The peripheral neutrophils in subjects with COPD-OSA overlap syndrome and severe comorbidities: A feasible inflammatory biomarker?

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dc.contributor.authorMacrea, Madallnaen
dc.contributor.authorCampbell, Sabrinaen
dc.contributor.authorMartin, Thomasen
dc.contributor.authorOursler, Kris Annen
dc.date.accessioned2019-09-03T18:48:06Zen
dc.date.available2019-09-03T18:48:06Zen
dc.date.issued2018-12en
dc.description.abstractBackground. Overlap syndrome (OS) describes the association of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in a single individual. Subjects with OS have increased cardiovascular mortality which is presumed to be inflammation-mediated. As a clinical biomarker, an increased neutrophil count correlates with the severity of coronary artery stenosis. Objectives. As little is known about the role of neutrophils in the underlying inflammatory mechanisms in OS, we aimed to assess the percentage of peripheral neutrophils (PPN) in OS vs in COPD alone. Material and methods. A cross-sectional study of patients with COPD and severe comorbidities, as defined by a Care Assessment Need score over 95, were seen in the Pulmonary Tele-Health Clinic at the Salem Veteran Affairs Medical Center, USA, over a 1-year period. Demographic and polysomnographic data, FEV1 and the Charlson Comorbidity Index (CCI) were extracted from the Electronic Medical Records. Obstructive sleep apnea was defined according to the American Academy of Sleep Medicine (AASM) guidelines. Serum inflammatory markers (PPN, CRP, fibrinogen and procalcitonin) were obtained after the Tele-Health appointment. Results. Out of the 38 subjects with COPD, 17 (44%) had OS. Compliance with continuous positive airway pressure therapy (CPAP) was excellent in 7 OS subjects (41%). There was a significant difference in the PPN of subjects with OS vs COPD alone, regardless of whether they were compliant (p = 0.03) with the CPAP therapy or not (p = 0.005). No differences in the severity of COPD, baseline comorbidity, smoking, or inflammatory markers were found between the OS and COPD-only subjects. Body mass index (BMI), COPD severity, smoking, and home oxygen therapy (HOT) use were not associated with PPN (p > 0.2). Conclusions. Overlap syndrome subjects have higher PPN than those with COPD alone, regardless of their CPAP compliance. Our results could be used to motivate OS subjects to improve their lifestyles and to comply with drug therapies aimed at reducing cardiovascular disease (CVD).en
dc.description.notesThis research was supported by the Department of Veteran Affairs, Veterans Health Administration, Rehabilitation Research and Development Service through the VA Career Development Award given to Dr. Macrea.en
dc.description.sponsorshipDepartment of Veteran Affairs, Veterans Health Administration, Rehabilitation Research and Development Service through the VA Career Development Awarden
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.17219/acem/75904en
dc.identifier.issn1899-5276en
dc.identifier.issue12en
dc.identifier.pmid30085419en
dc.identifier.urihttp://hdl.handle.net/10919/93336en
dc.identifier.volume27en
dc.language.isoenen
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivs 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectobstructive sleep apneaen
dc.subjectchronic obstructive pulmonary diseaseen
dc.subjectcardiovascularen
dc.subjectsystemic inflammationen
dc.subjectneutrophilsen
dc.titleThe peripheral neutrophils in subjects with COPD-OSA overlap syndrome and severe comorbidities: A feasible inflammatory biomarker?en
dc.title.serialAdvances in Clinical and Experimental Medicineen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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