Clinical Autonomic Research

, Volume 2, Issue 6, pp 397–401 | Cite as

Tachyphylaxis to capsaicin-induced cough and its reversal by indomethacin, in patients with the sinobronchial syndrome

  • Masaki Fujimura
  • Yumie Kamio
  • Sayuri Sakamoto
  • Takuma Bando
  • Shigeharu Myou
  • Tamotsu Matsuda
Research Paper


Cough reflex testing with capsaicin has been used to study the pathophysiology of the cough reflex and the antitussive effects of various drugs. Although the reproducibility of capsaicin-induced cough has been well established in normal subjects, it is not known if prior challenge with capsaicin reduces the subsequent cough response to inhaled capsaicin in patients with the sinobronchial syndrome, a condition characterized by chronic upper and lower airway inflammation. Measurement of the capsaicin cough threshold, defined as the lowest concentration of capsaicin eliciting five or more coughs, was repeated four times at intervals of 15, 30 and 60 min in eleven patients with the SBS and ten normal subjects. The cough thresholds at 15, 30 and 60 min were greater than the initial value in patients with the SBS but not in normal subjects. In addition, we examined the effect of 4 days treatment with indomethacin (100 mg/day) on the cough thresholds measured twice at an interval of 15 min in eight patients with the SBS. Indomehacin increased the initial cough threshold and reduced the increment in the post-15 min cough threshold from the initial value compared with placebo, thus reducing the tachyphylaxis. These results indicate that chronic airway inflammation may be responsible for the decreased response (tachyphylaxis) to repeated inhalation of capsaicin, and suggest that cyclooxygenase products released by the airway inflammation may be involved in tachyphylaxis, cough receptor sensitivity to inhaled capsaicin, or both, in patients with the SBS.

Key words

Tachyphylaxis Capsaicin-induced cough Sinobronchial syndrome normal subjects Indomethacin 


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  1. 1.
    Fuller RW, Jackson DM. Physiology and treatment of cough.Thorax 1990;45: 425–430.PubMedGoogle Scholar
  2. 2.
    Coleridge HM, Coleridge JCG. Impulse activity in afferent vagal C-fibers with endings in the intrapulmonary airways of dogs.Respir Physiol 1977;29: 125–142.PubMedGoogle Scholar
  3. 3.
    Lundberg JM, Saria A. Capsaicin-induced desensitization of airway mucosa to cigarette smoke, mechanical and chemical irritants.Nature 1983;302: 251–253.PubMedGoogle Scholar
  4. 4.
    Collier JG, Fuller RW. Capsaicin inhalation in man and the effects of sodium cromoglycate.Br J Pharmacol 1984;81: 113–117.PubMedGoogle Scholar
  5. 5.
    Nichol G, Nix A, Barnes PJ, Chung KF. Prostaglandin F2α enhancement of capsaicin-induced cough in man: modulation byβ 2 adrenergic and anticholinergic drugs.Thorax 1990;45: 694–698.PubMedGoogle Scholar
  6. 6.
    Fujimura M, Sakamoto S, Kamio Y, Bando T, Kurashima K, Matsuda T. Effect of inhaled procaterol on cough receptor sensitivity to capsaicin in patients with asthma, chronic bronchitis and normal subjects.Thorax 1993 (in press).Google Scholar
  7. 7.
    McBride JT, Brooks JG. Sinobronchial syndrome.Ear Nose Throat J 1984;63: 177–179.PubMedGoogle Scholar
  8. 8.
    American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma.Am Rev Respir Dis 1987;136: 225–244.Google Scholar
  9. 9.
    Homma H, Yamanaka A, Tanimoto S, Tamura M, Chijimatsu Y, Kira S, Izumi T. Diffuse panbronchiolitis, a disease of the transitional zone of the lung.Chest 1983;83: 63–69.PubMedGoogle Scholar
  10. 10.
    Suzaki H, Ichimura K, Kudoh S, Sugiyama Y, Maeda H. Symposium II: sinobronchial syndrome and its related subjects: clinical observation in sinobronchial syndrome from a viewpoint of otorhinolaryngology.J Jpn Bronchoesophagol Soc 1987;38: 181–186.Google Scholar
  11. 11.
    Dodge RR, Burrows B. The prevalence and incidence of asthma and asthma-like symptoms in a general population sample.Am Rev Respir Dis 1980;122: 567–575.PubMedGoogle Scholar
  12. 12.
    Karlsson JA, Sant'Ambrogio G, Widdicombe J. Afferent neural pathways in cough and reflex bronchoconstriction.J Appl Physiol 1988;65: 1007–1023.PubMedGoogle Scholar
  13. 13.
    Boushey HA, Richardson JG, Widdicombe JG, Wise JC. The response of larnygeal afferent fibres to mechanical and chemical stimuli.J Physiol (Lond) 1974;240: 153–175.Google Scholar
  14. 14.
    Boushey HA, Richardson PS, Widdicombe JG. Reflex effects of larnygeal irritation of the pattern of breathing and total lung resistance.J Physiol (Lond) 1972;224: 501–513.Google Scholar
  15. 15.
    Bartlett D Jr, Jeffery P, Sant'Ambrogio G, Wise JCM. Location of stretch receptors in the trachea and bronchi of the dog.J Physiol (Lond) 1976;258: 409–420.Google Scholar
  16. 16.
    Jammes Y, Fornaris E, Mei SS, Barrat E. Afferent of efferent components of the bronchial vagal branches in cats.J Auton Nerv Syst 1982;5: 165–176.PubMedGoogle Scholar
  17. 17.
    Widdicombe JG. Receptors in the trachea and bronchi of the cat.J Physiol 1954;123: 71–104.PubMedGoogle Scholar
  18. 18.
    Sant'Ambrogio JM. Information arising from the tracheobronchial tree of mammals.Physiol Rev 1982;62: 531–569.PubMedGoogle Scholar
  19. 19.
    Fujimura M, Sakamoto S, Kamio Y, Matsuda T. Sex difference in the inhaled tartaric acid cough threshold in non-atopic healthy subjects.Thorax 1990;45: 633–634.PubMedGoogle Scholar
  20. 20.
    Fujimura M, Sakamoto S, Kamio Y, Matsuda T. Effects of methacholine-induced bronchoconstriction and procaterol-induced bronchodilation on cough receptor sensitivity to inhaled capsaicin and tartaric acid.Thorax 1992;47: 441–445.PubMedGoogle Scholar
  21. 21.
    Fujimura M, Ogawa H, Shibata K, Saito M, Yasui M, Nakatsumi Y, Matsuda T, Kamio Y, Sakamoto S. Involvement of intrinsic prostaglandins in cough receptor sensitivity: comparison between patients with asthma and sinobronchial syndrome and healthy subjects.Jpn J Dis Chest 1992;30: 56 (abstract).Google Scholar
  22. 22.
    Choudry NB, Fuller RW, Pride NB. Sensitivity of the human cough reflex: effect of inflammatory mediators prostaglandin E2, bradykinin, and histamine.Am Rev Respir Dis 1989;140: 137–141.PubMedGoogle Scholar
  23. 23.
    Nicholls MG, Gilchrist NL. Sulindac and cough induced by converting enzyme inhibitors.Lancet 1987;i: 872.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd. 1992

Authors and Affiliations

  • Masaki Fujimura
    • 1
  • Yumie Kamio
    • 2
  • Sayuri Sakamoto
    • 1
  • Takuma Bando
    • 1
  • Shigeharu Myou
    • 1
  • Tamotsu Matsuda
    • 1
  1. 1.The Third Department of Internal MedicineKanazawa University School of MedicineKanazawaJapan
  2. 2.The Central LaboratoryKanazawa University HospitalKanazawaJapan

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