Breathing hot humid air induces airway irritation and cough in patients with allergic rhinitis

We studied the respiratory responses to an increase in airway temperature in patients with allergic rhinitis (AR). Responses to isocapnic hyperventilation (40% of maximal voluntary ventilation) for 4 min of humidified hot air (HA; 49 °C) and room air (RA; 21 °C) were compared between AR patients (n = 7) and healthy subjects (n = 6). In AR patients, cough frequency increased pronouncedly from 0.10 ± 0.07 before to 2.37 ± 0.73 during, and 1.80 ± 0.79 coughs/min for the first 8 min after the HA challenge, but not during the RA challenge. In contrast, neither HA nor RA had any significant tussive effect in healthy subjects. The HA challenge also caused respiratory discomfort (mainly throat irritation) measured by the handgrip dynamometry in AR patients, but not in healthy subjects. Bronchoconstriction was not detected after the HA challenge in either group of subjects. In conclusion, hyperventilation of HA triggered vigorous cough response and throat irritation in AR patients, indicating the involvement of sensory nerves innervating upper airways.