{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T22:51:03Z","timestamp":1788648663114,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672250"],"award-info":[{"award-number":["81672250"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cough variant asthma (CVA) is a chronic inflammatory airway disease characterized by airway hyper-responsiveness (AHR), of which cough is the only symptom. The cough is a result of the contraction of the vocal cords, diaphragm, sternocleidomastoid muscle, and other respiratory related muscles caused by the AHR. Long-term chronic coughing can lead to repetitive contraction and chronic strain of the muscles involved in the head and neck, ultimately contributing to the formation of latent myofascial trigger points (MTrPs). In turn, latent MTrPs can also irritate or compress the nerves around them, triggering cough. The date indicated that latent MTrPs can induce autonomic phenomena and are effective in allergic rhinitis. But their roles in asthma are unclear. In this article, the efficacy and safety of latent MTrPs injection therapy in CVA were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized controlled trial was conducted with 110 patients. Patients were assigned to the intervention or control group in a 1:1.5 ratio. Intervention group (<jats:italic>n<\/jats:italic>\u2009=\u200944): single injection therapy with latent MTrPs. Control group (<jats:italic>n<\/jats:italic>\u2009=\u200966): budesonide-formoterol plus montelukast for 8\u2009weeks. During the 36-week follow up period, the recurrence rate at week 36, cough visual analog scale (VAS), ACT (asthma control test)-scores, ACQ5 (asthma control questionnaire)-scores, AQLQ (asthma quality of life questionnaire)-scores, proportion of using rescue medication, and adverse events were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The recurrence rate at week 36 was lower in the intervention group than in the control group (36\u2009weeks, 5.0 vs. 34.55%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). There were significant differences between groups in change from baseline to 36\u2009weeks in VAS [36\u2009weeks, 1.70 (1.49) vs. 3.18 (2.04), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001]; ACT-score [36\u2009weeks, 21.38 (2.65) vs. 18.53 (3.00), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001]; ACQ5-score [36\u2009weeks, 0.85 (0.55) vs. 1.52 (0.62), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001]; AQLQ-score [36w, 174.40 (18.22) vs. 151.69 (24.04), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001]; proportion of using rescue medication (36\u2009weeks, 5.0 vs. 29.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Fewer adverse events occurred in the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Latent myofascial trigger points injection therapy provided long-acting, practical, short treatment duration and safety methods for CVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trials Registration<\/jats:title><jats:p><jats:ext-link>http:\/\/www.chictr.org.cn\/index.aspx<\/jats:ext-link>, Chinese Clinical Trial Registry Center, ChiCTR2100044079.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.937377","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T05:01:01Z","timestamp":1677128461000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Latent myofascial trigger points injection therapy for adult cough variant asthma: A randomized controlled trial"],"prefix":"10.3389","volume":"10","author":[{"given":"Qianqian","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiya","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/S0140-6736(19)31147-X","article-title":"Prevalence, risk factors, and management of asthma in China: a national cross-sectional study","volume":"394","author":"Huang","year":"2019","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1378\/chest.12-0441","article-title":"A prospective, multicenter survey on causes of chronic cough in China","volume":"143","author":"Lai","year":"2013","journal-title":"Chest"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13223-019-0318-5","article-title":"A retrospective study of clinical features of cough variant asthma in Chinese adults","volume":"15","author":"Liu","year":"2019","journal-title":"Allergy, Asthma Clin Immunol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2301","DOI":"10.1001\/jama.2020.21974","article-title":"Managing asthma in adolescents and adults: 2020 asthma guideline update from the National Asthma Education and prevention program","volume":"324","author":"Cloutier","year":"2020","journal-title":"JAMA"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.anai.2012.08.014","article-title":"Short-acting beta-agonist use and its ability to predict future asthma-related outcomes","volume":"109","author":"Stanford","year":"2012","journal-title":"Ann Allergy Asthma Immunol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1901136","DOI":"10.1183\/13993003.01136-2019","article-title":"ERS guidelines on the diagnosis and treatment of chronic cough in adults and children","volume":"55","author":"Morice","year":"2020","journal-title":"Eur Respir J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1517\/17425255.2014.939956","article-title":"Do genetic polymorphisms alter patient response to inhaled bronchodilators?","volume":"10","author":"Lima","year":"2014","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1111\/j.1398-9995.2008.01724.x","article-title":"Stability of asthma control with regular treatment: an analysis of the gaining optimal asthma controL (GOAL) study","volume":"63","author":"Bateman","year":"2008","journal-title":"Allergy"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1055\/s-0036-1586262","article-title":"Myofascial trigger point pain syndromes","volume":"36","author":"Gerwin","year":"2016","journal-title":"Semin Neurol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4386","DOI":"10.1109\/EMBC.2012.6346938","article-title":"Ultrasonic tissue characterization of the upper trapezius muscle in patients with myofascial pain syndrome","volume":"2012","author":"Turo","year":"2012","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/pm\/pnx219","article-title":"Trigger point diagnosis: at last, the first word on consensus","volume":"19","author":"Gerwin","year":"2018","journal-title":"Pain Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1159\/000112423","article-title":"Myofascial trigger point:a possible way of modulating tinnitus","volume":"13","author":"Bezerra Rocha","year":"2008","journal-title":"Audiol Neurootol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"731254","DOI":"10.3389\/fmed.2021.731254","article-title":"Latent myofascial trigger points injection reduced the severity of persistent, moderate to severe allergic rhinitis: a randomized controlled trial","volume":"8","author":"Liu","year":"2021","journal-title":"Front Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1183\/13993003.51387-2007","article-title":"Global strategy for asthma management and prevention: GINA executive summary","volume":"31","author":"Bateman","year":"2008","journal-title":"Eur Respir J"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1056\/NEJMoa1715275","article-title":"As-needed budesonide-formoterol versus maintenance budesonide in mild asthma","volume":"378","author":"Bateman","year":"2018","journal-title":"N Engl J Med"},{"key":"ref16","first-page":"653","article-title":"Trigger points: diagnosis and management","volume":"65","author":"Alvarez","year":"2002","journal-title":"Am Fam Physician"},{"key":"ref17","volume-title":"Travell & Simons\u2019 Myofascial Pain and Dysfunction: The Trigger Point Manual","author":"Simons","year":"1999"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1093\/pm\/pnx207","article-title":"International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: a Delphi study","volume":"19","author":"Fernandez-de-Las-Penas","year":"2018","journal-title":"Pain Med"},{"key":"ref19","first-page":"E134","article-title":"An open-label, multi-institutional, randomized study to evaluate the additive effect of a leukotriene receptor antagonist on cough score in patients with cough-variant asthma being treated with inhaled corticosteroids","volume":"64","author":"Miwa","year":"2018","journal-title":"Kobe J Med Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1038\/s41533-017-0064-4","article-title":"Weekly self-measurement of FEV1 and PEF and its impact on ACQ (asthma control questionnaire)-scores: 12-week observational study with 76 patients","volume":"27","author":"Werner","year":"2017","journal-title":"NPJ Prim Care Respir Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/978-1-4939-2895-8_5","article-title":"Regulation of glucose homeostasis by glucocorticoids","volume":"872","author":"Kuo","year":"2015","journal-title":"Adv Exp Med Biol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/1465-9921-13-26","article-title":"Transient receptor potential genes, smoking, occupational exposures and cough in adults","volume":"13","author":"Smit","year":"2012","journal-title":"Respir Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s12016-011-8272-0","article-title":"Occupational asthma","volume":"43","author":"Kenyon","year":"2012","journal-title":"Clin Rev Allergy Immunol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/j.1365-2222.2008.03172.x","article-title":"Provoked models of asthma: what have we learnt?","volume":"39","author":"O'Byrne","year":"2009","journal-title":"Clin Exp Allergy"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.pupt.2004.12.002","article-title":"Immunohistochemical localization of vanilloid receptor subtype 1 (TRPV1) in the Guinea pig respiratory system","volume":"18","author":"Watanabe","year":"2005","journal-title":"Pulm Pharmacol Ther"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1016\/j.jaci.2013.09.016","article-title":"Increased expression of bronchial epithelial transient receptor potential vanilloid 1 channels in patients with severe asthma","volume":"133","author":"McGarvey","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1968","DOI":"10.1002\/ejp.1647","article-title":"The pathophysiological nature of sarcomeres in trigger points in patients with myofascial pain syndrome: a preliminary study","volume":"24","author":"Jin","year":"2020","journal-title":"Eur J Pain"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e4650","DOI":"10.1097\/MD.0000000000004650","article-title":"Circulating biomarkers in acute myofascial pain: a case-control study","volume":"95","author":"Grosman-Rimon","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.molmed.2010.02.004","article-title":"TRPV1 in migraine pathophysiology","volume":"16","author":"Meents","year":"2010","journal-title":"Trends Mol Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.jtbi.2018.02.004","article-title":"Thermal actuation in TRPV1: role of embedded lipids and intracellular domains","volume":"444","author":"Melnick","year":"2018","journal-title":"J Theor Biol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1038\/nrn3946","article-title":"Crosstalk between the nociceptive and immune systems in host defence and disease","volume":"16","author":"McMahon","year":"2015","journal-title":"Nat Rev Neurosci"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1042\/CS20160487","article-title":"Cellular and molecular mechanisms of asthma and COPD","volume":"131","author":"Barnes","year":"2017","journal-title":"Clin Sci (Lond)"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1016\/j.jaci.2013.11.027","article-title":"Mechanisms underlying the neuronal-based symptoms of allergy","volume":"133","author":"Undem","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"777","DOI":"10.3889\/oamjms.2018.187","article-title":"Comparison of effect of leukotriene biosynthesis blockers and inhibitors of phosphodiesterase enzyme in patients with bronchial Hyperreactivity","volume":"6","author":"Morina","year":"2018","journal-title":"Open Access Maced J Med Sci"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"6694936","DOI":"10.1155\/2021\/6694936","article-title":"Acupuncture treatment for cough-variant asthma: a meta-analysis","volume":"2021","author":"Xiong","year":"2021","journal-title":"Evid Based Complement Alternat Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.937377\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T05:01:05Z","timestamp":1677128465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.937377\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":35,"alternative-id":["10.3389\/fmed.2023.937377"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.937377","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]},"article-number":"937377"}}