Analysis of bronchial biopsies in chronic cough

Abstract Background Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated w...

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Bibliographic Details
Published in:Respiratory medicine 2017-06, Vol.127, p.40-44
Main Authors: Macedo, Patricia, Zhang, Qingling, Saito, Junpei, Liang, Zhike, Ffolkes, Lorrette, Nicholson, Andrew G, Chung, Kian Fan
Format: Article
Language:English
Subjects:
Adult
Asthma
Asthma - complications
Basement Membrane - pathology
Biopsy
Biopsy - methods
Bronchi - pathology
Bronchial biopsies
Bronchitis
Bronchoscopy
Bronchoscopy - methods
Capsaicin
Capsaicin - administration & dosage
Capsaicin - adverse effects
Chronic cough
Chronic Disease
Cough
Cough - etiology
Cough - metabolism
Cough - pathology
Cough - physiopathology
Eosinophils - cytology
Eosinophils - pathology
Esophagus
Female
Gastroesophageal reflux
Gastroesophageal Reflux - complications
Goblet Cells - pathology
Humans
Hyperplasia
Infiltration
Inflammation
Leukocytes (eosinophilic)
Lymphocytes - cytology
Lymphocytes - pathology
Male
Medical diagnosis
Medical laboratories
Middle Aged
Neutrophils - cytology
Neutrophils - pathology
Patients
Pulmonary/Respiratory
Spirometry - methods
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Summary:Abstract Background Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated with chronic cough. Methods 100 consecutive patients referred to a specialist cough clinic underwent a systematic assessment including a fiberoptic bronchoscopy for bronchial biopsies. Results In 38 patients, treatment of associated causes led to amelioration of cough (‘explained’) and in 62, there was no association or improvement (‘idiopathic’). The latter group had a longer duration of cough, a lower FeNO levels and a more sensitive capsaicin cough response, with an increase in basement membrane thickness with no differences in goblet cell hyperplasia and seromucinous hyperplasia, and in lymphocyte, neutrophil and eosinophil counts. The duration of cough was inversely correlated with the degree of neutrophil infiltration. Conclusion We conclude that pathological examination of bronchial biopsies is unlikely to be useful in the diagnosis of chronic cough in non-smokers.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2017.04.001