Neurophysiology and Pharmacology of Cough Reflex Hypersensitivity
A cough lasting more than 2 months is known as a chronic cough, affecting 12-23% of the adult non-smoking population. Chronic cough has many associated complications including incontinence, muscular chest pains, blackouts and depression. Current treatment is often ineffective in these patients. To develop new medications the investigators need to understand more about the mechanisms that can lead to excessive coughing.
This study plans to compare a group of 12 healthy volunteers and 12 patients with a chronic cough. The investigators hypothesise that that chronic cough patients have a more sensitive cough reflex as a result central nervous system hyper-excitability (central sensitisation). The investigators will measure cough reflex sensitivity before and after administration of ketamine, a medication that blocks an important receptor in the central nervous system.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Manchester, United Kingdom, M23 9LT
- University of Manchester, Education and Research Centre, Wythenshawe Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Healthy Volunteers:
- Over 18 years old
- Measurable cough reflex sensitivity
- No current or past history of chronic cough or chronic respiratory disease.
- No symptoms of gastro-oesophageal reflux disease, asthma or post-nasal drip.
Chronic Cough Patients
- Over 18 years old
- Chronic persistent cough (> 8 weeks) despite investigation and/or treatment trials for cough variant asthma/post nasal drip and gastro-oesophageal reflux disease.
- Normal CXR
- Normal lung function
- Measurable cough reflex sensitivity
Exclusion Criteria:
- Recent Upper Respiratory Tract Infection (4 weeks)
- Pregnancy/breast feeding
- Current smokers or ex-smokers with < 6 months abstinence or cumulative history of > 10 packyears
- Diabetes Mellitus
- Opiate or ACE Inhibitor use.
- Any centrally acting medication which has the potential to alter cough reflex sensitivity.
- Significant and ongoing chronic respiratory, cardiovascular (in particular hypertension), gastro-intestinal, haematological (porphyria), neurological or psychiatric illness.
- Drug or alcohol abuse
- History of allergy or reaction to ketamine of other NMDA receptor antagonists.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Healthy Volunteers
|
Administration of low dose intravenous ketamine.
Dose: 0.075mg/kg over 10 minutes followed by 0.005mg/kg/min over 20 minutes.
Given as single infusion.
|
|
Active Comparator: Chronic Cough Patients
|
Administration of low dose intravenous ketamine.
Dose: 0.075mg/kg over 10 minutes followed by 0.005mg/kg/min over 20 minutes.
Given as single infusion.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Cough Reflex Sensitivity
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Upper Oesophageal Pain Thresholds
Time Frame: 6 months
|
6 months
|
|
Pain Thresholds Pharynx
Time Frame: 6 months
|
6 months
|
|
Pain Thresholds Chest Wall
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Immune System Diseases
- Respiration Disorders
- Signs and Symptoms, Respiratory
- Hypersensitivity
- Cough
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Dissociative
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Ketamine
Other Study ID Numbers
Other Study ID Numbers
- 07/H1004/142
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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