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Rhinosinusitis is the most common cause of chronic cough. There is clinical experience that cough can be elicited from lower airways including the larynx. However, there is no experimental evidence, that afferent nerve endings localized in the nose or sinuses can directly mediate the cough reflex. Stimulation of nasal afferents affects breathing pattern (apnea) and bronchial smooth muscles (nasobronchial reflex). The question arises of whether stimulation of nasal afferents could also interfere with the cough reflex. Intranasal capsaicin enhances the cough response in cats and guinea pigs. In the present study we address the problem of modulation of the cough response by intranasal capsaicin challenge in humans. Twelve healthy volunteers were recruited for the study. The effect of intranasal capsaicin (25µl, 750µM) and the airway cough threshold were determined at the start of the experiment. After that, cough response was provoked by inhalation of a tussigen during stimulation of nasal afferents with capsaicin and in control conditions in a randomized order. The cough response provoked during intranasal capsaicin was significantly enhanced compared with that during control conditions. Thus, the result was similar to that obtained in previous animal studies. The enhancement of the cough response could be explained by a facilitating interaction between the afferent information of nasal origin and the central neuronal network responsible for creation of cough pattern.
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Apnoeic responses to intracarotid nicotine challenge in anaesthetized cats

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To determine the effects of an intraarterial administration of nicotine on the occurrence of apnoea and the activity of rib cage respiratory muscles, we studied 31 anaesthetized, spontaneously breathing cats. Phrenic activity was used as an index of neural inspiratory drive. Activity of parasternal intercostal (PIM) and triangularis sterni (TS) muscles was recorded. Nicotine in a dose of 65 µg/kg was injected into the left common carotid artery prior to and after midcervical vagotomy, preceded by section of the superior laryngeal nerves (SLNs). In eight additional cats, initially neurotomized as mentioned, nicotine was injected after bilateral disruption of the carotid sinus nerves (CSNs). Nicotine induced prompt expiratory apnoea of mean duration of 5.4±0.3 s in 19 non-vagotomized and of 5.92±0.51 s (mean±S.E.M.) in 13 vagotomized cats. The occurrence and duration of the temporary arrest of breathing were reduced by midcervical vagotomy but not by subsequent CSNs neurotomy, which abolished post-apnoeic acceleration of breathing.In post-nicotine breathing of increased tidal volume and respiratory rate, peak activity of the parasternal intercostal muscles increased from baseline of 3.2±1.2 to 9.5±2.0 arbitrary units (p<0.001). The peak height of the phrenic nerve elevated from 7.9±0.9 to 14.5±1.7 arbitrary units (p<0.001). That of the triangularis sterni showed no change.The response of the respiratory effectors elicited by nicotine was independent of the vagal integrity and may be attributed to activation of nicotine receptors within the brainstem respiratory neurones.
The effects of an intravenous capsaicin challenge on the respiratory pattern and ventilation were studied in 15 urethane/chloralose-anaesthetized, spontanously breathing rats. Bolus injection of capsaicin at a dose of 5 |Lig/kg into the right femoral vein evoked respiratory arrest in all animals (both prior to and after bilateral midcervical vagotomy), which effect was abolished by ruthenium red pretreatment. Breathing that followed the apnoea was of enlarged tidal volume and initially increased respiratory rate, which resulted in an augmented ventilation. The capsaicin-induced respiratory changes were independent of vagal integrity and may depend on stimulation of vanilloid receptors within the nodose ganglia.
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