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A Comprehensive Evaluation of the Impact of ATP on Laryngeal Symptoms, Hypersensitivity and Function

Recruiting
Conditions
Chronic Refractory Cough
Interventions
Diagnostic Test: Laryngeal sensitivity testing
Registration Number
NCT05570981
Lead Sponsor
Bispebjerg Hospital
Brief Summary

OBJECTIVES

* To deliver a comprehensive model of laryngeal assessment, evaluating both the sensory and motor components of upper airway control and to relate this to symptom disturbance.

* Determine if laryngeal control is altered by coughing and the impact of repeated coughing on overall laryngeal control and relaxation to its baseline state.

* Evaluate if cell damage and tissue inflammation (including exposure to ATP) modulates laryngeal hypersensitivity and function, by using a comprehensive array of test modalities.

AIM To utilise state-of-the-art comprehensive assessment tools to evaluate laryngeal hypersensitivity and function in a cohort of individuals with chronic refractory cough and control subjects. The test modalities utilise direct stimulation of the laryngeal adductor reflex, measurement of laryngeal EMG and assessment of functional laryngeal response to an inhalational challenge with laryngoscopic techniques.

HYPOTHESIS Physiological markers of laryngeal hypersensitivity and dysfunction are highly prevalent in patients with chronic refractory cough and manifestations are driven by ATP stimulation.

OUTCOME MEASURES Measurements of laryngeal symptomatology will be measured over a run-in period and during challenge testing. Laryngeal relaxation will be studied using our novel tracking software capability, combining endoscopic imaging and physiological measurements of diaphragm activation.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Chronic Refractory Cough (CRC)Laryngeal sensitivity testingIndividuals with a diagnosis of chronic refractory cough
Healthy controlsLaryngeal sensitivity testingHealthy control subjects matched to the CRC group by age and gender
Primary Outcome Measures
NameTimeMethod
Change in laryngeal relaxation time (seconds) during challenge testingAt baseline and immediately after challenge testing

Change in time for glottic angle to normalise (i.e. achieve a value equal to or above the value prior to sensory stimulus)

Maximal decrease in glottic anterior angle (degrees) during challenge testingBaseline measurement is taken immediately before beginning the challenge test. Minimal value is taken from continuously measured glottic anterior angle, from immediately after baseline measurement and until immediately after challenge testing

The maximal decrease in glottic anterior angle during challenge testing

Maximal increase in glottic anterior angle (degrees) after challenge testingDuring challenge testing and from immediately after challenge testing until 5 minutes after challenge testing

The difference between the minimal glottic anterior angle observed during challenge testing and the maximal glottic anterior angle observed from immediately after challenge testing and until 5 minutes after challenge testing

Maximal laryngeal relaxation time (seconds)At baseline, during challenge testing and from immediately after challenge testing until 5 minutes after challenge testing

Maximum time for glottic angle to normalise (i.e. achieve a value equal to or above the value prior to sensory stimulus)

Change in laryngeal relaxation time (seconds) in recoveryImmediately after challenge testing and at 5 minutes after challenge testing

Change in time for glottic angle to normalise (i.e. achieve a value equal to or above the value prior to sensory stimulus)

Secondary Outcome Measures
NameTimeMethod
Cough VAS (0-100 mm)At baseline, during challenge testing at minutes 0:30, 1:00, 1:30, 2:00, 2:30, 3:00, 3:30 and 4:00 (from immediately after an administered dose of ATP and until 15 seconds after an administered dose) and immediately after challenge testing

This is a descriptive delineation of the ATP/Cough VAS dose/response relationship. The measure is taken at multiple times (see Time Frame) and visualised graphically.

Cough count and frequencyAt baseline, during challenge testing at minutes 0:30, 1:00, 1:30, 2:00, 2:30, 3:00, 3:30 and 4:00 (from immediately after an administered dose of ATP and until 15 seconds after an administered dose) and immediately after challenge testing

This is a descriptive delineation of the ATP/Cough count dose/response relationship. The measure is taken at multiple times (see Time Frame) and visualised graphically.

Trial Locations

Locations (1)

Bispebjerg Hospital

🇩🇰

Copenhagen, Denmark

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