Abstract
C-fibres probably represent the common final pathway in both ACE inhibitors and neoplastic cough. A recent report demonstrated that inhaled sodium cromoglycate is an effective treatment for ACE inhibitors' cough; this effect might be due to the suppression of afferent unmyelinated C-fibres. We tested the hypothesis that inhaled sodium cromoglycate might also be effective in lung cancer patients who presented with irritative neoplastic cough. Twenty non-small-cell lung cancer (NSCLC) patients complaining of cough resistant to conventional treatment were randomised to receive, in a double-blind trial, either inhaled sodium cromoglycate or placebo. Patients recorded cough severity daily, before and during treatment, on a 0 to 4 scale. The efficacy of treatment was tested with the Mann-Whitney U-test for non-parametric measures, comparing the intergroup differences in the measures of summary of symptom scores calculated in each patient before and after treatment. We report that inhaled sodium cromoglycate can reduce cough, also in NSCLC patients and that such reduction, observed in all patients treated, is statistically significant (P < 0.001). Inhaled sodium cromoglycate appears to be a cost-effective and safe treatment for lung cancer-related cough.
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Selected References
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- Bunn P. A., Jr, Chan D., Dienhart D. G., Tolley R., Tagawa M., Jewett P. B. Neuropeptide signal transduction in lung cancer: clinical implications of bradykinin sensitivity and overall heterogeneity. Cancer Res. 1992 Jan 1;52(1):24–31. [PubMed] [Google Scholar]
- Bunn P. A., Jr, Dienhart D. G., Chan D., Puck T. T., Tagawa M., Jewett P. B., Braunschweiger E. Neuropeptide stimulation of calcium flux in human lung cancer cells: delineation of alternative pathways. Proc Natl Acad Sci U S A. 1990 Mar;87(6):2162–2166. doi: 10.1073/pnas.87.6.2162. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coleridge H. M., Coleridge J. C. Pulmonary reflexes: neural mechanisms of pulmonary defense. Annu Rev Physiol. 1994;56:69–91. doi: 10.1146/annurev.ph.56.030194.000441. [DOI] [PubMed] [Google Scholar]
- Fuller R. W., Dixon C. M., Cuss F. M., Barnes P. J. Bradykinin-induced bronchoconstriction in humans. Mode of action. Am Rev Respir Dis. 1987 Jan;135(1):176–180. doi: 10.1164/arrd.1987.135.1.176. [DOI] [PubMed] [Google Scholar]
- Hargreaves M. R., Benson M. K. Inhaled sodium cromoglycate in angiotensin-converting enzyme inhibitor cough. Lancet. 1995 Jan 7;345(8941):13–16. doi: 10.1016/s0140-6736(95)91151-0. [DOI] [PubMed] [Google Scholar]
- Hollen P. J., Gralla R. J., Kris M. G., Potanovich L. M. Quality of life assessment in individuals with lung cancer: testing the Lung Cancer Symptom Scale (LCSS). Eur J Cancer. 1993;29A Suppl 1:S51–S58. doi: 10.1016/s0959-8049(05)80262-x. [DOI] [PubMed] [Google Scholar]
- Kaufman M. P., Coleridge H. M., Coleridge J. C., Baker D. G. Bradykinin stimulates afferent vagal C-fibers in intrapulmonary airways of dogs. J Appl Physiol Respir Environ Exerc Physiol. 1980 Mar;48(3):511–517. doi: 10.1152/jappl.1980.48.3.511. [DOI] [PubMed] [Google Scholar]
- Matthews J. N., Altman D. G., Campbell M. J., Royston P. Analysis of serial measurements in medical research. BMJ. 1990 Jan 27;300(6719):230–235. doi: 10.1136/bmj.300.6719.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Paintal A. S. Mechanism of stimulation of type J pulmonary receptors. J Physiol. 1969 Aug;203(3):511–532. doi: 10.1113/jphysiol.1969.sp008877. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ryan J. W. Processing of endogenous polypeptides by the lungs. Annu Rev Physiol. 1982;44:241–255. doi: 10.1146/annurev.ph.44.030182.001325. [DOI] [PubMed] [Google Scholar]