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Gultuna S, Basa Akdogan B, Gonul M, Aydin FN, Unal S, Erkek GN, Ozalp Ates FS, Yuceege MB, Ozdemir SAO. Sleep quality in patients with chronic spontaneous urticaria and relation with Orexin-A, leptin, and ghrelin. Allergy Asthma Proc 2024; 45:e38-e45. [PMID: 38982607 DOI: 10.2500/aap.2024.45.240023] [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: 07/11/2024]
Abstract
Background: Sleep can be affected in patients with chronic spontaneous urticaria (CSU). The mechanisms of sleep regulation remain poorly understood. Orexin-A, a neuroexcitatory peptide, plays a role in coordinating sleep-wake states. Ghrelin and leptin are involved in sleep regulation through the orexin system. Objective: The effects of orexin-A, ghrelin, and leptin on sleep quality in patients with CSU have not been investigated. We aimed to determine the effects of CSU on sleep quality and the association between serum orexin-A, ghrelin, and leptin levels, and sleep quality in patients with CSU. Methods: Thirty-three patients with CSU and 34 sex- and age-matched controls were included in the study. Serum orexin-A, leptin, and ghrelin levels, and the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) scores were measured in patients with CSU and in the controls; also used were the chronic urticaria quality-of-life questionnaire score and the urticaria activity score used for 7 consecutive days. Results: Median (minimum-maximum) orexin-A, leptin, and ghrelin levels in patients were 385 pg/mL (90-495 pg/mL), 3.1 ng/mL (0-21.2 ng/mL), and 701.8 pg/mL (101.9-827.7 pg/mL), respectively. Median serum orexin-A and leptin levels were higher in the patients compared with the controls (p < 0.001 and p = 0.012, respectively), whereas the median serum ghrelin levels were similar to the controls (p = 0.616). The serum orexin-A level was positively correlated with ghrelin (r = 0.298, p = 0.014), PSQI sleep quality (r = 0.356, p = 0.003), and ESS (r = 0.357, p = 0.003). Conclusion: Serum orexin-A is associated with sleep quality in patients with CSU. Further studies are needed to elucidate the role of ghrelin and leptin on sleep quality in patients with CSU.
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Affiliation(s)
- Selcan Gultuna
- From the Department of Immunology and Allergy, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Buket Basa Akdogan
- From the Department of Immunology and Allergy, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Muzeyyen Gonul
- Department of Dermatology, University of Health Sciences Etlik City Hospital, Ankara, Turkey
| | - Fevzi Nuri Aydin
- Department of Biochemistry, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital
| | - Simge Unal
- Department of Dermatology, University of Health Sciences Uşak Training and Research Hospital, Uşak, Turkey
| | | | - Funda Seher Ozalp Ates
- Department of Biostatics and Medical Informatics, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Melike Bagnu Yuceege
- Department of Chest Diseases, University of Health Sciences Etlik City Hospital, Ankara, Turkey; and
| | - Sinem Ayse Ornek Ozdemir
- Department of Dermatology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
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Cavalu S, Saber S, Hamad RS, Abdel-Reheim MA, Elmorsy EA, Youssef ME. Orexins in apoptosis: a dual regulatory role. Front Cell Neurosci 2024; 18:1336145. [PMID: 38699177 PMCID: PMC11064656 DOI: 10.3389/fncel.2024.1336145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/03/2024] [Indexed: 05/05/2024] Open
Abstract
The orexins, also referred to as hypocretins, are neuropeptides that originate from the lateral hypothalamus (LH) region of the brain. They are composed of two small peptides, orexin-A, and orexin-B, which are broadly distributed throughout the central and peripheral nervous systems. Orexins are recognized to regulate diverse functions, involving energy homeostasis, the sleep-wake cycle, stress responses, and reward-seeking behaviors. Additionally, it is suggested that orexin-A deficiency is linked to sleepiness and narcolepsy. The orexins bind to their respective receptors, the orexin receptor type 1 (OX1R) and type 2 (OX2R), and activate different signaling pathways, which results in the mediation of various physiological functions. Orexin receptors are widely expressed in different parts of the body, including the skin, muscles, lungs, and bone marrow. The expression levels of orexins and their receptors play a crucial role in apoptosis, which makes them a potential target for clinical treatment of various disorders. This article delves into the significance of orexins and orexin receptors in the process of apoptosis, highlighting their expression levels and their potential contributions to different diseases. The article offers an overview of the existing understanding of the orexin/receptor system and how it influences the regulation of apoptosis.
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Affiliation(s)
- Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Sameh Saber
- Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt
| | - Rabab S. Hamad
- Biological Sciences Department, College of Science, King Faisal University, Al Ahsa, Saudi Arabia
- Central Laboratory, Theodor Bilharz Research Institute, Giza, Egypt
| | - Mustafa Ahmed Abdel-Reheim
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Shaqra, Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt
| | - Elsayed A. Elmorsy
- Department of Pharmacology and Therapeutics, College of Medicine, Qassim University, Buraidah, Saudi Arabia
- Department of Clinical Pharmacology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mahmoud E. Youssef
- Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt
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Mogavero MP, Godos J, Grosso G, Caraci F, Ferri R. Rethinking the Role of Orexin in the Regulation of REM Sleep and Appetite. Nutrients 2023; 15:3679. [PMID: 37686711 PMCID: PMC10489991 DOI: 10.3390/nu15173679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/12/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Orexin plays a significant role in the modulation of REM sleep, as well as in the regulation of appetite and feeding. This review explores, first, the current evidence on the role of orexin in the modulation of sleep and wakefulness and highlights that orexin should be considered essentially as a neurotransmitter inhibiting REM sleep and, to a much lesser extent, a wake promoting agent. Subsequently, the relationship between orexin, REM sleep, and appetite regulation is examined in detail, shedding light on their interconnected nature in both physiological conditions and diseases (such as narcolepsy, sleep-related eating disorder, idiopathic hypersomnia, and night eating syndrome). Understanding the intricate relationship between orexin, REM sleep, and appetite regulation is vital for unraveling the complex mechanisms underlying sleep-wake patterns and metabolic control. Further research in this field is encouraged in order to pave the way for novel therapeutic approaches to sleep disorders and metabolic conditions associated with orexin dysregulation.
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Affiliation(s)
- Maria P. Mogavero
- Department of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy;
- San Raffaele Scientific Institute, Division of Neuroscience, Sleep Disorders Center, 20127 Milan, Italy
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (J.G.); (G.G.)
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (J.G.); (G.G.)
| | - Filippo Caraci
- Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute—IRCCS, 94018 Troina, Italy;
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute—IRCCS, 94018 Troina, Italy
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Carbone EA, Menculini G, de Filippis R, D’Angelo M, De Fazio P, Tortorella A, Steardo L. Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4431. [PMID: 36901441 PMCID: PMC10002427 DOI: 10.3390/ijerph20054431] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Patients with a generalized anxiety disorder (GAD) often report preeminent sleep disturbances. Recently, calcium homeostasis gained interest because of its role in the regulation of sleep-wake rhythms and anxiety symptoms. This cross-sectional study aimed at investigating the association between calcium homeostasis imbalance, anxiety, and quality of sleep in patients with GAD. A total of 211 patients were assessed using the Hamilton Rating Scale for Anxiety (HAM-A), Pittsburgh Sleep Quality Index questionnaire (PSQI) and Insomnia Severity Index (ISI) scales. Calcium, vitamin D, and parathyroid hormone (PTH) levels were evaluated in blood samples. A correlation and linear regression analysis were run to evaluate the association of HAM-A, PSQI, and ISI scores with peripheral markers of calcium homeostasis imbalance. Significant correlations emerged between HAM-A, PSQI, ISI, PTH, and vitamin D. The regression models showed that patients with GAD displaying low levels of vitamin D and higher levels of PTH exhibit a poor subjective quality of sleep and higher levels of anxiety, underpinning higher psychopathological burden. A strong relationship between peripheral biomarkers of calcium homeostasis imbalance, insomnia, poor sleep quality, and anxiety symptomatology was underlined. Future studies could shed light on the causal and temporal relationship between calcium metabolism imbalance, anxiety, and sleep.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia, 88100 Catanzaro, Italy
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
| | - Renato de Filippis
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Martina D’Angelo
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
| | - Luca Steardo
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
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Mohammadi I, Sadeghi M, Tajmiri G, Brühl AB, Sadeghi Bahmani L, Brand S. Evaluation of Blood Levels of Omentin-1 and Orexin-A in Adults with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis. Life (Basel) 2023; 13:life13010245. [PMID: 36676194 PMCID: PMC9865616 DOI: 10.3390/life13010245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/29/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
Background and objective: Obstructive sleep apnea (OSA) can be related to changes in the levels of adipokines and neuropeptides, which in turn may affect the energy balance components of neuronal cells. Herein, a systematic review and meta-analysis checked the changes in serum/plasma levels of omentin-1 (OM-1: an adipokine) and orexin-A (OXA: a neuropeptide) in adults (age > 18 years old) with OSA (aOSA) compared to controls. Materials and methods: Four databases (Cochrane Library, PubMed, Web of Science, and Scopus) were systematically searched until 14 November 2022, without any restrictions. The Joanna Briggs Institute (JBI) critical appraisal checklist adapted for case−control studies was used to assess the quality of the papers. The effect sizes were extracted using the Review Manager 5.3 software for the blood levels of OM-1 and OXA in aOSA compared with controls. Results: Thirteen articles, with six studies for OM-1 levels and eight for OXA levels, were included. The pooled standardized mean differences were −0.85 (95% confidence interval (CI): −2.19, 0.48; p = 0.21; I2 = 98%) and −0.20 (95%CI: −1.16, 0.76; p = 0.68; I2 = 96%) for OM-1 and OXA levels, respectively. Among the studies reporting OM-1, five were high and one was moderate quality. Among the studies reporting OXA, six were moderate, one was high, and one was low quality. Based on the trial sequential analysis, more participants are needed to confirm the pooled results of the analyses of blood levels of OM-1 and OXA. In addition, the radial plot showed outliers as significant factors for high heterogeneity. Conclusions: The main findings indicated a lack of association between the blood levels of OM-1 and OXA and OSA risk. Therefore, OM-1 and OXA did not appear to be suitable biomarkers for the diagnosis and development of OSA.
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Affiliation(s)
- Iman Mohammadi
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran
| | - Golnaz Tajmiri
- Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
| | - Laleh Sadeghi Bahmani
- Department of Education and Psychology, Shahid Ashrafi Esfahani University, Ishafan 8179949999, Iran
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Correspondence:
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Golshah A, Imani MM, Sadeghi M, Karami Chalkhooshg M, Brühl AB, Sadeghi Bahmani L, Brand S. Effect of Continuous Positive Airway Pressure on Changes of Plasma/Serum Ghrelin and Evaluation of These Changes between Adults with Obstructive Sleep Apnea and Controls: A Meta-Analysis. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010149. [PMID: 36676096 PMCID: PMC9865449 DOI: 10.3390/life13010149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Obstructive sleep apnea (OSA) can be related to high ghrelin hormone levels that may encourage additional energy intake. Herein, a new systematic review and meta-analysis were performed to check the changes in serum/plasma levels of ghrelin in adults with OSA compared to controls, as well as before compared after continuous positive airway pressure (CPAP) therapy in adults with OSA. MATERIALS AND METHODS Four main databases were systematically and comprehensively searched until 17 October 2022, without any restrictions. For assessing the quality, we used the Joanna Briggs Institute (JBI) critical appraisal checklist adapted for case-control studies and the National Institutes of Health (NIH) quality assessment tool for before-after studies. The effect sizes were extracted by the Review Manager 5.3 software for the blood of ghrelin in adults with OSA compared with controls, as well as before and after CPAP therapy. RESULTS Fifteen articles involving thirteen studies for case-control studies and nine articles for before-after studies were included. The pooled standardized mean differences were 0.30 (95% confidence interval (CI): -0.02, 0.61; p = 0.07; I2 = 80%) and 0.10 (95% CI: -0.08, 0.27; p = 0.27; I2 = 42%) for case-control and before-after studies, respectively. For thirteen case-control studies, nine had moderate and four high qualities, whereas for nine before-after studies, five had good and four fair qualities. Based on the trial sequential analysis, more studies are needed to confirm the pooled results of the analyses of blood ghrelin levels in case-control and before-after studies. In addition, the radial plot showed outliers for the analysis of case-control studies that they were significant factors for high heterogeneity. CONCLUSIONS The findings of the present meta-analysis recommended that the blood levels of ghrelin had no significant difference in the adults with OSA compared with the controls, nor did they have significant difference in adults with OSA before compared with after CPAP therapy. The present findings need to be confirmed in additional studies with more cases and higher qualities.
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Affiliation(s)
- Amin Golshah
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Mohammad Moslem Imani
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran
| | | | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
| | - Laleh Sadeghi Bahmani
- Department of Education and Psychology, Shahid Ashrafi Esfahani University, Esfahan 1461968151, Iran
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Correspondence:
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Zhu J, Zeng Z, Xiong M, Mo H, Jin M, Hu K. Associations between daytime and nighttime plasma orexin A levels and cognitive function in patients with obstructive sleep apnea. Sleep Biol Rhythms 2022; 20:421-429. [PMID: 38469416 PMCID: PMC10900028 DOI: 10.1007/s41105-022-00387-4] [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: 12/14/2021] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
The relationship between plasma orexin A (OXA) levels and cognitive function in patients with obstructive sleep apnea (OSA) remains unclear. This study aimed to evaluate associations between daytime and nighttime plasma OXA levels and cognitive function in patients with OSA. Subjects with suspected OSA underwent overnight polysomnography (PSG), Montreal Cognitive Assessment (MoCA), and Epworth Sleepiness Scale (ESS) assessment. Subjects were considered controls or having OSA according to the apnea-hypopnea index (AHI). Daytime and nighttime plasma OXA levels were determined by ELISA. Receiver-operating characteristics curves were used to evaluate the diagnostic value of plasma OXA levels for assessing cognitive impairment in OSA patients. One hundred and six subjects met the inclusion criteria. MoCA scores and plasma OXA concentrations were significantly lower in OSA patients than controls (p < 0.01). Patients with moderate and severe OSA had significantly lower MoCA scores than controls and mild OSA patients (p < 0.01). Daytime and nighttime OXA levels were significantly lower in OSA patients with cognitive impairment than those without cognitive impairment (p < 0.01). Both daytime and nighttime plasma OXA levels in patients with OSA were positively correlated with MoCA scores and nadir SaO2, negatively correlated with AHI, oxygen desaturation index, and percentage of time spent with an SaO2 below 90% (all p < 0.05), and not correlated with ESS scores. The optimal threshold of daytime plasma OXA to diagnose OSA with cognitive impairment was 49.34 pg/ml, with a sensitivity of 80.0% and a specificity of 74.3%. We concluded that plasma OXA concentrations might be related to cognitive function and daytime plasma OXA levels have diagnostic value for assessing cognitive impairment in OSA patients. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00387-4.
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Affiliation(s)
- Jing Zhu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China
- Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei China
| | - Zhaofu Zeng
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China
| | - Mengqing Xiong
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China
| | - Huaheng Mo
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China
| | - Meng Jin
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China
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