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Cough is a common and troublesome symptom in people with asthma and is often associated with poorer asthma control and exacerbations. Apart from asthma, other causes or comorbidities might underlie cough in asthma, such as rhinosinusitis and bronchiectasis. Eosinophilic inflammation and bronchoconstriction can lead to an acute episode of cough or worsen chronic cough. Cough hypersensitivity with laryngeal paraesthesia, allotussia, and hypertussia might underlie the cough of asthma through augmented sensory nerve excitability of upper-airway vagal sensory nerves. Cough associated with bronchoconstriction and type 2 inflammation should respond to inhaled corticosteroids and long-acting β-adrenoceptor agonist therapy. For cough hypersensitivity in adults, speech and language therapy and neuromodulators (eg, gabapentin) could be considered. In children, there is no consistent association of asthma with cough sensitivity or between cough and asthma severity. Further research is needed to realise the potential of cough as a measure of asthma control, to understand the mechanisms of cough in asthma, and to develop safe, effective treatments and a precision-medicine approach to the management of cough in asthma in children and adults. [ABSTRACT FROM AUTHOR]

Summary Background New Zealand has one of the highest rates of asthma and atopy. Selenium has been implicated in the aetiology of asthma, and associations between low selenium status and asthma in New Zealand children have been reported. Objective The aim was to investigate the association between selenium status and allergic disease in a birth cohort of New Zealand children. Methods The New Zealand Asthma and Allergy Cohort Study is a prospective birth cohort in Wellington and Christchurch, involving 1105 infants born 1997-2001. During the 6-year assessment ( n = 635), associations were investigated between plasma selenium ( PlSe) and whole blood glutathione peroxidase activity ( WBGPx) and allergy-related health outcomes including asthma, wheeze, hayfever, rhinitis, eczema and rash. Results Wellington children had greater PlSe and WBGPx than Christchurch children ( P < 0.001 for both). PlSe ( P = 0.004) and WBGPx ( P = 0.03) were lower in children exposed to environmental smoke, but differences were no longer significant after adjustment for study location, current household smoking (5-6 years), maternal smoking during pregnancy, family history (either parent with asthma, eczema or hayfever), prioritized ethnicity ( Maori, Pacific peoples, Other, European), gender, season born, number of siblings, New Zealand Deprivation Index and body mass index at 6 years. Analysis of PlSe or WBGPx as continuous variables or of quartiles of PlSe with health outcomes showed no significant associations after adjustment. Univariate analysis of quartiles of PlSe and WBGPx with persistent wheeze showed significant inverse trends ( P = 0.005 for both), but these reduced after adjustment. Conclusions and Clinical Relevance Our results do not support a strong association between selenium status and the high incidence of asthma in New Zealand. However, there was a modest association between lower PlSe and WBGPx activity and higher incidence of persistent wheeze. [ABSTRACT FROM AUTHOR]

Background In general, studies reporting positive associations between antibiotic exposure and respiratory and allergic disease have been unable to determine the nature of this association. Objective To examine the association between antibiotic exposure in infancy and the development of asthma, eczema and atopy in early childhood. Methods In a birth cohort study, we collected reported antibiotic exposure before 3 months and before 15 months along with outcomes (wheeze, asthma, eczema, rash, inhaler use) at 15 months ( n=1011) and 4 years ( n=986). Atopy was measured using skin prick tests at 15 months. Results We found significant univariate associations of antibiotic exposure before 3 months with asthma developing between birth and 15 months [OR 2.32 (95% CI 1.45–3.69)]. After adjustment for chest infections, this association reduced (OR=1.58, 95% CI 0.96–2.60) becoming marginally significant ( P=0.07). A marginally significant association of antibiotics with atopy (OR=1.44, 95% CI 0.96–2.14) in the univariate analysis also reduced after adjustment for chest infections (OR=1.36, 95% CI 0.91–2.05). There was no effect of antibiotic exposure before 15 months on asthma developing after 15 months and present between 3 and 4 years (OR=1.35 95% CI 0.85–2.14). Antibiotic exposure before 3 months was not associated with eczema and rash developing between birth and 15 months but exposure before 15 months was related to eczema [OR 1.83 (95% CI 1.10–3.05)] and rash [OR 1.61 (95% CI 1.02–2.53)] developing after 15 months and remaining present at 4 years. These effects reduced in the multivariate analysis. Conclusions Our findings suggest that the effect of antibiotics on respiratory disease may be due to confounding by chest infections at an early age when asthma may be indistinguishable from infection. [ABSTRACT FROM AUTHOR]

Examines bronchial hyperresponsiveness and its relationship to asthma in childhood. Observation of several characteristic patterns of asthma in childhood; Development of the methods of performing bronchial challenge tests; Emphasis on the definition of bronchial hyperresponsiveness; Determinants of bronchial responsiveness; Analysis on the mechanism and significance of bronchial hyperresponsiveness.