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Tussive challenge with ATP and AMP: does it reveal cough hypersensitivity?

Fowles, Helen Elizabeth; Rowland, Tim; Wright, Caroline; Morice, Alyn


Helen Elizabeth Fowles

Tim Rowland

Caroline Wright


Recent studies have demonstrated that blockade of P2X3 adenosine triphosphate (ATP) receptors may profoundly inhibit chronic cough. We have considered whether inhaled ATP produces a tussive response and whether chronic cough patients are hypersensitive to inhaled ATP compared to healthy volunteers. A standardised inhalational cough challenge was performed with ATP and adenosine monophosphate (AMP). 20 healthy volunteers and 20 chronic cough patients were randomised as to the order of challenges. C5 (the concentration of challenge solution causing at least 5 coughs) was compared for ATP and AMP. The study population consisted of 6 male and 14 female volunteers in each group. 2/19 healthy volunteers coughed with AMP, none achieved C5. 8/20 chronic cough patients coughed with AMP, 2 achieved C5. 18/20 healthy volunteers coughed with ATP with 15 achieving C5. 19/19 chronic cough patients coughed with ATP, 18 achieved C5. The chronic cough patients had a greater cough response at lower concentrations of ATP. The greater potency of ATP versus AMP in inhalational challenge suggests that tussive responses are mediated through members of the P2X purinergic receptor family. This acute effect was however not sufficient to explain cough hypersensitivity syndrome.  


Fowles, H. E., Rowland, T., Wright, C., & Morice, A. (2017). Tussive challenge with ATP and AMP: does it reveal cough hypersensitivity?. European respiratory journal, 49(2),

Acceptance Date Nov 2, 2016
Online Publication Date Feb 8, 2017
Publication Date 2017-02
Deposit Date Nov 8, 2016
Publicly Available Date Aug 9, 2018
Journal European respiratory journal
Print ISSN 0903-1936
Electronic ISSN 1399-3003
Publisher European Respiratory Society
Peer Reviewed Peer Reviewed
Volume 49
Issue 2
Article Number ARTN 1601452
Keywords Pulmonary and Respiratory Medicine
Public URL
Publisher URL
Copyright Statement ©2018 The authors
Additional Information This is a description of an article which has been published in: European respiratory journal, 2017, v.49, issue 2.


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