The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals.
Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced when applying the single breath inhalation method in similar groups of patients with symptoms related to odorous chemicals e.g. other persons wearing of perfume; and to investigate to what extent the reporting of lower airway symptoms influenced the cough reflex. Sixteen patients fulfilling Cullen's criteria for multiple chemical sensitivity and 15 eczema patients with airway symptoms elicited by odorous chemicals were compared with 29 age-matched, healthy controls. We measured C5--the capsaicin concentration causing five coughs or more--using the single breath inhalation test. No difference was found between groups in age, body mass index or pulmonary function. The median C5 were 129 micromol/L (control group), 48 micromol/L (multiple chemical sensitivity patients), 32 micromol/L (eczema patients). The reporting of lower airway symptoms from odorous chemicals was significantly (p<0.05) correlated to increased cough reflex sensitivity to capsaicin, independent of patient group or co-existence of asthma. The results suggest that the C5 is not reliable for diagnosing MCS but C5 can be used to verify presence of lower airway symptoms related to odorous chemicals.
The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Denmark.
H
H
Holst
L
L
Arendt-Nielsen
H
H
Mosbech
S
S
Vesterhauge
J
J
Elberling
D000328:Adult; D000393:Air Pollutants; D001985:Bronchial Provocation Tests; D002211:Capsaicin / Q000008:administration & dosage; D002212:Capsicum / Q000737:chemistry; D016022:Case-Control Studies; D003371:Cough / Q000209:etiology*; D004305:Dose-Response Relationship, Drug; D004485:Eczema / Q000503:physiopathology; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D016015:Logistic Models; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity / Q000175:diagnosis*; D009812:Odorants; D010936:Plant Extracts; D055549:Volatile Organic Compounds / Q000009:adverse effects*
D000393:Air Pollutants; D010936:Plant Extracts; D055549:Volatile Organic Compounds; D002211:Capsaicin