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Vol. 37. Issue 6.
Pages 292-296 (June 2001)
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Vol. 37. Issue 6.
Pages 292-296 (June 2001)
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Test de provocación tusígena con capsaicina: resultados en una población sana
Cough-inducing capsaicin challenge test in a healthy population
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M.L. Nieto Cabrera*, A. de Diego Damiá, M. Perpiñá Tordera, E. Martínez Pérez, L. Compte Torrero, V. Macián Gisbert
Servicio de Neumología. Hospital Universitario La Fe. Valencia
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Abstract
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Objetivos

Es conocido el uso de agentes tusígenos en el estudio del reflejo de la tos, tanto en el campo de la investigación farmacológica como de la fisiología de dicho reflejo. Su aplicación clínica como una herramienta más en los algoritmos diagnósticos se ve limitada por la falta de uniformidad metodológica y de valores de referencia en sujetos sanos. El objetivo del presente estudio ha sido determinar el umbral tusígeno a la capsaicina en una muestra de sujetos sanos, evaluando la influencia de la edad, el sexo y el tabaquismo, así como analizando la fiabilidad y repetibilidad del test.

Material Y Métodos

Se incluyeron en el estudio 92 sujetos sanos a los que se les aplicó el test de provocación con capsaicina, cuyas concentraciones iban desde 0,49 a 500 μM. Se determinaron los valores de C2 y C5, siendo éstas las concentraciones de capsaicina que provocan al menos dos y 5 toses, respectivamente. La prueba se repitió a los 3 días en una submuestra de 30 sujetos.

Resultados

Ningún paciente presentó evidencia clínica ni funcional de broncoconstricción. Los valores medios obtenidos en la población de estudio fueron log C2: 1,5 ± 0,69 μM y log C5: 2,1 ± 0,4 μM. La media geométrica para ambos valores fue: C2: 31,6 y C5: 134,8 μM. No se hallaron diferencias significativas para el sexo ni el tabaquismo. Sin embargo, la edad guardó una asociación significativa con el log C5. La repetibilidad del test de la capsaicina fue alta, con un coeficiente de correlación intraclase y un intervalo de confianza del 95% de 0,75 (0,53–0,87) y 0,88 (0,76–0,94) para C2 y C5, respectivamente.

Conclusión

El test de provocación con capsaicina ha resultado seguro, fácil de aplicar, con unos resultados reproducibles y nos ha permitido obtener unos valores de referencia en una población sana de nuestra área.

Palabras clave:
Pruebas de provocación
Capsaicina
Tos
Objective

Cough-inducing agents are used to study the cough reflex in both pharmacological and physiological research. Clinical use of cough challenge testing as a tool in diagnostic algorithms has been limited by the lack of either uniform methodology or reference values for healthy subjects. The objective of this study was to determine the cough threshold for capsaicin in a sample of healthy subjects, while also evaluating the influence of age, sex and smoking. We also assessed the reliability and repeatability of the test.

Material And Methods

Ninety-two healthy subjects were enrolled and given a capsaicin challenge test using concentrations from 0.49 to 500 mg. The concentrations of capsaicin that triggered two and five coughs, C2 and C5 respectively, were recorded. The test was repeated three days later in a sub-sample of 30 subjects.

Results

No subject showed clinical or functional signs of bronchoconstriction. The mean values obtained for the study population were log C2: 1.5 ± 0.69 mM. and log C5: 2.1 ± 0.4 μM. The geometric means were 31.6 and 134.8 μM for C2 and C5, respectively. No significant differences were found for sex or smoking; however age was significantly related to log C5 (r: −0.27, p < 0.05). Repeatability of the capsaicin test was high, with intra-class correlation coefficients and 95% confidence intervals of 0.75 (0.53–0.87) and 0.88 (0.76–0.97) for C2 and C5, respectively.

Conclusion

The capsaicin challenge test was safe and easy to administer, gave reproducible results and allowed us to obtain reference values for a healthy population in our community.

Key words:
Challenge test
Capsaicin
Cough
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Copyright © 2001. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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