神经源性炎症介质CGRP对咳嗽敏感性的影响

Impact of neurogenic inflammatory mediator CGRP in cough sensitivity

摘要:

目的 探讨神经源性炎症介质降钙素基因相关肽（calcitonin gene related peptide, CGRP）对咳嗽敏感性的作用。方法 2018年2月—2018年3月，18例健康人群吸入不同浓度的CGRP溶液，找到合适CGRP浓度造成辣椒素咳嗽敏感性（即引起5次及以上咳嗽的最低辣椒素浓度，C5）增高，且不引起肺通气功能变化。进一步选取耳鼻喉科确诊无咳嗽鼻炎患者23例，予以吸入合适浓度的CGRP溶液，探索咳嗽敏感性及肺功能变化情况。结果 健康组在吸入10、20μg/mL CGRP溶液后，咳嗽敏感性明显增高（Z=-3.71,P=0.037；Z=-3.58,P=0.031）。但20μg/mL CGRP会造成肺通气功能障碍： 第一秒用力呼气容积占预计值、用力肺活量占预计值、峰流速占预计值、最大呼气中期流速占预计值均显著下降（P＜0.05）。鼻炎患者吸入5μg/mL CGRP溶液后，咳嗽敏感性明显增高（Z=-2.11,P=0.029），且咳嗽敏感性和肺通气功能在30min内无进一步变化趋势（P>0.05）。结论 神经源性炎症介质CGRP是鼻炎患者咳嗽敏感性增高的原因之一，可能是此类患者产生咳嗽的因素。

Abstract:

Objective To investigate the role of calcitonin gene-related peptide(CGRP), a neurogenic inflammatory mediator, in cough sensitivity. Methods The study was conducted in the ENT department of our hospital from February 2018 to March 2018. Eighteen healthy subjects inhaled different concentrations of CGRP solution for testing the appropriate CGRP concentration to increase cough sensitivity to capsaicin and not to cause changes in pulmonary ventilation function. Twenty-three rhinitis patients without coughing were treated with inhalation of a suitable concentration of CGRP solution to test the cough sensitivity and changes in lung function. Results After inhalation of 10 and 20μg/mL CGRP solution, cough sensitivity in the healthy subjects increased significantly(Z=-3.71, P=0.037；Z=-3.58, P=0.031), and the latter caused pulmonary ventilation dysfunction: the forced expiratory volume in one second（FEV1）%, forced vital capacity(FVC) %, peak expiratory flows (PEF) % and maximal mid-expiratory flow(MMEF)% were significantly decreased（P＜0.05）. For safety, patients with rhinitis inhaled 5μg/mL CGRP solution, the cough sensitivity increased significantly(Z=-2.11, P=0.029)，and the cough sensitivity and lung ventilation function were not further changed in 30min（P>0.05）. Conclusion Neurogenic inflammatory mediator CGRP can increase cough sensitivity and may cause cough in patients with rhinitis.