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. 2021 Sep 6;21(1):284.
doi: 10.1186/s12890-021-01652-x.

Cough hypersensitivity in patients with metabolic syndrome: a clinical finding and its possible mechanisms

Jiafen Cheng #  1   2 , Zhuangli Xie #  3 , Shengyuan Wang #  4 , Siwan Wen  4 , Shanshan Niu  4 , Cuiqin Shi  4 , Li Yu  5 , Xianghuai Xu  6
Affiliations

Cough hypersensitivity in patients with metabolic syndrome: a clinical finding and its possible mechanisms

Jiafen Cheng et al. BMC Pulm Med. .

Abstract

Purpose: To investigate the changes of cough sensitivity in patients with metabolic syndrome and its possible mechanisms.

Method: A total of 29 metabolic syndrome (MetS) patients with OSAHS (group-1), 22 MetS patients without OSAHS (group-2), and 25 healthy controls (group-3) were included. All participants underwent a routine physical examination and completed the gastroesophageal reflux disease questionnaire (GerdQ), and the inflammatory mediator profile were determined. The cough threshold for capsaicin, induced sputum cell count and cell classification, and inflammatory mediators in induced sputum supernatants were compared. The correlation between capsaicin cough sensitivity and various indicators in the MetS population was analyzed.

Results: The minimum concentration of inhaled capsaicin needed to induce ≥ 5 coughs (C5) was significantly different among three groups (H = 14.393, P = 0.001) and lower for group-1 and group-2 than it for group-3 (P = 0.002, P = 0.005). The percentage of neutrophils in induced sputum and the concentrations of calcitonin gene-related peptide (CGRP), substance P (SP), and interleukin 8 (IL-8) in the sputum supernatant of group-1 and group-2 were significantly higher than those of group-3. Besides, the pepsin concentrations were significantly different among the 3 groups (F = 129.362, P < 0.001), which significantly was highest in group-1 (P < 0.001) and lowest in group-3 (P < 0.001). Triglycerides, AHI, pepsin concentration and BMI were risk factors of increased capsaicin cough sensitivity.

Conclusion: Increased capsaicin cough sensitivity in MetS patients is closely related to sleep apnea and gastroesophageal reflux. For patients in MetS patients without OSAHS, gastroesophageal reflux is an important factor for increased capsaicin cough sensitivity. Airway inflammation, especially airway neurogenic inflammation, may also play a role in the pathogenesis of increased capsaicin cough sensitivity. Trial registration The protocol was registered in the Chinese Clinical Trials Register ( http://www.chictr.org.cn/ ) (ChiCTR1800014768). Written informed consent was obtained from all participants before enrollment.

Keywords: Airway inflammation; Cough sensitivity; Gastroesophageal reflux disease; Metabolic syndrome; Obstructive sleep apnea–hypopnea syndrome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The inclusion process of the three groups of participants of MetS with OSAHS, MetS without OSAHS and healthy control group
Fig. 2
Fig. 2
The proportion of neutrophils (a) and macrophages (b) in induced sputum
Fig. 3
Fig. 3
Correlation between lgC5 and the AHI in the MetS with OSAHS group
See this image and copyright information in PMC

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