title: Tracheostomy and related host-pathogen interaction are associated with airway inflammation as characterized by tracheal aspirate analysis.
abstract: In the last years an increasing number of subjects experienced respiratory failure and underwent tracheostomy. The aim of the present study was to analyze tracheal aspirates from the inflammatory point of view. Samples were collected from 38 consecutive tracheostomized patients: 13 COPD, 6 with neurologic disorders and 19 with other different causes of respiratory failure. We analyzed cells and soluble mediators related to inflammation and/or infection. We also compared results obtained in the tracheal aspirate of COPD patients with the same determination in the sputum of another group of non-tracheostomized COPD patients (n=41). Regardless of the underlying diagnosis, most of the samples were Pseudomonas aeruginosa positive and cells and soluble mediator did not differ. Treatment with steroids was associated with lower amount of total cells, neutrophils and lymphocytes, whereas treatment with antibiotics was not. Tracheal aspirate neutrophils correlated with PaCO(2) values; neutrophils and eosinophils correlated with their percentages in blood. As compared with sputa obtained from another group of culture-positive non-tracheostomized COPDs, tracheal aspirates showed similar cell count, proportions of inflammatory cells, and infection/inflammatory mediators. In conclusion tracheal aspirates presented high amounts of viable cells and soluble mediators independently to the cause of respiratory failure leading to tracheotomy and they represent suitable specimens to study infection/inflammation interactions.
authors.affiliation: Allergy and Immunology Unit, IRCCS Fondazione Salvatore Maugeri, 27100 Pavia, Italy. patrizia.pignatti@fsm.it
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pignatti
authors.forename: Antonella
authors.initials: A
authors.lastname: Balestrino
authors.forename: Christian
authors.initials: C
authors.lastname: Herr
authors.forename: Robert
authors.initials: R
authors.lastname: Bals
authors.forename: Dania
authors.initials: D
authors.lastname: Moretto
authors.forename: Massimo
authors.initials: M
authors.lastname: Corradi
authors.forename: Rossella
authors.initials: R
authors.lastname: Alinovi
authors.forename: Monica
authors.initials: M
authors.lastname: Delmastro
authors.forename: Claus
authors.initials: C
authors.lastname: Vogelmeier
authors.forename: Stefano
authors.initials: S
authors.lastname: Nava
authors.forename: Gianna
authors.initials: G
authors.lastname: Moscato
authors.forename: Bruno
authors.initials: B
authors.lastname: Balbi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001991:Bronchitis / Q000382:microbiology* / Q000473:pathology; D002478:Cells, Cultured; D005260:Female; D054884:Host-Pathogen Interactions / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000382:microbiology*; D012131:Respiratory Insufficiency / Q000382:microbiology* / Q000473:pathology; D012141:Respiratory Tract Infections / Q000382:microbiology* / Q000473:pathology; D013183:Sputum / Q000378:metabolism / Q000382:microbiology; D014132:Trachea / Q000378:metabolism / Q000382:microbiology; D014139:Tracheostomy