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The regulation effect and mechanism of respiratory syncytial virus (RSV) infection on the expression of tachykinin substance P (SP) in airway epithelial cells was investigated. The regulation of SP expression by RSV was investigated in the BEAS-2B airway epithelial cell line. RT-qPCR, immunofluorescence, and ELISA assay were used to examine the expression of the SP encoding gene TAC1, the intracellular SP protein expression, and the extracellular SP secretion. The mRNA expression of TAC1 and the intracellular SP protein level in BEAS-2B cells were significantly enhanced by RSV infection with multiplicity of infection (MOI) values of both 1 and 0.1 at 48 hours post infection. Heat-inactivated and UV-inactivated RSV, but not live RSV, significantly induced SP secretion in both control BEAS-2B cells and CX3CR1 receptor knockout cells without affecting the TAC1 gene expression or cell viability. RSV G protein (2–10 μg/ml) and fractalkine (10–50 ng/ml), both CX3CR1 receptor ligands, did not affect SP secretion in BEAS-2B cells. Inhibition of STAT1 phosphorylation by fludarabine (1 μM) markedly reduced the RSV-induced TAC1 gene expression and antagonized the inhibition of RSV replication by interferon-α in BEAS-2B cells. STAT1 participates in RSV infection-induced SP expression in airway epithelial cells. [ABSTRACT FROM AUTHOR]

Background An empirical therapy based on the clinical characteristics of cough had not been reported. We evaluated this strategy of empirical therapy on chronic cough. Methods Patients with chronic cough were initially diagnosed with corticosteroid-responsive cough ( CRC), postnasal drip syndrome ( PNDS) and gastroesophageal reflux-related cough ( GERC) based on their medical history and clinical presentation, and received a sequential three-step empirical therapy. A successful response was required for final diagnosis. Results A total of 96 patients were recruited with a median duration of cough for 4 months (range, 2-100). The primary diagnosis based on history and clinical presentation was CRC in 53 patients (55.2%), PNDS in 36 (37.5%) and GERC in 7 (7.3%). Cough improved in 60 patients (62.5%) at the first step with mean time of 6.2 ± 3.3 days. Three-step empirical therapy was beneficial in 78 of 96 (81.2%) patients at last. The final spectrum and frequency of causes of cough based on therapeutic response were as follows: CRC (46.7%), PNDS (27.5%) and GERC (10.8%). Eighteen cases (18.8%) were not responsive to empirical treatment, seven of whom were identified as other causes by diagnostic tests. Conclusions The empirical therapy aimed at primary diagnosis on the basis of history and clinical characteristics is a more targeted approach, and leads to improvement of chronic cough more quickly in most patients. CRC is the most common cause of chronic cough. [ABSTRACT FROM AUTHOR]

Chronic cough is a common refractory symptom of various respiratory diseases. However, the neural mechanisms that modulate the cough sensitivity and mediate chronic cough remain elusive. Here, we report that GABAergic neurons in the lateral/ventrolateral periaqueductal gray (l/vlPAG) suppress cough processing via a descending pathway. We found that l/vlPAG neurons are activated by coughing-like behaviors and that tussive agent-evoked coughing-like behaviors are impaired after activation of l/vlPAG neurons. In addition, we showed that l/vlPAG neurons form inhibitory synapses with the nucleus of the solitary tract (NTS) neurons. The synaptic strength of these inhibitory projections is weaker in cough hypersensitivity model mice than in naïve mice. Important, activation of l/vlPAG GABAergic neurons projecting to the NTS decreases coughing-like behaviors. In contrast, suppressing these neurons enhances cough sensitivity. These results support the notion that l/vlPAG GABAergic neurons play important roles in cough hypersensitivity and chronic cough through disinhibition of cough processing at the medullary level., Competing Interests: The authors declare no competing interests., (© 2021 The Author(s).)

Objective: To establish the method of cytological examination and the normal reference values for hypertonic saline solution-induced sputum of healthy children (age range from 5 to 15 years) with physical examination in Guangzhou., Method: A total of 352 children, 5 to 15 years old, were enrolled from primary school and middle school in Guangzhou from January to December, 2010. All subjects completed a standardized questionnaire on the presence of respiratory, allergic symptoms and family history, the medical history and the physical examination was performed by doctors, lung function (forced expiratory volume at 1 s in predicted normal, FEV(1)%) was determined. There were 266 healthy children (137 males, 129 females) who were selected and undergone hypertonic saline solution induction of sputum, and cytological examination was performed. Hypertonic saline (5%) was nebulized and inhaled for 15 - 30 min. No expectoration within 30 min was defined as failure, and the procedure was terminated. The part of opaque and higher density sputum samples was detected by cytology. The proportion of neutrophils, lymphocytes, eosinophils, macrophages and monocytes was calculated. This study was approved by the institutional Ethics Review Committee of First Affiliated Hospital of Guangzhou Medical College. Informed consent was obtained from the legal guardians of all participants following a detailed description of the purpose and potential benefits of the study., Result: There were 175 subjects' induced sputum specimens (175/266, 65.8%), non-qualified sputum samples were obtained from 16 of the subjects. The proportions of median (IQR) of lymphocytes were 0.012 (0.020), 95%CI were ranged from 0.015 to 0.022; neutrophils 0.207 (0.330), 95%CI 0.266 - 0.356 macrophages 0.761 (0.327), 95%CI 0.607 - 0.699; eosinophils 0.004 (0.019), 95%CI 0.013 - 0.022. There were no significant differences in proportions of cytological findings of female or male, different age groups and second-hand smoking or not (all P > 0.05). The incidence of adverse event was 4.40% (7/159)., Conclusion: The method and the preliminary data may be used for research, diagnosis and treatment of patients with chronic cough and airway inflammation.

Objective: To establish a guinea pig model of cough induced by human parainfluenza virus type 3 (PIV3) infection, and to investigate the change of the cough reflex sensitivity (CRS)., Methods: Sixty male SPF guinea pigs were divided into 6 groups (n=10, each), namely, a normal control group, an asthma group and 4 groups of PIV3 inoculation which included post-infection day (PID) 6, 12, 28, and 42. Infected animals were inoculated by intranasal instillation of PIV3 suspension. Control animals were inoculated by uninfected cell culture medium. Asthma animals were sensitized and challenged by ovalbumin. The Buxco system was used to assess cough reflex sensitivity (CRS) elicited by capsaicin and airway hyper-reaction (AHR). Airway inflammation was studied by bronchoalveolar lavage (BAL) cytology and lung histopathology., Results: The CRS of PID 6, 12, 28 and 42 groups was 7.50 (5.25), 7.30 (7.25), 8.40 (9.75) and 8.20 (5.50) Cough counts (CCnt). Compared with 2.50 (3.00) CCnt of the vehicle group, the CRS to capsaicin increased significantly in all the animals with PIV3 inoculation (P value were 0.024, 0.03, 0.011 and 0.008) and peaked in PID 42. There was no significant difference (P=0.18) between 3.90 (1.75) CCnt of the asthma animals and the normal control. Animals of PID 6 showed significantly greater AHR to 2 highest concentrations of methacholine than the normal controls. BAL total cell counts of both the PIV3-inoculated and the asthma animals were significantly higher than those of the normal control, with the number of lymphocytes increased significantly within first 2 weeks after PIV3 inoculation. The lung pathology of PIV3-inoculated animals showed airway inflammation without pneumonia in acute infectious phase., Conclusions: An animal model of cough induced by PIV3 was created. The CRS of infected guinea pigs increased significantly in both acute and subacute phases of cough. Elevation of CRS may be characteristic of cough caused by virus.

Objective: To observe the effect of repeated esophageal acid infusion on specific airway resistance (sRaw) and airway reactivity in the guinea pigs and explore the mechanism., Methods: sRaw and airway reactivity were measured by double-chamber plethysmography in normal control group (group N), saline control group (group NS), and repeated acid irrigation group (group H). The initial measurement was used as the baseline sRaw and airway reactivity (1d1), and 2 h after the initial measurement, sRaw and airway reactivity were measured again (1d2). Similarly, such measurements were repeated on the 15th day for all the guinea pigs (15d1, 15d2) with a 2-h interval. The content of Substance P (SP) and vasoactive intestinal peptide (VIP) in lung tissue, trachea, BALF and ganglion were detected by ELISA., Results: The percent change of sRaw, (15d2-1d1)/1d1 in group H was significantly higher than that in group N. The differences in the airway reactivity of the group N, group NS, and group H were not statistically significant. The SP content in the lung, trachea, ganglion and bronchoalveolar lavage fluid (BALF) in group H was significantly higher than those in group N. The SP content in ganglion showed a significant positive correlation to that in the trachea. No significant differences were found in the VIP content in the lung, trachea, ganglion or BALF between the groups., Conclusion: Repeated esophageal acid infusion increases the airway resistance, but not the airway reactivity in normal guinea pigs. SP may be involved in development of high sRaw through the esophageal-tracheobronchial reflex.

Objective: To evaluate whether the clinical characteristics of chronic cough were helpful in determining its specific causes., Methods: Patients with chronic cough were evaluated by a validated systematic diagnostic protocol. The patients with identified single cause were divided into 4 groups accordingly: cough-variant asthma (CVA), upper airway cough syndrome (UACS) or post-nasal drip syndrome (PNDS), eosinophilic bronchitis (EB), gastroesophageal reflux related cough (GERC), and the characteristics of the timing, character, onset and associated manifestations of chronic cough in different causes were compared., Results: A total of 196 patients met the inclusion criteria, including 55 with EB, 45 with UACS, 50 with CVA and 46 with GERC. No significant difference was found in age, gender and course among EB, UACS, CVA and GERC. The incidence of nocturnal cough in CVA was 26.0% (13/44), significantly higher than in EB (9.1% (5/55), chi2 = 5.272, P<0.05), UACS (2.2% (1/45), chi2 = 10.657, P<0.01) and GERC (0% (0/46), chi2 = 13.833, P<0.01). The specificity of nocturnal cough for CVA was 95.9%. The sensitivity and specificity of cough associated with meals in GERC was 52.2% (24/46) and 83.3%, and regurgitation associated symptom in GERC were 69.6% (32/46) and 80.0%, which were significantly higher than other groups. The incidence of postnasal drip, rhinitis associated symptom and case history of nasal diseases in UACS were 66.7% (30/45), 88.9% (40/45) and 82.2% (37/45), and the specificity of them were 89.4%, 65.6% and 63.6% respectively., Conclusion: The timing character and some associated symptoms of chronic cough are useful in predicting a single cause.

Objective: To establish a method for measurement of airway resistance (sRaw) and reactivity in guinea pigs., Methods: Methacholine spray at gradient concentrations was given to guinea pigs. PC100 was defined as the concentration of methacholine when the sRaw doubled in the guinea pigs using a double-chamber plethysmograph. The time for the recovery of PC100 resistance to baseline levels was measured. The sRaw and PC100 were measured twice on days 1 and 15 (4 time points) in the guinea pigs before and after OVA challenge., Results: PC100 in a normal guinea pig airway was shown to recover the baseline level within 1 h. Double-chamber plethysmographical measurement of the sRaw and PC100 in normal guinea pigs did not show significant differences between the time points [sRaw: 3.25-/+0.67, 3.33-/+0.58, 3.30-/+0.56, and 3.32-/+0.75 cm H2O.s; log2PC100: 8.48-/+0.94, 8.64-/+1.04, 8.56-/+0.67, and 8.64-/+0.60, respectively, P>0.05]. The sRaw and airway reactivity were significantly increased in guinea pigs challenged with OVA [sRaw: 7.08-/+1.82 vs 2.87-/+0.53 cmH2O.s, P<0.01; log2PC100: 6.64-/+1.26 vs 8.48-/+1.17, P<0.01]., Conclusion: A double-chamber plethysmography for measurement of sRaw and airway reactivity in guinea pig is established successfully.

Objective: To study the prevalence of cough and its risk factors in young college students in Guangzhou., Methods: Using a questionnaire with uniform scheme, a cluster-randomized sampling survey was conducted among young college students in Guangzhou. Fluoroscopy of chest was performed in subjects with persisted cough longer than 8 weeks., Results: There were 1087 cases with complete data from 1091 people including 648 males, 439 females with an average age of 21.16 years old. The total prevalence of cough was 10.9%. Difference in prevalence of cough between males and females showed no significance (10.3% vs. 11.9%, P > 0.05). There were also no significant differences between male and female in prevalence rates of acute cough (6.9% vs. 8.7%, P > 0.05) and chronic cough (3.4% vs. 3.2%, P > 0.05). Under chronic cough condition, cough was more likely to be the only or major symptom than under acute cough condition (77.8% vs. 44.6%, chi(2) = 11.166, P < 0.01). Nasal disease was an important risk factor to the development of chronic cough, which was found in 33.3% of the patients with chronic cough and when having chronic nasal diseases., Conclusion: Cough seemed a common disorder in young college student in Guangzhou and there was no significant difference in prevalence between males and females. Nasal disease was an important risk factor to chronic cough.

Objective: The spectrum and frequency of causes and the diagnostic protocol for chronic cough were explored., Methods: A total of 194 patients with at least 3 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of Guangzhou Institute of Respiratory Diseases between July 2003 to June 2004. The causes were investigated using a well-established protocol. The diagnostic protocol included history inquiring and physical examination, pulmonary function tests, induced sputum cell differentials, 24 h esophageal pH monitoring, CT of the paranasal sinuses or chest, fiberoptic rhinoscopy or bronchoscopy. The final diagnosis was made based on clinical manifestation, examination findings and a positive response to therapy., Results: The cause of chronic cough was defined in 95.4% of the patients, with a single cause found in 153 patients (82.7%), and multiple causes in 32 patients (17.3%). The five most important causes of cough were: eosinophilic bronchitis (n = 51, 22.4%), rhinitis and/or paranasal sinusitis (PNDs, n = 39, 17.1%), cough-variant asthma (n = 31, 13.6%), atopic cough (n = 28, 12.3%), and gastroesophageal reflux (n = 27, 11.8%)., Conclusions: The spectrum and frequency of causes of chronic cough in our study is different from the previous reports in western countries. Eosinophilic bronchitis and atopic cough are important causes of chronic cough. A modified diagnostic protocol was established accordingly.

Objective: To assess the application and the safety of capsaicin cough provocation test by dosimeter method., Methods: Capsaicin inhalation cough challenge test by dosimeter method was performed on 60 healthy volunteers (group A), 11 subjects with upper respiratory infection (group B), 10 patients with gastroesophageal reflux cough (group C) and 10 patients with asthma (group D). Each subject inhaled doubling concentrations of capsaicin (1.95, 3.90, 7.80, 15.6, 31.2, 62.5, 125, 250, 500, 1,000 micromol/L) by a breath-activated dosimeter until the concentration inducing five or more coughs (C(5)) was reached. The lg C(5) was calculated as the cough reflex sensitivity. General lung ventilation and impedance with impulse oscillometry were measured before and after the cough provocation test., Results: There was no serious side effect of the test in all subjects; two subjects complained of slight nausea; one of heartburn, and three of hoarseness. Before the provocation the values of FEV(1) in group A, B, C and D were (3.6 +/- 0.5) L, (3.7 +/- 0.7) L, (2.7 +/- 0.8) L and (2.1 +/- 0.8) L, compared with (3.6 +/- 0.5) L, (3.7 +/- 0.8) L, (2.6 +/- 0.7) L and (2.1 +/- 0.8) L after the test, the differences being not significant (all P > 0.05). Compared with the measurements after provocation, Zrs was (2.6 +/- 0.8) mm Hg.L(-1).s(-1) vs (2.7 +/- 0.8) mm Hg.L(-1).s(-1) in group A, (2.5 +/- 0.5) mm Hg.L(-1).s(-1) vs (2.6 +/- 0.3) mm Hg.L(-1).s(-1) in group B, (2.7 +/- 0.7) mm Hg.L(-1).s(-1) vs (2.7 +/- 0.7) mm Hg.L(-1).s(-1) in group C, (3.3 +/- 1.5) mm Hg.L(-1).s(-1) vs (3.7 +/- 2.0) mm Hg.L(-1).s(-1) in group D, the differences showed no significance (all P > 0.05 respectively). The lg C(5) value was 2.45 +/- 0.46 in group A, 2.51 +/- 0.20 in group B, 1.52 +/- 0.70 in group C, 2.34 +/- 0.56 in group D. Compared with group A, B and D, the lg C(5) value in group C was significantly different (all P < 0.01 respectively). The lg C(5) value showed no significant difference among group A, group B and group D (all P > 0.05)., Conclusion: Capsaicin inhalation cough provocation test by dosimeter method is a safe and specific tool for measuring cough reflex sensitivity.

Objective: To investigate the features of airway inflammation in patients with eosinophilic bronchitis (EB) by analyzing the inflammatory cells and mediators in induced sputum and bronchoalveolar lavage fluid (BALF)., Methods: Sputum induced by hypertonic saline aerosol inhalation was collected in 43 patients with EB (EB group), 20 patients with cough variant asthma (CVA, CVA group), 16 patients with bronchial asthma (asthma group) and 21 healthy controls (healthy group). Bronchoalveolar lavage was also performed in 11 patients with EB and 10 patients with CVA. Differential cell count was carried out in sputum and BALF. Levels of eosinophilic cationic protein (ECP), leukotriene C(4) (LTC(4)) and histamine in sputum and BALF were measured., Results: The percentage of sputum eosinophils (EOS) showed significant difference among the four groups; healthy group 0.0020 +/- 0.0050, EB group 0.1130 +/- 0.1470, CVA group 0.1900 +/- 0.1800, asthma group 0.3860 +/- 0.2670 (P < 0.01). The difference between asthma group and CVA group, and the difference between CVA group and EB group were significant (P < 0.05). The percentage of EOS in BALF was (0.011 +/- 0.016) in EB group, (0.053 +/- 0.040) in CVA group, the difference being significant (P < 0.05). The concentration of sputum ECP was (0.62 +/- 0.66) mg/L in EB group, (1.27 +/- 1.74) mg/L in CVA group, (0.07 +/- 0.10) mg/L in healthy group, the difference among the three groups being significant (P < 0.01). The difference of LTC(4) level was also significant when CVA group (0.65 +/- 0.62) microg/L was compared with EB group (0.39 +/- 0.61) microg/L (P < 0.05) and healthy group (0.15 +/- 0.11) microg/L (P < 0.01). The difference of histamine level in the supernatant of BALF was significant between CVA group (3.4 +/- 1.4) microg/L and EB group (1.6 +/- 1.5) microg/L (P < 0.05)., Conclusions: EOS infiltration is mainly localized to the central airway in EB, with lower airway levels of LTC(4) and histamine as compared to CVA. These inflammatory features may partly explain the absence of non-specific airway hyperresponsiveness in patients with EB.

Objective: To investigate the role of airway neurogenic inflammation in the pathogenesis of gastro-esophageal reflux induced cough (GERC)., Methods: Sputum was induced by hypertonic saline aerosol inhalation in 20 patients with GERC (GERC group), 10 healthy subjects (normal control group) and 8 patients with chronic cough due to other causes but complicated with gastro-esophageal reflux diseases (GERD, GERD group). Airway mucosal biopsy was performed in 6 patients with GERC and 4 patients with GERD using flexible fiberoptic bronchoscopy. The expression of substance P (SP), neurokinin 1 receptor and neurokinin A (NKA) in sputum cells and airway mucosa were detected by immunohistochemistry, and was assessed semi-quantitatively. SP, NKA, and NKB in the supernatant of induced sputum were measured with enzyme linked immunosorbent assay. Calcitonin gene-related peptide (CGRP) was measured with radioimmunoassay., Results: The concentration of SP in the supernatant of induced sputum was significantly higher in GERC group [(266 +/- 207) ng/L] than those in normal control group [(143 +/- 36) ng/L, P < 0.05] and GERD group [(130 +/- 11) ng/L, P < 0.05], and the sputum supernatant concentration of CGRP in GERC group [(180 +/- 83) ng/L] was significantly higher than those in normal control group [(105 +/- 64) ng/L, P < 0.01] and GERD group [(89 +/- 16) ng/L, P < 0.01]. The expression of SP, NK-1 receptor and NKA in induced sputum cells in GERC group were significantly higher than those in normal control group (P < 0.01, < 0.05, < 0.05) and GERD group (all P < 0.05); Expressions of SP in airway mucosa was significantly higher in GERC group than in GERD group (P < 0.01). After treatment, the concentration of CGRP in the supernatant of sputum in GERC patients was significantly lower than that before treatment (P < 0.05); the expression of SP, NK-1 and NKA in the induced sputum cells were significantly lower than that before treatment (P < 0.01, P < 0.01 or P < 0.05)., Conclusion: There is airway neurogenic inflammation in GERC patients, which maybe closely related to the development of GERC.

Objective: Gastro-esophageal reflux (GER) is an important etiological factor inducing chronic cough. This study aims to identify the clinical features for the diagnosis of GER induced cough (GERC)., Methods: A modified Irwin's diagnostic protocol and continuous 24-hour esophageal pH monitoring were performed in 50 patients with chronic cough. Twenty patients were diagnosed as having GERC. The clinical features were compared with those of non-GER (NGER) induced cough., Results: One hundred and ninety-two patients met the chronic cough criteria and were fully evaluated. The x +/- s of age was (40.6 +/- 12.1) years (range, 10 - 69 years) and 101 were males and 91 were females, with a cough history of 25 months (range, 2 - 487 months). GER accounted for 10.4% (n = 20) of the causes and was the fourth common cause of chronic cough. The mean +/- SD of age was (37.7 +/- 13.9) years (range, 10 - 60 years) in the GERC group, with a cough history of 61 months (range, 3 - 360 months). Cough associated with having meals (occurring while eating or anytime during the subsequent 2 h) was present in 13 out of the 20 patients in GERC, significantly higher than that in NGER (2 out of 23 patients) (chi2= 14.29, P < 0.01). The specificity, the positive predictive value and the sensitivity of cough associated with meals for GERC were 91.3%, 86.7% and 65.0%, respectively. Regurgitation associated symptom was present in 11 out of the 20 patients in the GERC group, not significantly different from that in the NGER group (8 out of 23 patients). Continuous 24 hour ambulatory esophageal pH measurement showed that reflux events were more common in upright [8.9 (range, 1.9 - 71.9)%] than in supine position [1.4 (range, 0 - 41.2)%] as well as at post-meal [20.2 (range, 2.1 - 84.2)%] than during meal period [1.95 (range, 0 - 51.6)%] (P < 0.01 and P < 0.05)., Conclusion: Cough associated with having meals is of diagnostic value for GERC. The reflux events are more frequent when patients are awake, with upright position and after meals.

Objective: To investigate inhibitory effect of serum severe acute respiratory syndrome (SARS) -specific antibodies from convalescent patients after half an year of onset on SARS-CoV-mediated cytopathic response., Methods: SARS-CoV immunoglobulin G (IgG) antibody was determined by enzyme linked immunoadsorbent assay (ELISA). Twelve serum samples from convalescent patients, diluted by 1:8 with maintenance medium, were mixed with the three dilution supernatants of SARS-CoV. SARS-CoV were isolated, cultured and identified by the Guangzhou Institute of Respiratory Disease, and cultured with Vero E6 cell suspension. The extent of cytopathic response was observed., Results: The absorbance (A) value of SARS-CoV IgG antibody ranged from 0.81 to 2.06 in patients after half an year of SARS onset, and form 0.79 to 2.01 in patients before half an year of SARS onset. The extent of cytopathic response was decreased by more than 25% in all 12 convalescent patients, as compared with control serum., Conclusion: The A value of SARS-CoV IgG antibody in serum of convalescent patients tended to elevate in half an year after SARS onset. SARS-CoV IgG antibody could inhibit SARS-CoV-mediated cytopathic response, indicating it might be one of protective antibodies.

Objective: To explore the spectrum and frequency of causes for chronic cough in Chinese patients., Methods: 86 patients with chronic cough were enrolled in the study. The diagnostic procedure was based on the anatomical protocol for diagnosing chronic cough designed by Irwin, and additional cytological assay was performed for sputum induced by hypertonic saline aerosol inhalation. The efficacy of therapy specific to the diagnosis was evaluated., Results: Definite diagnosis was made in 77 (89.5%) out of the 86 patients with chronic cough. The most common causes included cough variant asthma (CVA) (24/86, 27.9%), postnasal drip syndrome (PNDs) (22/86, 25.6%), eosinophilic bronchitis (EB) (13/86, 15.1%), and gastroesophageal reflux (GER) (12/86, 14.0%). After active management based on the diagnosis, cough improved in 72 patients (93.5%)., Conclusions: In addition to CVA, PNDs and GER, eosinophilic bronchitis is also an important cause of chronic cough. A positive response to the specific therapy is essential to a definite diagnosis.

Objective: To investigate the clinical features, diagnosis and management of gastroesophageal reflux induced cough (GERC)., Methods: The continuous ambulatory esophageal pH measurement was performed for 24 hour in 41 cases with chronic cough who had normal chest roentgenographic presentation, negative histamine provocation test and no abnormality of nasal cavity. The symptom association probability (SAP) was adopted to analyze the correlation of cough with gastroesophageal reflux. The anti-reflux treatment was given for 12 weeks to those patients with Demeester score >or= 14.72 and/or SAP >or= 75%., Results: Twenty six out of 41 cases were diagnosed as patients with gastroesophageal reflux. The cough was completely cured in 12 cases after antireflux treatment. The SAP of cough in this cured group (proximal probe 0.75 +/- 0.21, distal probe 0.91 +/- 0.12, respectively) was significantly higher than that of patients who failed in response to antireflux treatment (proximal probe 0.36 +/- 0.31, distal probe 0.47 +/- 0.30, respectively, P < 0.05)., Conclusion: The gastroesophageal reflux may be an independent factor which could induce chronic cough. Not only the frequency and severity of gastroesophageal reflux but also the SAP were helpful in making the diagnosis of GERC. Satisfied effect was achieved after sufficient anti-reflux treatment in patients with GERC.

Objective: To study the clinical features and airway inflammation in eosinophilic bronchitis (EB) and the treatment outcomes., Methods: Irwin's anatomic protocol for diagnosing chronic cough was used in 86 patients with chronic cough, and induced sputum by hypertonic saline aerosol inhalation was performed. Differential cell counts were performed in induced sputum, and eosinophilic cationic protein (ECP) was measured with fluoroimmunoassay, while interleukin-8 (IL-8) was measured with enzyme-linked absorbed immunoassay. EB was diagnosed according to Gibson's criteria and treated with inhaled budesonide 200 - 400 micro g twice daily for four weeks, and in some patients oral prednisone 10 - 15 mg/d or methyl-prednisone 8 - 12 mg/d was given for one week., Results: 13 (15%) out of 86 patients with chronic cough were diagnosed as having EB. Dry cough was the major compliant and all had normal lung function with negative histamine provocation test. The Eos count was 0.1862 +/- 0.1632 and the concentration of ECP (2.53 +/- 2.07) mg/L in induced sputum were significant higher in patients with EB as compared with those normal subjects (P < 0.01). The cough disappeared in all patients at the end of one week of inhaled or orally administered corticosteroids., Conclusion: EB, an eosinophilic airway inflammation, is one of important causes of chronic cough and responds well to corticosteroid therapy.