Cough Clinical Trial
Official title:
Validation of Peptest™ for the Detection of Reflux in Cough; Induction of Cough in Healthy Volunteers
Chronic cough is a common presenting problem which has a significant impact on quality of
life. Gastro-oesophageal reflux (GOR) is a common cause of chronic cough and reflux of
stomach contents into the airways has been implicated in the pathogenesis of a number of
respiratory diseases. Clinical history in patients with suspected reflux can aid in the
diagnosis but traditional investigations for GOR including 24hr oesophageal pH monitoring or
endoscopy are not reliable diagnostic tools since the reflux may be non acidic.
The detection of pepsin in the sputum, saliva or bronchial biopsy has been found to be an
accurate marker of reflux into the airways. Pepsin is solely produced by parietal cells in
the stomach. The presence of pepsin in the upper airways therefore indicates reflux. Studies
have demonstrated that pepsin was frequently found in laryngeal biopsies and sputum of
patients with signs and symptoms of airways reflux and that Nissen fundoplication resulted in
a decrease in pepsin detection alongside an improvement in symptoms. The Peptest™ lateral
flow device has been shown to be effective in the detection of pepsin in sputum and saliva of
patients with chronic cough and gastro-oesophageal reflux. The investigators have detected
pepsin in expectorated saliva during episodes of cough, apparently supporting a diagnosis of
airways reflux. Critics, however, have suggested that the act coughing itself is responsible
for the reflux.
This study aims to identify if cough induced by inhaled citric acid in healthy adult
volunteers leads to detectable pepsin in expectorated saliva.
n/a
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