Abstract
BackgroundPharyngeal lavage was reported as a novel technique for noninvasive assessment of inflammation of the pharynx.AimTo study upper airway inflammation in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) and its correlation with systemic inflammation.Patients and methodsA total of 36 patients with known OSAHS, admitted to the Chest Department, Alexandria Main University Hospital (group I), and 15 healthy volunteers (group II) were enrolled into the study. Informed consent was taken from all participants. The two groups underwent complete history taking, assessment of BMI, measurement of serum C-reactive protein (CRP), overnight polysomnography, and oropharyngeal lavage (OPL) analysis.ResultsIn group I, the most prevalent cell type of OPL was lymphocytes followed by neutrophils. Compared with control group (group II), the most prevalent cell type in OPL was macrophages followed by epithelial cells. Regarding the OPL differential cell count which denotes local pharyngeal inflammation, there was a statistically significant difference between both groups (P<0.001). Similarly, CRP, a marker of systemic inflammation, showed a significant statistical difference between both groups (P<0.001). Strikingly, there was no statistically significant correlation between CRP and apnea–hypopnea index (P=0.604). Snoring, apnea–hypopnea index, and other sleep parameters correlated significantly with lymphocytic predominance in OPL (P<0.001), whereas CRP correlates significantly with neutrophils and eosinophil’s in OPL (P<0.001 and P=0.015, respectively).ConclusionOur study had provided a novel vision into the pathophysiology of OSAHS in emphasizing the existence of upper airway lymphocytic inflammation. OPL is a simple, applicable, and easy noninvasive procedure for assessment of upper airway inflammation.
Highlights
Obstructive sleep apnea–hypopnea syndrome (OSAHS) is a disorder characterized by frequent episodes of obstruction in the upper airway during sleep [1]
In group I, the most prevalent cell type of oropharyngeal lavage (OPL) was lymphocytes followed by neutrophils
Apnea–hypopnea index (AHI), apnea–hypopnea index; CRP, C-reactive protein; DM, diabetes mellitus; HTN, hypertension; ODI 4%, oxygen desaturation index more than 4%; T90, time of sleep with oxygen saturation below 90%
Summary
Obstructive sleep apnea–hypopnea syndrome (OSAHS) is a disorder characterized by frequent episodes of obstruction in the upper airway during sleep [1]. Evidence advocates that both local airway inflammation and systemic inflammation are involved in the pathophysiology of this apparently mechanical disorder [2,3]. Accumulating evidence suggests that local and systemic inflammatory responses exist in patients with OSAHS [5]. Vicente et al reported a novel technique for noninvasive examination of pharyngeal inflammation called oropharyngeal lavage (OPL) [8]. Pharyngeal lavage was reported as a novel technique for noninvasive assessment of inflammation of the pharynx
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