Why bradykinin cough

The lung contains large amounts of ACE, which is centrally involved in the metabolism of the inflammatory peptide bradykinin. Therefore, ACE inhibition would be expected to increase bradykinin levels in the lung. Bradykinin is known to sensitize somatosensory fibers, causing hyperalgesia. The British investigators reasoned that the same might be true of the sensory fibers in the lung that initiate the cough reflex.

Guinea pigs were treated with captopril for two weeks. They developed an enhanced cough reflex on challenge with inhaled citric acid. Treatment with the bradykinin receptor antagonist, icatibant, prevented this reflex. In some cases the dry cough may disappear spontaneously. The use of provocative tests has not been clinically satisfactory in exploring possible mechanisms or clinical severity. Conclusions: Dry cough is the most common and annoying, although harmless, side effect associated with the use of ACE inhibitors.

Its incidence has probably been underestimated in earlier studies, but it usually disappears on withdrawal of the specific ACE inhibitor. Abstract Purpose: To review clinical and experimental data and epidemiological observations on the incidence and mechanism of dry cough that has been seen with the use of angiotensin converting enzyme ACE inhibitors in patients with hypertension.

Tsubone, H. Laryngeal afferent activity and reflexes in the guinea-pig. Dray, A. The pharmacology of chronic pain. Trends Pharmacol. Download references. Alyson J. Fox, Umesh G. Lalloo, Maria G. You can also search for this author in PubMed Google Scholar. Reprints and Permissions.

Bradykinin—evoked sensitization of airway sensory nerves: A mechanism for ACE—inhibitor cough. Nat Med 2, — Download citation. Received : 18 January Accepted : 29 May Published : 01 July Issue Date : 01 July Anyone you share the following link with will be able to read this content:.

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Skip to main content Thank you for visiting nature. Abstract Cough accompanied by an increased sensitivity of the cough reflex is the most common symptom of inflammatory airway disease 1,5. Access through your institution. Buy or subscribe.