title: Obstructive Sleep Apnoea Modulates Airway Inflammation and Remodelling in Severe Asthma.
abstract: BACKGROUND
  Obstructive sleep apnoea (OSA) is frequently observed in severe asthma but the causal link between the 2 diseases remains hypothetical. The role of OSA-related systemic and airway neutrophilic inflammation in asthma bronchial inflammation or remodelling has been rarely investigated. The aim of this study was to compare hallmarks of inflammation in induced sputum and features of airway remodelling in bronchial biopsies from adult patients with severe asthma with and without OSA.
  
  
  METHODS
  An overnight polygraphy was performed in 55 patients referred for difficult-to-treat asthma, who complained of nocturnal respiratory symptoms, poor sleep quality or fatigue. We compared sputum analysis, reticular basement membrane (RBM) thickness, smooth muscle area, vascular density and inflammatory cell infiltration in bronchial biopsies.
  
  
  RESULTS
  In total, 27/55 patients (49%) had OSA diagnosed by overnight polygraphy. Despite a moderate increase in apnoea-hypopnoea index (AHI; 14.2 ± 1.6 event/h [5-35]), the proportion of sputum neutrophils was higher and that of macrophages lower in OSA than non-OSA patients, with higher levels of interleukin 8 and matrix metalloproteinase 9. The RBM was significantly thinner in OSA than non-OSA patients (5.8 ± 0.4 vs. 7.8 ± 0.4 μm, p<0.05). RBM thickness and OSA severity assessed by the AHI were negatively correlated (rho = -0.65, p<0.05). OSA and non-OSA patients did not differ in age, sex, BMI, lung function, asthma control findings or treatment.
  
  
  CONCLUSIONS
  Mild OSA in patients with severe asthma is associated with increased proportion of neutrophils in sputum and changes in airway remodelling.
authors.affiliation: Service de Pneumologie A et Centre de Compétence des Maladies Pulmonaires Rares, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.|Laboratoire d'Excellence INFLAMEX, Paris, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Taillé
authors.affiliation: Centre du Sommeil, Service de Physiologie-Explorations Fonctionnelles, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.
authors.forename: Anny
authors.initials: A
authors.lastname: Rouvel-Tallec
authors.affiliation: Centre du Sommeil, Service de Physiologie-Explorations Fonctionnelles, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.
authors.forename: Maria
authors.initials: M
authors.lastname: Stoica
authors.affiliation: Laboratoire d'Anatomie et Cytologie Pathologiques Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.|Laboratoire d'Excellence INFLAMEX, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Danel
authors.affiliation: Laboratoire de Biochimie, Hôpital Bichat-Claude Bernard Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.|Laboratoire d'Excellence INFLAMEX, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Dehoux
authors.affiliation: Inserm UMR-S 996, Faculté de Pharmacie, Université Paris sud, Châtenay-Malabry, France.
authors.forename: Viviana
authors.initials: V
authors.lastname: Marin-Esteban
authors.affiliation: Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.|Laboratoire d'Excellence INFLAMEX, Paris, France.
authors.forename: Marina
authors.initials: M
authors.lastname: Pretolani
authors.affiliation: Service de Pneumologie A et Centre de Compétence des Maladies Pulmonaires Rares, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.|Laboratoire d'Excellence INFLAMEX, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Aubier
authors.affiliation: Centre du Sommeil, Service de Physiologie-Explorations Fonctionnelles, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm UMR 1152, Paris, France.|Département Hospitalo-Universitaire FIRE, Paris, France.
authors.forename: Marie-Pia
authors.initials: MP
authors.lastname: d'Ortho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000503:physiopathology*; D016209:Interleukin-8 / Q000378:metabolism; D008264:Macrophages / Q000378:metabolism; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D011446:Prospective Studies; D012137:Respiratory System / Q000378:metabolism / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000378:metabolism / Q000503:physiopathology*; D013183:Sputum / Q000378:metabolism; D055815:Young Adult
chemical_list: C508606:CXCL8 protein, human; D016209:Interleukin-8; D020780:Matrix Metalloproteinase 9