title: Pharyngeal lavage lymphocytosis in patients with obstructive sleep apnea: a preliminary observation.
abstract: BACKGROUND
  Upper airway inflammation has been previously demonstrated in obstructive sleep apnea (OSA). However, investigation has been hampered by the necessity of invasive tissue biopsies.
  
  
  OBJECTIVE
  To evaluate the pharyngeal lavage (PHAL) as a new tool to analyze mucosal inflammation in the pharynx of patients with sleep-related disordered breathing.
  
  
  METHODS
  36 patients with a diagnosis of OSA, 14 patients with heavy snorer syndrome (HS) or body position dependent OSA (bd-OSA), and 14 healthy volunteers underwent PHAL. Inflammatory cell counts were compared.
  
  
  RESULTS
  Neutrophils were the predominant cells in PHAL in all groups (94.3% ± 0.7%, 98.5% ± 0.6%, 94.3% ± 0.7%, and 96.2% ± 1.4%). OSA patients had significantly increased numbers of lymphocytes (3.2% ± 0.4%) compared to bd-OSA/HS and controls group (0.5% ± 0.1% and 0.6% ± 0.2%, respectively; P<0.05). Patients with moderate to severe OSA had significantly higher numbers of lymphocytes compared to patients with mild OSA (P<0.05).
  
  
  CONCLUSIONS
  Data from this study suggest that PHAL is a feasible tool to investigate upper airway inflammation in OSA. In addition, PHAL demonstrates lymphocytic inflammation of the pharynx in OSA patients. Future studies are warranted to evaluate whether PHAL can be used to monitor disease and whether lymphocytic inflammation is affected by OSA treatment.
authors.affiliation: Sleep Disorder Unit, Medical Clinic, Research Center Borstel, Borstel, Germany. hphauber@fz-borstel.de
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hauber
authors.forename: Stefan
authors.initials: S
authors.lastname: Rüller
authors.forename: Ernst
authors.initials: E
authors.lastname: Müller
authors.forename: Eike
authors.initials: E
authors.lastname: Hansen
authors.forename: Peter
authors.initials: P
authors.lastname: Zabel
mesh_terms: D016022:Case-Control Studies; D002452:Cell Count; D005240:Feasibility Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology; D008218:Lymphocytosis / Q000175:diagnosis* / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D010614:Pharynx / Q000473:pathology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000473:pathology*; D007507:Therapeutic Irrigation / Q000379:methods*