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Golshah A, Sadeghi M, Sadeghi E. Evaluation of Serum/Plasma Levels of Interleukins (IL-6, IL-12, IL-17, IL-18, and IL-23) in Adults and Children with Obstructive Sleep Apnea: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis. J Interferon Cytokine Res 2024; 44:300-315. [PMID: 38757606 DOI: 10.1089/jir.2024.0057] [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] [Indexed: 05/18/2024] Open
Abstract
Obstructive sleep apnea (OSA) is a chronic inflammatory disease characterized by partial or complete upper airway obstruction during sleep. We aimed to evaluate serum/plasma levels of several cytokines (interleukin [IL]-6, IL-12, IL-17, IL-18, and IL-23) in a systematic review meta-analysis in both adults and children with OSA compared with controls. We conducted a comprehensive search of 4 digital databases (PubMed, Web of Science, Scopus, and Cochrane Library) up until October 19, 2023, without any limitations. For our meta-analysis, we used Review Manager, version 5.3, and displayed the data as the standardized mean difference (SMD) and 95% confidence interval (CI) to assess the correlation between cytokine levels and OSA. We utilized Comprehensive Meta-Analysis version 3.0 software to conduct bias analyses, meta-regression, and sensitivity analyses. From 1881 records, 84 articles were included in the systematic review and meta-analysis. In adults, the pooled SMDs for IL-6 level were 0.79 (P value < 0.00001), for IL-17 level were 0.74 (P value = 0.14), and for IL-18 level were 0.43 (P value = 0.00002). In children, the pooled SMD for IL-6 was 1.10 (P value < 0.00001), for IL-12 was 0.47 (P value = 0.10), for IL-17 was 2.21 (a P value = 0.24), for IL-18 was 0.19 (P value = 0.07), and for IL-23 was 2.46 (P value < 0.0001). The subgroup analysis showed that the ethnicity, mean body mass index, and mean apnea-hypopnea index for IL-6 levels in adults and the ethnicity for IL-6 levels in children were effective factors in the pooled SMD. The findings of the trial sequential analysis revealed that adequate evidence has been obtained. The analysis of IL levels in adults and children with OSA compared with those without OSA revealed significant differences. In adults, IL-6 and IL-18 levels were significantly higher in the OSA group, while in children, only IL-6 and IL-23 levels were significantly elevated.
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Affiliation(s)
- Amin Golshah
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Edris Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Fiedorczuk P, Olszewska E, Rogalska J, Brzóska MM. Osteoprotegerin, Chitinase 3-like Protein 1, and Cardiotrophin-1 as Potential Biomarkers of Obstructive Sleep Apnea in Adults-A Case-Control Study. Int J Mol Sci 2023; 24:ijms24032607. [PMID: 36768925 PMCID: PMC9916736 DOI: 10.3390/ijms24032607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/15/2023] [Accepted: 01/28/2023] [Indexed: 02/03/2023] Open
Abstract
Obstructive sleep apnea (OSA) is a prevalent, underdiagnosed disease and is considered a risk factor for cardiovascular diseases, depression, accidents, and stroke. Recent clinical practice guidelines for OSA expressed the need for a new clinical tool that establishes the Apnea-Hypopnea Index (AHI) to determine the disease burden. The serum and plasma concentrations of Osteoprotegerin (OPG), Chitinase 3-like protein 1 (YKL-40), and Cardiotrophin-1 (CT-1) in 80 subjects-52 OSA patients, 27 moderate (15 ≤ AHI ˂ 30) and 25 severe (AHI ≥ 30), and 28 non-OSA controls (AHI 0-5)-were determined. Moreover, the Total Oxidative Status (TOS), Total Antioxidative Status (TAS), and Oxidative Stress Index (OSI) were assessed in the serum and plasma to evaluate whether the severity of OSA and the concentrations of OPG, YKL-40, and CT-1 correlate with the oxidative/reductive status. The serum and plasma concentrations of YKL-40 and CT-1 were higher in the OSA group, whereas the serum and plasma concentrations of OPG were lower compared to the control group. The concentrations of OPG, YKL-40, and CT-1 in the serum and plasma correlated with AHI; however, a better correlation of the concentrations was obtained for the above-mentioned proteins in the plasma. The concentrations of YKL-40 and CT-1 in the serum and OPG in the plasma show better diagnostic capabilities for moderate and severe OSA than the concentrations of YKL-40 and CT-1 in the plasma and the concentrations of OPG in the serum.
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Affiliation(s)
- Piotr Fiedorczuk
- Department of Otolaryngology, Medical University of Bialystok, 15-089 Bialystok, Poland
- Correspondence: ; Tel.: +48-663-751-516
| | - Ewa Olszewska
- Department of Otolaryngology, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Joanna Rogalska
- Department of Toxicology, Medical University of Bialystok, 15-089 Bialystok, Poland
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Wang Y, Meagher RB, Ambati S, Ma P, Phillips BG. Patients with obstructive sleep apnea have suppressed levels of soluble cytokine receptors involved in neurodegenerative disease, but normal levels with airways therapy. Sleep Breath 2020; 25:1641-1653. [PMID: 33037528 PMCID: PMC8376707 DOI: 10.1007/s11325-020-02205-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/13/2020] [Accepted: 09/26/2020] [Indexed: 12/14/2022]
Abstract
Purpose Obstructive sleep apnea (OSA) results in systemic intermittent hypoxia. By one model, hypoxic stress signaling in OSA patients alters the levels of inflammatory soluble cytokines TNF and IL6, damages the blood brain barrier, and activates microglial targeting of neuronal cell death to increase the risk of neurodegenerative disorders and other diseases. However, it is not yet clear if OSA significantly alters the levels of the soluble isoforms of TNF receptors TNFR1 and TNFR2 and IL6 receptor (IL6R) and co-receptor gp130, which have the potential to modulate TNF and IL6 signaling. Methods Picogram per milliliter levels of the soluble isoforms of these four cytokine receptors were estimated in OSA patients, in OSA patients receiving airways therapy, and in healthy control subjects. Triplicate samples were examined using Bio-Plex fluorescent bead microfluidic technology. The statistical significance of cytokine data was estimated using the nonparametric Wilcoxon rank-sum test. The clustering of these high-dimensional data was visualized using t-distributed stochastic neighbor embedding (t-SNE). Results OSA patients had significant twofold to sevenfold reductions in the soluble serum isoforms of all four cytokine receptors, gp130, IL6R, TNFR1, and TNFR2, as compared with control individuals (p = 1.8 × 10−13 to 4 × 10−8). Relative to untreated OSA patients, airways therapy of OSA patients had significantly higher levels of gp130 (p = 2.8 × 10−13), IL6R (p = 1.1 × 10−9), TNFR1 (p = 2.5 × 10−10), and TNFR2 (p = 5.7 × 10−9), levels indistinguishable from controls (p = 0.29 to 0.95). The data for most airway-treated patients clustered with healthy controls, but the data for a few airway-treated patients clustered with apneic patients. Conclusions Patients with OSA have aberrantly low levels of four soluble cytokine receptors associated with neurodegenerative disease, gp130, IL6R, TNFR1, and TNFR2. Most OSA patients receiving airways therapy have receptor levels indistinguishable from healthy controls, suggesting a chronic intermittent hypoxia may be one of the factors contributing to low receptor levels in untreated OSA patients. Electronic supplementary material The online version of this article (10.1007/s11325-020-02205-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ye Wang
- Department of Statistics, University of Georgia, Athens, GA, 30602, USA
| | - Richard B Meagher
- Department of Genetics, University of Georgia, Athens, GA, 30602, USA.
| | - Suresh Ambati
- Department of Genetics, University of Georgia, Athens, GA, 30602, USA
| | - Ping Ma
- Department of Statistics, University of Georgia, Athens, GA, 30602, USA
| | - Bradley G Phillips
- Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, 30602, USA.,Clinical and Translational Research Unit, University of Georgia, Athens, GA, 30602, USA
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Imani MM, Sadeghi M, Khazaie H, Emami M, Sadeghi Bahmani D, Brand S. Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression. Front Immunol 2020; 11:1343. [PMID: 32793188 PMCID: PMC7385225 DOI: 10.3389/fimmu.2020.01343] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/27/2020] [Indexed: 12/29/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is considered a low-grade chronic inflammatory disease. Interleukin-6 (IL-6) is one of the most significant inflammatory markers and an excellent proxy for the inflammatory/immune system. The present meta-analysis and meta-regression aimed at comparing plasma and serum levels of IL-6 between individuals (children and adults) with OSAS and healthy controls. Four databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, were comprehensively searched to retrieve articles published up to December, 2019, with no further restrictions. RevMan 5.3 software was used to calculate the crude mean difference (MD) and 95% confidence interval (CI). The results of funnel plots and meta-regression were analyzed by the CMA 2.0 software. Sixty-three studies (57 with adults; six with children) were included in the present meta-analysis. For adults, 37 studies reported significantly higher serum IL-6 levels and 20 reported significantly higher plasma IL-6 levels for those with OSAS than for healthy controls [pooled MD of 2.89 pg/ml (P < 0.00001) and pooled MD of 2.89 pg/ml (P < 0.00001), respectively]. The pooled analysis of serum and plasma IL-6 levels in children with OSAS compared with controls revealed that only the MD of plasma IL-6 levels was significant (MD = 0.84 pg/ml, P = 0.004). Results of the meta-regression showed that greater age was associated with higher serum IL-6 levels. Egger's test revealed a publication bias across the studies for serum and plasma IL-6 levels (P = 0.00044 and P = 0.01445, respectively). In summary, the meta-analysis and meta-regression confirmed that, compared to healthy controls, individuals with OSAS (children and adults) had higher serum/plasma IL-6 levels.
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Affiliation(s)
- Mohammad Moslem Imani
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Emami
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dena Sadeghi Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Zhang Z, Wang Q, Chen B, Wang Y, Miao Y, Han L. Association study of genetic variations of inflammatory biomarkers with susceptibility and severity of obstructive sleep apnea. Mol Genet Genomic Med 2019; 7:e801. [PMID: 31210414 PMCID: PMC6712723 DOI: 10.1002/mgg3.801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/19/2019] [Accepted: 05/23/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) increases health risks of cardiovascular disease and stroke. Both genetic factors and environmental exposures contribute to the occurrence of OSA. The purpose of this study was to determine the role of four functional inflammatory single nucleotide polymorphisms (SNPs) (VWF rs1063856, IL-6 rs1800796, TNF rs1800629, and CRP rs2794521) in the susceptibility and severity of OSA. METHODS A case-control study of OSA among Chinese population was conducted. Genotyping was performed using ABI TaqMan SNP genotyping technique. RESULTS We found VWF rs1063856 (OR = 1.50, 95% CIs = 1.10-2.04; p = 0.010), IL-6 rs1800796 (OR = 1.32, 95% CIs = 1.11-1.56; p = 0.002), TNF rs1800629 (OR = 1.44, 95% CIs = 1.13-1.83; p = 0.003), and CRP rs2794521 (OR = 1.27, 95% CIs = 1.04-1.55; p = 0.021) were all significantly associated with increased susceptibility of OSA, while VWF rs1063856 (OR = 1.75, 95% CIs = 1.18-2.62; p = 0.006), IL-6 rs1800796 (OR = 1.39, 95% CIs = 1.10-1.76; p = 0.006) were associated with the severity of OSA. CONCLUSIONS Our study indicated that functional variants of inflammatory biomarkers could cause the occurrence of OSA and influence the severity of OSA. These findings further support that inflammatory cytokines were closely related to the occurrence and development of OSA.
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Affiliation(s)
- Zeming Zhang
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Qiubo Wang
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Baoyuan Chen
- Department of Respiratory Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yancun Wang
- Department of Neurology Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Yafang Miao
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Li Han
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
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Cardiotrophin-1 and leptin as cardiovascular risk markers in male patients with obstructive sleep apnea syndrome. ACTA ACUST UNITED AC 2019; 3:e123-e128. [PMID: 30775602 PMCID: PMC6374564 DOI: 10.5114/amsad.2018.79407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/01/2018] [Indexed: 11/19/2022]
Abstract
Introduction Elevated cardiotrophin-1 (CT-1) and leptin levels are important risk factors for cardiovascular diseases (CVDs). Obstructive sleep apnea syndrome (OSAS) has also been reported to increase this risk. The aim of this study is to evaluate serum concentrations of CT-1 and leptin in patients with OSAS and whether there is a possible association between CT-1, leptin and OSAS severity. Material and methods Fifty newly diagnosed OSAS patients and thirty nonapneic snoring subjects participated in this study. Fasting serum lipid profile markers were evaluated. The measurements of serum CT-1 and leptin levels were carried out using human ELISA kits. Results Significant differences were found in the serum CT-1 and leptin levels between the two groups. Serum median CT-1 levels in patient and control groups, respectively, were 19.47; 8.23 pg/ml and leptin levels were 2.07; 1.29 ng/ml (p < 0.001). In the severe patient group, serum median CT-1 level was statistically significantly higher than the median level in the mild/moderate group. There was no correlation between patients’ leptin and lipid profile parameters and CT-1 concentrations were not associated with triglyceride, cholesterol or LDL cholesterol levels except HDL cholesterol: CT-1 levels were positively correlated with HDL levels (p = 0.02). Conclusions Both CT-1 and leptin were significantly elevated in the patient group. Furthermore, CT-1 and leptin were associated with OSAS and CT-1 was associated with the disease severity.
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Roles of interleukin (IL)-6 gene polymorphisms, serum IL-6 levels, and treatment in obstructive sleep apnea: a meta-analysis. Sleep Breath 2015; 20:719-31. [DOI: 10.1007/s11325-015-1288-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/21/2015] [Accepted: 11/02/2015] [Indexed: 12/20/2022]
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