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Updated: Jul 20, 2026
Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Induced sputum inflammatory measures correlate with disease severity in children with obstructive sleep apnoea
1Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. albertmli@cuhk.edu.hk
Insights
Children with obstructive sleep apnoea (OSA) show increased airway inflammation, specifically higher neutrophil counts in sputum. This finding links inflammation to OSA severity in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Inflammation
Background:
- Obstructive sleep apnoea (OSA) is a common condition in children.
- The role of airway inflammation in pediatric OSA requires further elucidation.
Purpose of the Study:
- To investigate the association between airway inflammation and the severity of obstructive sleep apnoea (OSA) in children.
- To determine if specific inflammatory markers in sputum correlate with OSA diagnosis.
Main Methods:
- Recruited children with suspected OSA symptoms.
- Collected data through questionnaires, physical exams, spirometry, sputum induction, and polysomnography.
- Analyzed sputum for inflammatory cell counts, particularly neutrophils.
Main Results:
- Sputum induction was successful in 59% of participants.
- Children diagnosed with OSA exhibited significantly higher percentage sputum neutrophils compared to those without OSA (p=0.006).
- Percentage sputum neutrophil was independently associated with OSA diagnosis (OR=1.1, p=0.013).
Conclusions:
- Pediatric OSA is characterized by airway inflammation, evidenced by increased neutrophils.
- These findings suggest neutrophils as a potential biomarker for inflammation in childhood OSA.
- Further research is warranted to explore the molecular mechanisms and cellular interactions in pediatric OSA pathogenesis.
Objective:
To establish the association between airway inflammation and severity of obstructive sleep apnoea (OSA) in children.
Methods:
Consecutive children presenting with symptoms suggestive of OSA were recruited. They completed a sleep apnoea symptom questionnaire, underwent physical examination, spirometry, sputum induction and an overnight polysomnography. Adequate sputum contained <50% squamous epithelial cells, and OSA was diagnosed if the obstructive apnoea index was >1.
Results:
73 children with a median (interquartile range (IQR)) age of 11.3 (10.0-13.2) years were recruited. There were 21 girls and the median body mass index of the group was 24.0 (18.0-27.0) kg/m2. The most common presenting symptoms were habitual snoring, mouth breathing and prone sleeping position. Sputum induction was successful in 43 (59%) children, of whom 14 were found to have OSA. Children with OSA had significantly greater percentage sputum neutrophil than those without OSA (18.5 (IQR 8.0-42.0) v 4 (IQR 3.0-11.3), p = 0.006). On multiple regression analysis, percentage sputum neutrophil was significantly associated with OSA (odds ratio = 1.1, p = 0.013).
Conclusion:
Children with OSA had airway inflammation characterised by a marked increase in neutrophils. Further studies are needed to confirm these findings and to better define the downstream cellular interactions and molecular pathogenesis in childhood OSA.
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