| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2003: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 2002: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Research Abstract |
The cough sensitivity was measured in patients with globus sensation of the pharynx (14patients) and with laryngeal granuloma (5patients) after taking a history regarding gastro-esophageal reflux and laryngeal inspection : Capsaicin, cough inducing substance, was prepared in the concentration of 0 0.98,1.95,3.9,7.8,15.6,31.2,62.5,125,250 μ mol/l. The patients were inhalated with capsaicin solution in turn from the lowest concentration. Capsaicin concentration producing cough in globus sensation patients was 6.8μmol/l in average and it was lower than that in the control group of 11.2 μmol/l. This might indicate that the cough sensitivity was increased in patients with globus sensation but there was no statistical difference with normal control. After two week administration of proton pump inhibitor (PPI), their globus sensation was disappeared in 8 out of 14 patients, and chronic cough decreased in 2 out of 5 patients. Capsaicin concentration elevated from 6.8 to 8.5μmol/l after PPI tre
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atment. Out of 8 patients who improved their globus sensation, 5 patients revealed the decrease in cough sensitivity after PPI treatment. Two out of 6 patients who did not show any symptomatic change slightly decreased their cough sensitivity. All 5 patients with laryngeal granuloma showed a great improvement in the size of granuloma after 3 month PPI treatment. Twenty-four_hours pH monitoring revealed, that the reflux period under pH 4 was 2 minutes and the period under pH 5 was 38 minutes and sensitivity decreased from 3.9 to 7.8. The results that PPI treatment diminished the globus sensation suggest that the gastro-esophageal reflux participates in the generation of globus sensation of the pharynx and elevation of cough sensitivity. Immunohistochemical study in rats revealed that only a few fibers were stained by antibody against capsaicin receptor (vanilloid receptor) in the laryngeal mucosa. This may indicates that the nociceptive sensory fibers relating cough production by capsaicin is transmitted by other neuropeptides like, CGRP or substance P, or other type of vanilloid receptors. Less
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