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Bordas-Martinez J, Salord N, Vicens-Zygmunt V, Carmezim J, Pérez S, Prado E, Calvo M, Blavia R, Bermudo G, Santos S, Monasterio C, Molina-Molina M. Treating sleep-disordered breathing of idiopathic pulmonary fibrosis patients with CPAP and nocturnal oxygen treatment. A pilot study : Sleep-disordered breathing treatment in IPF. Respir Res 2024; 25:247. [PMID: 38890648 PMCID: PMC11186220 DOI: 10.1186/s12931-024-02871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Sleep-disordered breathing (SDB) is a major comorbidity in idiopathic pulmonary fibrosis (IPF) and is associated with a poor outcome. There is a lack of knowledge regarding the impact of SDB treatment on IPF. We assessed at one year: (1) the effect of CPAP and/or nocturnal oxygen therapy on IPF regarding lung function, blood mediators, and quality of life; (2) adherence to SDB treatment and SDB changes. METHODOLOGY This is a prospective study of consecutive newly diagnosed IPF patients initiating anti-fibrotic treatment. Lung function, polysomnography, blood tests and quality of life questionnaires were performed at inclusion and after one year. Patients were classified as obstructive sleep apnoea (OSA), central sleep apnoea (CSA), and sleep-sustained hypoxemia (SSH). SDB therapy (CPAP and/or nocturnal oxygen therapy) was initiated if needed. RESULTS Fifty patients were enrolled (36% had OSA, 22% CSA, and 12% SSH). CPAP was started in 54% of patients and nocturnal oxygen therapy in 16%. At one-year, polysomnography found improved parameters, though 17% of patients had to add nocturnal oxygen therapy or CPAP, while 33% presented SDB onset at this second polysomnography. CPAP compliance at one year was 6.74 h/night (SD 0.74). After one year, matrix metalloproteinase-1 decreased in OSA and CSA (p = 0.029; p = 0.027), C-reactive protein in OSA (p = 0.045), and surfactant protein D in CSA group (p = 0.074). There was no significant change in lung function. CONCLUSIONS Treatment of SBD with CPAP and NOT can be well tolerated with a high compliance. IPF patients may exhibit SDB progression and require periodic re-assessment. Further studies to evaluate the impact of SDB treatment on lung function and serological mediators are needed.
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Affiliation(s)
- Jaume Bordas-Martinez
- Interstitial Lung Disease Unit, Respiratory Department, Bellvitge University Hospital. IDIBELL. CIBERES, University of Barcelona. -Hospitalet de Llobregat (Barcelona), Barcelona, Spain
- Sleep Unit, Respiratory Department, Bellvitge University Hospital, IDIBELL. University of Barcelona. - Hospitalet de Llobregat (Barcelona), 08907, Barcelona, Spain
- Respiratory Department, Granollers University Hospital. -Granollers (Barcelona), Barcelona, Spain
| | - Neus Salord
- Sleep Unit, Respiratory Department, Bellvitge University Hospital, IDIBELL. University of Barcelona. - Hospitalet de Llobregat (Barcelona), 08907, Barcelona, Spain
| | - Vanesa Vicens-Zygmunt
- Interstitial Lung Disease Unit, Respiratory Department, Bellvitge University Hospital. IDIBELL. CIBERES, University of Barcelona. -Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - João Carmezim
- Biostatistics Unit, IDIBELL. Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Sandra Pérez
- Sleep Unit, Respiratory Department, Bellvitge University Hospital, IDIBELL. University of Barcelona. - Hospitalet de Llobregat (Barcelona), 08907, Barcelona, Spain
| | - Eliseo Prado
- Sleep Unit, Respiratory Department, Bellvitge University Hospital, IDIBELL. University of Barcelona. - Hospitalet de Llobregat (Barcelona), 08907, Barcelona, Spain
| | - María Calvo
- Sleep Unit, Respiratory Department, Bellvitge University Hospital, IDIBELL. University of Barcelona. - Hospitalet de Llobregat (Barcelona), 08907, Barcelona, Spain
| | - Rosana Blavia
- Respiratory Department, Hospital Moises Broggi. -Sant Joan Despí, Barcelona, Spain
| | - Guadalupe Bermudo
- Interstitial Lung Disease Unit, Respiratory Department, Bellvitge University Hospital. IDIBELL. CIBERES, University of Barcelona. -Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Salud Santos
- Interstitial Lung Disease Unit, Respiratory Department, Bellvitge University Hospital. IDIBELL. CIBERES, University of Barcelona. -Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Carmen Monasterio
- Sleep Unit, Respiratory Department, Bellvitge University Hospital, IDIBELL. University of Barcelona. - Hospitalet de Llobregat (Barcelona), 08907, Barcelona, Spain.
| | - María Molina-Molina
- Interstitial Lung Disease Unit, Respiratory Department, Bellvitge University Hospital. IDIBELL. CIBERES, University of Barcelona. -Hospitalet de Llobregat (Barcelona), Barcelona, Spain
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Molecular Pathology, Oxidative Stress, and Biomarkers in Obstructive Sleep Apnea. Int J Mol Sci 2023; 24:ijms24065478. [PMID: 36982552 PMCID: PMC10058074 DOI: 10.3390/ijms24065478] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia (IH) during sleep due to recurrent upper airway obstruction. The derived oxidative stress (OS) leads to complications that do not only concern the sleep-wake rhythm but also systemic dysfunctions. The aim of this narrative literature review is to investigate molecular alterations, diagnostic markers, and potential medical therapies for OSAS. We analyzed the literature and synthesized the evidence collected. IH increases oxygen free radicals (ROS) and reduces antioxidant capacities. OS and metabolic alterations lead OSAS patients to undergo endothelial dysfunction, osteoporosis, systemic inflammation, increased cardiovascular risk, pulmonary remodeling, and neurological alterations. We treated molecular alterations known to date as useful for understanding the pathogenetic mechanisms and for their potential application as diagnostic markers. The most promising pharmacological therapies are those based on N-acetylcysteine (NAC), Vitamin C, Leptin, Dronabinol, or Atomoxetine + Oxybutynin, but all require further experimentation. CPAP remains the approved therapy capable of reversing most of the known molecular alterations; future drugs may be useful in treating the remaining dysfunctions.
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Advances in Molecular Pathology of Obstructive Sleep Apnea. Molecules 2022; 27:molecules27238422. [PMID: 36500515 PMCID: PMC9739159 DOI: 10.3390/molecules27238422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a common syndrome that features a complex etiology and set of mechanisms. Here we summarized the molecular pathogenesis of OSA, especially the prospective mechanism of upper? airway dilator fatigue and the current breakthroughs. Additionally, we also introduced the molecular mechanism of OSA in terms of related studies on the main signaling pathways and epigenetics alterations, such as microRNA, long non-coding RNA, and DNA methylation. We also reviewed small molecular compounds, which are potential targets for gene regulations in the future, that are involved in the regulation of OSA. This review will be beneficial to point the way for OSA research within the next decade.
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Cai X, Li N, Hu J, Wen W, Yao X, Zhu Q, Heizhati M, Hong J, Sun L, Tuerxun G, Zhang D, Luo Q. Nonlinear Relationship Between Chinese Visceral Adiposity Index and New-Onset Myocardial Infarction in Patients with Hypertension and Obstructive Sleep Apnoea: Insights from a Cohort Study. J Inflamm Res 2022; 15:687-700. [PMID: 35140499 PMCID: PMC8819537 DOI: 10.2147/jir.s351238] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/15/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose We aimed to investigate the relationship between the Chinese visceral adiposity index (CVAI) and the risk of new-onset myocardial infarction (MI) in patients with hypertension and obstructive sleep apnoea (OSA) and to inspect possible modifiers of the effect. Methods The Cox regression model was used to evaluate the relationship between baseline CVAI and risk of new-onset MI. A generalized additive model was used to identify the nonlinear relationship. Besides, we conducted subgroup analyses and interaction tests. Results A total of 2177 patients with hypertension and OSA undergoing polysomnography were enrolled in this study. During a median follow-up period of 87 months, 82 participants developed new-onset MI. Overall, CVAI was positively related to the risk of new-onset MI (per 1 SD increase; HR = 1.54, 95% CI: 1.28–1.85). In multivariable-adjusted models, the risk of new-onset MI increased with quartiles of CVAI, with an HR of 3.64 (95% CI: 1.94–6.83) for quartile 4 compared with quartile 1. The generalized additive model and smoothed curve fit revealed a nonlinear relationship between CVAI and risk of new-onset MI with an inflection point of approximately 112. None of the stratification variables had a significant effect on the relationship between CVAI and new-onset MI. Similar outcomes were observed in the sensitivity analysis. The addition of CVAI significantly improved reclassification and discrimination over the conventional model, with a category-free NRI of 0.132 (95% CI 0.021 to 0.236, P = 0.021) and an IDI of 0.012 (95% CI 0.005 to 0.023, P < 0.001). Conclusion This study demonstrated a nonlinear relationship between CVAI and the risk of new-onset MI in patients with hypertension and OSA. Higher CVAI was significantly associated with the risk of new-onset MI when CVAI was ≥112.
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Affiliation(s)
- Xintian Cai
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Nanfang Li
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Correspondence: Nanfang Li, Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China, Email
| | - Junli Hu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Wen Wen
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Xiaoguang Yao
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qing Zhu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Jing Hong
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Le Sun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Guzailinuer Tuerxun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Delian Zhang
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qin Luo
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
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Ribot C, Morell-Garcia D, Piérola J, Peña-Zarza JA, Sanchís P, Muñiz J, de la Peña M, Alonso-Fernández A, Barceló A. Surfactant protein D concentration in a pediatric population with suspected sleep disorder. Pediatr Pulmonol 2022; 57:285-292. [PMID: 34559461 DOI: 10.1002/ppul.25697] [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: 07/22/2020] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 11/06/2022]
Abstract
Obstructive sleep apnea (OSA) affects between 2% and 4% in children and there is a search for new biomarkers that can be useful both in the diagnosis and in the evolution of the disease. The surfactant protein D (SP-D) is a collection that is part of the innate immune system exerting an anti-inflammatory and antimicrobial effect. Thus, the objective of this study was to evaluate the concentration of SP-D in the suspect OSA pediatric population. A total of 178 children were recruited in this prospective study. Blood samples, sleep parameters, feeding habits, anthropometric, sociodemographic, and family data were collected. Specific biochemical determinations were made, and the plasmatic concentrations of SP-D were measured by enzyme-linked immunosorbent assay. We found no statistical correlation between the SP-D concentration and the apnea-hypopnea index (AHI) from the data. Nevertheless, the changes in SP-D levels could be correlated to a large extent by the arousals that often go along with hypopneas (r = -0.258, p = 0.011 unadjusted; r = -0.258, p = 0.014 adjusted by age and body mass inded [BMI] Z-score). Intermittent hypoxia was correlated with C-reactive protein levels (r = 0.547, p < 0.001 unadjusted; r = 0.542, p < 0.001 adjusted by age and BMI Z-score). Although AHI and SP-D did not appear to correlate, a secondary analysis suggests that sleep fragmentation, which is produced by arousals, may do, and further research is needed to determine the mechanisms by which changes in SP-D occur in OSA.
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Affiliation(s)
- Caterina Ribot
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain.,Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Javier Piérola
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - José A Peña-Zarza
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain.,Department of Pediatrics, Sleep Unit, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Pilar Sanchís
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - Jesús Muñiz
- Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Mónica de la Peña
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Madrid, Spain.,Department of Respiratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Alberto Alonso-Fernández
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Madrid, Spain.,Department of Respiratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Antonia Barceló
- Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain.,Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Madrid, Spain
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Zhang C, Cheng Y, Liu F, Ma J, Wang G. A community study of the risk for obstructive sleep apnea and respiratory inflammation in an adult Chinese population. Postgrad Med 2021; 133:531-540. [PMID: 33851902 DOI: 10.1080/00325481.2021.1914466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: We aimed to investigate the relationship between obstructive sleep apnea (OSA) risk and respiratory inflammation evaluated by the exhaled breath condensate (EBC) interleukin-6 (IL-6) and plasma surfactant protein-D (SP-D), based on the Berlin questionnaire (BQ) screening values in an adult, urban community in Beijing, China.Methods: Volunteers aged >40 years were recruited from the Shichahai community of central Beijing (Registration number: NCT04832711). Their general information and disease history were recorded. OSA risk was assessed using the BQ. IL-6 in EBC and plasma SP-D were d etected by enzyme-linked immunoassay through specimens collected while fasting. The differences in IL-6 and SP-D values between high-risk and low-risk groups for OSA were compared, and the factors affecting their values were analyzed.Results: Among 1,239 participants, 18.8% of participants were in the high-risk group. There were more participants with higher body mass index, chronic hypertension, coronary heart disease, and diabetes in the high-risk group than in the low-risk group (P < 0.05). There were no significant differences in EBC IL-6 and plasma SP-D between the high- and low-OSA risk groups (p > 0.05). After adjustment for age, sex and chronic comorbidities, multivariate logistic regression showed that there was no correlation between risk of OSA and IL-6 in EBC. However, the risk of OSA (odds ratio [OR] [95% CI]: 1.69 [1.15,2.48]; β = 0.522) and BMI (OR [95%CI]: 0.94 [0.91,0.98]; β = -0.061) were independently associated with plasma SP-D level (p < 0.05 for both). Stratification analysis showed that OSA risk were independently associated with plasma SP-D levels in participants <65 years, or men, or participants with BMI<25.Conclusion: This study showed that plasma SP-D, an inflammation biomarker, was associated with risk of OSA and BMI in a Chinese central urban community.The relationship between the risk of OSA and respiratory inflammation in community populations needs to be further evaluated.
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Affiliation(s)
- Cheng Zhang
- The Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yuan Cheng
- The Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Feng Liu
- The Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Jing Ma
- The Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- The Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Glial Cell- Derived Neurotrophic Factor Functions as a Potential Candidate Gene in Obstructive Sleep Apnea Based on a Combination of Bioinformatics and Targeted Capture Sequencing Analyses. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6656943. [PMID: 33688499 PMCID: PMC7911711 DOI: 10.1155/2021/6656943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/27/2021] [Accepted: 02/10/2021] [Indexed: 02/07/2023]
Abstract
Background Obstructive sleep apnea (OSA) is a prevalent chronic disease that increases the risk of cardiovascular disease and metabolic and neuropsychiatric disorders, resulting in a considerable socioeconomic burden. The present study was aimed at identifying potential key genes influencing the mechanisms and consequences of OSA. Methods Gene expression profiles associated with OSA were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) in subcutaneous adipose tissues from patients with OSA and normal tissues were screened using R software, followed by gene ontology and pathway enrichment analyses. Subsequently, a protein-protein interaction (PPI) network was constructed and hub genes were extracted using Cytoscape plugins. The intersected core genes derived from different topological algorithms were considered hub genes, and the potential candidate gene was selected from them for further analyses of expression variations using another GEO dataset and targeted capture sequencing in 100 subjects (50 with severe OSA and 50 without OSA). Results A total of 373 DEGs were identified in OSA samples relative to normal controls, which were primarily associated with olfactory transduction and neuroactive ligand-receptor interaction. Upon analyses of nine topological algorithms and available literature, we finally focused on glial cell-derived neurotrophic factor (GDNF) as the candidate gene and validated its low expression in OSA samples. Two rare nonsynonymous variants (p.D56N and p.R93Q) were identified among the 100 cases through targeted sequencing of GDNF, which could be potentially deleterious based on pathogenicity prediction programs; however, no significant association was detected in single nucleotide polymorphisms. Conclusion The present study identified GDNF as a promising candidate gene for OSA and its two rare and potentially deleterious mutations through a combination of bioinformatics and targeted capture sequencing analyses.
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Yang W, Shao L, Heizhati M, Wu T, Yao X, Wang Y, Wang L, Li N. Oropharyngeal Microbiome in Obstructive Sleep Apnea: Decreased Diversity and Abundance. J Clin Sleep Med 2019; 15:1777-1788. [PMID: 31855163 PMCID: PMC7099180 DOI: 10.5664/jcsm.8084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To explore and analyze diversity and abundance of oropharyngeal microbiota in patients with obstructive sleep apnea (OSA). METHODS This was a cross-sectional study. Middle-aged men, suspected to have OSA, referred to full-night polysomnography, and willing to provide oropharyngeal swab samples, were consecutively enrolled. OSA severity was assessed by apnea-hypopnea index (AHI) as non-OSA (AHI < 5 events/h) and OSA (AHI ≥ 15 events/h). Bacterial DNA of oropharyngeal samples was extracted and quality test performed. Oropharyngeal microbiota was analyzed using 16S ribosomal DNA (rDNA) sequencing, and bioinformatic analysis carried out after sequencing. RESULTS Samples from 51 men (25 in the non-OSA group and 26 in the OSA group) were sent for examination. Of these, 40 samples were found to have sufficient concentration of DNA and were analyzed for bioinformatics. In alpha diversity analysis, the OSA group exhibited significantly lower sobs (198.33 ± 21.71 versus 216.57 ± 26.21, P = .022), chao (221.30 ± 26.62 versus 243.86 ± 26.20, P = .014), ace (222.17 ± 27.15 versus 242.42 ± 25.81, P = .028) and shannon index (3.14 ± 0.23 versus 3.31 ± 0.26, P = .035), suggesting a reduction in microbial species diversity. We further divided participants into non-OSA, moderate OSA, and severe OSA groups and observed a significant decrease in the bacterial biodiversity of OSA groups compared with the non-OSA group, with the most significant decrease occurring in the moderate OSA group. Principal coordinate analysis showed two extremely different oropharyngeal microbial communities in non-OSA and OSA groups. More interestingly, proportion of Neisseria was slightly higher in the severe OSA group (20.64%), followed by the moderate OSA and non-OSA groups (12.57% and 9.69%, respectively). Glaciecola was not detected in the OSA groups compared to the non-OSA group (0 versus 0.772 ± 0.4754, P < .001). CONCLUSIONS Middle-aged men with OSA showed less oropharyngeal species diversity and altered abundance, on which further confirmation is warranted.
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Affiliation(s)
- Wenbo Yang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
- Contributed equally
| | - Liang Shao
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
- Contributed equally
| | - Mulalibieke Heizhati
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
| | - Ting Wu
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
| | - Xiaoguang Yao
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
| | - Yingchun Wang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
| | - Lei Wang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
| | - Nanfang Li
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, China
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Heizati M, Li N, Shao L, Yao X, Wang Y, Hong J, Zhou L, Zhang D, Chang G, Abulikemu S. Does increased serum d-lactate mean subclinical hyperpermeability of intestinal barrier in middle-aged nonobese males with OSA? Medicine (Baltimore) 2017; 96:e9144. [PMID: 29245360 PMCID: PMC5728975 DOI: 10.1097/md.0000000000009144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Few attention has been directed to the potential effects of intermittent hypoxia experienced in obstructive sleep apnea on the integrity and permeability of intestinal barrier, particularly in adults. Therefore, we evaluated alteration in serum d-lactate concentration in middle-aged males with obstructive sleep apnea to value permeability of intestinal barrier. In this current cross-sectional study, consecutive 159 males were studied. Obstructive sleep apnea was determined by polysomnography and apnea hypopnea index ≥15 event/h was defined as obstructive sleep apnea. D-lactate, lipopolysaccharide binding protein, interleukin-1β, interleukin-6 and tumor necrosis factor-α by ELISA method. Nonobese obstructive sleep apnea (OSA) males showed significantly higher serum d-LA than did nonobese [1374.35 (816-1735) μg/L vs 1166.43 (730-1815) μg/L, P = .018], and obese non-OSA ones [1374.35 (816-1735) μg/L vs 1188.75 (736-1557) μg/L, P = .045], whereas serum LBP levels showed no differences within groups. Serum IL-1β was also slightly higher in nonobese OSA males, but with statistical significance, than in nonobese (19.39 ± 4.67 ng/L vs 17.25 ± 3.66 ng/L, P = .041), and obese non-OSA ones (19.39 ± 4.67 ng/L vs 17.42 ± 3.79 ng/L, P = .047), whereas other biomarkers, IL-6 and TNF-a did not show significant differences among groups. In stepwise multiple linear regression analysis, serum d-LA was independently positively associated with AHI (B = 5.577, P = .022), and ODI3 (B = 4.550, P = .024) and negatively with LSaO2 (B = -12.234, P = .019). Finally, we arrived at a conclusion that serum d-lactate was increased in nonobese middle-aged males with obstrutive sleep apnea, possibly suggesting existence of subclinical disruption of intestinal barrier, and showed significant associations with inflammatory mediators, possibly being involved in systemic inflammation of obstructive sleep apnea.
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Shao L, Heizhati M, Yao X, Wang Y, Abulikemu S, Zhang D, Zhou L, Hong J, Li N. Influences of obstructive sleep apnea on blood pressure variability might not be limited only nocturnally in middle-aged hypertensive males. Sleep Breath 2017; 22:377-384. [PMID: 29150775 DOI: 10.1007/s11325-017-1571-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/11/2017] [Accepted: 09/11/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE In this cross-sectional study, we analyzed the potential association between sleep measures and blood pressure variability. METHODS Ninety-three middle-aged hypertensive males, who underwent polysomnography and 24-h ambulatory blood pressure monitoring, were enrolled. Blood pressure variability was assessed by blood pressure standard deviation. Obstructive sleep apnea (apnea hypopnea index ≥ 15) was diagnosed in 52 (55.91%) patients. Mean body mass index and age were 27.77 ± 3.11 kg/m2 and 44.05 ± 8.07 years, respectively. RESULTS Hypertensive males with obstructive sleep apnea showed significantly higher 24-h, diurnal, and nocturnal diastolic blood pressure variability, compared to those without obstructive sleep apnea. While total cohort was further divided into two groups using the median of oxygen desaturation index, another indicator for severity of OSA, significant differences were also observed in 24-h, diurnal, and nocturnal diastolic blood pressure variability between two groups with higher and lower oxygen desaturation index. While subjects were also divided into two groups via the mean of sleep stage 1, hypertensive males with sleep stage 1 ≥ 8.1% showed significantly higher diurnal diastolic blood pressure variability than those with sleep stage 1 < 8.1%. Apnea hypopnea index was independently associated with 24-h and nocturnal diastolic blood pressure variability; oxygen desaturation index of 3% with 24-h diastolic, diurnal, and nocturnal diastolic blood pressure; and sleep stage 1 was with 24-h and with diurnal diastolic blood pressure variability in all study subjects. CONCLUSION Effects of obstructive sleep apnea on blood pressure variability may not be limited nocturnally.
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Affiliation(s)
- Liang Shao
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Mulalibieke Heizhati
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Xiaoguang Yao
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Yingchun Wang
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Suofeiya Abulikemu
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Delian Zhang
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Ling Zhou
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Jing Hong
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China
| | - Nanfang Li
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region China, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang China, No. 91 Tianchi Road, Tianshan District, Urumqi, Xinjiang, 830001, China.
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Pulmonary surfactant-associated proteins and inflammatory factors in obstructive sleep apnea. Sleep Breath 2017; 22:99-107. [DOI: 10.1007/s11325-017-1536-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/16/2017] [Accepted: 07/03/2017] [Indexed: 12/15/2022]
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Lu D, Li N, Yao X, Zhou L. Potential inflammatory markers in obstructive sleep apnea-hypopnea syndrome. Bosn J Basic Med Sci 2017; 17:47-53. [PMID: 27754829 DOI: 10.17305/bjbms.2016.1579] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/11/2016] [Accepted: 09/13/2016] [Indexed: 11/16/2022] Open
Abstract
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a complex chronic inflammatory respiratory disease with multiple pathogenic factors and high morbidity and mortality. Serum levels of nuclear factor-κB (NF-κB), hypoxia-inducible factor-1 alpha (HIF-1α), and surfactant protein D (SPD) were investigated in OSAHS patients, to determine their clinical significance and correlation with the pathogenesis. Patients were classified into a mild and moderate OSAHS group (n = 25) and severe OSAHS group (n = 33). Twenty healthy patients served as a control group. Peripheral blood levels of NF-κB, HIF-1α, and SPD were determined by Western blot, and a correlation analysis was performed. Severe OSAHS patients received nasal continuous positive airway pressure (nCPAP) therapy and were followed up after 2 months. NF-κB p65, HIF-1α, and SPD expression levels were determined after valid nCPAP therapy. NF-κB p65 and HIF-1α expression was significantly higher in severe OSAHS group than in the other two groups (p < 0.01), and was positively correlated with the apnea-hypopnea index (AHI) (r = 0.696, p < 0.001; r = 0.634, p < 0.001). SPD expression was significantly lower in severe OSAHS group than in the control group (p < 0.01) and mild and moderate OSAHS group (p < 0.01), and was negatively correlated with AHI (r = -0.569, p < 0.001). OSAHS pathogenesis was associated with changes in NF-κB, HIF-1α, and SPD protein expression levels. nCPAP therapy could improve the clinical characteristics of the patients, lower serum NF-κB and HIF-1α levels, and increase serum SPD levels. We conclude that OSAHS is related to the expression of NF-κB, HIF-1, and SPD.
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Affiliation(s)
- Dongmei Lu
- Postgraduate College of Xinjiang Medical University, Xinjiang Medical University, Urumqi, China; Department of Respiratory and Critical Care Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
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Relationship between surfactant proteins B and C and obstructive sleep apnea: is serum SP-B concentration a potential biomarker of obstructive sleep apnea? Sleep Breath 2015; 20:25-31. [DOI: 10.1007/s11325-015-1179-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/25/2015] [Accepted: 04/06/2015] [Indexed: 11/26/2022]
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