Atopic cough and fungal allergy.
We have shown that some patients presenting with chronic bronchodilator-resistant non-productive cough have a global atopic tendency and cough hypersensitivity without nonspecific bronchial hyperresponsiveness, abbreviated as atopic cough (AC). The cough can be treated successfully with histamine H1 antagonists and/or glucocorticoids. Eosinophilic tracheobronchitis and cough hypersensitivity are pathological and physiological characteristics of AC. Fungus-associated chronic cough (FACC) is defined as chronic cough associated with basidiomycetous (BM) fungi found in induced sputum, and recognition of FACC has provided the possibility of using antifungal drugs as new treatment strategies. Bjerkandera adusta is a wood decay BM fungus, which has attracted attention because of its potential role in enhancing the severity of cough symptoms in FACC patients by sensitization to this fungus. Before making a diagnosis of "idiopathic cough" in cases of chronic refractory cough, remaining intractable cough-related laryngeal sensations, such as "a sensation of mucus in the throat (SMIT)," which is correlated with fungal colonization, should be evaluated and treated appropriately in each patient. The new findings, i.e., the detection of environmental mushroom spores that should not be present in the human airways in addition to the good clinical response of patients to antifungal drugs, may lead to the development of novel strategies for treatment of chronic cough.
1 Division of Pulmonary Medicine, Ishikawa-ken Saiseikai, Kanazawa Hospital, Kanazawa 920-0353, Japan ; 2 Respiratory Medicine, National Hospital Organization Nanao Hospital, Nanao 926-8531, Japan ; 3 Ishikawa Prefectural Central Hospital, Respiratory Medicine, Kanazawa, Japan ; 4 Laboratory of Space and Environmental Medicine, Graduate School of Medicine and Graduate School of Medical Technology, Teikyo University, Itabashi-ku Tokyo, Japan.
Haruhiko
H
Ogawa
1 Division of Pulmonary Medicine, Ishikawa-ken Saiseikai, Kanazawa Hospital, Kanazawa 920-0353, Japan ; 2 Respiratory Medicine, National Hospital Organization Nanao Hospital, Nanao 926-8531, Japan ; 3 Ishikawa Prefectural Central Hospital, Respiratory Medicine, Kanazawa, Japan ; 4 Laboratory of Space and Environmental Medicine, Graduate School of Medicine and Graduate School of Medical Technology, Teikyo University, Itabashi-ku Tokyo, Japan.
Masaki
M
Fujimura
1 Division of Pulmonary Medicine, Ishikawa-ken Saiseikai, Kanazawa Hospital, Kanazawa 920-0353, Japan ; 2 Respiratory Medicine, National Hospital Organization Nanao Hospital, Nanao 926-8531, Japan ; 3 Ishikawa Prefectural Central Hospital, Respiratory Medicine, Kanazawa, Japan ; 4 Laboratory of Space and Environmental Medicine, Graduate School of Medicine and Graduate School of Medical Technology, Teikyo University, Itabashi-ku Tokyo, Japan.
Noriyuki
N
Ohkura
1 Division of Pulmonary Medicine, Ishikawa-ken Saiseikai, Kanazawa Hospital, Kanazawa 920-0353, Japan ; 2 Respiratory Medicine, National Hospital Organization Nanao Hospital, Nanao 926-8531, Japan ; 3 Ishikawa Prefectural Central Hospital, Respiratory Medicine, Kanazawa, Japan ; 4 Laboratory of Space and Environmental Medicine, Graduate School of Medicine and Graduate School of Medical Technology, Teikyo University, Itabashi-ku Tokyo, Japan.
Koichi
K
Makimura
Atopic cough (AC); Bjerkandera adusta; cough variant asthma (CVA); cough-related laryngeal sensations; fungus-associated chronic cough (FACC)