BACKGROUND A higher incidence of Arnold Nerve Reflex (ANR) has been observed in patients with chronic cough. However, the different ANR response in various causes of chronic cough remains unclear. Furthermore, it is unknown whether ANR will change after effective treatment. METHODS Patients with chronic cough were enrolled in the Guangzhou Institute of Respiratory Health. The causes of chronic cough were diagnosed via a validated management algorithm. Patients underwent an assessment of ANR response before and after one-month etiological treatment. RESULT A total of 127 patients with chronic cough and 55 healthy controls were enrolled. The positive response, defined as cough-only ANR or urge-to-cough (UTC), was present in 14.8% of cough variant asthma (CVA), 11.1% of upper airway cough syndrome (UACS), 15.4% of gastroesophageal reflex related cough (GERC), 4.8% of eosinophilic bronchitis (EB), 26.9% of unexplained cough (UC), respectively. No ANR or UTC was found in the healthy controls. The incidence of the positive response was higher in subjects with CVA, GERC and UC compared with healthy controls (all P<0.05). No difference was observed among the different causes of chronic cough (all P>0.05). After one-month treatment, 87.5% of patients identified with a positive response changed to a negative response. In a subgroup analysis, an increased cough sensitivity to capsaicin was found in the patients with a positive response compared with the patients with a negative response (P<0.05). CONCLUSION A positive ANR appears to be a sign of vagal hypersensitivity and can be reversed after effective treatment of chronic cough. However, while various causes of chronic cough share a similar feature of an elevated ANR response in a minority of patients, there appears to be limited usefulness in assessing the ANR because it does not appear to be a valid predictor of etiology of chronic cough or outcome of treatment.

中文翻译：

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Arnold 神经反射：各种原因引起的慢性咳嗽的迷走神经超敏反应

背景已在慢性咳嗽患者中观察到较高的阿诺德神经反射 (ANR) 发生率。然而，慢性咳嗽的各种原因导致的不同 ANR 反应仍不清楚。此外，尚不清楚有效治疗后ANR是否会改变。方法 慢性咳嗽患者入组广州呼吸卫生研究所。通过经过验证的管理算法诊断慢性咳嗽的原因。患者在一个月的病因治疗前后接受了 ANR 反应的评估。结果共纳入慢性咳嗽患者127例和健康对照者55例。阳性反应，定义为仅咳嗽 ANR 或急迫性咳嗽 (UTC)，出现在 14.8% 的咳嗽变异性哮喘 (CVA) 和 11.1% 的上气道咳嗽综合征 (UACS) 中，15。胃食管反射相关性咳嗽 (GERC) 的 4%、嗜酸性支气管炎 (EB) 的 4.8%、不明原因咳嗽 (UC) 的 26.9%。在健康对照中未发现 ANR 或 UTC。与健康对照组相比，CVA、GERC 和 UC 受试者的阳性反应发生率更高（均 P<0.05）。慢性咳嗽不同病因间无差异（均P>0.05）。经过 1 个月的治疗，87.5% 确定为阳性反应的患者变为阴性反应。在亚组分析中，与阴性反应患者相比，阳性反应患者对辣椒素的咳嗽敏感性增加（P<0.05）。结论 ANR 阳性似乎是迷走神经超敏反应的标志，在有效治疗慢性咳嗽后可以逆转。然而，