J, Denburg J, Ramsdale EH, Hargreave FE. Chronic cough: eosinophilic bronchitis without asthma. Lancet 1989;1:1346–1348.
      OpenUrlPubMedWeb of Science
    4. ↵
      Pavord ID, Brightling CE, Woltmann G, Wardlaw AJ. Non-eosinophilic corticosteroid unresponsive asthma. Lancet 1999;353:2213–2214.
      OpenUrlCrossRefPubMedWeb of Science
    5. ↵
      Pizzichini E, Pizzichini MM, Gibson P, et al. Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis. Am J Respir Crit Care Med 1998;158:1511–1517.
      OpenUrlCrossRefPubMedWeb of Science
    6. ↵
      Brightling CE, Monteiro W, Ward R, et al. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomized controlled trial. Lancet 2000;365:1480–1485.
      OpenUrl
    7. ↵
      Pizzichini MMM, Pizzichini E, Parameswaran K, et al. Non-asthmatic chronic cough: no effect of treatment with an inhaled corticosteroid in patients without sputum eosinophilia. Can Respir J 1999;6:323–330.
      OpenUrlPubMed
    8. ↵
      Brightling CE, Ward R, Goh KL, Wardlaw AJ, Pavord ID. Eosinophilic bronchitis is an important cause of cough. Am J Respir Crit Care Med 1999;160:406–410.
      OpenUrlCrossRefPubMedWeb of Science
    9. Carney IK, Gibson PG, Murree-Allen K, Saltos N, Olson LG, Hensley MJ. A systematic evaluation of mechanisms in chronic cough. Am J Respir Crit Care Med 1997;156:211–216.
      OpenUrlPubMedWeb of Science
    10. ↵
      Ayik SO, Basoglu OK, Erdinc M, et al. Eosinophilic bronchitis as a cause of chronic cough. Respir Med 2003;97:695–701.
      OpenUrlCrossRefPubMedWeb of Science
    11. ↵
      Rytila P, Metso T, Petays T. Eosinophilic airway inflammation as an underlying mechanism of undiagnosed prolonged cough in primary healthcare patients. Respir Med 2002;96:52–58.
      OpenUrlCrossRefPubMedWeb of Science
    12. ↵
      Rytila P, Metso T, Heikkinen K, Saarelainen P, Helenius IJ, Haahtela T. Airway inflammation in patients with symptoms suggesting asthma but with normal lung function. Eur Respir J 2000;16:824–830.
      OpenUrlAbstract/FREE Full Text
    PreviousNext
    Back to top
    View this article with LENS
    Vol 26 Issue 1 Table of Contents
    • Table of Contents
    • Index by author
    Email

    Thank you for your interest in spreading the word on European Respiratory Society .

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    From the authors
    (Your Name) has sent you a message from European Respiratory Society
    (Your Name) thought you would like to see the European Respiratory Society web site.
    CAPTCHA
    This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
    Print
    Alerts
    Sign In to Email Alerts with your Email Address
    Citation Tools
    From the authors
    B. P. Ponsioen, P. N. R. Dekhuijzen, A. M. Bohnen, N. A. Vermue
    European Respiratory Journal Jul 2005, 26 (1) 181-182; DOI: 10.1183/09031936.05.00034605

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero

    Share
    From the authors
    B. P. Ponsioen, P. N. R. Dekhuijzen, A. M. Bohnen, N. A. Vermue
    European Respiratory Journal Jul 2005, 26 (1) 181-182; DOI: 10.1183/09031936.05.00034605
    del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
    Full Text (PDF)

    Jump To

    • Article
      • References
    • Info & Metrics
    • PDF
    • Tweet Widget
    • Facebook Like
    • Google Plus One

    More in this TOC Section

    • Prevalence of pulmonary embolism on hospital admission in COVID-19 patients: Is there a role for pre-test probability scores and home treatment?
    • Asthma admissions during the COVID-19 pandemic
    • Defining optimal fluoroquinolone exposure against M. tuberculosis
    Show more Correspondence

    Related Articles

    Navigate

    • Home
    • Current issue
    • Archive

    About the ERJ

    • Journal information
    • Editorial board
    • Reviewers
    • CME
    • Press
    • Permissions and reprints
    • Advertising

    The European Respiratory Society

    • Society home
    • myERS
    • Privacy policy
    • Accessibility

    ERS publications

    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS books online
    • ERS Bookshop

    Help

    • Feedback

    For authors

    • Instructions for authors
    • Submit a manuscript
    • ERS author centre

    For readers

    • Alerts
    • Subjects
    • Podcasts
    • RSS

    Subscriptions

    • Accessing the ERS publications

    Contact us

    European Respiratory Society
    442 Glossop Road
    Sheffield S10 2PX
    United Kingdom
    Tel: +44 114 2672860
    Email: journals@ersnet.org

    ISSN

    Print ISSN:  0903-1936
    Online ISSN: 1399-3003

    Copyright © 2021 by the European Respiratory Society