Non-invasive evaluation of airway flogosis in Obstructive Sleep Apnea Syndrome patients [Valutazione non invasiva della flogosi nelle vie aeree di pazienti con Sindrome delle Apnee Ostruttive Notturne]

Background. Airway inflammation after sleep has been suggested in moderate-severe Obstructive Sleep Apnea Syndrome (OSAS); the same authors put into evidence the key-role of inflammatory mediators and oxidative stress of upper airways, but few data exist on inflammatory cellularities patterns in OSAS patients airways. Aim. Aim of this study was to evaluate the presence of airway inflammation in a group of OSAS patients using exhaled nitric oxide (eNO) levels, an a specific marker of airway flogosis, and examining induced sputum (IS) cellularly, Materials and methods. eNO levels in the exhaled air were evaluated immediately after sleep in a sample of 12 moderate-severe obese OSAS patients with apnea-hypopnea index (AHI) > 10/h and in 10 healthy control subjects, sputum was induced with hypertonic saline. Results. eNO levels in OSAS patients were higher than control group; data from the differential cell count between two groups show the presence of neutrophilic inflammation in the lower airways. Conclusions. The main finding of this study, was that OSAS patients show airway inflammation with increase either of eNO levels and bronchial neutrophils, drawing attention to the possible role of inflammatory mechanisms in the pathophysiology of upper airway dysfunction in snoring and obstructive sleep apnea.