Validation of the ERS standard citric acid cough challenge in healthy adult volunteers 英文参考文献.docVIP

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Validation of the ERS standard citric acid cough challenge in healthy adult volunteers 英文参考文献.doc

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Validation of the ERS standard citric acid cough challenge in healthy adult volunteers 英文参考文献

Wrightetal.Cough2010,6:8 /content/6/1/8 Cough RESEARCH OpenAccess ValidationoftheERSstandardcitricacidcough challengeinhealthyadultvolunteers CarolineEWright*?,JenniferJackson?,RachelLThompson,AlynHMorice Abstract Protocolsmeasuringcoughsensitivitycanvaryintermsofnebuliser,tussiveagent,singleanddoseresponse.A definitivemethodformeasuringcoughsensitivityneedstobeestablished. TheERSguidelinesrecommendtheKoKoDigiDoser(KD)deliverysystem.Studyaim,wastocomparethereprodu- cibilityofthiscitricacid(CA)coughchallengeandpreviouslyestablishedMefardosimeter(MD)protocol. 39(female26)volunteersmeanage(40.4yrs)wererandomisedtoeitherKDorMD.Intra-dayandinter-dayrepro- ducibilitywascompared. Wecalculatedtheconcentrationofcitricacidevoking2coughs(C2). ThegeometricmeanC2(95%CI)wassimilarforbothKDandMD,of263(200,339)mMand209(151,288)mM respectively. ThemeanKDC2wasnotsignificantlydifferent.(F=0.807,p=0.93)frombaselineover1,2,and4hrshowever, theMDdemonstratedsignificantvariability(F=7.85,P0.001) MeasuringmeanlogC2atbaselineandat2weeks,theKDdemonstratedastrongerintraclasscorrelationoflog C2atbaselinewith2weeklogC2,ICC=0.70thanwasshownwiththeMefar,ICC=0.41 AdministeringCAfromKDoffersareproduciblecoughchallengeinhealthyvolunteers.Theresultscorrelatewell withtheMDchallengebutoffergreaterintra-dayandinter-dayreproducibility. TrialRegistration:CurrentcontrolledtrialsISRCTBackground The tussive stimulus of citric acid has been used to Themethodologyofcitricacidcoughchallengewasfirst demonstratedifferencesincoughresponsebetweenthe reported in humans over 50 yrs ago [1]. It was devel- sexes [3,4] and has supported the efficacy of a number opedtoallowforthequantificationofcoughreflexsen- ofcoughmedicationsincludingopiates[5]anddiphen- sitivity and also as a tool for the assessment of hydramine [6]. We have previously demonstrated that antitussivetherapies.Sincethistimemanydifferentpro- the most widely used antitussive, dextromethorphan, tocolshavebeenpublishedandthe