Prevenstion of aspiration pneumonia and Research of the clinical application by VR1 and CMR1 agonists.

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Recurrent pneumonia in older people is due to silent aspiration caused by depressed swallowing and cough reflexes because of an insufficient release of substance P.Direct administration of capsaicin to the pharynx can improve the swallowing reflex in older people. However, whether the daily capsaicin supplementation affects those risk factors for recurrent aspiration bronchitis and pneumonia in older people has not been investigated. To determine whether oral capsaicin troche supplementation every meal upregulates the impairment of upper respiratory protective reflexes such as the swallowing reflex and the cough reflex. Randomized-controlled study with recruitment through nursing homes in Sendai, Japan from September 2002 to December 2003. Sixty-four participants in nursing homes aged mean 81.9 ± 1.0 year old with chronic physical status. Participants were randomly assigned to the program for the supplementation of capsaicin trochisci or placebo trochisci soon before every meal for 4 w … More eeks. Assessment of individual latency of the swallowing reflex (LTSR) and cough reflex sensitivity. Before the commencement of this study, there were no significant baseline differences in multiple parameters between the intervention group and control group. LTSR in participants in the intervention group was significantly shortened, compared with the control group (P<.05). The odds ratio (OR) of the shortening of the LTSR of more than 1 minute in the intervention group was 3.4 [95% confidence interval (CI), 1.1-10.4], compared with the control group (P=.03). Particularly, daily capsaicin supplementation significantly increased the ratio of LTSR reduction at 4 weeks after the study to baseline LTSR in the high risk group (baseline LTSR>6.0sec) compared with the low risk group (baseline LTSR<3.0sec) and the intermediate group (3.0sec<baseline LTSR<6.0sec)(P<.005). The participants whose cough reflex sensitivity showed a decrease of the cough reflex threshold was observed in 17 participants (52.1%) in the intervention group but in only 7 participants (21.9%) in the control group after this study (OR : 4.1, [95% CI : 1.4-12.2], P<.01). Daily capsaicin supplementation showed a significant improvement in upper protective respiratory reflexes, particularly in older people with a high risk for aspiration. Less