title: The relationship between the Leicester cough questionnaire, eosinophilic airway inflammation and asthma patient related outcomes in severe adult asthma.
abstract: Severe asthma is characterised by a variety of symptoms, which include chronic cough, however the mechanisms responsible for cough reflex hypersensitivity in asthma remain poorly elucidated. Current asthma patient-related outcome instruments such as the six-point Juniper Asthma Control Score (ACQ-6) and Asthma Quality of Life Questionnaire (AQLQ) were not primarily designed to capture cough and its related morbidity in asthma. The Leicester Cough Questionnaire (LCQ) is a patient-related outcome instrument designed to capture the health-related quality of life associated with cough. To date the LCQ has not been evaluated in a severe asthma population.
  
  
  
  We evaluated 262 extensively characterised adult patients with severe asthma attending the Leicester Severe Asthma Service. All patients had a clinician diagnosis of asthma and objective physiological evidence and met the ATS/ERS criterion for servere asthma. In all patients we evaluated a) the LCQ distribution and b) the relationships between the LCQ and ACQ-6, AQLQ, airway inflammation in sputum.
  
  
  
  The LCQ demonstrated the following properties; mean: 15.0, standard deviation: 4.54, median: 15.48, and range: 11.6-19.2. We found a moderate correlation between LCQ and ACQ-6 (r = - 0.605, p < 0.0001) and a LCQ and AQLQ (r = 0.710, p < 0.0001). There was no relationship between LCQ and log10sputum percentage eosinophils (%).
  
  
  
  A proportion of patients with severe asthma have a significant degree of cough-related morbidity that appears independent of eosinophilic airway inflammation and is not captured fully by existing asthma patient-reported outcome instruments. Our preliminary findings suggest that further research is now required to validate the LCQ and its responsiveness in severe asthma populations to capture cough-related morbidity and response to specific interventions.
authors.affiliation: Department of Infection, Immunity and Inflammation, NIHR Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK.
authors.forename: Sushiladevi
authors.initials: S
authors.lastname: Natarajan
authors.affiliation: Department of Infection, Immunity and Inflammation, NIHR Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Free
authors.affiliation: Department of Infection, Immunity and Inflammation, NIHR Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Bradding
authors.affiliation: Centre for Infection & Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Ireland.
authors.forename: Lorcan
authors.initials: L
authors.lastname: McGarvey
authors.affiliation: Department of Infection, Immunity and Inflammation, NIHR Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK. ss338@le.ac.uk.
authors.forename: Salman
authors.initials: S
authors.lastname: Siddiqui
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D003371:Cough / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000453:epidemiology*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Asthma; Cough