loading page

EFFECT OF CENTRALLY AND PERIPHERALLY ACTING GABAB AGONISM ON THE COUGH REFLEX
  • +7
  • Huda Badri,
  • Carmen Farrelly,
  • Dimitra Denton,
  • Imran Satia,
  • Kimberley Holt,
  • Rachel Dockry,
  • Graeme Wilkinson,
  • Alison Holt,
  • Brendan Canning,
  • Jaclyn Smith
Huda Badri
The University of Manchester Faculty of Biology Medicine and Health
Author Profile
Carmen Farrelly
The University of Manchester Faculty of Biology Medicine and Health
Author Profile
Dimitra Denton
The University of Manchester Faculty of Biology Medicine and Health
Author Profile
Imran Satia
The University of Manchester Faculty of Biology Medicine and Health
Author Profile
Kimberley Holt
The University of Manchester Faculty of Biology Medicine and Health
Author Profile
Rachel Dockry
The University of Manchester Faculty of Biology Medicine and Health
Author Profile
Graeme Wilkinson
AstraZeneca Medimmune Cambridge
Author Profile
Alison Holt
AstraZeneca Medimmune Cambridge
Author Profile
Brendan Canning
Johns Hopkins Asthma and Allergy Center
Author Profile
Jaclyn Smith
The University of Manchester

Corresponding Author:[email protected]

Author Profile

Abstract

Background: Currently there are no effective licensed anti-tussive therapies. Understanding how the neuronal mechanisms mediating the cough reflex in animal models translate to humans is important for the development of effective therapies. Pre-clinical studies suggest that the activation of GABAB receptors in both the peripheral and central nervous systems inhibit cough. Objective: To compare the effect of central and peripherally acting GABAB agonists (lesogaberan and baclofen) on the cough reflex in healthy volunteers. Methods: We performed a single center, double-blind, double-dummy, three-way crossover trial in healthy controls comparing single doses of lesogaberan (120mg MR), with baclofen (40mg) and placebos. Cough responses to inhaled capsaicin were assessed at screening and 2h post-dose on each study day. The primary endpoint was the maximum number of coughs evoked at any concentration of capsaicin (Emax) and the secondary endpoint was the concentration evoking 50% of the maximal response (ED50). Results: Fifteen patients enrolled onto the study (median age 29 (IQR 25-44) years; 7 females, mean BMI 24.6(±3.0). Lesogaberan treatment produced a small, statistically significant increase in Emax compared with placebo [mean 13.4coughs (95%CI 10.1-17.9) vs. 11.8coughs (8.8-15.9), p=0.04], but had no effect on ED50 [geometric mean 47.4µM (95%CI 24.4-91.7) vs 37.6 µM (95%CI 19.2-73.5), p=0.37]. In contrast, baclofen had no significant effect on Emax (11.1, 95%CI 8.1-15.4) (p=0.23), but significantly increased ED50 compared with placebo (geometric mean 75.2µM (95%CI 37.2-151.8), p=0.002). Conclusion: This data suggests the anti-tussive actions of GABAB agonists, in healthy volunteers, occur in the central rather than the peripheral nervous system.