Details

Autor(en) / Beteiligte

• Devouassoux, Gilles, MD, PhD
• Lévy, Patrick, MD, PhD
• Rossini, Eliane, MSc
• Pin, Isabelle, MD, PhD
• Fior-Gozlan, Michèle, MD
• Henry, Mireille, MSc
• Seigneurin, Daniel, MD, PhD
• Pépin, Jean-Louis, MD, PhD

Titel

Sleep apnea is associated with bronchial inflammation and continuous positive airway pressure–induced airway hyperresponsiveness

Ist Teil von

• Journal of allergy and clinical immunology, 2007-03, Vol.119 (3), p.597-603

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2007

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Background Obstructive sleep apnea syndrome (OSA) is associated with systemic and upper airway inflammation. Pharyngeal inflammation has a potential role in upper airway collapse, whereas systemic inflammation relates to cardiovascular morbidity. However, the presence of an inflammatory involvement of lower airway has been poorly investigated. Objective The aim of the study was to demonstrate an inflammatory process at the bronchial level in patients with OSA and to analyze effects of continuous positive airway pressure (CPAP) application and humidification on bronchial mucosa. Methods The study was conducted by using sequential induced sputum for cell analysis and IL-8 production, nitric oxide exhalation measurement, and methacholine challenge before and after CPAP. Results Bronchial neutrophilia and a high IL-8 concentration were observed in untreated OSA compared with controls (75% ± 20% vs 43% ± 12%, P < .05; and 25.02 ± 9.43 ng/mL vs 8.6 ± 3.7 ng/mL, P < .001, respectively). IL-8 in sputum supernatant was correlated to apnea hypopnea index ( P < .01; r  = 0.81). After 1 month of CPAP, this inflammatory pattern remained unchanged, and an increase in airway hyperresponsiveness (AHR) was observed ( P < .001). Conclusion Obstructive sleep apnea syndrome is associated with bronchial inflammation. Our data demonstrate CPAP effect on the development of AHR, possibly facilitated by the pre-existing inflammation. Both issues should be evaluated during long-term CPAP use. Clinical implications Results showing a spontaneous bronchial inflammation in OSA and the development of a CPAP-related AHR require a long-term follow-up to evaluate consequences on chronic bronchial obstruction.