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Battaglia E, Banfi P, Compalati E, Nicolini A, Diaz DE Teran T, Gonzales M, Solidoro P. The pathogenesis of OSA-related hypertension: what are the determining factors? Minerva Med 2024; 115:68-82. [PMID: 37947781 DOI: 10.23736/s0026-4806.23.08466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Sleep-disordered breathing has a relatively high prevalence, which varies from 3-7% in males and from 2-5% in females in the adult population. Studies published in the literature have shown that sleep apnea is closely related to an increased risk of developing various pathologies, among which arterial hypertension stands out. The prevalence of hypertension in patients suffering from obstructive sleep apnea (OSA) ranges from 35-80% and appears to be related to OSA severity. Approximately 40-50% of patients affected by hypertension are also affected by OSA and this association seems to be stronger in young and middle-aged adults (<50 years of age). The primary objective of this narrative review is to provide an update on what are the main contributing comorbidities to the development of a hypertensive state in patients suffering from OSA, an independent risk factor for diurnal hypertension, implicated as a risk factor for the first stroke, recurrent stroke, and post-stroke mortality. There are a lot of factors that contribute to developing a hypertensive state in OSA patients, some more decisive, others less. More evidence from longitudinal studies is needed on the impact of OSA on cardiovascular risk in females, on the causal link between OSA and arterial hypertension or metabolic diseases, like diabetes and glucose intolerance, and the effect of different kinds of OSA treatment.
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Affiliation(s)
- Elvia Battaglia
- IRCCS Don Carlo Gnocchi Foundation - Santa Maria Nascente, Milan, Italy
| | - Paolo Banfi
- IRCCS Don Carlo Gnocchi Foundation - Santa Maria Nascente, Milan, Italy
| | - Elena Compalati
- IRCCS Don Carlo Gnocchi Foundation - Santa Maria Nascente, Milan, Italy -
| | | | - Teresa Diaz DE Teran
- Sleep Disorders and Non Invasive Ventilation Unit, Division of Pneumology, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Monica Gonzales
- Sleep Disorders and Non Invasive Ventilation Unit, Division of Pneumology, Marqués de Valdecilla University Hospital, Santander, Spain
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Tian Y, Wang S, Tong W, Wang H, Zhang Y, Teng B. Pseudoginsenoside GQ mitigates chronic intermittent hypoxia-induced cognitive damage by modulating microglia polarization. Int Immunopharmacol 2024; 126:111234. [PMID: 37977071 DOI: 10.1016/j.intimp.2023.111234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/04/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023]
Abstract
Obstructive sleep apnea (OSA), a state of sleep disruption, is characterized by recurrent apnea, chronic intermittent hypoxia (CIH) and hypercapnia. Previous studies have showed that CIH-induced neuroinflammatory plays a crucial role in cognitive deficits. Pseudoginsenoside GQ (PGQ) is a new oxytetracycline-type saponin formed by the oxidation and cyclization of the 20(S) Rg3 side chain. Rg3 has been found to afford anti-inflammatory effects, while whether PGQ plays a role of anti-neuroinflammatory remains unclear. The purpose of this study was to investigate whether PGQ attenuates CIH-induced neuroinflammatory and cognitive impairment and the possible mechanism it involves. We found that PGQ significantly ameliorated CIH-induced spatial learning deficits, and inhibited microglial activation, pro-inflammatory cytokine release, and neuronal apoptosis in the hippocampus of CIH mice. In addition, PGQ pretreatment promoted microglial M1 to M2 phenotypic transition in IH-induced BV-2 microglial, as well as indirectly inhibited IH-induced neuronal injury via modulation of microglia polarization. Furthermore, we noted that activation of HMGB1/TLR4/NF-κB signaling pathway induced by IH was inhibited by PGQ. Molecular docking results revealed that PGQ could bind to the active sites of HMGB1 and TLR4. Taken together, this work supports that PGQ inhibits M1 microglial polarization via the HMGB1/TLR4/NF-κB signaling pathway, and indirectly exerts neuroprotective effects, suggesting that PGQ may be a potential therapeutic strategy for cognitive impairment accompanied OSA.
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Affiliation(s)
- Yanhua Tian
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Sanchun Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Weifang Tong
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Hongyan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Yating Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Bo Teng
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China.
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Meyhöfer S, Steffen A, Plötze-Martin K, Marquardt JU, Meyhöfer SM, Bruchhage KL, Pries R. Obesity-related Plasma CXCL10 Drives CX3CR1-dependent Monocytic Secretion of Macrophage Migration Inhibitory Factor. Immunohorizons 2024; 8:19-28. [PMID: 38175171 PMCID: PMC10835669 DOI: 10.4049/immunohorizons.2300114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
Obesity is characterized by excessive body fat accumulation and comorbidities such as diabetes mellitus, cardiovascular disease, and obstructive sleep apnea syndrome (OSAS). Both obesity and OSAS are associated with immune disturbance, alterations of systemic inflammatory mediators, and immune cell recruitment to metabolic tissues. Chemokine CXCL10 is an important regulator of proinflammatory immune responses and is significantly increased in patients with severe obesity. This research project aims to investigate the impact of CXCL10 on human monocytes in patients with obesity. We studied the distribution of the CD14/CD16 monocyte subsets as well as their CX3CR1 expression patterns in whole-blood measurements from 92 patients with obesity and/or OSAS with regard to plasma CXCL10 values and individual clinical parameters. Furthermore, cytokine secretion by THP-1 monocytes in response to CXCL10 was analyzed. Data revealed significantly elevated plasma CXCL10 in patients with obesity with an additive effect of OSAS. CXCL10 was found to drive monocytic secretion of macrophage migration inhibitory factor via receptor protein CX3CR1, which significantly correlated with the individual body mass index. Our data show, for the first time, to our knowledge, that CX3CR1 is involved in alternative CXCL10 signaling in human monocytes in obesity-related inflammation. Obesity is a multifactorial disease, and further investigations regarding the complex interplay between obesity-related inflammatory mediators and systemic immune balances will help to better understand and improve the individual situation of our patients.
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Affiliation(s)
- Svenja Meyhöfer
- Department of Medicine 1, University Hospital of Schleswig-Holstein, Luebeck, Germany
- Institute for Endocrinology & Diabetes, Department of Internal Medicine 1, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Armin Steffen
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Kirstin Plötze-Martin
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Jens-Uwe Marquardt
- Department of Medicine 1, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Sebastian M Meyhöfer
- Institute for Endocrinology & Diabetes, Department of Internal Medicine 1, University Hospital of Schleswig-Holstein, Luebeck, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Ralph Pries
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Luebeck, Germany
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Huang Y, Shen C, Zhao W, Shang Y, Wang Y, Zhang HT, Ouyang R, Liu J. Genes Associated with Altered Brain Structure and Function in Obstructive Sleep Apnea. Biomedicines 2023; 12:15. [PMID: 38275376 PMCID: PMC10812994 DOI: 10.3390/biomedicines12010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Obstructive sleep apnea (OSA) has been widely reported to cause abnormalities in brain structure and function, but the genetic mechanisms behind these changes remain largely unexplored. Our research aims to investigate the relationship between sleep characteristics, cognitive impairments, genetic factors, and brain structure and function in OSA. Using structural and resting-state functional magnetic resonance imaging data, we compared cortical morphology and spontaneous brain activity between 28 patients with moderate-to-severe OSA and 34 healthy controls (HCs) utilizing voxel-based morphology (VBM) and the amplitude of low-frequency fluctuations (ALFF) analyses. In conjunction with the Allen Human Brain Atlas, we used transcriptome-neuroimaging spatial correlation analyses to investigate gene expression patterns associated with changes in gray matter volume (GMV) and ALFF in OSA. Compared to the HCs, the OSA group exhibited increased ALFF values in the left hippocampus (t = 5.294), amygdala (t = 4.176), caudate (t = 4.659), cerebellum (t = 5.896), and decreased ALFF values in the left precuneus (t = -4.776). VBM analysis revealed increased GMV in the right inferior parietal lobe (t = 5.158) in OSA. Additionally, functional enrichment analysis revealed that genes associated with both ALFF and GMV cross-sampling were enriched in gated channel activity and synaptic transmission, glutamatergic synapse, and neuron.
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Affiliation(s)
- Yijie Huang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; (Y.H.); (W.Z.); (Y.S.); (Y.W.)
| | - Chong Shen
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China;
| | - Wei Zhao
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; (Y.H.); (W.Z.); (Y.S.); (Y.W.)
- Clinical Research Center for Medical Imaging, Changsha 410011, China
- Department of Radiology Quality Control Center, Changsha 410011, China
| | - Youlan Shang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; (Y.H.); (W.Z.); (Y.S.); (Y.W.)
| | - Yisong Wang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; (Y.H.); (W.Z.); (Y.S.); (Y.W.)
| | - Hui-Ting Zhang
- MR Research Collaboration Team, Siemens Healthineers, Wuhan 430000, China;
| | - Ruoyun Ouyang
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China;
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; (Y.H.); (W.Z.); (Y.S.); (Y.W.)
- Clinical Research Center for Medical Imaging, Changsha 410011, China
- Department of Radiology Quality Control Center, Changsha 410011, China
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Kumari N, Arora N, Das S, Tiple S, Singh H, Patidar N, Mishra M, Majumdar A. Assessment of risk of obstructive sleep apnea with thyroid eye disease and its activity. Indian J Ophthalmol 2023; 71:3711-3714. [PMID: 37991309 PMCID: PMC10788756 DOI: 10.4103/ijo.ijo_912_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To evaluate the association between obstructive sleep apnea (OSA) and thyroid eye disease (TED) and its effect on disease activity. METHODS A prospective case-control study was conducted from January 2020 to March 2022. All TED patients (group A) were clinically evaluated. The activity of thyroid eye disease was calculated based on the clinical activity score (CAS), and grading of severity was done according to the EUGOGO classification. All TED patients (group A) were screened for OSA using the Snoring Tired Observed Pressure (STOP)-Bang survey. Age- and gender-matched control group patients (group B) without TED were screened for OSA. RESULTS One hundred TED patients and 138 control patients without TED were included in the respective groups. Sixty-two (62%) patients in group A and 48 (34.78%) patients in group B were having high risk of OSA, and this difference was statistically significant (P = 0.001). Further, in group A patients, on univariate analysis, TED activity was significantly associated with a high risk of OSA (P = 0.009). On multivariate logistic regression analysis, OSA also showed significant association with TED activity (odds ratio [OR]: 4.14, 95% confidence interval [CI]: 1.11-18.85 at 10% level; P = 0.05). CONCLUSION Our study showed that OSA is significantly associated with TED disease and its activity. However, no significant association was found between OSA and severity of the disease.
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Affiliation(s)
- Namita Kumari
- Oculoplasty and Ocular Oncology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Nitish Arora
- Oculoplasty and Ocular Oncology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Sima Das
- Oculoplasty and Ocular Oncology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Sweety Tiple
- Oculoplasty and Ocular Oncology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Harshdeep Singh
- Oculoplasty and Ocular Oncology, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Narendra Patidar
- Oculoplasty and Ocular Oncology, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Mihir Mishra
- Oculoplasty and Ocular Oncology, MGM Eye Institute, Raipur, Chattisgarh, India
| | - Atanu Majumdar
- Oculoplasty and Ocular Oncology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Janmohammadi P, Raeisi T, Zarei M, Nejad MM, Karimi R, Mirali Z, Zafary R, Alizadeh S. Adipocytokines in obstructive sleep apnea: A systematic review and meta-analysis. Respir Med 2023; 208:107122. [PMID: 36682601 DOI: 10.1016/j.rmed.2023.107122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIM Adipocytokines play an important role in obstructive sleep apnea (OSA) by mediating inflammatory responses. Previous studies have reported that OSA is related to a change in the serum levels of adipocytokines; however, the results are still controversial. This meta-analysis aimed to assess the relationship between OSA and circulating level of adipocytokines in adults and children. METHODS A comprehensive search was conducted in databases of Medline/PubMed and Scopus for pertinent articles published since their inception to July 2022. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to assess the strength of the relationship between the concentrations of adipocytokines with OSA. RESULTS In the overall analysis, contrary to IL-10, which showed a significant reduction, IL-1β, IL-4, IL-8, IL-17, and IFN- gamma showed higher levels in OSA patients in comparison with control groups (p <0.05). For adults, IL-1β, IL-8, IL-17, IL-18, vaspin, visfatin, and chemerin were linked to a greater serum levels in patients with OSA, while, IL-5 and IL-10 were detected significantly lower in adults with OSA in comparison with healthy adults (p <0.05). In children with OSA, the serum levels of IL-4, IL-8, IL-12, IL-17, IL-23, and IFN-gamma were significantly higher than healthy children (p <0.05). CONCLUSION The levels of inflammatory markers were found to be higher in OSA patients compared with control individuals, suggesting that adipocytokines may contribute to the pathology of OSA.
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Affiliation(s)
- Parisa Janmohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Tahereh Raeisi
- Department of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mahtab Zarei
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Mofidi Nejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Roya Karimi
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Zahra Mirali
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Reza Zafary
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Shahab Alizadeh
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Meyhöfer S, Steffen A, Plötze-Martin K, Lange C, Marquardt JU, Bruchhage KL, Meyhöfer SM, Pries R. Plasma Leptin Levels, Obstructive Sleep Apnea Syndrome, and Diabetes Are Associated with Obesity-Related Alterations of Peripheral Blood Monocyte Subsets. Immunohorizons 2023; 7:191-199. [PMID: 36921085 PMCID: PMC10563442 DOI: 10.4049/immunohorizons.2300009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
Obesity is a dramatically increasing disease, accompanied with comorbidities such as cardiovascular disease and obstructive sleep apnea syndrome (OSAS). Both obesity and OSAS per se are associated with systemic inflammation. However, the multifactorial impact of obesity, OSAS, and its concomitant diseases on the immunological characteristics of circulating monocytes has not yet been fully resolved. Monocyte subsets of 82 patients with obesity were analyzed in whole blood measurements in terms of the CD14/CD16 cell surface expression patterns and different monocytic adhesion molecules using flow cytometry. Plasma levels of adipokines adiponectin and leptin of all patients were evaluated and correlated with accompanying cellular and clinical values. Whole blood measurements revealed a significant overall redistribution of CD14/CD16 monocyte subsets in patients with obesity. Monocytic adhesion molecules CD11a, CD11b, and CX3CR1 were significantly elevated. The observed alterations significantly correlated with plasma leptin levels and diabetes status as crucial amplifying factors. The additive impact of obesity, diabetes, and OSAS on the immunological balance of peripheral blood monocytes requires a coordinated regimen in terms of therapeutic treatment, respiratory support, and weight loss to improve the systemic immunity in these patients.
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Affiliation(s)
- Svenja Meyhöfer
- Department of Medicine 1, University Hospital of Schleswig-Holstein, Lübeck, Germany
- Institute for Endocrinology & Diabetes, Department of Internal Medicine 1, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Armin Steffen
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Kirstin Plötze-Martin
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Christian Lange
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Jens-Uwe Marquardt
- Department of Medicine 1, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Sebastian M. Meyhöfer
- Institute for Endocrinology & Diabetes, Department of Internal Medicine 1, University Hospital of Schleswig-Holstein, Lübeck, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Ralph Pries
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, Lübeck, Germany
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Kim BY, Lee SH, Kim IK, Park JY, Bae JH. Chronic intermittent hypoxia impacts the olfactory nervous system in an age-dependent manner: pilot study. Eur Arch Otorhinolaryngol 2023; 280:241-248. [PMID: 35780199 DOI: 10.1007/s00405-022-07529-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/24/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse during sleep, which induces chronic intermittent hypoxia (CIH). CIH results in low-grade inflammation, sympathetic overactivity, and oxidative stress. Nevertheless, it remains unclear how exposure to CIH affects olfaction. The purpose of this study was, therefore, to investigate the cytotoxic effects of CIH exposure on mouse olfactory epithelium and the underlying pathophysiology involved. METHODS Mice were randomly divided into four groups: Youth mouse (You) + room air (RA), You + intermittent hypoxia (IH), Elderly mouse (Eld) + RA, and Eld + IH (n = 6 mice/group). Mice in the two hypoxia groups were exposed to CIH. The control condition involved exposure to room air (RA) for 4 weeks. Olfactory neuroepithelium was harvested for histologic examination, gene ontology analysis, quantitative real-time polymerase chain reaction (qRT-PCR), and western blotting. RESULTS Based on qRT-PCR analysis, olfactory marker protein (OMP), Olfr1507, ADCY3, and GNAL mRNA levels were lower, whereas NGFR, CNPase, NGFRAP1, NeuN, and MAP-2 mRNA levels were higher in the You + IH group than in the You + RA group. Olfactory receptor-regulated genes, neurogenesis-related genes and immunohistochemical results were altered in nasal neuroepithelium under CIH exposure. CONCLUSIONS Based on genetic and cytologic analysis, CIH impacted the olfactory neuroepithelium in an age-dependent manner. Our findings suggest that CIH-induced damage to the olfactory neuroepithelium may induce more severe change in the youth than in the elderly.
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Affiliation(s)
- Boo-Young Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Seoul Hospital, Ewha Womans University, Gangseo-gu, Gonghang-daero 260, Seoul, Korea.
| | - Sang Haak Lee
- Department of Clinical Laboratory, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Eunpyeong, Seoul, Korea
| | - In Kyoung Kim
- Department of Clinical Laboratory, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Eunpyeong, Seoul, Korea
| | - Ju Yeon Park
- Department of Clinical Laboratory, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Banpo, Seoul, Korea
| | - Jung Ho Bae
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Seoul Hospital, Ewha Womans University, Gangseo-gu, Gonghang-daero 260, Seoul, Korea
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Huang J, Chen L, Li X, Chen M, Lin T, Chen G. Association Between Metabolic-Associated Fatty Liver Disease and Obstructive Sleep Apnea: A Cross-Sectional Study. Nat Sci Sleep 2023; 15:49-57. [PMID: 36879664 PMCID: PMC9985450 DOI: 10.2147/nss.s398971] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
AIM Emerging evidence has revealed that obstructive sleep apnea (OSA) is an independent risk factor for the development of a variety of adverse metabolic disease states. In this study, we evaluated the association between OSA severity and metabolic dysfunction-associated fatty liver disease (MAFLD) among Asian populations. MATERIALS AND METHODS This was a cross-sectional, single-center study. The study cohort consisted of patients undergoing polysomnography and abdominal ultrasonography. Logistic regression analysis was used to evaluate the independent risk factors of MAFLD in patients with OSA. RESULTS A total of 1065 patients (277 non-MAFLD and 788 MAFLD) were included in the study. The prevalence of MAFLD in non-OSA, mild-moderate OSA, and severe OSA patients was 58.16%, 72.41%, and 78.0%, respectively (p < 0.001). We identified significant differences in body mass index (BMI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and lowest O2 saturation (LaSO2) between non-MAFLD and MAFLD patients (all p < 0.001). After adjusting for confounding variables, we used multivariate regression analysis to show that BMI, ODI, and triglyceride (TG) levels independently predicted the occurrence of MAFLD (odds ratio [OR] = 1.234, p < 0.001; OR = 1.022, p = 0.013; OR = 1.384, p = 0.001, respectively). Moreover, stratified analysis according to BMI indicated that TG levels were the predominant risk factor for MAFLD in a group of patients with a BMI < 23 kg/m2, while BMI, ODI, TG levels, and total cholesterol (TC) were the major risk factors for MAFLD in a group of patients with a BMI ≥ 23 kg/m2 (all p < 0.05). CONCLUSION OSA-associated chronic intermittent hypoxia was independently associated with the risk of MAFLD, especially in OSA patients with a BMI ≥ 23 kg/m2, suggesting that oxidative stress might play an important role in the pathogenesis of MAFLD in patients with OSA.
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Affiliation(s)
- Jiefeng Huang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Lida Chen
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Xiangcheng, Zhangzhou, People's Republic of China
| | - Xiuling Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Menglan Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Ting Lin
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Gongping Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
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Fadaei R, Mohassel Azadi S, Rhéaume E, Khazaie H. High-density lipoprotein cholesterol efflux capacity in patients with obstructive sleep apnea and its relation with disease severity. Lipids Health Dis 2022; 21:116. [PMID: 36344946 PMCID: PMC9639319 DOI: 10.1186/s12944-022-01723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
Background Obstructive sleep apnea (OSA) is linked to an accelerated risk of cardiovascular disease (CVD). Some key CVD risk factors are present in patients suffering from OSA such as hypertension, inflammation, oxidative stress, and dyslipidemia. High-density lipoprotein (HDL) cholesterol efflux capacity (CEC) is proposed as a reliable biomarker of HDL function and the present study aimed to quantify this biomarker in patients with OSA. Methods ATP binding cassette subfamily A member 1 (ABCA1), non-ABCA1, and total CEC were determined in 69 polysomnographic-confirmed OSA patients and 23 controls. Moreover, paraoxonase (PON) activities, high-sensitivity C-reactive protein (hsCRP), apolipoprotein B (apo B), and apolipoprotein A-I (apo A-I) circulating levels were quantified in the studied population. Results: All CEC measures were reduced in the OSA group compared to the control group. Strikingly, ABCA1 CEC was diminished in severe OSA in comparison with mild OSA. Furthermore, PON activities and apo A-I showed lower levels, while hsCRP and apo B were elevated in OSA patients compared to controls. Moreover, ABCA1 CEC showed an inverse association with hsCRP and a positive association with apo A-I, while non-ABCA1 CEC presented an association with HDL-C. Conclusion These results suggest the presence of an impaired HDL function in OSA. In particular, ABCA1 CEC was associated with disease severity and inflammation which could be a factor increasing the risk of CVD. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01723-w.
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Affiliation(s)
- Reza Fadaei
- grid.412112.50000 0001 2012 5829Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samaneh Mohassel Azadi
- grid.411705.60000 0001 0166 0922Department of Clinical Biochemistry, Faculty of Medicine Tehran University of Medical Sciences, Tehran, Iran
| | - Eric Rhéaume
- grid.482476.b0000 0000 8995 9090Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8 Canada ,grid.14848.310000 0001 2292 3357Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal, H3T 1J4 Canada
| | - Habibolah Khazaie
- grid.412112.50000 0001 2012 5829Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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11
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Sun H, Du Y, Zhang L, Yu H, Jiao X, Lv Q, Li F, Wang Y, Sun Q, Hu C, Li L, Zhang H, Du Z, Qin Y. Increasing circulating ESM-1 and adhesion molecules are associated with earlystage atherosclerosis in OSA patients:A cross-sectional study. Sleep Med 2022; 98:114-120. [PMID: 35830780 DOI: 10.1016/j.sleep.2022.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/02/2022] [Accepted: 06/16/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND There are increasing evidences for a direct relationship between the vascular system and obstructive sleep apnea (OSA). The aim of this study was to investigate the relationship between circulating endothelial cell specific molecule-1 (ESM-1), adhesion molecules and subclinical atherosclerosis in patients with OSA. METHODS This was a cross-sectional study in which 161 patients with OSA and 56 controls were recruited. Demographic data, biochemical and polysomnography parameters were collected. We used a powerful high-throughput Multiplex Immunobead Assay technique to simultaneously test plasm levels of ESM-1, P-selectin, E-selectin, L-selectin, inter-cellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1). Carotid intima-media thickness (CIMT) were measured as parameters of vascular endothelial dysfunction and early atherosclerosis. RESULTS Increasing circulating levels of ESM-1, P-selectin, E-selectin, L-selectin, ICAM-1 and VCAM-1 were found increased in patients with OSA (all P < 0.001). Furthermore, OSA patients exhibited increased CIMT than controls (P < 0.05). Multivariate linear analysis indicated that elevated ESM-1, P-Selectin, E-selectin, and L-selectin levels were associated with AHI (all P < 0.05). Moreover, multivariate analysis showed that increasing ESM-1, VCAM-1, P-Selectin, and L-selectin were significantly associated with thick CIMT in OSA patients (all P < 0.05). CONCLUSIONS Increased circulating ESM-1 and adhesion molecules associated with thick CIMT in OSA, which is a marker of subclinical atherosclerosis. Strict attention to monitor circulating ESM-1 and adhesion molecules is necessary for early detection of subclinical atherosclerosis in OSA patients.
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Affiliation(s)
- Haili Sun
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Yunhui Du
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Lichuan Zhang
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Huahui Yu
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Xiaolu Jiao
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Qianwen Lv
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Fan Li
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Yu Wang
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Qiuju Sun
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Chaowei Hu
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Linyi Li
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Huina Zhang
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Zhiyong Du
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China
| | - Yanwen Qin
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, 100029, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China.
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12
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Wang D, Si D, Li G, Ding Z, Yang X, Gao C. Dysregulated autophagic activity induced in response to chronic intermittent hypoxia contributes to the pathogenesis of NAFLD. Front Physiol 2022; 13:941706. [PMID: 35982710 PMCID: PMC9379323 DOI: 10.3389/fphys.2022.941706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic intermittent hypoxia (CIH) is a pathological characteristic of obstructive sleep apnea (OSA) that has been linked to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The specific link between CIH, autophagic activity, and NAFLD, however, has not previously been characterized. The goal of this study was to assess the relationship between CIH-induced autophagy and the pathogenesis of OSA-associated NAFLD. Western blotting was used to assess the expression of proteins associated with lipid synthesis, endoplasmic reticulum (ER) stress, and autophagic activity. To establish an in vivo model system, C57BL/6 mice were subjected to CIH conditions for 8 h per day over a 12-week period, and were administered chloroquine (CQ) for 1 week prior to euthanization. Levels of serum and liver triglycerides in these animals were assessed, as were proteins related to hepatic autophagy, ER stress, and lipogenesis. qPCR was additionally used to assess hepatic inflammation-related gene expression, while transmission electron microscopy was used to monitor lipid droplet (LD) accumulation and ER morphology. OSA patients and CIH model mice exhibited increases in the expression of proteins associated with hepatic autophagy, ER stress, and lipogenesis. CIH was also associated with more pronounced LD accumulation, hepatic inflammation, and hepatic steatosis in these mice. While serum and hepatic TG and TC levels and serum ALT/AST were increased in response to CIH treatment, the administration of CQ to these mice led to reductions in ER stress-related proteins (XBP1, IRE1α, EIF2α) and lipogenesis-related proteins (ACC, SCD1, FASn), in addition to significantly reducing hepatic inflammation, steatosis, and LD accumulation in these animals. These results suggest that persistent CIH can drive dysregulated hepatic autophagic activity, hepatic steatosis, and ER stress, highlighting potential targets for therapeutic intervention aimed at preventing or treating OSA-associated NAFLD.
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Affiliation(s)
- Dong Wang
- Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dongyu Si
- Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Gang Li
- Department of Otorhinolaryngology Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, China
| | - Zhimin Ding
- Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaonan Yang
- Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chaobing Gao
- Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Chaobing Gao,
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13
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Popadic V, Brajkovic M, Klasnja S, Milic N, Rajovic N, Lisulov DP, Divac A, Ivankovic T, Manojlovic A, Nikolic N, Memon L, Brankovic M, Popovic M, Sekulic A, Macut JB, Markovic O, Djurasevic S, Stojkovic M, Todorovic Z, Zdravkovic M. Correlation of Dyslipidemia and Inflammation With Obstructive Sleep Apnea Severity. Front Pharmacol 2022; 13:897279. [PMID: 35694268 PMCID: PMC9179947 DOI: 10.3389/fphar.2022.897279] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/28/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction: Obstructive sleep apnea (OSA) is a serious condition linked with various metabolic disorders and associated with increased all-cause and cardiovascular mortality. Although the potential mechanisms of pathophysiological processes related to OSA are relatively well known, the data regarding the correlation between obstructive sleep apnea, dyslipidemia, and systemic inflammation are still inconclusive. Methods: The study was conducted as a retrospective cohort study including 328 patients with newly diagnosed obstructive sleep apnea during the period between April 2018, and May 2020, in University Clinical Hospital Center “Bezanijska kosa”, Belgrade, Serbia. Polysomnography was performed in all patients according to the protocol. Numerous demographic, antropometric, laboratory, and clinical data were correlated to Apnea-Hypopnea Index (AHI) as a dependent variable, with a particular review on the relation between lipid abnormalities, inflammatory parameters, and obstructive sleep apnea severity. Multivariate logistic regression model was used to assess predictors of severe OSA (AHI ≥30 per hour). Results: A total of 328 patients were included in the study. The mean age of the patients was 54.0 ± 12.5 years and more than two-thirds were male (68.8%). The majority of the patients had an AHI of at least 30 events per hour. Patients with severe OSA were more frequently male, obese, hypertensive and hyperlipidemic, and had increased neck circumference (both male and female patients). One hundred and thirty-two patients had metabolic syndrome. Patients with severe OSA more frequently had metabolic syndrome and significantly higher levels of glucose, creatinine, uric acid, AST, ALT, CK, microalbumine/creatinine ratio, triglyceride, total cholesterol, HDL, total cholеsterol to HDL‐C ratio, CRP, and ESR. In the multivariate linear regression model with AHI (≥30 per hour) as a dependent variable, of demographic and clinical data, triglycerides ≥1.7 mmol/L and CRP >5 mg/L were significantly associated with AHI≥30 per hour. Conclusion: The present study on 328 patients with newly diagnosed obstructive sleep apnea revealed significant relation of lipid abnormalities, inflammatory markers, and other clinically important data with obstructive sleep apnea severity. These results can lead to a better understanding of the underlying pathophysiological processes and open the door to a new world of potentially useful therapeutic modalities.
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Affiliation(s)
- Viseslav Popadic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- *Correspondence: Viseslav Popadic,
| | - Milica Brajkovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Slobodan Klasnja
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
- Department of Internal Medicine,Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MI, United States
| | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | | | - Anica Divac
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Tatjana Ivankovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Andrea Manojlovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Novica Nikolic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Lidija Memon
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Marija Brankovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Maja Popovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
| | - Ana Sekulic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelica Bjekic Macut
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Olivera Markovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Maja Stojkovic
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Todorovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Zdravkovic
- University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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14
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Cheng H, Jin S, Huang S, Hu T, Zhao M, Li D, Wu B. Serum Proteomic Analysis by Tandem Mass Tag-Based Quantitative Proteomics in Pediatric Obstructive Sleep Apnea. Front Mol Biosci 2022; 9:762336. [PMID: 35480887 PMCID: PMC9035643 DOI: 10.3389/fmolb.2022.762336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/04/2022] [Indexed: 12/02/2022] Open
Abstract
Pediatric obstructive sleep apnea (OSA) is a frequent respiratory disorder with an estimated prevalence of 3–6% in the general population. However, the underlying pathophysiology of OSA remains unclear. Recently, proteomic analysis using high-resolution and high-throughput mass spectrometry has been widely used in the field of medical sciences. In the present study, tandem mass tag (TMT)-based proteomic analysis was performed in the serum of patients with OSA. The proteomic analysis revealed a set of differentially expressed proteins that may be associated with the pathophysiology of OSA. The differentially expressed proteins in patients with OSA were enriched in pathways including phagosome and glycan synthesis/degradation, immune response, and the hedgehog signaling pathway, indicating that such functions are key targets of OSA. Moreover, the experimental validation studies revealed that four proteins including ANTXR1, COLEC10, NCAM1, and VNN1 were reduced in the serum from patients with moderate and severe OSA, while MAN1A1 and CSPG4 protein levels were elevated in the serum from patients with severe OSA. The protein levels of ANTXR1, COLEC10, NCAM1, and VNN1 were inversely correlated with apnea-hypopnea index (AHI) in the recruited subjects, while the protein level of MAN1A1 was positively correlated with AHI, and no significant correlation was detected between CSPG4 protein and AHI. In summary, the present study for the first time identified differentially expressed proteins in the serum from OSA patients with different severities by using TMT-based proteomic analysis. The functional enrichment studies suggested that several signaling pathways may be associated with the pathophysiology of OSA. The experimental validation results indicated that six proteins including ANTXR1, COLEC10, NCAM1, VNN1, CGPG4, and MAN1A1 may play important roles in the pathophysiology of OSA, which requires further mechanistic investigation.
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Affiliation(s)
- Hanrong Cheng
- Institute of Respiratory Diseases, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Shoumei Jin
- Longgang ENT Hospital, Institute of ENT and Shenzhen Key Laboratory of ENT, Shenzhen, China
| | - Simin Huang
- Longgang ENT Hospital, Institute of ENT and Shenzhen Key Laboratory of ENT, Shenzhen, China
| | - Tianyong Hu
- Longgang ENT Hospital, Institute of ENT and Shenzhen Key Laboratory of ENT, Shenzhen, China
| | - Miao Zhao
- Longgang ENT Hospital, Institute of ENT and Shenzhen Key Laboratory of ENT, Shenzhen, China
| | - Dongcai Li
- Longgang ENT Hospital, Institute of ENT and Shenzhen Key Laboratory of ENT, Shenzhen, China
- *Correspondence: Dongcai Li, ; Benqing Wu,
| | - Benqing Wu
- Department of Neonatology, University of Chinese Academy of Science-Shenzhen Hospital, Shenzhen, China
- *Correspondence: Dongcai Li, ; Benqing Wu,
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15
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Ji Y, Liang Y, Mak JC, Ip MS. Obstructive sleep apnea, intermittent hypoxia and non-alcoholic fatty liver disease. Sleep Med 2022; 95:16-28. [DOI: 10.1016/j.sleep.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022]
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Mo J, Zeng C, Li W, Song W, Xu P. Manuscript Title: A 4-miRNAs Serum Panel for Obstructive Sleep Apnea Syndrome Screening. Nat Sci Sleep 2022; 14:2055-2064. [PMID: 36394070 PMCID: PMC9656345 DOI: 10.2147/nss.s382765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is a common chronic sleep disorder. OSAS is closely related to cardiovascular disease, metabolic disorders, cancer risk, and sudden death. This association has special significance in young people. Although it is known that OSAS has a great impact on physical health, it is estimated that 70-80% of patients with moderate-to-severe OSAS remain undiagnosed. Therefore, a new method for early diagnosis of the disease, the therapeutic effect of OSAS and prevention of complications to important. METHODS A total of 110 patients with moderate-to-severe OSAS diagnosed in the Sleep Disorders Diagnosis and Treatment Center of Peking University Shenzhen Hospital were selected. After excluding other diseases, 59 patients were finally selected as the OSAS group. In addition, 60 healthy people were selected as the control group. Serum RNA was then extracted. Eight RNA samples were randomly selected from the two groups for high-throughput miRNA sequencing. The 10 miRNAs with the greatest differences were selected as preselected markers from the results. Then, qRT-PCR was performed on the remaining RNA samples of the two groups to extract and verify the 10 miRNAs, and statistical analysis was performed between groups. RESULTS A diagnostic panel was constructed by a stepwise logistic regression model combined with the expression data of miRNAs in the validation phase. A four-miRNA panel was identified to better predict OSAS, and the model was calculated using the following formula: Logit (P)= 0.77-1.65 × miR-486-5p - 4.56 × miR-148a-3p + 1.79 × miR-744-5p + 1.13 × let-7d-3p. The AUC for the four-miRNA panel was 0.955 (95% CI: 0.899 to 0.985; sensitivity = 91.38%, specificity = 91.38%). Gene Ontology (GO) annotation and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis was included in bioinformatic analysis. CONCLUSION A 4-miRNAs panel as a diagnostic biomarker for OSAS screening is feasible.
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Affiliation(s)
- Jianming Mo
- Department of Pulmonary and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, 518034, People's Republic of China
| | - Chao Zeng
- Department of Pulmonary and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, 518034, People's Republic of China
| | - Wei Li
- Department of Pulmonary and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, 518034, People's Republic of China
| | - Weidong Song
- Department of Pulmonary and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, 518034, People's Republic of China
| | - Ping Xu
- Department of Pulmonary and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, 518034, People's Republic of China
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Mitchell GS, Baker TL. Respiratory neuroplasticity: Mechanisms and translational implications of phrenic motor plasticity. HANDBOOK OF CLINICAL NEUROLOGY 2022; 188:409-432. [PMID: 35965036 DOI: 10.1016/b978-0-323-91534-2.00016-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Widespread appreciation that neuroplasticity is an essential feature of the neural system controlling breathing has emerged only in recent years. In this chapter, we focus on respiratory motor plasticity, with emphasis on the phrenic motor system. First, we define related but distinct concepts: neuromodulation and neuroplasticity. We then focus on mechanisms underlying two well-studied models of phrenic motor plasticity: (1) phrenic long-term facilitation following brief exposure to acute intermittent hypoxia; and (2) phrenic motor facilitation after prolonged or recurrent bouts of diminished respiratory neural activity. Advances in our understanding of these novel and important forms of plasticity have been rapid and have already inspired translation in multiple respects: (1) development of novel therapeutic strategies to preserve/restore breathing function in humans with severe neurological disorders, such as spinal cord injury and amyotrophic lateral sclerosis; and (2) the discovery that similar plasticity also occurs in nonrespiratory motor systems. Indeed, the realization that similar plasticity occurs in respiratory and nonrespiratory motor neurons inspired clinical trials to restore leg/walking and hand/arm function in people living with chronic, incomplete spinal cord injury. Similar application may be possible to other clinical disorders that compromise respiratory and non-respiratory movements.
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Affiliation(s)
- Gordon S Mitchell
- Breathing Research and Therapeutics Center, Department of Physical Therapy and McKnight Brain Institute, University of Florida, Gainesville, FL, United States.
| | - Tracy L Baker
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, United States
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18
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González KA, Tarraf W, Wallace DM, Stickel AM, Schneiderman N, Redline S, Patel SR, Gallo LC, Mossavar-Rahmani Y, Daviglus ML, Zee PC, Talavera GA, Sotres-Alvarez D, González HM, Ramos A. Phenotypes of obstructive sleep apnea in the Hispanic Community Health Study/Study of Latinos. Sleep 2021; 44:zsab181. [PMID: 34272952 PMCID: PMC8664595 DOI: 10.1093/sleep/zsab181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Recent work on US Whites from clinical samples used obstructive sleep apnea (OSA) symptoms to generate phenotypes for individuals with moderate-severe OSA which suggested 3 to 5 symptom classes. However, it is unknown whether similar classes generalize to diverse Hispanics/Latino adults. Therefore, we sought to fill this gap by empirically deriving sleep phenotypes among a large sample of diverse Hispanics/Latinos. METHODS We used data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011), a prospective cohort study designed using a multisite multistage probability sample of adults 18-74 years old. The subpopulation of interest included participants with moderate-severe OSA symptoms (≥15 respiratory event index (REI) events per hour; n = 1,605). We performed latent class analysis for complex survey data using 15 common OSA symptoms (e.g. Epworth Sleepiness Scale) and 4 comorbidities to identify phenotype classes. RESULTS Average age was 52.4 ± 13.9 years and 34.0% were female. Mean REI was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided the best fit to the data. The three phenotypes were: (1) Minimally Symptomatic (47.7%), (2) Excessive sleepiness (37.1%), and (3) Disturbed Sleep (15.2%). Sensitivity models were consistent with the main proposed solution. CONCLUSIONS Derived sleep phenotypes among diverse Hispanic/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium, but we found notable differences in class prevalence relative to Whites. Further research is needed to link derived sleep phenotypes to health comorbidities in diverse populations.
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Affiliation(s)
- Kevin A González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Douglas M Wallace
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ariana M Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | | | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Linda C Gallo
- Department of Psychology and South Bay Latino Research Center, San Diego State University, San Diego, CA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Alberto Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
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Prospective Correlation of Risk of Obstructive Sleep Apnea With Severe Clinical Features of Thyroid Eye Disease. Ophthalmic Plast Reconstr Surg 2021; 37:S58-S61. [PMID: 32852372 DOI: 10.1097/iop.0000000000001809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate the association between risk of obstructive sleep apnea (OSA) and severity of thyroid eye disease (TED) using a validated OSA screening tool. METHODS A prospective, observational cohort study was performed. New adult TED patients were offered OSA screening with the Snoring Tired Observed Pressure (STOP)-Bang survey during their initial evaluation. Clinical examination and treatment for TED were standard of care and utilized the International Thyroid Eye Disease Society Vision Inflammation Strabismus Appearance system. At the conclusion of the study period, analysis was performed correlating maximum severity of TED signs and symptoms between high- and low-risk OSA groups. Multivariate logistic and linear regression analyses were also performed to analyze the association between the numerical STOP-Bang score and maximum severity of the potentially actionable clinical features of TED (compressive optic neuropathy, vertical prism deviation, horizontal prism deviation, exophthalmos, vertical fissure height). RESULTS Eighty-five patients met inclusion criteria. Twenty-eight percent were at high risk of OSA (STOP-Bang score of 3 or higher). When comparing the low- and high-risk cohorts, increased risk of OSA was significantly associated with the development of TED compressive optic neuropathy (p = 0.014), conjunctival injection (p = 0.027), chemosis (p = 0.013), upper eyelid edema (p = 0.024), lower eyelid edema (p = 0.003), eyelid erythema (p = 0.037), and vertical strabismus (p = 0.047). In the multivariate regression analyses, higher STOP-Bang scores correlated with increased risk of TED compressive optic neuropathy (p = 0.006), vertical strabismus (p = 0.019), and higher subjective diplopia scores (p = 0.045). CONCLUSIONS Increased risk of OSA, as determined by the STOP-Bang survey, is associated with increased severity of multiple clinical features of TED, including TED compressive optic neuropathy and strabismus.
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Ding MC, Hsu CM, Liu SYC, Lee YC, Yang YH, Liu CY, Chang GH, Tsai YT, Lee LA, Yang PR, Li HY, Tsai MS. Deep Neck Infection Risk in Patients with Sleep Apnea: Real-World Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063191. [PMID: 33808734 PMCID: PMC8003369 DOI: 10.3390/ijerph18063191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 12/20/2022]
Abstract
(1) Background: Sleep apnea may be a risk factor for deep neck infection (DNI). The objective of this study was to investigate the effects of sleep apnea on DNI. (2) Methods: In this first nationwide retrospective cohort study on the sleep apnea–DNI correlation, we obtained data from the Longitudinal Health Insurance Database 2005, a subset of the Taiwan National Health Insurance Research Database. Patients who were newly diagnosed with sleep apnea between 1997 and 2012 were identified, and patients without sleep apnea were matched at a 1:4 ratio in age, sex, socioeconomic status, and urbanization level. The primary outcome of this study was DNI occurrence. The treatment modalities for sleep apnea and the comorbidities that occurred during the study period were also analyzed. (3) Results: Our sleep apnea and comparison (non-sleep apnea) cohorts comprised 6114 and 24,456 patients, respectively. We compared the cumulative incidence of DNI between these cohorts and found a greater incidence of DNI in the sleep apnea cohort (p < 0.001). A strong sleep apnea–DNI association was found following analysis via the adjusted Cox proportional-hazards model (full model hazard ratio, 1.71; 95% confidence interval, 1.28–2.28; p < 0.001). In the subgroup analysis, sleep apnea increased DNI risk in men, in those aged < 50 years, and in those without diabetes mellitus, end-stage renal disease, liver cirrhosis, autoimmune disease, obesity, tonsillectomy, or adenotonsillectomy. (4) Conclusions: Our results confirmed sleep apnea to be an independent risk factor for DNI. Physicians should be aware of the potential occurrence of DNI in patients with sleep apnea.
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Affiliation(s)
- Meng-Chang Ding
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
| | - Cheng-Ming Hsu
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
| | - Stanley Yung-Chuan Liu
- Division of Sleep Surgery, Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology–Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Yao-Hsu Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Geng-He Chang
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Pei-Rung Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Hsueh-Yu Li
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Correspondence: (H.-Y.L.); (M.-S.T.); Tel.: +886-3-328-1200 (ext. 3968) (H.-Y.L.); +886-5-362-1000 (ext. 2076) (M.-S.T.); Fax: +886-3-397-9361 (H.-Y.L.); +886-5-3623002 (M.-S.T.)
| | - Ming-Shao Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (M.-C.D.); (C.-M.H.); (G.-H.C.); (Y.-T.T.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-C.L.); (Y.-H.Y.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: (H.-Y.L.); (M.-S.T.); Tel.: +886-3-328-1200 (ext. 3968) (H.-Y.L.); +886-5-362-1000 (ext. 2076) (M.-S.T.); Fax: +886-3-397-9361 (H.-Y.L.); +886-5-3623002 (M.-S.T.)
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Polasky C, Steffen A, Loyal K, Lange C, Bruchhage KL, Pries R. Redistribution of Monocyte Subsets in Obstructive Sleep Apnea Syndrome Patients Leads to an Imbalanced PD-1/PD-L1 Cross-Talk with CD4/CD8 T Cells. THE JOURNAL OF IMMUNOLOGY 2020; 206:51-58. [PMID: 33268482 DOI: 10.4049/jimmunol.2001047] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022]
Abstract
Obstructive sleep apnea syndrome (OSAS) represents a substantial disease of recurrent sleep fragmentation, leading to intermittent hypoxia and subsequent diseases such as cardiovascular, metabolic, or cognitive dysfunctions. In addition, OSAS is considered as low-grade systemic inflammation, which is associated with a higher incidence of cancer, severity of infections, and an overall immune dysregulation. This research project aims to comprehensively investigate the interplay of wholesome sleep and the immune functions of circulating monocytes and T cells in OSAS patients, which are known to be affected by oxidative stress. We studied the distribution of the CD14/CD16 characterized monocyte subsets in peripheral blood as well as their PD-L1 expression and complex formation with T cells. Furthermore, a detailed analysis of T cell subsets with regard to their PD-1 and PD-L1 expression was performed. Data revealed a decrease of classical monocytes accompanied by an increase of both CD16+ monocyte subsets in OSAS patients that was positively correlated with the body mass index. OSAS patients revealed an increased PD-1 and PD-L1 expression in T cells and monocytes, respectively, which was linked to the severity of monocyte subset alterations. The complex formation of monocytes and T cells was also elevated in OSAS patients, which indicates a deregulated PD-1/PD-L1 cross-talk between these cells. Our data show for the first time, to our knowledge, massive alterations of peripheral monocyte subsets in response to OSAS and its accompanying phenomena.
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Affiliation(s)
- Christina Polasky
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany
| | - Armin Steffen
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany
| | - Kristin Loyal
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany
| | - Christian Lange
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany
| | - Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany
| | - Ralph Pries
- Department of Otorhinolaryngology, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany
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Kaya H, Pekel G, Kaya D, Kara CO, Hıraali MC. The Effects of Surgical Treatment on Retina-Choroidal Findings in Patients With Obstructive Sleep Apnea Syndrome. Ophthalmic Surg Lasers Imaging Retina 2020; 51:35-42. [PMID: 31935301 DOI: 10.3928/23258160-20191211-05] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/29/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The purpose of this study was to determine the effect of surgical treatment on ocular findings in obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS The authors studied 34 eyes of 34 newly diagnosed OSAS patients. The sleep study was performed before and 6 months after expansion sphincter pharyngoplasty (ESP). Retinal nerve fiber layer (RNFL), choroidal thickness (CT), and retinal arteriolar caliber (RAC) analyses were performed using spectral-domain optical coherence tomography. Intraocular pressure (IOP) and ocular pulse amplitude were performed using the Pascal dynamic contour tonometer. RESULTS The preoperative and postoperative Apnea Hypopnea Index scores and average oxygen saturation values were significantly different (P = .0001 and P = .001, respectively). There was no significant difference between the preoperative and postoperative RNFL thicknesses (P > .05). The preoperative subfoveal, nasal, temporal CT, and IOP were significantly different from the postoperative measurements (P = .006, P = .05, P = .036, and P = .0001, respectively). CONCLUSIONS ESP had a significant influence on CT and IOP in patients with OSAS, maintaining a decrease in CT and IOP 6 months after surgery. The determination of these ocular findings may be useful to show the positive effects of ESP. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:35-42.].
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Sun H, Wen W, Zhao M, Yan X, Zhang L, Jiao X, Yang Y, Fang F, Qin Y, Zhang M, Wei Y. EMMPRIN: A potential biomarker for predicting the presence of obstructive sleep apnea. Clin Chim Acta 2020; 510:317-322. [PMID: 32673670 DOI: 10.1016/j.cca.2020.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder which is strongly associated with the development of cardiovascular diseases. The aim of the study was to investigate the association between circulating extracellular matrix metalloproteinase inducer (EMMPRIN) and OSA risk. METHODS This was a cross-sectional study in which a total of 144 patients were recruited. Demographic data, blood biochemical parameters and polysomnography parameters were collected. We used a powerful high-throughput Multiplex Immunobead Assay technique to simultaneously detect circulating levels of EMMPRIN and E-selectin. RESULTS Circulating levels of EMMPRIN were significantly increased in patients with OSA compared to controls (7.58[6.21-8.80] vs 1.47[0.80-5.91] ng/ml, P < 0.001). After adjusting for confounding factors, we found that circulating EMMPRIN levels were independently associated with the presence of OSA (odds ratio[OR] = 2.240, 95% confidence interval [CI] = 1.391-3.607, P < 0.001). Furthermore, circulating EMMPRIN showed greater discriminatory accuracy in predicting the presence of OSA (AUC:0.904). CONCLUSIONS Circulating EMMPRIN levels were significantly increased in patients with OSA, and may be a novel marker for predicting the risk of OSA.
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Affiliation(s)
- Haili Sun
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Wanwan Wen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Mengmeng Zhao
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaoguang Yan
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lichuan Zhang
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaolu Jiao
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yunyun Yang
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Fang Fang
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yanwen Qin
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Ming Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yongxiang Wei
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
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Zhang CQ, Yi S, Chen BB, Cui PP, Wang Y, Li YZ. mTOR/NF-κB signaling pathway protects hippocampal neurons from injury induced by intermittent hypoxia in rats. Int J Neurosci 2020; 131:994-1003. [PMID: 32378972 DOI: 10.1080/00207454.2020.1766460] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To expound the roles of mTOR and NF-kB signaling pathway in intermittent hypoxia (IH)-induced damage of hippocampal neurons. METHODS For rat experiments, mTOR inhibitor (Rapamycin, Rapa) and NF-κB signaling inhibitor (ammonium pyrrolidine dithiocarbamate, PDTC) were applied to inhibit mTOR and NF-κB signaling, respectively. For neuron experiments, hippocampal neurons from rat were successfully cultured. Different concentrations of Rapa and PDTC were added to the cultured hippocampal neurons. Rat or primary hippocampal neurons were exposed to normoxic or IH conditions after administration of Rapa and PDTC. The effects of Rapa and PDTC administration on learning and memory ability of rats and hippocampal injury after IH exposure were assayed by Morris water maze and H&E staining. Electron microscope was utilized to examine primary hippocampal neuron ultrastructure changes after IH exposure and Rapa or PDTC administration. The expressions of NF-κB-p65, IκBα, IKKβ, BDNF, TNF-α, IL-1β, PSD-95 and SYN in hippocampal neurons were examined. RESULTS Compared with normal control rats or neurons, IH-treated group had elevated expression levels of NF-kB, TNF-α and IL-1β and suppressed expression level of BDNF, PSD-95 and SYN. These results were reversed upon pre-treatment with Rapa and PDTC. Furthermore, IκBα and IKKβ expressions were down-regulated in IH group. No notable difference was manifested in PDTC pre-treatment group, while a prominent increase was shown after Rapa pre-administration. CONCLUSION The administration of PDTC and Rapa could prevent IH-induced hippocampal neuron impairment, indicating that inhibition of the mTOR and NF-κB pathway may likely act as a therapeutic target for obstructive sleep apnea.
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Affiliation(s)
- Chu-Qin Zhang
- Department of Otorhinolaryngology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China.,Department of Otorhinolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Song Yi
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Bo-Bei Chen
- Department of Otorhinolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Pan-Pan Cui
- Department of Otorhinolaryngology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Yan Wang
- Department of Otorhinolaryngology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Yan-Zhong Li
- Department of Otorhinolaryngology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
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Association of Risk of Obstructive Sleep Apnea With Thyroid Eye Disease: Compressive Optic Neuropathy. Ophthalmic Plast Reconstr Surg 2020; 35:232-234. [PMID: 30134386 DOI: 10.1097/iop.0000000000001211] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the association of risk of obstructive sleep apnea (OSA) and thyroid eye disease-compressive optic neuropathy (TED-CON). METHODS The authors performed a retrospective observational study. All TED patients evaluated by the principal investigator over the past 5 years were screened with the snoring tired observed pressure (STOP)-Bang questionnaire to assess their risk for OSA. Patients were grouped into 2 age-matched cohorts based on the presence (TED-CON) or absence of CON. The groups were then compared using chi-square analysis for binary variables and Student t test for continuous variables. RESULTS Three hundred twenty-six patients were identified to have TED. Of those, 109 were enrolled in the study. The prevalence of high risk of OSA was significantly higher in the TED-CON (59.2%) when compared with the noncompressive TED group (32.8%; p = 0.006). CONCLUSIONS Obstructive sleep apnea and TED have each been independently associated with elevated serologic and tissue inflammatory mediators. The systemic inflammation associated with OSA has been implicated in the pathogenesis of disease states aggravated by untreated OSA. Effective treatment of OSA decreases the levels of circulating inflammatory mediators. Currently, smoking is the only known modifiable risk factor in TED. There is evidence to implicate the pathologic elevation of inflammatory cytokines in the mechanism of smoking on TED. This preliminary investigation reveals a significantly greater prevalence of OSA risk factors among patients with TED-CON, suggesting that this may be another modifiable risk factor associated with TED. Based on screening with the STOP-Bang questionnaire, there is a higher percentage of patients at high risk of OSA with TED with CON than with TED without CON.
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Katsumata Y, Terada J, Matsumura T, Koshikawa K, Sakao S, Tomiyoshi G, Shinmen N, Nakamura R, Kuroda H, Nagashima K, Kobayashi Y, Kobayashi E, Iwadate Y, Zhang XM, Hiwasa T, Tatsumi K. Circulating Anti-Sorting Nexins 16 Antibodies as an Emerging Biomarker of Coronary Artery Disease in Patients with Obstructive Sleep Apnea. Diagnostics (Basel) 2020; 10:E71. [PMID: 32012743 PMCID: PMC7168932 DOI: 10.3390/diagnostics10020071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/17/2020] [Accepted: 01/25/2020] [Indexed: 12/21/2022] Open
Abstract
Biomarkers are not available for monitoring the onset and progression of coronary artery disease (CAD) in patients with obstructive sleep apnea (OSA), a major risk factor for arteriosclerotic cardiovascular diseases. This study aimed to test for correlation between circulating anti-Sorting Nexins 16 antibody (SNX16-Ab) levels, CAD history and clinical parameters of patients with OSA. Sixty-four healthy donors, 82 adults with OSA, and 96 with acute coronary syndrome (ACS) were studied. Serum samples were collected at diagnostic polysomnography in the OSA group or at the disease onset in the ACS group. Serum SNX16-Ab levels were measured by amplified luminescence proximity homogeneous assay (AlphaLISA), and correlation between SNX16-Ab levels and clinical parameters was analyzed. SNX16-Ab levels and apnea-hypopnea index (AHI) were weakly correlated. Additionally, logistic regression analyses of OSA group identified that elevated SNX16-Ab level associated with the history of CAD. Circulating SNX16-Ab could increase during CAD pathogenesis in patients with OSA. Further prospective studies are required to prove the predictive potential of SNX16-Ab level in CAD onset of patients with OSA.
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Affiliation(s)
- Yusuke Katsumata
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.K.); (T.M.); (K.K.); (S.S.); (K.T.)
| | - Jiro Terada
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.K.); (T.M.); (K.K.); (S.S.); (K.T.)
| | - Takuma Matsumura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.K.); (T.M.); (K.K.); (S.S.); (K.T.)
| | - Ken Koshikawa
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.K.); (T.M.); (K.K.); (S.S.); (K.T.)
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.K.); (T.M.); (K.K.); (S.S.); (K.T.)
| | - Go Tomiyoshi
- Fujikura Kasei Co.,Ltd., Minato-ku, Tokyo 105-0011, Japan; (G.T.); (N.S.); (R.N.); (H.K.)
| | - Natsuko Shinmen
- Fujikura Kasei Co.,Ltd., Minato-ku, Tokyo 105-0011, Japan; (G.T.); (N.S.); (R.N.); (H.K.)
| | - Rika Nakamura
- Fujikura Kasei Co.,Ltd., Minato-ku, Tokyo 105-0011, Japan; (G.T.); (N.S.); (R.N.); (H.K.)
| | - Hideyuki Kuroda
- Fujikura Kasei Co.,Ltd., Minato-ku, Tokyo 105-0011, Japan; (G.T.); (N.S.); (R.N.); (H.K.)
| | - Kengo Nagashima
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo 190-8562, Japan;
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Eiichi Kobayashi
- Department of Neurological Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (E.K.); (Y.I.); (T.H.)
| | - Yasuo Iwadate
- Department of Neurological Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (E.K.); (Y.I.); (T.H.)
| | - Xiao-Meng Zhang
- Department of Biochemistry and Genetics, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Takaki Hiwasa
- Department of Neurological Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (E.K.); (Y.I.); (T.H.)
- Department of Biochemistry and Genetics, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (Y.K.); (T.M.); (K.K.); (S.S.); (K.T.)
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Severe depletion of peripheral blood dendritic cell subsets in obstructive sleep apnea patients: A new link with cancer? Cytokine 2019; 125:154831. [PMID: 31473474 DOI: 10.1016/j.cyto.2019.154831] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/12/2022]
Abstract
Recent evidence suggests that alterations of the immune responses are associated with the inflammatory nature of obstructive sleep apnea (OSA) and of its related co-morbidities. In this scenario, we asked whether circulating dendritic cell (DC) subsets may be possible players as their role has not yet been detailed. The frequency distribution of peripheral blood myeloid (mDC1 and mDC2) and plasmacytoid (p) DCs was investigated by mean of multi-parametric flow cytometry in 45 OSA patients (mean age: 53 yrs; M = 29) at the time of the first diagnosis and compared to 30 age- and sex-matched healthy controls. Oxidative burst (OB) and serum levels of tumor necrosis factor (TNF)-α, (interleukin) (IL)-6, interferon (INF)-γ, IL-2, IL-4, IL-10 and vascular endothelial growth factor (VEGF) were also analyzed. All subsets of circulating DCs were significantly depleted in OSA patients as compared to healthy subjects (p < 0.01, in all instances), with mDC2 and pDC subtypes being more severely compromised. These findings were co-existing with higher levels of OB along with an increased expression of IL-6, IL-10, TNF-α, IFN-γ, and VEGF (p < 0.005 in all instances). In particular, IL6 levels were significantly higher (p = 0.013) in severe OSA patients (apnea/hypopnea index >30) and were inversely correlated with both mDC2 (r = -0.802, p < 0.007) and pDC (r = -0.317, p = 0.04) subsets. We first provide evidence for a constitutive reduction of all circulating DC subsets in OSA patients. Perturbation of DCs coexists with an inflammatory milieu and is negatively correlated with the expression of IL-6, which is actually recognized as a pivotal inhibitor of DC maturation. Future studies exploring the contribution of DCs in the pathogenesis of OSA and of its complications should be encouraged.
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Sun H, Fang F, Li K, Zhang H, Zhang M, Zhang L, Li J, Qin Y, Wei Y. Circulating ESM-1 levels are correlated with the presence of coronary artery disease in patients with obstructive sleep apnea. Respir Res 2019; 20:188. [PMID: 31429753 PMCID: PMC6701084 DOI: 10.1186/s12931-019-1143-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 07/24/2019] [Indexed: 12/26/2022] Open
Abstract
Background Endothelial dysfunction is one of the most important early indicators of atherosclerosis in obstructive sleep apnea (OSA) patients. Endothelial cell specific molecules-1 (ESM-1), which is a novel endothelial dysfunction marker that may be linked to cardiovascular disease. We investigated to assess whether circulating ESM-1 levels are correlated with the presence of coronary artery disease (CAD) in patients with OSA. Methods We performed a cross-sectional study in 228 Chinese OSA subjects, including 185 patients with OSA and 43 controls. The Gensini stenosis scoring system was used to assess the severity of CAD. Circulating ESM-1 levels were measured by Human Magnetic Luminex Screening Assay. The associations between circulating ESM-1 levels and CAD were determined by multivariate logistic regression analysis. The association between ESM-1 levels and Gensini scores was determined by multivariate linear regression analysis. Results CAD patients had significantly higher circulating ESM-1 levels compared with non-CAD patients (1279.01[918.52–1770.71] pg/ml vs 585.46[423.61–812.56] pg/ml, P < 0.001). After adjusting for confounding factors, we found that circulating ESM-1 levels were an independent risk factor for CAD (OR = 1.633/100 pg ESM-1, 95%CI =1.179–2.262, P = 0.003), while circulating ESM-1 levels have no significant correlation with the Gensini score. Furthermore, circulating ESM-1 showed higher discriminatory accuracy in predicting the presence of OSA (AUC:0.910). Conclusions Circulating ESM-1 might function as a useful biomarker for monitoring the development and progression of CAD in OSA patients. Electronic supplementary material The online version of this article (10.1186/s12931-019-1143-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haili Sun
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China.,Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, No. 2 Anzhen Road, Beijing, 100029, China
| | - Fang Fang
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China.,Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, No. 2 Anzhen Road, Beijing, 100029, China
| | - Kun Li
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China
| | - Huina Zhang
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, No. 2 Anzhen Road, Beijing, 100029, China
| | - Ming Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China
| | - Lichuan Zhang
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China
| | - Juan Li
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, No. 2 Anzhen Road, Beijing, 100029, China
| | - Yanwen Qin
- Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, No. 2 Anzhen Road, Beijing, 100029, China.,Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China
| | - Yongxiang Wei
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, NO.2 Anzhen Road, Beijing, 100029, China. .,Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, No. 2 Anzhen Road, Beijing, 100029, China.
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Borel AL, Tamisier R, Böhme P, Priou P, Avignon A, Benhamou PY, Hanaire H, Pépin JL, Kessler L, Valensi P, Darmon P, Gagnadoux F. Obstructive sleep apnoea syndrome in patients living with diabetes: Which patients should be screened? DIABETES & METABOLISM 2019; 45:91-101. [DOI: 10.1016/j.diabet.2018.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/16/2018] [Accepted: 08/11/2018] [Indexed: 12/27/2022]
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30
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Zaremba S, Güresir E. Is there a causal relationship between obstructive sleep apnea and the pathophysiology of intracranial aneurysm? SOMNOLOGIE 2019. [DOI: 10.1007/s11818-019-0191-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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31
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Borel AL, Tamisier R, Böhme P, Priou P, Avignon A, Benhamou PY, Hanaire H, Pépin JL, Kessler L, Valensi P, Darmon P, Gagnadoux F. [Reprint of : Management of obstructive sleep apnea syndrome in people living with diabetes: context, screening, indications and treatment modalities: context, screening, indications and treatment modalities: a French position statement]. Rev Mal Respir 2018; 35:1067-1089. [PMID: 30429090 DOI: 10.1016/j.rmr.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- A-L Borel
- Hôpital universitaire Grenoble Alpes, Département d'Endocrinologie, Diabétologie, Nutrition, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, laboratoire "Hypoxie physiopahologie" INSERM U1042, Grenoble, France.
| | - R Tamisier
- Université Grenoble Alpes, laboratoire "Hypoxie physiopahologie" INSERM U1042, Grenoble, France; Hôpital universitaire Grenoble Alpes, Pôle "Thorax et Vaisseaux", clinique de physiologie, sommeil et exercice, Grenoble, France
| | - P Böhme
- Hôpital universitaire de Nancy, Département d'Endocrinologie, Diabétologie, Nutrition, Nancy, France; Université de Lorraine, EA4360 APEMAC, Nancy, France
| | - P Priou
- Hôpital universitaire d'Angers, Département des maladies respiratoires, Angers, France; Université d'Angers, INSERM UMR 1063, Angers, France
| | - A Avignon
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France; Hôpital universitaire de Montpellier, département de Nutrition, Montpellier, France
| | - P-Y Benhamou
- Hôpital universitaire Grenoble Alpes, Département d'Endocrinologie, Diabétologie, Nutrition, 38043 Grenoble cedex 9, France
| | - H Hanaire
- Hôpital universitaire de Toulouse, Université de Toulouse, Toulouse, France
| | - J-L Pépin
- Université Grenoble Alpes, laboratoire "Hypoxie physiopahologie" INSERM U1042, Grenoble, France; Hôpital universitaire Grenoble Alpes, Pôle "Thorax et Vaisseaux", clinique de physiologie, sommeil et exercice, Grenoble, France
| | - L Kessler
- Hôpital universitaire de Strasbourg, département de diabétologie, INSERM UMR 1260, Strasbourg, France
| | - P Valensi
- Departement d'Endocrinologie Diabétologie Nutrition, APHP, Hôpital Jean Verdier, Université Paris Nord, CRNH-IdF, CINFO, Bondy, France
| | - P Darmon
- Hôpital universitaire de Marseille, département d'Endocrinologie, et Université de France & Aix Marseille, INSERM, INRA, C2VN, Marseille, France
| | - F Gagnadoux
- Hôpital universitaire d'Angers, Département des maladies respiratoires, Angers, France; Université d'Angers, INSERM UMR 1063, Angers, France
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Khurana S, Sharda S, Saha B, Kumar S, Guleria R, Bose S. Canvassing the aetiology, prognosis and molecular signatures of obstructive sleep apnoea. Biomarkers 2018; 24:1-16. [DOI: 10.1080/1354750x.2018.1514655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Sartaj Khurana
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Shivani Sharda
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Biswajit Saha
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Sachin Kumar
- Department of Medical Oncology, IRCH, AIIMS, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Medicine and Sleep Disorders, AIIMS, New Delhi, India
| | - Sudeep Bose
- Amity Institute of Biotechnology, Amity University, Noida, India
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Concerning "Comments and question on "Selective inhibition of endothelial NF-kB signaling attenuates chronic intermittent hypoxia-induced atherosclerosis in mice" ". Atherosclerosis 2018; 277:227-228. [PMID: 29961598 DOI: 10.1016/j.atherosclerosis.2018.06.862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/15/2018] [Indexed: 11/22/2022]
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AKCAN FA, Bayram Akcan H, Dündar Y, Uluat A, Karakuş E. The Histopathological Effect of Topical Nasal Corticosteroids on Adenoid Tissue. KONURALP TIP DERGISI 2018. [DOI: 10.18521/ktd.365710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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Pépin JL, Tamisier R, Hwang D, Mereddy S, Parthasarathy S. Does remote monitoring change OSA management and CPAP adherence? Respirology 2018; 22:1508-1517. [PMID: 29024308 DOI: 10.1111/resp.13183] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/14/2017] [Accepted: 08/14/2017] [Indexed: 12/15/2022]
Abstract
It is increasingly recognized that the high prevalence of obstructive sleep apnoea (OSA), and its associated cardio-metabolic morbidities make OSA a burden for society. Continuous positive airway pressure (CPAP), the gold standard treatment, needs to be used for more than 4 h/night to be effective, but suffers from relatively poor adherence. Furthermore, CPAP is likely to be more effective if combined with lifestyle changes. Thus, the remote telemonitoring (TM) of OSA patients in terms of CPAP use, signalling of device problems, following disease progression, detection of acute events and monitoring of daily physical activity is an attractive option. In the present review, we aim to summarize the recent scientific data on remote TM of OSA patients, and whether it meets expectations. We also look at how patient education and follow-up via telemedicine is used to improve adherence and we discuss the influence of the profile of the healthcare provider. Then, we consider how TM might be extended to encompass the patient's cardio-metabolic health in general. Lastly, we explore how TM and the deluge of data it potentially generates could be combined with electronic health records in providing personalized care and multi-disease management to OSA patients.
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Affiliation(s)
- Jean L Pépin
- Laboratory for Hypoxia and Pathophysiology, University of Grenoble Alpes, Grenoble, France.,Inserm U1042 and Pole Thorax and Vaisseaux, Grenoble Alps University Hospital, Grenoble, France
| | - Renaud Tamisier
- Laboratory for Hypoxia and Pathophysiology, University of Grenoble Alpes, Grenoble, France.,Inserm U1042 and Pole Thorax and Vaisseaux, Grenoble Alps University Hospital, Grenoble, France
| | - Dennis Hwang
- Sleep Medicine, Southern California Permanente Medical Group, Kaiser Permanente Fontana Sleep Disorders Center, Fontana, California, USA
| | - Suresh Mereddy
- Department of Medicine, University of Arizona, Tucson, Arizona, USA.,University of Arizona Health Sciences, Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona, USA
| | - Sairam Parthasarathy
- Department of Medicine, University of Arizona, Tucson, Arizona, USA.,University of Arizona Health Sciences, Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona, USA
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36
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Fındık H, Çeliker M, Aslan MG, Çeliker FB, İnecikli MF, Dursun E, Okutucu M, Şahin Ü. The relation between retrobulbar blood flow and posterior ocular changes measured using spectral-domain optical coherence tomography in patients with obstructive sleep apnea syndrome. Int Ophthalmol 2018; 39:1013-1025. [PMID: 29594838 DOI: 10.1007/s10792-018-0892-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 03/16/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the effect of posterior ocular hemodynamics on the retinal nerve fiber layer (RNFL), choroid thickness (CT) and central macular thickness (CMT) in patients with obstructive sleep apnea syndrome (OSAS) and to reveal the association with glaucomatous optic neuropathy. METHODS The research was planned as a prospective, randomized study. The ophthalmic, retinal and posterior ciliary artery pulsatile index (PI) and resistive index (RI) were measured by colored Doppler sonography. RNFL thickness, CMT and CT were then measured by spectral-domain optical coherence tomography. RESULTS Sixty subjects were divided into four groups-mild, moderate and severe OSAS and a control group. There were 16 subjects in the control group, 14 in the mild OSAS group, 15 in the moderate OSAS group and 15 in the severe OSAS group. Ophthalmic artery and central retinal artery PI and RI values of the OSAS patients did not show statistically significant difference than those of the control group, but posterior ciliary artery (PCA) PI and RI values were significantly higher. In addition, mean, superior and inferior RNFL thickness values were significantly lower than those in the control group. Moreover, the glaucoma prevalence of the OSAS patients in this study was 6.8% and all of these patients were in the severe OSAS group. CONCLUSION PI and RI values of the PCA, which supplies the optic nerve, show a linear increase as the apnea hypoxia index values in OSAS. As the grade of OSAS improves, this situation leads to a more serious ischemic optic neuropathy. Furthermore, the prevalence of glaucoma in this study is found to be higher in the severe OSAS group.
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Affiliation(s)
- Hüseyin Fındık
- Ophthalmology Department, Recep Tayyip Erdoğan University School of Medicine, 53200, Rize, Turkey.
| | - Metin Çeliker
- Otorhinolaryngology Department, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
| | - Mehmet Gökhan Aslan
- Ophthalmology Department, Recep Tayyip Erdoğan University School of Medicine, 53200, Rize, Turkey
| | - Fatma Beyazal Çeliker
- Radiology Department, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
| | - Mehmet Fatih İnecikli
- Radiology Department, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
| | - Engin Dursun
- Otorhinolaryngology Department, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
| | - Murat Okutucu
- Ophthalmology Department, Recep Tayyip Erdoğan University School of Medicine, 53200, Rize, Turkey
| | - Ünal Şahin
- Pulmonology Department, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
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Orexin-A aggravates the impairment of hippocampal neurons caused by intermittent hypoxemia by the OXR-PLCβ1-ERK1/2 pathway. Neuroreport 2018; 28:331-338. [PMID: 28306607 DOI: 10.1097/wnr.0000000000000768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Obstructive sleep apnea is a highly prevalent but under-recognized disorder that causes neurocognitive deficits such as spatial memory and learning deficits. These deficits are frequently accompanied by an increase in orexin-A, which has been shown to be involved in learning and memory as well as in neuronal apoptosis in brain areas involved in cognition, such as the hippocampus. The aim of this work was to study the possible harmful effects of orexin-A on intermittent hypoxemia-induced hippocampal neuronal damage and to investigate the potential underlying molecular mechanisms and signaling pathways in vitro. We established a hypoxia model in cultured rat hippocampal neurons and evaluated the effects of orexin-A by testing the apoptosis rate of the hippocampal neurons. Further studies using the extracellular signal-regulated kinase 1/2 inhibitor U0126, siRNA-PLCβ1, and siRNA-PLCβ4 were carried out to evaluate the mechanisms by which orexin-A contributes toward impairment of hippocampal neurons. The results showed that orexin-A increases intermittent hypoxemia-induced hippocampal neurons damage by overphosphorylating extracellular signal-regulated kinase 1/2 through the OXR-PLCβ1 pathway.
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Gautier-Veyret E, Pépin JL, Stanke-Labesque F. Which place of pharmacological approaches beyond continuous positive airway pressure to treat vascular disease related to obstructive sleep apnea? Pharmacol Ther 2017; 186:45-59. [PMID: 29277633 DOI: 10.1016/j.pharmthera.2017.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete upper airway obstruction, occurring during sleep, leading to chronic intermittent hypoxia (IH), which harms the cardiovascular system. OSA is associated with both functional and structural vascular alterations that contribute to an increased prevalence of fatal and non-fatal cardiovascular events. OSA is a heterogeneous disease with respect to the severity of hypoxia, the presence of daytime symptoms, obesity, and cardiovascular comorbidities. Various clusters of OSA phenotypes have been described leading to more highly personalized treatment. The aim of this review is to describe the various therapeutic strategies including continuous positive airway pressure (CPAP), oral appliances, surgery, weight loss, and especially pharmacological interventions that have been evaluated to reduce vascular alterations in both OSA patients and preclinical animal models. Conventional therapies, predominantly CPAP, have a limited impact on vascular alterations in the presence of co-morbidities. A better knowledge of pharmacological therapies targeting IH-induced vascular alterations will facilitate the use of combined therapies and is crucial for designing clinical trials in well-defined OSA phenotypes.
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Affiliation(s)
- Elodie Gautier-Veyret
- Univ. Grenoble Alpes, HP2, F-38041 Grenoble, France; INSERM U1042, 38041 Grenoble, France; Centre hospitalier Universitaire Grenoble Alpes, 38043 Grenoble, France.
| | - Jean-Louis Pépin
- Univ. Grenoble Alpes, HP2, F-38041 Grenoble, France; INSERM U1042, 38041 Grenoble, France; Centre hospitalier Universitaire Grenoble Alpes, 38043 Grenoble, France
| | - Françoise Stanke-Labesque
- Univ. Grenoble Alpes, HP2, F-38041 Grenoble, France; INSERM U1042, 38041 Grenoble, France; Centre hospitalier Universitaire Grenoble Alpes, 38043 Grenoble, France
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Fajardo-Escolar AP, Perea-Bello AH, Hidalgo-Martinez P. Manejo perioperatorio del paciente con síndrome de apnea-hipopnea obstructiva del sueño (SAHOS). REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n1sup.59568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Los pacientes con diagnóstico de síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) pueden ser llevados de forma segura a cualquier procedimiento quirúrgico, incluso de manera ambulatoria si tienen control adecuado de sus otras comorbilidades. El tratamiento con presión positiva continúa en vía aérea (CPAP) en pacientes con diagnóstico confirmado disminuye el riesgo de presentar complicaciones cardiovasculares a largo plazo. La sedación debe ser hecha por un anestesiólogo, quien, además, debe vigilar al paciente y disponer del equipo adecuado para atender complicaciones respiratorias emergentes. Se sugiere que, en estos pacientes, los procedimientos sean hechos en el ámbito hospitalario, donde se tenga disponibilidad en la unidad de cuidados post-anestésicos y personal para monitoreo por al menos una hora tras finalizar el procedimiento. El tratamiento con CPAP debe continuar según sea ordenado por el médico tratante. Es importante que desde la valoración preanestésica se identifique a los pacientes con riesgo de SAHOS para lograr trazar un plan anestésico que disminuya las complicaciones a nivel respiratorio y del manejo de la vía área.
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Kang HH, Kim IK, Lee HI, Joo H, Lim JU, Lee J, Lee SH, Moon HS. Chronic intermittent hypoxia induces liver fibrosis in mice with diet-induced obesity via TLR4/MyD88/MAPK/NF-kB signaling pathways. Biochem Biophys Res Commun 2017. [DOI: 10.1016/j.bbrc.2017.06.047] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Evaluation of Inflammatory Markers in a Large Sample of Obstructive Sleep Apnea Patients without Comorbidities. Mediators Inflamm 2017; 2017:4573756. [PMID: 28831208 PMCID: PMC5555019 DOI: 10.1155/2017/4573756] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/19/2017] [Accepted: 07/03/2017] [Indexed: 02/01/2023] Open
Abstract
Systemic inflammation is important in obstructive sleep apnea (OSA) pathophysiology and its comorbidity. We aimed to assess the levels of inflammatory biomarkers in a large sample of OSA patients and to investigate any correlation between these biomarkers with clinical and polysomnographic (PSG) parameters. This was a cross-sectional study in which 2983 patients who had undergone a polysomnography for OSA diagnosis were recruited. Patients with known comorbidities were excluded. Included patients (n = 1053) were grouped according to apnea-hypopnea index (AHI) as mild, moderate, and severe. Patients with AHI < 5 served as controls. Demographics, PSG data, and levels of high-sensitivity C-reactive protein (hs-CRP), fibrinogen, erythrocyte sedimentation rate (ESR), and uric acid (UA) were measured and compared between groups. A significant difference was found between groups in hs-CRP, fibrinogen, and UA. All biomarkers were independently associated with OSA severity and gender (p < 0.05). Females had increased levels of hs-CRP, fibrinogen, and ESR (p < 0.001) compared to men. In contrast, UA levels were higher in men (p < 0.001). Our results suggest that inflammatory markers significantly increase in patients with OSA without known comorbidities and correlate with OSA severity. These findings may have important implications regarding OSA diagnosis, monitoring, treatment, and prognosis. This trial is registered with ClinicalTrials.gov number NCT03070769.
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Pépin JL. Syndrome d’apnées obstructives du sommeil : redéfinir les parcours de soins et accéder à la médecine personnalisée. Presse Med 2017; 46:465-467. [DOI: 10.1016/j.lpm.2017.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Weinstock LB, Myers TL, Walters AS, Schwartz OA, Younger JW, Chopra PJ, Guarino AH. Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea. ACTA ACUST UNITED AC 2017; 6:272-6. [PMID: 26867023 DOI: 10.1213/xaa.0000000000000292] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Complex regional pain syndrome (CRPS) is evoked by conditions that may be associated with local and/or systemic inflammation. We present a case of long-standing CRPS in a patient with Ehlers-Danlos syndrome in which prolonged remission was attained by directing therapy toward concomitant small intestinal bacterial overgrowth, obstructive sleep apnea, and potential increased microglia activity. We theorize that cytokine production produced by small intestinal bacterial overgrowth and obstructive sleep apnea may act as stimuli for ongoing CRPS symptoms. CRPS may also benefit from the properties of low-dose naltrexone that blocks microglia Toll-like receptors and induces production of endorphins that regulate and reduce inflammation.
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Affiliation(s)
- Leonard B Weinstock
- From the Departments of *Anesthesia and †Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; ‡Specialists in Gastroenterology, LLC, St. Louis, Missouri; §Department of Neurology, Vanderbilt University, Nashville, Tennessee; ‖Sleep and EEG Laboratory, Barnes Jewish West County, BJC Medical Group Center for Sleep Medicine, St. Louis, Missouri; Departments of ¶Psychology, #Anesthesiology, and **Rheumatology, Neuroinflammation, Pain and Fatigue Lab, University of Alabama, Birmingham, Alabama; ††Pain Management Center, Department of Anesthesia, Warren Alpert Medical School of Brown University, Providence, Rhode Island; and ‡‡Department of Anesthesia, Washington University School of Medicine, St. Louis, Missouri
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Haba-Rubio J, Marti-Soler H, Tobback N, Andries D, Marques-Vidal P, Waeber G, Vollenweider P, von Gunten A, Preisig M, Castelao E, Tafti M, Heinzer R, Popp J. Sleep characteristics and cognitive impairment in the general population: The HypnoLaus study. Neurology 2016; 88:463-469. [PMID: 28039311 DOI: 10.1212/wnl.0000000000003557] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 10/03/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To assess the association between sleep structure and cognitive impairment in the general population. METHODS Data stemmed from 580 participants aged >65 years of the population-based CoLaus/PsyCoLaus study (Lausanne, Switzerland) who underwent complete sleep evaluation (HypnoLaus). Evaluations included demographic characteristics, personal and treatment history, sleep complaints and habits (using validated questionnaires), and a complete polysomnography at home. Cognitive function was evaluated using a comprehensive neuropsychological test battery and a questionnaire on the participant's everyday activities. Participants with cognitive impairment (global Clinical Dementia Rating [CDR] scale score > 0) were compared with participants with no cognitive impairment (global CDR score = 0). RESULTS The 291 participants with a CDR score > 0 (72.5 ± 4.6 years), compared to the 289 controls with CDR = 0 (72.1 ± 4.6 years), had significantly more light (stage N1) and less deep (stage N3) and REM sleep, as well as lower sleep efficiency, higher intrasleep wake, and higher sleepiness scores (all p < 0.05). Sleep-disordered breathing was more severe in participants with cognitive impairment with an apnea/hypopnea index (AHI) of 18.0 (7.8-35.5)/h (p50 [p25-p75]) (vs 12.9 [7.2-24.5]/h, p < 0.001), and higher oxygen desaturation index (ODI). In the multivariate analysis after adjustments for confounding variables, the AHI and the ODI ≥4% and ≥6% were independently associated with cognitive impairment. CONCLUSIONS Participants aged >65 years with cognitive impairment have higher sleepiness scores and a more disrupted sleep. This seems to be related to the occurrence of sleep-disordered breathing and the associated intermittent hypoxia.
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Affiliation(s)
- José Haba-Rubio
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland.
| | - Helena Marti-Soler
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Nadia Tobback
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Daniela Andries
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Gérard Waeber
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Peter Vollenweider
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Armin von Gunten
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Martin Preisig
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Enrique Castelao
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Mehdi Tafti
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Raphaël Heinzer
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Julius Popp
- From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland.
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Aron-Wisnewsky J, Clement K, Pépin JL. Nonalcoholic fatty liver disease and obstructive sleep apnea. Metabolism 2016; 65:1124-35. [PMID: 27324067 DOI: 10.1016/j.metabol.2016.05.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/03/2016] [Accepted: 05/07/2016] [Indexed: 12/18/2022]
Abstract
Obstructive sleep apnea (OSA) and more importantly its hallmark, chronic intermittent hypoxia (CIH), are established factors in the pathogenesis and exacerbation of nonalcoholic fatty liver disease (NAFLD). This has been clearly demonstrated in rodent models exposed to intermittent hypoxia, and strong evidence now also exists in both paediatric and adult human populations. OSA and CIH induce insulin-resistance and dyslipidemia which are involved in NAFLD physiopathogenesis. CIH increases the expression of the hypoxia inducible transcription factor HIF1α and that of downstream genes involved in lipogenesis, thereby increasing β-oxidation and consequently exacerbating liver oxidative stress. OSA also disrupts the gut liver axis, increasing intestinal permeability and with a possible role of gut microbiota in the link between OSA and NAFLD. OSA patients should be screened for NAFLD and vice versa those with NAFLD for OSA. To date there is no evidence that treating OSA with continuous positive airway pressure (CPAP) will improve NAFLD but it might at least stabilize and slow its progression. Nevertheless, these multimorbid patients should be efficiently treated for all their metabolic co-morbidities and be encouraged to follow weight stabilization or weight loss programs and physical activity life style interventions.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, UMR_S U1166, Nutriomics, 75013 Paris, France; INSERM, UMR_S U1166, Nutriomics, 75013 Paris, France.
| | - Karine Clement
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, UMR_S U1166, Nutriomics, 75013 Paris, France; INSERM, UMR_S U1166, Nutriomics, 75013 Paris, France
| | - Jean-Louis Pépin
- Institut National de la Santé et de la Recherche Médicale (INSERM), U 1042, HP2 Laboratory (Hypoxia: Pathophysiology), Grenoble Alpes Univ., Grenoble, F-38000, France;; Grenoble Alpes University Hospital, Pole Thorax et Vaisseaux, F-38000, France.
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Baltzis D, Bakker JP, Patel SR, Veves A. Obstructive Sleep Apnea and Vascular Diseases. Compr Physiol 2016; 6:1519-28. [PMID: 27347900 DOI: 10.1002/cphy.c150029] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Obstructive sleep apnea (OSA) affects a large proportion of adults, and is as an independent risk factor for cerebrovascular and cardiovascular disease. The repetitive airway obstruction that characterizes OSA results in intermittent hypoxia, intrathoracic pressure swings, and sleep fragmentation, which in turn lead to sympathetic activation, oxidative stress, inflammation, and endothelial dysfunction. This review outlines the associations between OSA and vascular diseases and describes basic mechanisms that may be responsible for this association, in both the micro- and macrocirculation. It also reports on interventional studies that aim to ameliorate OSA and thereby reduce vascular disease burden. © 2016 American Physiological Society. Compr Physiol 6:1519-1528, 2016.
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Affiliation(s)
- Dimitrios Baltzis
- Microcirculation Lab and Joslin-Beth Israel Deaconess Foot Center, Harvard Medical School, Boston, USA
| | - Jessie P Bakker
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Aristidis Veves
- Microcirculation Lab and Joslin-Beth Israel Deaconess Foot Center, Harvard Medical School, Boston, USA
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Daulatzai MA. Fundamental role of pan-inflammation and oxidative-nitrosative pathways in neuropathogenesis of Alzheimer's disease in focal cerebral ischemic rats. AMERICAN JOURNAL OF NEURODEGENERATIVE DISEASE 2016; 5:102-30. [PMID: 27335702 PMCID: PMC4913220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 02/09/2016] [Indexed: 06/06/2023]
Abstract
Alzheimer's disease (AD) is a chronic progressive neurodegenerative condition of the brain, and it is the most common cause of dementia. Several neurobiological etiologies of AD are described in the literature. These include vascular, infectious, toxic, nutritional, metabolic, and inflammatory. However, these heterogeneous etiologies have a common denominator - viz. Inflammation and oxidative stress. Lipopolysaccharide (LPS) elevates the synthesis of proinflammatory cytokines and chemokines; chronically, together they trigger various pathological responses in the periphery and the CNS including dysfunctional memory consolidation and memory decline. Aging - the main risk factor for AD is inherently associated with inflammation. There are several age-related comorbidities that are also associated with inflammation and oxidative stress. Such co-prevailing aggravating factors, therefore, persist against a background of underlying aging-related pathology. They may converge, and their synergistic propagation may modify the disease course. A critical balance exists between homeostasis/repair and inflammatory factors; chronic, unrelenting inflammatory milieu succeeds in promoting a neuroinflammatory and neurodegenerative outcome. Extensive evidence is available that CNS inflammation is associated with neurodegeneration. LPS, proinflammatory cytokines, several mediators secreted by microglia, and oxidative-nitrosative stress in concert play a pivotal role in triggering neuroinflammatory processes and neurodegeneration. The persistent uncontrolled activity of the above factors can potentiate cognitive decline in tandem enhancing vulnerability to AD. Despite significant progress during the past twenty years, the prevention and treatment of AD have been tantalizingly elusive. Current studies strongly suggest that amelioration/prevention of the deleterious effects of inflammation may prove beneficial in preventing AD onset and retarding cognitive dysfunction in aging and AD. A concerted multi-focal therapeutic effort around the inflammation-oxidative-nitrosative stress paradigm may be crucial in preventing and treating AD. This paper informs on such relevant polypharmacy approach.
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Affiliation(s)
- Mak Adam Daulatzai
- Sleep Disorders Group, EEE/Melbourne School of Engineering, The University of Melbourne Parkville, Victoria 3010, Australia
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Tintinger G, Pretorius L, Labadarios D. Obstructive sleep apnoea and obesity. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2011.11734384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Protective effect of resveratrol against chronic intermittent hypoxia-induced spatial memory deficits, hippocampal oxidative DNA damage and increased p47Phox NADPH oxidase expression in young rats. Behav Brain Res 2016; 305:65-75. [DOI: 10.1016/j.bbr.2016.02.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 12/26/2022]
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Pamidi S, Marc I, Simoneau G, Lavigne L, Olha A, Benedetti A, Sériès F, Fraser W, Audibert F, Bujold E, Gagnon R, Schwartzman K, Kimoff RJ. Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study. Thorax 2016; 71:719-25. [DOI: 10.1136/thoraxjnl-2015-208038] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/11/2016] [Indexed: 11/04/2022]
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