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Thorax. Jan 2003; 58(1): 14–18.
PMCID: PMC1746464

Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?


Background: We have described a group of patients who present with isolated chronic bronchodilator resistant non-productive cough with an atopic constitution, eosinophilic tracheobronchitis, and airway cough receptor hypersensitivity without bronchial hyperresponsiveness, which we have termed "atopic cough". Although cough variant asthma (in which the cough responds to bronchodilators) is recognised as a precursor of typical asthma, it is not known whether atopic cough is also a precursor of asthma.

Methods: Eighty two patients with atopic cough were retrospectively examined for onset of typical asthma and compared with 55 patients with cough variant asthma (20 untreated patients and 35 treated with long term inhaled beclomethasone dipropionate (BDP), 218–467 µg/day). The median follow up period for patients with atopic cough and cough variant asthma was 4.8 (1–11.5) years and 3.7 (1–12.4) years, respectively.

Results: Onset of typical asthma occurred in only one of the patients with atopic cough. In patients with cough variant asthma, typical asthma developed in two of 35 patients taking BDP and six of 20 untreated patients (difference 24.3%, 95% CI 2.8 to 45.8, p<0.02).

Conclusions: These findings suggest that cough variant asthma is a precursor of typical asthma but that atopic cough is not. Treatment with inhaled steroids may prevent the transformation of cough variant asthma into typical asthma.

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Selected References

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  • Fujimura M, Sakamoto S, Matsuda T. Bronchodilator-resistive cough in atopic patients: bronchial reversibility and hyperresponsiveness. Intern Med. 1992 Apr;31(4):447–452. [PubMed]
  • Nishi K, Amemiya T, Mizuguchi M, Ooka T, Fujimura M, Matsuda T. [A case of chronic persistent cough caused by gastro-esophageal reflux]. Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Jun;33(6):652–659. [PubMed]
  • Fujimura M, Ogawa H, Yasui M, Matsuda T. Eosinophilic tracheobronchitis and airway cough hypersensitivity in chronic non-productive cough. Clin Exp Allergy. 2000 Jan;30(1):41–47. [PubMed]
  • Niimi A, Amitani R, Suzuki K, Tanaka E, Murayama T, Kuze F. Eosinophilic inflammation in cough variant asthma. Eur Respir J. 1998 May;11(5):1064–1069. [PubMed]
  • Corrao WM, Braman SS, Irwin RS. Chronic cough as the sole presenting manifestation of bronchial asthma. N Engl J Med. 1979 Mar 22;300(12):633–637. [PubMed]
  • Johnson D, Osborn LM. Cough variant asthma: a review of the clinical literature. J Asthma. 1991;28(2):85–90. [PubMed]
  • Braman SS, Corrao WM. Chronic cough. Diagnosis and treatment. Prim Care. 1985 Jun;12(2):217–225. [PubMed]
  • Gibson PG, Fujimura M, Niimi A. Eosinophilic bronchitis: clinical manifestations and implications for treatment. Thorax. 2002 Feb;57(2):178–182. [PMC free article] [PubMed]
  • Fujimura M, Sakamoto S, Kamio Y, Matsuda T. Sex difference in the inhaled tartaric acid cough threshold in non-atopic healthy subjects. Thorax. 1990 Aug;45(8):633–634. [PMC free article] [PubMed]
  • Fujimura M, Sakamoto S, Kamio Y, Matsuda T. Cough receptor sensitivity and bronchial responsiveness in normal and asthmatic subjects. Eur Respir J. 1992 Mar;5(3):291–295. [PubMed]
  • Cockcroft DW, Ruffin RE, Dolovich J, Hargreave FE. Allergen-induced increase in non-allergic bronchial reactivity. Clin Allergy. 1977 Nov;7(6):503–513. [PubMed]
  • Fujimura M, Songür N, Kamio Y, Matsuda T. Detection of eosinophils in hypertonic saline-induced sputum in patients with chronic nonproductive cough. J Asthma. 1997;34(2):119–126. [PubMed]
  • Fujimura M, Kamio Y, Hashimoto T, Matsuda T. Cough receptor sensitivity and bronchial responsiveness in patients with only chronic nonproductive cough: in view of effect of bronchodilator therapy. J Asthma. 1994;31(6):463–472. [PubMed]
  • Glauser FL. Variant asthma. Ann Allergy. 1972 Aug;30(8):457–459. [PubMed]
  • Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough in the adult: the spectrum and frequency of causes and successful outcome of specific therapy. Am Rev Respir Dis. 1981 Apr;123(4 Pt 1):413–417. [PubMed]
  • McGarvey LP, Heaney LG, Lawson JT, Johnston BT, Scally CM, Ennis M, Shepherd DR, MacMahon J. Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol. Thorax. 1998 Sep;53(9):738–743. [PMC free article] [PubMed]
  • Fujimura M, Sakamoto S, Kamio Y, Matsuda T. Effects of methacholine induced bronchoconstriction and procaterol induced bronchodilation on cough receptor sensitivity to inhaled capsaicin and tartaric acid. Thorax. 1992 Jun;47(6):441–445. [PMC free article] [PubMed]
  • Doan T, Patterson R, Greenberger PA. Cough variant asthma: usefulness of a diagnostic-therapeutic trial with prednisone. Ann Allergy. 1992 Dec;69(6):505–509. [PubMed]
  • Parks DP, Ahrens RC, Humphries CT, Weinberger MM. Chronic cough in childhood: approach to diagnosis and treatment. J Pediatr. 1989 Nov;115(5 Pt 2):856–862. [PubMed]
  • Cheriyan S, Greenberger PA, Patterson R. Outcome of cough variant asthma treated with inhaled steroids. Ann Allergy. 1994 Dec;73(6):478–480. [PubMed]
  • Gibson PG, Dolovich J, Denburg J, Ramsdale EH, Hargreave FE. Chronic cough: eosinophilic bronchitis without asthma. Lancet. 1989 Jun 17;1(8651):1346–1348. [PubMed]
  • Gibson PG, Zlatic K, Scott J, Sewell W, Woolley K, Saltos N. Chronic cough resembles asthma with IL-5 and granulocyte-macrophage colony-stimulating factor gene expression in bronchoalveolar cells. J Allergy Clin Immunol. 1998 Mar;101(3):320–326. [PubMed]
  • Brightling CE, Pavord ID. Eosinophilic bronchitis - what is it and why is it important? Clin Exp Allergy. 2000 Jan;30(1):4–6. [PubMed]
  • Fujimura M. Eosinophilic bronchitis is an important cause of chronic cough. Am J Respir Crit Care Med. 2000 May;161(5):1764–1765. [PubMed]
  • Brightling CE, Ward R, Wardlaw AJ, Pavord ID. Airway inflammation, airway responsiveness and cough before and after inhaled budesonide in patients with eosinophilic bronchitis. Eur Respir J. 2000 Apr;15(4):682–686. [PubMed]

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