51
|
High apolipoprotein M serum levels correlate with chronic obstructive pulmonary disease. Lipids Health Dis 2016; 15:59. [PMID: 27001252 PMCID: PMC4802916 DOI: 10.1186/s12944-016-0228-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/15/2016] [Indexed: 11/16/2022] Open
Abstract
Background Recently, variations in a component of high-density lipoprotein (HDL), namely apolipoprotein M (apoM), were found to be associated with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the association between apoM and COPD severity. Factors associated with apoM, COPD, or coronary artery disease (CAD) were also assessed. Methods A total of 110 COPD patients and 110 age- and sex-matched non-COPD controls were included. Among them, thirty COPD patients and seven non-COPD controls had CAD. ApoM and pentraxin-3 levels were measured by ELISA. Additionally, the levels of high-sensitivity C-reactive protein (hs-CRP), cholesterol, and triglyceride were assessed using an automatic biochemical analyzer. Results Serum apoM levels increased gradually with COPD severity, with the most prominent apoM elevation observed in very severe COPD cases. In addition, ApoM was correlated with percent-predicted forced expiratory volume in one second (% predicted FEV1) (r = −0.38, P < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = 0.23, P < 0.017), and hs-CRP (r = 0.24, P = 0.01) in COPD patients. Furthermore, apoM was shown to be a risk factor for COPD onset (OR = 1.095, 95 % CI = 1.034–1.160, P = 0.002), but not associated with CAD in COPD patients. Conclusions Serum apoM was elevated in COPD patients and increased gradually with COPD severity. However, there was no association between apoM and CAD development in COPD patients. Electronic supplementary material The online version of this article (doi:10.1186/s12944-016-0228-1) contains supplementary material, which is available to authorized users.
Collapse
|
52
|
Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy. World J Pediatr 2016; 12:103-8. [PMID: 26684310 DOI: 10.1007/s12519-015-0066-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 10/15/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Adenotonsillar hypertrophy can produce cardiopulmonary disease in children. However, it is unclear whether adenotonsillar hypertrophy causes atherosclerosis. This study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy. METHODS The study included 40 children with adenotonsillar hypertrophy (age: 5-10 years) and 36 healthy children with similar age and body mass index. Systolic blood pressure, diastolic blood pressure, and pulse pressure were measured in all subjects. Carotid intima-media thickness, carotid arterial systolic diameter, and carotid arterial diastolic diameter were measured using a high-resolution ultrasound device. Based on these measurements, carotid arterial strain, carotid artery distensibility, beta stiffness index, and elasticity modulus were calculated. RESULTS Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy (0.36±0.05 mm vs. 0.34±0.04 mm, P=0.02) compared to healthy controls. Beta stiffness index (3.01±1.22 vs. 2.98±0.98, P=0.85), elasticity modulus (231.39±99.23 vs. 226.46±83.20, P=0.88), carotid arterial strain (0.17±0.06 vs. 0.17±0.04, P=0.95), and carotid artery distensibility (13.14±3.88 vs. 12.92±3.84, P=0.75) were similar between children with adenotonsillar hypertrophy and the healthy controls. CONCLUSIONS The present study revealed increased carotid intima-media thickness in children with adenotonsillar hypertrophy. The risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.
Collapse
|
53
|
Kim HS, Won S, Lee EK, Chun YH, Yoon JS, Kim HH, Kim JT. Pentraxin 3 as a clinical marker in children with lower respiratory tract infection. Pediatr Pulmonol 2016; 51:42-8. [PMID: 25832310 PMCID: PMC7168119 DOI: 10.1002/ppul.23199] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 02/06/2015] [Accepted: 02/27/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pentraxin 3 (PTX-3) is an acute-phase protein that increases in the plasma during inflammation. OBJECTIVE We aimed to evaluate the usefulness of PTX-3 as a clinical marker in children with lower respiratory tract infection (LRTI) and examine the correlation of PTX-3 with other biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT). METHODS We enrolled 117 consecutive patients admitted to Seoul St. Mary's Hospital with LRTI using the WHO criteria. We recorded data on fever duration and peak temperature before admission, duration of fever after admission, respiratory rate, heart rate, oxygen saturation upon admission, duration of oxygen supplementation, and duration of hospital stay. Upon admission, white blood cell (WBC) count, erythrocyte sedimentation rate, CRP level were measured. Multiplex respiratory virus polymerase chain reaction was performed using nasal swabs. PTX-3, PCT, and various cytokines were measured after the study had been completed. RESULTS We found that there was no significant difference in the level of PTX-3 according to the type of viral infection. PTX-3 levels showed a significant correlation with PCT levels, but not with levels of CRP. The level of PTX-3 showed a significant correlation with peak temperature and duration of fever before admission as well as interleukin (IL)-6 levels. PCT levels showed a significant correlation with IL-6 and granulocyte-colony stimulating factor levels, peak temperature, and duration of fever before admission, and duration of hospital stay. CRP levels showed a significant correlation with duration of fever before admission, total WBC count, and neutrophil count. PCT levels significantly predicted a hospital stay of 7 days or more. PTX-3, PCT, and CRP levels showed no correlation with any other clinical features. CONCLUSION PTX-3 reflected disease severity but failed to predict length of hospital stay. Further studies evaluating the use of PTX-3 as a biomarker in mild LRTI would be useful.
Collapse
Affiliation(s)
- Hwan Soo Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sulmui Won
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eu Kyoung Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon Hong Chun
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
54
|
Obstructive Sleep Apnea, Hypertension, and Their Additive Effects on Atherosclerosis. Biochem Res Int 2015; 2015:984193. [PMID: 26697221 PMCID: PMC4678058 DOI: 10.1155/2015/984193] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 09/29/2015] [Indexed: 01/30/2023] Open
Abstract
Background and Aims. It is widely accepted that obstructive sleep apnea (OSA) is independently associated with atherosclerosis. Similar to OSA, hypertension (HTN) is a condition associated with atherosclerosis. However, to date, the impact of the simultaneous presence of OSA and HTN on the risk of atherosclerosis has not been extensively studied. The aim of this study was to evaluate the consequences of the coexistence of OSA and HTN on carotid intima-media thickness (IMT) and on inflammatory markers of atherosclerosis (such as interleukin- [IL-] 6 and pentraxin- [PTX-] 3). Methods. The study design allowed us to define 4 groups: (1) controls (n = 30); (2) OSA patients without HTN (n = 30); (3) HTN patients without OSA (n = 30); (4) patients with OSA and HTN (n = 30). In the morning after portable monitoring (between 7 am and 8 am), blood samples were collected, and carotid IMT was measured. Results. Carotid IMT, IL-6, and PTX-3 in OSA normotensive patients and in non-OSA HTN subjects were significantly higher compared to control subjects; in addition, in OSA hypertensive patients they were significantly increased compared to OSA normotensive, non-OSA HTN, or control subjects. Conclusions. OSA and HTN have an additive role in the progression of carotid atherosclerosis and in blood levels of inflammatory markers for atherosclerosis, such as interleukin-6 and pentraxin-3.
Collapse
|
55
|
Normal human CD4(+) helper T cells express Kv1.1 voltage-gated K(+) channels, and selective Kv1.1 block in T cells induces by itself robust TNFα production and secretion and activation of the NFκB non-canonical pathway. J Neural Transm (Vienna) 2015; 123:137-57. [PMID: 26611796 DOI: 10.1007/s00702-015-1446-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 08/16/2015] [Indexed: 10/22/2022]
Abstract
TNFα is a very potent and pleiotropic pro-inflammatory cytokine, essential to the immune system for eradicating cancer and microorganisms, and to the nervous system, for brain development and ongoing function. Yet, excess and/or chronic TNFα secretion causes massive tissue damage in autoimmune, inflammatory and neurological diseases and injuries. Therefore, many patients with autoimmune/inflammatory diseases receive anti-TNFα medications. TNFα is secreted primarily by CD4(+) T cells, macrophages, monocytes, neutrophils and NK cells, mainly after immune stimulation. Yet, the cause for the pathologically high and chronic TNFα secretion is unknown. Can blocking of a particular ion channel in T cells induce by itself TNFα secretion? Such phenomenon was never revealed or even hypothesized. In this interdisciplinary study we discovered that: (1) normal human T cells express Kv1.1 voltage-gated potassium channel mRNA, and the Kv1.1 membrane-anchored protein channel; (2) Kv1.1 is expressed in most CD4(+)CD3(+) helper T cells (mean CD4(+)CD3(+)Kv1.1(+) T cells of 7 healthy subjects: 53.09 ± 22.17 %), but not in CD8(+)CD3(+) cytotoxic T cells (mean CD8(+)CD3(+)Kv1.1(+) T cells: 4.12 ± 3.04 %); (3) electrophysiological whole-cell recordings in normal human T cells revealed Kv currents; (4) Dendrotoxin-K (DTX-K), a highly selective Kv1.1 blocker derived from snake toxin, increases the rate of rise and decay of Kv currents in both resting and activated T cells, without affecting the peak current; (5) DTX-K by itself induces robust TNFα production and secretion by normal human T cells, without elevating IFNγ, IL-4 and IL-10; (6) intact Ca(2+) channels are required for DTX-induced TNFα secretion; (7) selective anti-Kv1.1 antibodies also induce by themselves TNFα secretion; (8) DTX-K activates NFκB in normal human T cells via the unique non-canonical-pathway; (9) injection of Kv1.1-blocked human T cells to SCID mice, causes recruitment of resident mouse cells into the liver, alike reported after TNFα injection into the brain. Based on our discoveries we speculate that abnormally blocked Kv1.1 in T cells (and other immune cells?), due to either anti-Kv1.1 autoimmune antibodies, or Kv1.1-blocking toxins alike DTX-K, or Kv1.1-blocking genetic mutations, may be responsible for the chronic/excessive TNFα in autoimmune/inflammatory diseases. Independently, we also hypothesize that selective block of Kv1.1 in CD4(+) T cells of patients with cancer or chronic infectious diseases could be therapeutic, since it may: a. augment beneficial secretion and delivery of TNFα to the disease-affected sites; b. induce recruitment and extravasation of curative immune cells and factors; c. improve accessibility of drugs to the brain and few peripheral organs thanks to TNFα-induced increased permeability of organ's barriers.
Collapse
|
56
|
Roles of interleukin (IL)-6 gene polymorphisms, serum IL-6 levels, and treatment in obstructive sleep apnea: a meta-analysis. Sleep Breath 2015; 20:719-31. [DOI: 10.1007/s11325-015-1288-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/21/2015] [Accepted: 11/02/2015] [Indexed: 12/20/2022]
|
57
|
Wang J, Yu W, Gao M, Zhang F, Gu C, Yu Y, Wei Y. Impact of Obstructive Sleep Apnea Syndrome on Endothelial Function, Arterial Stiffening, and Serum Inflammatory Markers: An Updated Meta-analysis and Metaregression of 18 Studies. J Am Heart Assoc 2015; 4:e002454. [PMID: 26567373 PMCID: PMC4845236 DOI: 10.1161/jaha.115.002454] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/02/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) has been indicated to contribute to the development of cardiovascular disease; however, the underlying mechanism remains unclear. This study aimed to test the hypothesis that OSAS may be associated with cardiovascular disease by elevating serum levels of inflammatory markers and causing arterial stiffening and endothelial dysfunction. METHODS AND RESULTS Related scientific reports published from January 1, 2006, to June 30, 2015, were searched in the following electronic literature databases: PubMed, Excerpta Medica Database, ISI Web of Science, Directory of Open Access Journals, and the Cochrane Library. The association of OSAS with serum levels of inflammatory markers, endothelial dysfunction, and arterial stiffening were investigated. Overall, 18 eligible articles containing 736 patients with OSAS and 424 healthy persons were included in this meta-analysis. Flow-mediated dilation in patients with moderate-severe OSAS was significantly lower than that in controls (standardized mean difference -1.02, 95% CI -1.31 to -0.73, P<0.0001). Carotid-femoral pulse wave velocity (standardized mean difference 0.45, 95% CI 0.21-0.69, P<0.0001), augmentation index (standardized mean difference 0.57, 95% CI 0.25-0.90, P<0.0001), and serum levels of high-sensitivity C-reactive protein and C-reactive protein (standardized mean difference 0.58, 95% CI 0.42-0.73, P<0.0001) were significantly higher in patients with OSAS than in controls. CONCLUSION OSAS, particularly moderate-severe OSAS, appeared to reduce endothelial function, increase arterial stiffness, and cause chronic inflammation, leading to the development of cardiovascular disease.
Collapse
Affiliation(s)
- Jiayang Wang
- Department of Cardiac SurgeryBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| | - Wenyuan Yu
- Department of Cardiac SurgeryBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| | - Mingxin Gao
- Department of Cardiac SurgeryBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| | - Fan Zhang
- Department of Cardiac SurgeryBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| | - Chengxiong Gu
- Department of Cardiac SurgeryBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| | - Yang Yu
- Department of Cardiac SurgeryBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| | - Yongxiang Wei
- Department of OtolaryngologyBeijing An Zhen HospitalCapital Medical UniversityBeijingChina
| |
Collapse
|
58
|
Meng LL, Tang YZ, Ni CL, Yang M, Song HN, Wang G, Li YZ, Zhang M, Li DQ. Impact of inflammatory markers on the relationship between sleep quality and incident cardiovascular events in type 2 diabetes. J Diabetes Complications 2015; 29:882-6. [PMID: 26190532 DOI: 10.1016/j.jdiacomp.2015.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/23/2015] [Accepted: 06/25/2015] [Indexed: 11/26/2022]
Abstract
AIMS To analyze relevance of sleep quality with CVD in T2D patients and determine whether inflammation prompted by poor sleep has impact on the CVD. METHODS 332 T2D patients were recruited and their sleep qualities were evaluated by PSQI. The patients with PSQI score >7 were in the poor sleep group, and the others were in the good sleep group. Plasma samples of the patients were obtained to measure inflammatory markers. Correlation analyses and regression analyses were performed to examine the cross-sectional relationships among the poor sleep, inflammatory markers and CVD. RESULTS The morbidity of CVD was significantly higher in the poor sleep patients compared to the good sleep patients (P=0.000). PSQI score ORs were both >1 for CVD in model 1 and model 2 (P<0.05). PSQI score were positively related to IL-6 and ICAM-1(P<0.05), negatively to FBI (P<0.05), but not related to CRP in linear regression models. Multiple logistic regression analysis showed IL-6 and ICAM-1, but not FBI and CRP, were related to CVD (P<0.05). CONCLUSIONS Poor sleep is regarded as a plausible risk factor for CVD in T2D patients, and may be mediated by certain inflammatory markers.
Collapse
Affiliation(s)
- Ling-Ling Meng
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Yun-Zhao Tang
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Chang-Lin Ni
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Min Yang
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Hong-Na Song
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Gang Wang
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Yu-Zhu Li
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Min Zhang
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China
| | - Dai-Qing Li
- Key Laboratory of Hormones and Development (Ministry of Health), Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China.
| |
Collapse
|
59
|
Kanbay A, Kaya E, Büyükoğlan H, Kaya MG, Şimşek ZÖ, Tutar N, Demir R. Correlation between pentraxin-3 and endothelial dysfunction in obstructive sleep apnea syndrome. Ann Thorac Med 2015; 10:199-203. [PMID: 26229563 PMCID: PMC4518351 DOI: 10.4103/1817-1737.160840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 04/30/2015] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIM Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for cardiovascular disease. Recent studies showed endothelial dysfunction and pentraxin-3 both of an early marker for development of cardiovascular disease. The aim of the study was to evaluate the relationship between severity of OSAS and endothelial dysfunction and inflammatory markers including pentraxin-3 and high-sensitivity C-reactive protein (hs-CRP). METHODS This was a cross-sectional study in which patients who had undergone a polysomnographic study for diagnosis of OSAS were recruited. Included patients were grouped according to apnea-hypopnea index (AHI) as mild (AHI between 5 and 14.9) and moderate-severe OSAS (AHI ⩾ 15). Patients with AHI < 5 served as control group. Endothelial function was evaluated by flow-mediated dilatation (FMD). Serum pentraxin-3 and hs-CRP levels were measured. RESULTS Eighty-three patients enrolled for the study. We found a significant increment in pentraxin-3 and hs-CRP levels and a significant decrement in FMD as the severity of OSAS increased. There was a negative correlation between FMD and AHI, pentraxin, and hs-CRP. CONCLUSION OSAS patients have significantly elevated pentraxin-3 levels and endothelial dysfunction. Furthermore, both pentraxin-3 and endothelial dysfunction were independently associated with severity of OSAS defined by AHI.
Collapse
Affiliation(s)
- Asiye Kanbay
- Department of Pulmonary Medicine, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Elif Kaya
- Department of Pulmonary Medicine, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Hakan Büyükoğlan
- Department of Pulmonary Medicine, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Mehmet Güngör Kaya
- Department of Cardiology, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Zuhal Özer Şimşek
- Department of Pulmonary Medicine, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Nuri Tutar
- Department of Pulmonary Medicine, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Ramazan Demir
- Department of Pulmonary Medicine, Erciyes University, School of Medicine, Kayseri, Turkey
| |
Collapse
|
60
|
Morrone CD, Liu M, Black SE, McLaurin J. Interaction between therapeutic interventions for Alzheimer's disease and physiological Aβ clearance mechanisms. Front Aging Neurosci 2015; 7:64. [PMID: 25999850 PMCID: PMC4419721 DOI: 10.3389/fnagi.2015.00064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 04/13/2015] [Indexed: 01/05/2023] Open
Abstract
Most therapeutic agents are designed to target a molecule or pathway without consideration of the mechanisms involved in the physiological turnover or removal of that target. In light of this and in particular for Alzheimer’s disease, a number of therapeutic interventions are presently being developed/investigated which target the amyloid-β peptide (Aβ). However, the literature has not adequately considered which Aβ physiological clearance pathways are necessary and sufficient for the effective action of these therapeutics. In this review, we evaluate the therapeutic strategies targeting Aβ presently in clinical development, discuss the possible interaction of these treatments with pathways that under normal physiological conditions are responsible for the turnover of Aβ and highlight possible caveats. We consider immunization strategies primarily reliant on a peripheral sink mechanism of action, small molecules that are reliant on entry into the CNS and thus degradation pathways within the brain, as well as lifestyle interventions that affect vascular, parenchymal and peripheral degradation pathways. We propose that effective development of Alzheimer’s disease therapeutic strategies targeting Aβ peptide will require consideration of the age- and disease-specific changes to endogenous Aβ clearance mechanisms in order to elicit maximal efficacy.
Collapse
Affiliation(s)
- Christopher D Morrone
- Biological Sciences, Sunnybrook Research Institute Toronto, ON, Canada ; Department of Laboratory Medicine and Pathobiology, University of Toronto Toronto, ON, Canada
| | - Mingzhe Liu
- Biological Sciences, Sunnybrook Research Institute Toronto, ON, Canada
| | - Sandra E Black
- Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Department of Medicine (Neurology), University of Toronto Toronto, ON, Canada ; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre and University of Toronto Toronto, ON, Canada
| | - JoAnne McLaurin
- Biological Sciences, Sunnybrook Research Institute Toronto, ON, Canada ; Department of Laboratory Medicine and Pathobiology, University of Toronto Toronto, ON, Canada
| |
Collapse
|
61
|
Zhang B, Wang J, Xu Y, Zhou X, Liu J, Xu J, Li B, Zhi G. Correlative association of interleukin-6 with intima media thickness: a meta-analysis. Int J Clin Exp Med 2015; 8:4731-4743. [PMID: 26064414 PMCID: PMC4443248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 03/02/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Involvement of inflammatory processes in the atherogenesis is now well-recognized. The present study examines the relationship between a proinflammatory cytokine, interleukin-6 (IL-6), and atherosclerosis by meta-analyzing the correlation coefficients between IL-6 and intima media thickness reported in the relevant studies. METHOD Relevant research articles were searched in several electronic databases by using most relevant MeSH terms and keywords. For the meta-analyses, correlation coefficients of individual studies were first converted into Fisher's z scores and then overall effect size was transformed into correlation coefficient. Between-study hete rogeneity was tested by I(2) index and subgroup analyses were performed. Quality of the included studies was assessed and tests for publication bias were carried out. RESULTS Thirty seven studies were selected for the meta-analysis from which data of 14832 participants including healthy persons, persons at risk of CVD and patients of various diseases is used. The effect size (correlation coefficient) with 95% confidence interval (CI) between IL-6 and intima media thickness was 0.336 (0.327 to 0.345); P < 0.0001 in the overall meta-analysis, 0.446 (0.422 to 0.47); P < 0.0001 in patients suffering from any pathological condition; 0.478 (0.446 to 0.508); P < 0.0001 in patients suffering either from a CVD or a disease which poses risk of CVD; 0.327 (0.264 to 0.388); P < 0.0001 in patients suffering from a disease with no CVD risk; and 0.31 (0.291 to 0.327); P < 0.0001 in participants of community-based surveys. There was no significant publication bias. CONCLUSION Intima media thickness is significantly correlated with IL-6 levels in the patients with CVD or a disease posing risk of CVD as well as in apparently healthy populations.
Collapse
Affiliation(s)
- Bo Zhang
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Jing Wang
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Yong Xu
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Xiao Zhou
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Junsong Liu
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Jing Xu
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Bo Li
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| | - Guang Zhi
- Department of Cardiology, Chinese PLA General Hospital Beijing 100853, China
| |
Collapse
|
62
|
Abstract
Obstructive sleep apnea (OSA) is a common disorder associated with cardiovascular disease (CVD). One theory to explain this relationship proposes that OSA can induce systemic inflammation, thereby inducing CVD. This theory is based on the premise that obesity is a pro-inflammatory state, and that physiological derangements during sleep in subjects with OSA further aggravate inflammation. In support of this theory, some clinical studies have shown elevated inflammatory biomarkers in OSA subjects, or improvement in these markers following treatment of OSA. However, the data are inconsistent and often confounded by the effects of comorbid obesity. Animal models of OSA have been developed, which involve exposure of rodents or cells to intermittent hypoxia, a hallmark feature of OSA. Several of these experiments demonstrate that intermittent hypoxia can stimulate inflammatory pathways and lead to cardiovascular or metabolic pathology. In this review, we review relationships between OSA and inflammation, with particular attention to studies published within the last year.
Collapse
Affiliation(s)
- Dileep Unnikrishnan
- Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Rm 5B.81, Baltimore, MD, 21224, USA
| | | | | |
Collapse
|
63
|
Haberka M, Gąsior Z. Carotid extra-media thickness in obesity and metabolic syndrome: a novel index of perivascular adipose tissue: extra-media thickness in obesity and metabolic syndrome. Atherosclerosis 2015; 239:169-77. [PMID: 25617857 DOI: 10.1016/j.atherosclerosis.2014.12.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/27/2014] [Accepted: 12/29/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We aimed to evaluate the association between a novel ultrasound index extra-media thickness (EMT), obesity, and metabolic syndrome (MS) using several measures of adiposity. METHODS Four hundred patients were included in the study (age: 60.95 ± 7.3 years, F/M: 35/65%). Both common carotid arteries (CCA) indexes (EMT and intima-media thickness), anthropometric parameters, body fat percentage and ultrasound measures of different fat depots were obtained in all patients. MS was identified using three alternative definitions: International Diabetes Federation 2005 (IDF), National Cholesterol Education Program Adult Treatment Panel III 2001 (NCEP ATP III) and World Health Organization 1998 (WHO). RESULTS The study group included patients with very high (80.2%) or high (19.8%) CV risk (IDF MS: 59.5%). Carotid EMT measures averaged from both sides (±SD) were as follows: mean EMT: 791 ± 126 μm, mean minimum EMT: 731 ± 115 μm and mean maximum EMT: 885 ± 210 μm. Patients with MS, irrespective of its definition and measures of obesity, displayed significantly thicker mean EMT compared to non-MS individuals: 819 ± 129 μm vs 747 ± 113 μm (p < 0.001; IDF), 824 ± 131 μm vs 751 ± 112 μm (p < 0.001; NCEP ATP III) and 825 ± 137 μm vs 773 ± 120 μm (p < 0.001; WHO). Moreover, EMT was related to all major parameters of general obesity, abdominal fat distribution, regional neck subcutaneous fat with weaker association between EMT and epicardial fat thickness. Finally, EMT is associated with an increasing number of CV risk factors. CONCLUSIONS This is the first study providing novel findings on the relationship between EMT, MS, and adiposity indexes. Our results suggest that EMT may be a new non-invasive index of perivascular adipose tissue corresponding to cardiometabolic risk.
Collapse
Affiliation(s)
- Maciej Haberka
- School of Health Sciences, Medical University of Silesia, Department of Cardiology, Katowice, Poland.
| | - Zbigniew Gąsior
- School of Health Sciences, Medical University of Silesia, Department of Cardiology, Katowice, Poland
| |
Collapse
|
64
|
Jennum P, Tønnesen P, Ibsen R, Kjellberg J. All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: a registry study with 10 years of follow-up. Nat Sci Sleep 2015; 7:43-50. [PMID: 25914563 PMCID: PMC4399513 DOI: 10.2147/nss.s75166] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND More information is needed about the effect on mortality of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), especially in women. METHODS We employed a historical cohort study design, using data from 25,389 patients with a diagnosis of OSA selected from the Danish National Patient Registry for the period 1999-2009. We used Cox proportional hazard function to evaluate the all-cause mortality from OSA in middle-aged and elderly males and females who were treated, or not, with CPAP. RESULTS Female OSA patients had a lower mortality than males, irrespective of whether they received CPAP treatment. CPAP treatment improved survival, as illustrated by the hazard ratio of 0.62 (P<0.001). This effect was dependent on gender: CPAP had no significant effect on 20- to 39-year-old males and females, but the overall mortality in this age group was small. Survival was increased by CPAP in 40- to 59-year-old and ≥60-year-old males, but no such effect was observed in females. Positive predictors of survival were young age, female gender, higher educational level, and low 3-year prior comorbidity as estimated by the Charlson Comorbidity Index. Negative predictors for survival were male gender, age ≥60 years, no CPAP treatment, prior comorbidity, and low educational level. CONCLUSION CPAP therapy is associated with reduced all-cause mortality in middle-aged and elderly males, but no significant effect was found in females.
Collapse
Affiliation(s)
- Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Copenhagen, Denmark ; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Philip Tønnesen
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Copenhagen, Denmark
| | | | - Jakob Kjellberg
- Danish National Institute for Local and Regional Government Research, Copenhagen, Denmark
| |
Collapse
|
65
|
El-Shafey BI, El-Bedewy MM, Mostafa T, Attia M. Serum resistin level in obstructive sleep apnea patients complicated with cardiac diseases, diabetes mellitus or renal impairment. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2014.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
66
|
Diagnostic potential of differentially expressed Homer1, IL-1β, and TNF-α in coronary artery disease. Int J Mol Sci 2014; 16:535-46. [PMID: 25551602 PMCID: PMC4307261 DOI: 10.3390/ijms16010535] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/22/2014] [Indexed: 11/22/2022] Open
Abstract
Increasing evidences suggest that inflammation plays an important role in the pathogenesis of coronary artery disease (CAD). Numerous inflammatory cytokines and related genes mediate adverse cardiovascular events in patients with CAD, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and Homer in the present study. The study was carried out on 163 CAD patients at different stages and 68 controls. The gene expression of Homer1, Homer2, Homer3, IL-1β, and TNF-α in the peripheral blood leukocytes were measured by real-time polymerase chain reaction. The mRNA levels of Homer1, IL-1β, and TNF-α in CAD patients were significantly higher than those in the control group, but not Homer2 and Homer3. However, there was no considerable difference in the mRNA levels of Homer1, IL-1β, and TNF-α among AMI, UAP, and SAP three subgroups of CAD. The receiver operating characteristic (ROC) curves showed that Homer1 had a better diagnostic value for UAP patients compared with IL-1β and TNF-α. Like IL-1β and TNF-α, Homer1 may also be an important participant of atherosclerotic plaque development and eventually rupture. The results of the present study may provide an important basis for diagnosing CAD patients, and provide new therapeutic targets for CAD.
Collapse
|
67
|
Biomarkers to improve diagnosis and monitoring of obstructive sleep apnea syndrome: current status and future perspectives. Pulm Med 2014; 2014:930535. [PMID: 25538852 PMCID: PMC4265695 DOI: 10.1155/2014/930535] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/23/2014] [Indexed: 02/06/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper airway collapse associated with oxygen desaturation and sleep disruption. It is proposed that these periodic changes lead to molecular variations that can be detected by assessing serum biomarkers. Studies have identified inflammatory, oxidative, and metabolic perturbations attributable to sleep-disordered breathing. Given that OSAS is associated with increased cardiovascular and cerebrovascular morbidity, the ideal biomarker should enable timely recognition with the possibility of intervention. There is accumulating data on the utility of serum biomarkers for the evaluation of disease severity, prognosis, and response to treatment. However, current knowledge is limited by data collection techniques, disease complexity, and potential confounding factors. The current paper reviews the literature on the use of serum biomarkers in OSAS. It is concluded that the ideal serum biomarker still needs to be discovered, while caution is needed in the interpretation of hitherto available results.
Collapse
|
68
|
Gunbatar H, Sertogullarindan B, Ekin S, Akdag S, Arisoy A, Sayhan H. The correlation between red blood cell distribution width levels with the severity of obstructive sleep apnea and carotid intima media thickness. Med Sci Monit 2014; 20:2199-204. [PMID: 25380170 PMCID: PMC4301218 DOI: 10.12659/msm.891001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive collapse of the upper airway during sleep. Red blood cell distribution width (RDW) increases platelet activation and has been reported as an independent predictor of adverse outcomes in the general population and is believed to be associated with cardiovascular morbidity and mortality. We evaluated RDW, mean platelet volume (MPV), and platelet distribution width (PDW) as a severity index in OSAS and the relationship between carotid intima media thickness and pulmonary hypertension. Material/Methods The study population consisted of 99 patients who were admitted to the sleep laboratory. Based on the apnea-hypopnea index, patients were grouped into 3 OSAS severity categories. Morning blood samples were withdrawn from patients after a 12-hour fasting period. MPV, PDW, and RDW were measured in a blood sample. Bilateral common carotid arteries of the patients were scanned. Results Ninety-nine patients – 73 with OSAS and 26 simple snoring control cases – were included. Mean values of MPV, PDW, and RDW were similar in patients compared to simple snoring subjects in the control group (p=0.162, p=0.656, p=0.091). RDW showed an inverse correlation with mean desaturation and lowest desaturation (p<0.01). Body mass index, apnea-hypopnea index, pulmonary artery pressure, and desaturation time under 90% were positively correlated with RDW (p<0.05). MPV, PDW, and carotid intima media thickness had no correlation with any other parameters. Conclusions The study showed a positive relationship between RDW and the apnea-hypopnea index and systolic pulmonary hypertension in patients with OSAS.
Collapse
Affiliation(s)
- Hulya Gunbatar
- Department of Pulmonary and Critical Care, Yuzuncu Yil University, Medical Faculty, Van, Turkey
| | | | - Selami Ekin
- Department of Pulmonary and Critical Care, Yuzuncu Yil University, Medical Faculty, Van, Turkey
| | - Serkan Akdag
- Department of Cardiology, Yuzuncu Yil University, Medical Faculty, Van, Turkey
| | - Ahmet Arisoy
- Department of Pulmonary and Critical Care, Special Istanbul Hospital, Van, Turkey
| | - Havva Sayhan
- Department of Anesthesiology, Special Lokman Hekim Hospital, Van, Turkey
| |
Collapse
|
69
|
Obstructive sleep apnea in patients with rheumatoid arthritis: Correlation with disease activity and pulmonary function tests. EGYPTIAN RHEUMATOLOGIST 2014. [DOI: 10.1016/j.ejr.2014.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
70
|
Hanikoglu F, Huseyinoglu N, Ozben S, Cort A, Ozdem S, Ozben T. Increased plasma soluble tumor necrosis factor receptor-1 and myeloperoxidase activity in patients with obstructive sleep apnea syndrome. Int J Neurosci 2014; 125:655-62. [DOI: 10.3109/00207454.2014.960521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
71
|
Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study. Mediators Inflamm 2014; 2014:605280. [PMID: 24991089 PMCID: PMC4058796 DOI: 10.1155/2014/605280] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/17/2014] [Accepted: 05/01/2014] [Indexed: 11/30/2022] Open
Abstract
Introduction. Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. Aim. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers. Results. 204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST). BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P < 0.01), while MCP-1 levels were associated with more prolonged nocturnal hypercapnia (P < 0.001). Conclusion. IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.
Collapse
|