Airway cell patterns in patients suffering from COPD and OSAS (Overlap Syndrome)

Summary Background Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often coexist within an individual. This coexistence is known as Overlap Syndrome (OS). Both diseases are characterized by local and systemic inflammations, but no studie...

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Veröffentlicht in:Respiratory medicine 2011-02, Vol.105 (2), p.303-309
Hauptverfasser: Lacedonia, Donato, Salerno, Francesco G, Sabato, Roberto, Carpagnano, Giovanna E, Aliani, Maria, Palladino, Grazia P, Foschino Barbaro, Maria P
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container_end_page 309
container_issue 2
container_start_page 303
container_title Respiratory medicine
container_volume 105
creator Lacedonia, Donato
Salerno, Francesco G
Sabato, Roberto
Carpagnano, Giovanna E
Aliani, Maria
Palladino, Grazia P
Foschino Barbaro, Maria P
description Summary Background Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often coexist within an individual. This coexistence is known as Overlap Syndrome (OS). Both diseases are characterized by local and systemic inflammations, but no studies to date have investigated local airway inflammation in patients suffering from Overlap Syndrome. Methods We performed a Berlin Questionnaire to evaluate the presence of the principal OSAS symptoms, a pulmonary function test, and then a nocturnal oximetry and polysomnography in 72 patients that were divided into five groups: OS ( n  = 18), COPD ( n  = 15), OSAS ( n  = 16), 12 obese without OSAS or COPD, and one control group of 11 normal subjects. All patients underwent sputum induction and the analysis of cell patterns were evaluated in all groups. The relationship with the degree of obesity, airway obstruction and OSAS severity was also evaluated. Results The percentage of neutrophils in induced sputum was higher in OS (74.33% ± 14.8), COPD (63.33% ± 13.22) and OSAS (60.69% ± 17.6) subjects compared with control groups of obese (43.5% ± 17.49) and normal weight (32.04% ± 12.26). No difference was found among Overlap, COPD, and OSAS patients ( p  = 0.56). A negative correlation was found between PaO2 and percentage of airway neutrophils ( r  = −0.29, p  
doi_str_mv 10.1016/j.rmed.2010.10.023
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This coexistence is known as Overlap Syndrome (OS). Both diseases are characterized by local and systemic inflammations, but no studies to date have investigated local airway inflammation in patients suffering from Overlap Syndrome. Methods We performed a Berlin Questionnaire to evaluate the presence of the principal OSAS symptoms, a pulmonary function test, and then a nocturnal oximetry and polysomnography in 72 patients that were divided into five groups: OS ( n  = 18), COPD ( n  = 15), OSAS ( n  = 16), 12 obese without OSAS or COPD, and one control group of 11 normal subjects. All patients underwent sputum induction and the analysis of cell patterns were evaluated in all groups. The relationship with the degree of obesity, airway obstruction and OSAS severity was also evaluated. Results The percentage of neutrophils in induced sputum was higher in OS (74.33% ± 14.8), COPD (63.33% ± 13.22) and OSAS (60.69% ± 17.6) subjects compared with control groups of obese (43.5% ± 17.49) and normal weight (32.04% ± 12.26). No difference was found among Overlap, COPD, and OSAS patients ( p  = 0.56). A negative correlation was found between PaO2 and percentage of airway neutrophils ( r  = −0.29, p  &lt; 0.05); similarly, no correlations arose between BMI, FEV1 or ODI. Conclusion Patients suffering from Overlap Syndrome present a high percentage of neutrophils in induced sputum like patients affected by COPD or OSAS alone. Our result suggests that airway inflammations is always involved in all of these diseases, even though probably sustained by different mechanisms.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2010.10.023</identifier><identifier>PMID: 21130635</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Airway inflammation ; Airway management ; Biological and medical sciences ; Chronic obstructive pulmonary disease, asthma ; Continuous Positive Airway Pressure - methods ; COPD ; Disease ; Female ; Humans ; Hypotheses ; Hypoxia ; Laboratories ; Leukocyte Count ; Male ; Medical sciences ; Middle Aged ; Neutrophils ; Obesity ; OSAS ; Overlap Syndrome ; Pneumology ; Polysomnography - methods ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Disease, Chronic Obstructive - therapy ; Pulmonary/Respiratory ; Respiratory Function Tests - methods ; Risk Factors ; Sleep Apnea, Obstructive - diagnosis ; Sleep Apnea, Obstructive - physiopathology ; Sleep Apnea, Obstructive - therapy ; Sleep disorders ; Spirometry ; Sputum - cytology ; Statistical analysis ; Surveys and Questionnaires ; Syndrome ; Treatment Outcome</subject><ispartof>Respiratory medicine, 2011-02, Vol.105 (2), p.303-309</ispartof><rights>Elsevier Ltd</rights><rights>2010 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Ltd. 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This coexistence is known as Overlap Syndrome (OS). Both diseases are characterized by local and systemic inflammations, but no studies to date have investigated local airway inflammation in patients suffering from Overlap Syndrome. Methods We performed a Berlin Questionnaire to evaluate the presence of the principal OSAS symptoms, a pulmonary function test, and then a nocturnal oximetry and polysomnography in 72 patients that were divided into five groups: OS ( n  = 18), COPD ( n  = 15), OSAS ( n  = 16), 12 obese without OSAS or COPD, and one control group of 11 normal subjects. All patients underwent sputum induction and the analysis of cell patterns were evaluated in all groups. The relationship with the degree of obesity, airway obstruction and OSAS severity was also evaluated. Results The percentage of neutrophils in induced sputum was higher in OS (74.33% ± 14.8), COPD (63.33% ± 13.22) and OSAS (60.69% ± 17.6) subjects compared with control groups of obese (43.5% ± 17.49) and normal weight (32.04% ± 12.26). No difference was found among Overlap, COPD, and OSAS patients ( p  = 0.56). A negative correlation was found between PaO2 and percentage of airway neutrophils ( r  = −0.29, p  &lt; 0.05); similarly, no correlations arose between BMI, FEV1 or ODI. Conclusion Patients suffering from Overlap Syndrome present a high percentage of neutrophils in induced sputum like patients affected by COPD or OSAS alone. 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Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lacedonia, Donato</au><au>Salerno, Francesco G</au><au>Sabato, Roberto</au><au>Carpagnano, Giovanna E</au><au>Aliani, Maria</au><au>Palladino, Grazia P</au><au>Foschino Barbaro, Maria P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Airway cell patterns in patients suffering from COPD and OSAS (Overlap Syndrome)</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>105</volume><issue>2</issue><spage>303</spage><epage>309</epage><pages>303-309</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Summary Background Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often coexist within an individual. This coexistence is known as Overlap Syndrome (OS). Both diseases are characterized by local and systemic inflammations, but no studies to date have investigated local airway inflammation in patients suffering from Overlap Syndrome. Methods We performed a Berlin Questionnaire to evaluate the presence of the principal OSAS symptoms, a pulmonary function test, and then a nocturnal oximetry and polysomnography in 72 patients that were divided into five groups: OS ( n  = 18), COPD ( n  = 15), OSAS ( n  = 16), 12 obese without OSAS or COPD, and one control group of 11 normal subjects. All patients underwent sputum induction and the analysis of cell patterns were evaluated in all groups. The relationship with the degree of obesity, airway obstruction and OSAS severity was also evaluated. Results The percentage of neutrophils in induced sputum was higher in OS (74.33% ± 14.8), COPD (63.33% ± 13.22) and OSAS (60.69% ± 17.6) subjects compared with control groups of obese (43.5% ± 17.49) and normal weight (32.04% ± 12.26). No difference was found among Overlap, COPD, and OSAS patients ( p  = 0.56). A negative correlation was found between PaO2 and percentage of airway neutrophils ( r  = −0.29, p  &lt; 0.05); similarly, no correlations arose between BMI, FEV1 or ODI. Conclusion Patients suffering from Overlap Syndrome present a high percentage of neutrophils in induced sputum like patients affected by COPD or OSAS alone. Our result suggests that airway inflammations is always involved in all of these diseases, even though probably sustained by different mechanisms.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>21130635</pmid><doi>10.1016/j.rmed.2010.10.023</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Airway inflammation
Airway management
Biological and medical sciences
Chronic obstructive pulmonary disease, asthma
Continuous Positive Airway Pressure - methods
COPD
Disease
Female
Humans
Hypotheses
Hypoxia
Laboratories
Leukocyte Count
Male
Medical sciences
Middle Aged
Neutrophils
Obesity
OSAS
Overlap Syndrome
Pneumology
Polysomnography - methods
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Disease, Chronic Obstructive - therapy
Pulmonary/Respiratory
Respiratory Function Tests - methods
Risk Factors
Sleep Apnea, Obstructive - diagnosis
Sleep Apnea, Obstructive - physiopathology
Sleep Apnea, Obstructive - therapy
Sleep disorders
Spirometry
Sputum - cytology
Statistical analysis
Surveys and Questionnaires
Syndrome
Treatment Outcome
title Airway cell patterns in patients suffering from COPD and OSAS (Overlap Syndrome)
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