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Published ahead of print on August 11, 2004, doi:10.1164/rccm.200404-458OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 10, November 2004, 1114-1119

A more recent version of this article appeared on November 15, 2004
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Submitted on April 10, 2004
Accepted on August 10, 2004

Influence of Weight and Sleep Apnea Status on the Immunological and Structural Features of the Uvula

Frederic Series1*, Jamila Chakir1, and Dominick Boivin1

1 Unite de recherche en pneumologie, Centre de recherche de l'Hopital Laval, Institut universitaire de cardiologie et de pneumologie de l'Universite Laval, Saint-Foy, Quebec, Canada

* To whom correspondence should be addressed. E-mail: frederic.series{at}med.ulaval.ca.

We investigated the influence of weight and obstructive sleep apnea status on the inflammatory and histological features of the uvula. Tissue samples ressected during uvulopalatopharyngoplasty in 11 non-OSA snorers, 11 OSA subjects with similar body mass index and age and 8 additional obese sleep apnea subjects were examined using immunohistochemistry and histological staining techniques. The frequency and distribution of immune cells, the amount of collagen and the integrity of the elastin fiber network were evaluated in the proximal and distal uvular sections. T cell (CD4+, CD8+) and macrophage counts were higher in the more obese apneic subjects than in the other two groups. In all patients, the T cells counts correlated with the body mass index but there was no relationship with the apnea + hypopnea index. A positive correlation was found between elastin fiber network disorganization score and the apnea + hypopnea index. We conclude that: 1) the amount of inflammatory markers is linked to obesity rather than sleep-related breathing disorders, 2) obstructive sleep apnea is associated with a structural alteration of the extra-cellular matrix of upper airway tissue.
Key words: obesity, inflammation, upper airways, elastin, collagen, lymphocyte, macrophage, neutrophil




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