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Kader MA, Sainudeen S, Khan AAG, Arora S, Ronsivalle V, Marrapodi MM, Cicciù M, Minervini G. Prevalence of obstructive sleep apnoea syndrome in oncological patients: A systematic review and meta-analysis. J Oral Rehabil 2024; 51:1236-1249. [PMID: 38528326 DOI: 10.1111/joor.13681] [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: 10/02/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Obstructive sleep apnoea syndrome (OSAS) has garnered increasing attention in recent years due to its potential association with cancer. This systematic review and meta-analysis aimed to assess the prevalence of OSAS in cancer patients through a comprehensive analysis of existing literature. METHODS This systematic review and meta-analysis, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, aimed to evaluate the prevalence of OSAS in cancer patients. A comprehensive search of electronic databases was performed to identify relevant studies published up to September 2021. Eligible studies reporting on the prevalence of OSAS in cancer patients, encompassing various study designs, were included in the analysis. Pooled estimates of the odds ratios (OR) with 95% confidence intervals (CIs) were calculated using a random effects model. Heterogeneity among the studies was assessed using the I2 statistic. RESULTS Seventeen studies fulfilled the inclusion criteria and were subsequently included in the review. The prevalence of OSAS in cancer patients was estimated to have an overall OR of 0.80 (95% CI: 0.75-0.85). In comparison with non-cancer patients, cancer patients had a statistically significant greater risk of OSAS, as indicated by the total estimated RR for the prevalence of OSAS in cancer patients, which was 0.89 (95% CI: 0.86-0.92). Nonetheless, there was a significant amount of heterogeneity (I2 = 96%) among the studies. CONCLUSION The overall data analysed in this review indicates that patients with cancer had far reduced likelihood of developing OSAS than individuals without cancer. However, the significant variation across the included studies highlights the need for additional investigation to fully clarify the complex association between OSAS and cancer incidence. These results emphasise how critical it is to identify OSAS as a possible comorbidity in cancer patients, one that should be taken into account for clinical management and ongoing research.
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Affiliation(s)
- Mohammed Abdul Kader
- Department of Restorative Dental Science, College of Dentistry, King Khalid University Abha, Abha, Saudi Arabia
| | - Shan Sainudeen
- Department of Restorative Dental Science, College of Dentistry, King Khalid University Abha, Abha, Saudi Arabia
| | - Abdul Ahad Ghaffar Khan
- Department of Oral and Maxillofacial Surgery, King Khalid University College of Dentistry, Abha, Saudi Arabia
| | - Suraj Arora
- Department of Restorative Dental Science, College of Dentistry, King Khalid University Abha, Abha, Saudi Arabia
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, Largo Madonna delle Grazie 1, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Briançon-Marjollet A, Joyeux-Faure M, Ben Messaoud R, Bailly S, Ngo V, Colombet S, Gaucher J, Baillieul S, Tamisier R, Pépin JL. Long-term incident severe outcomes in a prospective cohort of non-obese obstructive sleep apnoea patients free of comorbidities at inclusion. ERJ Open Res 2024; 10:00930-2023. [PMID: 38978551 PMCID: PMC11228602 DOI: 10.1183/23120541.00930-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/20/2024] [Indexed: 07/10/2024] Open
Abstract
In a prospective cohort of OSA patients without comorbidities at inclusion, age, mean blood pressure, mean oxygen saturation and minimum oxygen saturation were associated with long-term incidence of severe health events https://bit.ly/3VyYEzC.
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Affiliation(s)
- Anne Briançon-Marjollet
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- These authors contributed equally
| | - Marie Joyeux-Faure
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
- These authors contributed equally
| | - Raoua Ben Messaoud
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Sébastien Bailly
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Van Ngo
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Sabrina Colombet
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
| | - Jonathan Gaucher
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
| | - Sébastien Baillieul
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Renaud Tamisier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Jean Louis Pépin
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
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Cho J, Jo S. Association of obstructive sleep apnea with risk of lung cancer: a nationwide cohort study in Korea. Sci Rep 2024; 14:12394. [PMID: 38811831 PMCID: PMC11137051 DOI: 10.1038/s41598-024-63238-x] [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: 03/12/2024] [Accepted: 05/27/2024] [Indexed: 05/31/2024] Open
Abstract
Current knowledge regarding the relationship between obstructive sleep apnea (OSA) and the risk of lung cancer is limited. This study aimed to evaluate associations between OSA and the incidence of lung cancer based on the Korean National Health Information Database. The study outcome was the incidence of newly diagnosed lung cancer, and a Cox proportional hazards model was used for analysis. A total of 181,070 adult patients newly diagnosed with OSA between 2011 and 2018 were matched with those without OSA by up to 1:5 propensity score matching based on age and sex. During follow-up over (mean ± standard deviation) 9.1 ± 2.0 years, 2614 incident cases of lung cancer were identified. The incidence rate was 39.51 per 100,000 person-years in the OSA group, and 24.93 per 100,000 person-years in the control group. After adjusting for income and the presence of comorbidities, the association remained significant (hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.74-2.18, p-value < 0.001). The adjusted HR for incident lung cancer was 2.14 (95% CI 1.69-2.70) in female patients with OSA, and 1.90 (95% CI 1.67-2.16) in male patients with OSA. The risk of incident lung cancer increased with age, with a HR of 2.99 (95% CI 2.46-3.64) in those aged ≥ 65 years. This nationwide study showed an independent association between OSA and an increased risk of lung cancer in the Korean population.
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Affiliation(s)
- Jaeyoung Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Soomin Jo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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Zhao ZW, Huang WS, Li L, Chen LD, Lin L, Zeng HX. Association between sleep apnea and ultrasound-defined liver fibrosis: Results from NHANES 2017 to 2020. Medicine (Baltimore) 2024; 103:e37949. [PMID: 38669359 PMCID: PMC11049750 DOI: 10.1097/md.0000000000037949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Liver fibrosis is a critical factor in the advancement of nonalcoholic fatty liver disease towards cirrhosis. There is limited research exploring the association between obstructive sleep apnea (OSA) and liver fibrosis among community populations. The present study aimed to assess the association between sleep apnea (SA) and liver fibrosis based on the National Health and Nutrition Examination Survey (NHANES). Data were acquired from NHANES survey cycle 2017 to 2020. We assessed liver fibrosis by the median values of liver stiffness measurement (LSM). The diagnosis of SA was based on participants' response to sleep questionnaire. Univariate and multivariate logistic regression were used to validate the association of SA and liver fibrosis. A total of 7615 participants were included in this study. The LSM level of SA group was significantly higher than non-SA group. The proportion of liver fibrosis in SA group was markedly higher than that in non-SA group (14.0% vs 7.3%, P < .001). Univariate logistic analysis showed that SA was positively associated with liver fibrosis (OR = 2.068, 95%CI = 1.715-2.494, P < .001). Further multivariate logistic analysis revealed that SA was independently associated with increased risk of liver fibrosis after adjusting for confounding factors (OR = 1.277, 95%CI = 1.003-1.625, P = .048). The current study demonstrated an independent association between self-reported SA and increased risk of ultrasound-defined liver fibrosis in community-based sample.
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Affiliation(s)
- Zhi-Wei Zhao
- Department of Otolaryngology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People's Republic of China
| | - Wen-Sen Huang
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People's Republic of China
| | - Ling Li
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People's Republic of China
| | - Li-Da Chen
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People's Republic of China
| | - Li Lin
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People's Republic of China
| | - Hui-Xue Zeng
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People's Republic of China
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Ren Y, Cui X, Zhu X, Guo H, Zhou Q, Yuan P, Cheng H, Wu W. Effect of Weight Loss on the Apnea Hypopnea Index is Related to Waist Circumference in Chinese Adults with Overweight and Obesity. Diabetes Metab Syndr Obes 2024; 17:453-463. [PMID: 38299196 PMCID: PMC10829506 DOI: 10.2147/dmso.s442738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Purpose The present study aimed to evaluate the efficiency of traditional anthropometric and body composition parameters in predicting apnea hypopnea index (AHI) change after weight loss. Patients and Methods Chinese adults with overweight and obesity were included into this study containing two parts. A cross-sectional study was conducted in 137 individuals using the baseline data from two weight loss intervention trials. The second part was the weight-loss intervention study conducted in 60 overweight and obese patients with obstructive sleep apnea (OSA). All participants underwent physical examination, bioelectrical impedance analysis and overnight polysomnography. Multivariate linear regression models were used to identify the most accurate parameters to predict AHI and the mediation analysis to evaluate the mediators between weight loss and AHI reduction. Results Waist circumference (WC), body mass index and fat mass were positively associated with AHI after adjusting multiple collinearities in the cross-sectional study. After weight-loss intervention, body weight decreased from 94.6 ± 15.3 to 88.0 ± 13.9 kg, and AHI decreased from 41.9 (13.0,66.9) to 20.7 (8.7,51.2) events/h. Among these parameters, only percentage changes in WC and AHI across the intervention were positively intercorrelated after controlling for covariates (adjusted r = 0.271, P = 0.041). The mediation analysis supported WC as a mediator between weight loss and AHI reduction (standardized indirect effect [95% CI] = 4.272[0.936,7.999]). Conclusion Both general and abdominal obesity are of high prognostic value for OSA. WC as an easily accessible parameter mediates the effects of weight loss in decreasing OSA severity.
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Affiliation(s)
- Ye Ren
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Xiaochuan Cui
- Department of Sleep Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Xiaowen Zhu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Hua Guo
- Department of Sleep Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Qunyan Zhou
- Department of Nutrition Department, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Peng Yuan
- Department of Rehabilitation, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Haiyan Cheng
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Wenjun Wu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
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Chen LD, Lin L, Chen JZ, Song Y, Zhang WL, Li HY, Luo JM, Zhang XB. Identification of key genes in chronic intermittent hypoxia-induced lung cancer progression based on transcriptome sequencing. BMC Cancer 2024; 24:41. [PMID: 38183079 PMCID: PMC10770984 DOI: 10.1186/s12885-023-11785-3] [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: 09/30/2023] [Accepted: 12/21/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with increased risk of lung cancer mortality. Nevertheless, little is known about the underlying molecular mechanisms. This research aimed to investigate differentially expressed genes (DEGs) and explore their function in Lewis lung carcinoma (LLC)-bearing mice exposed to chronic intermittent hypoxia (CIH) by transcriptome sequencing. METHODS Lung cancer tissues in LLC-bearing mice exposed to CIH or normoxia were subjected for transcriptome sequencing to examine DEGs. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were employed to explore the function of DEGs. To evaluate the prognostic value of DEGs, the Kaplan-Meier survival analysis in combination with Cox proportional hazard model were applied based on The Cancer Genome Atlas. RESULTS A total of 388 genes with 207 up-regulated and 181 down-regulated genes were differentially expressed between the CIH and normoxia control groups. Bioinformatics analysis revealed that the DEGs were related to various signaling pathways such as chemokine signaling pathway, IL-17 signaling pathway, TGF-β signaling pathway, transcriptional misregulation in cancer, natural killer cell mediated cytotoxicity, PPAR signaling pathway. In addition, the DEGs including APOL1, ETFB, KLK8, PPP1R3G, PRL, SPTA1, PLA2G3, PCP4L1, NINJ2, MIR186, and KLRG1 were proven to be significantly correlated with poorer overall survival in lung adenocarcinoma. CONCLUSIONS CIH caused a significant change of gene expression profiling in LLC-bearing mice. The DEGs were found to be involved in various physiological and pathological processes and correlated with poorer prognosis in lung cancer.
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Affiliation(s)
- Li-Da Chen
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Li Lin
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Ji-Zhi Chen
- Department of Emergency Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Yang Song
- Ningde Food and Drug Inspection Testing Center, Ningde, Fujian Province, China
| | - Wei-Liang Zhang
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Huang-Yu Li
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Jia-Min Luo
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Xiao-Bin Zhang
- The School of Clinical Medicine, Fujian Medical University, No. 1, Xuefu North Road, University New District, Fuzhou, Fujian Province, 350122, People's Republic of China.
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Xiamen University, Xiamen, Fujian Province, China.
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Afsar S, Syed RU, Bin Break MK, Alsukaybi RH, Alanzi RA, Alshobrmi AM, Alshagdali NM, Alshammari AD, Alharbi FM, Alshammari AM, Algharbi WF, Albrykan KM, Alshammari FN. The dual role of MiR-210 in the aetiology of cancer: A focus on hypoxia-inducible factor signalling. Pathol Res Pract 2024; 253:155018. [PMID: 38070222 DOI: 10.1016/j.prp.2023.155018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/24/2024]
Abstract
Tumorigenesis exemplifies the complex process of neoplasm origination, which is characterised by somatic genetic alterations and abnormal cellular growth. This multidimensional phenomenon transforms previously dormant cells into malignant equivalents, resulting in uncontrollable proliferation and clonal expansion. Various elements, including random mutations, harmful environmental substances, and genetic predispositions, influence tumorigenesis's aetiology. MicroRNAs (miRNAs) are now recognised as crucial determinants of gene expression and key players in several biological methods, including oncogenesis. A well-known hypoxia-inducible miRNA is MiR-210, which is of particular interest because of its complicated role in the aetiology of cancer and a variation of physiological and pathological situations. MiR-210 significantly impacts cancer by controlling the hypoxia-inducible factor (HIF) signalling pathway. By supporting angiogenesis, metabolic reprogramming, and cellular survival in hypoxic microenvironments, HIF signalling orchestrates adaptive responses, accelerating the unstoppable development of tumorous growth. Targeting several components of this cascade, including HIF-1, HIF-3, and FIH-1, MiR-210 plays a vital role in modifying HIF signalling and carefully controlling the HIF-mediated response and cellular fates in hypoxic environments. To understand the complexities of this relationship, careful investigation is required at the intersection of MiR-210 and HIF signalling. Understanding this relationship is crucial for uncovering the mechanisms underlying cancer aetiology and developing cutting-edge therapeutic approaches. The current review emphasises MiR-210's significance as a vital regulator of the HIF signalling cascade, with substantial implications spanning a range of tumor pathogenesis.
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Affiliation(s)
- S Afsar
- Department of Virology, Sri Venkateswara University, Tirupathi, Andhra Pradesh 517502, India
| | - Rahamat Unissa Syed
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia.
| | - Mohammed Khaled Bin Break
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia; Medical and Diagnostic Research Centre, University of Hail, Hail 55473, Saudi Arabia
| | | | - Reem A Alanzi
- College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia
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Zhou S, Xu H, Zhu J, Fan X, Zhang J. Clinical efficacy and metabolomics study of Wendan Decoction in the treatment of phlegm-dampness obstructive sleep apnea-hypopnea syndrome with type 2 diabetes mellitus. JOURNAL OF ETHNOPHARMACOLOGY 2023; 317:116775. [PMID: 37311503 DOI: 10.1016/j.jep.2023.116775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/23/2023] [Accepted: 06/10/2023] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Wendan Decoction (WDD) is one of the classic traditional Chinese prescriptions that has been used in the treatment of type 2 diabetes mellitus (T2DM), metabolic syndrome, obstructive sleep apnea-hypopnea syndrome (OSAHS) and so on. The therapeutic effects and mechanism of WDD remain to be explored, especially from the perspective of metabolomics, oxidative stress and inflammation. AIM OF THE STUDY To investigate the therapeutic and metabolic regulatory effects and the underlying mechanism of WDD in OSAHS with T2DM patients. MATERIALS AND METHODS All included patients were from Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu Province, China. Both groups received lifestyle interventions; at the same time, all of them were administered metformin (1500 mg/day) and dapagliflozin (10 mg/day), and the treatment group was administered WDD orally. All patients were treated for two months. Before and after treatment, the changes in clinical symptoms and signs of the two groups of patients were evaluated, and the detection indicators such as body mass index (BMI), apnea-hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), Epworth sleepiness scale (ESS), percentage of total sleep time with oxygen saturation <90% (TST90), fasting plasma glucose (FPG), 2-h post-load glucose(2h-PG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR),hemoglobin A1c (HbA1c), blood lipid levels, as well as the adverse reactions and compliance of the patients were observed and detection of serum metabolites in patients to screen out specific biomarkers. The serum metabolic profile of WDD in OSAHS with T2DM patients was explored using ultra-high-performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Q Orbitrap HRMS). RESULTS After treatment with WDD for 8 weeks, biochemical indicators, including BMI, FPG, 2h-PG, blood lipid, FINS, HbA1c, AHI, ESS, LSaO2, TST90, and HOMA-IR, were significantly improved. Serum metabolomic analysis showed that metabolites were differentially expressed before and after WDD-treated patients. Metabolomics results revealed that WDD regulated the biomarkers, such as DL-arginine, guaiacol sulfate, azelaic acid, phloroglucinol, uracil, L-tyrosine, cascarillin, Cortisol and L-alpha-lysophosphatidylcholine. Pathway enrichment analysis showed that the metabolites were associated with oxidative stress and inflammation. CONCLUSION The study based on clinical research and metabolomics indicated that WDD can improve OSAHS with T2DM through multiple targets and pathways, and it may be a useful alternative therapy for the treatment of OSAHS with T2DM patients.
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Affiliation(s)
- Sifeng Zhou
- Department of Endocrinology, Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, 226400, China; School of Traditional Chinese Medicine·Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China.
| | - Haishu Xu
- Department of Pharmacy, Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, 226400, China.
| | - Jieyun Zhu
- Department of Ophthalmology, Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, 226400, China.
| | - Xinsheng Fan
- School of Traditional Chinese Medicine·Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China.
| | - Jinming Zhang
- Department of Endocrinology, Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, 226400, 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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10
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Cui Z, Ruan Z, Li M, Ren R, Ma Y, Zeng J, Sun J, Ye W, Xu W, Guo X, Xu D, Zhang L. Obstructive sleep apnea promotes the progression of lung cancer by modulating cancer cell invasion and cancer-associated fibroblast activation via TGFβ signaling. Redox Rep 2023; 28:2279813. [PMID: 38010093 PMCID: PMC11001276 DOI: 10.1080/13510002.2023.2279813] [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: 11/29/2023] Open
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is associated with severity of pneumonia; however, the mechanism by which OSA promotes lung cancer progression is unclear. METHODS Twenty-five lung cancer patients were recruited to investigate the relationship between OSA and cancer-associated fibroblast (CAFs) activation. Lung cancer cells (A549) and WI38 fibroblast cells were used to explore the hypoxia-induced TGFβ expression using qPCR, Western blot, and ELISA. Wound healing and transwell assays were performed to evaluate cancer cell migration and invasion. A549 or A549-Luc + WI38 xenograft mouse models were established to detect the intermittent hypoxia (IH) associated with lung tumor growth and epithelial-mesenchymal transition (EMT) in vivo. RESULTS OSA promotes CAF activation and enrichment in lung cancer patients. Hypoxia (OSA-like treatment) activated TGFβ signaling in both lung cancer cells and fibroblasts, which promoted cancer cell migration and invasion, and enriched CAFs. IH promoted the progression and EMT process of lung cancer xenograft tumor. Co-inoculation of lung cancer cells and fibroblast cells could further promote lung cancer progression. CONCLUSIONS IH promotes lung cancer progression by upregulating TGFβ signaling, promoting lung cancer cell migration, and increasing the CAF activation and proportion of lung tumors.
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Affiliation(s)
- Zhilei Cui
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Zhengshang Ruan
- Department of Infectious Disease, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Meigui Li
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Rongrong Ren
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Yizong Ma
- Pharmacy Management Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Junxiang Zeng
- Department of Laboratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jinyuan Sun
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wenjing Ye
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Weiguo Xu
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xuejun Guo
- Department of Respiratory Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Dengfei Xu
- Department of Oncology, Henan Key Laboratory for Precision Medicine in Cancer, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou, People’s Republic of China
| | - Linlin Zhang
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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11
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Oscullo G, Gomez-Olivas JD, Martínez-García MÁ. Sleep apnoea, intermittent hypoxia and cutaneous melanoma incidence and aggressiveness. More than a coincidence? Sleep Med 2023; 108:8-10. [PMID: 37302169 DOI: 10.1016/j.sleep.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/13/2023]
Affiliation(s)
- Grace Oscullo
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Miguel Ángel Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain.
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12
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Tong J, Yu Q, Li Y, Du J, Qiu J. Obstructive sleep apnea and cardiovascular events in acute coronary syndrome: a meta-analysis. Coron Artery Dis 2023; 34:177-184. [PMID: 36762648 DOI: 10.1097/mca.0000000000001207] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) in patients with the acute coronary syndrome (ACS) were at high risk for cardiovascular events, but the results are currently inconclusive. We aimed to conduct a systematic review to determine the incidence of cardiovascular events among ACS patients with OSA by a meta-analysis of observational studies. METHODS PubMed, Embase, and Cochrane Library were searched for studies related to the association between OSA and the risk of cardiovascular events in patients with ACS. Risk of bias in observational studies was assessed according to the Risk Of Bias In the Non-randomized Studies-Of Interventions tool.We performed a meta-analysis using a random-effects model to calculate estimates of pooled hazard ratios (HR) with 95% confidence intervals (CI), and heterogeneity was assessed using the statistics. RESULTS A total of 12 studies evaluating ACS patients with OSA were included in the meta-analysis. OSA was related to the increased risk of MACE (HR = 2.2; 95% CI, 1.274-3.805, I2 = 76.1%). The effect of OSA on MACCE (HR = 1.921; 95% CI, 1.45-2.546; I2 = 19.1%) and readmission for unstable angina (HR = 3.137, 95% CI, 1.06-9.283; I2 = 52.4%) were statistically significant in the pooled analysis. All of the outcomes in the included studies had a serious risk of bias and the Grading of Recommendation, Assessment, Development, and Evaluation evidence level of all the evaluation results were very low. CONCLUSIONS OSA was associated with a significant increase in the risk of cardiovascular events for patients with ACS. Additional randomized controlled trial studies are required to confirm the results and to prove the treatment of OSA can change the prognosis.
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Affiliation(s)
- Jiangtao Tong
- Department of Cardiovascular Medicine, Foresea Life Insurance Guangzhou General Hospital, Guangzhou, China
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13
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Šmon J, Kočar E, Pintar T, Dolenc-Grošelj L, Rozman D. Is obstructive sleep apnea a circadian rhythm disorder? J Sleep Res 2023:e13875. [PMID: 36922163 DOI: 10.1111/jsr.13875] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
Obstructive sleep apnea is the most common sleep-related breathing disorder worldwide and remains underdiagnosed. Its multiple associated comorbidities contribute to a decreased quality of life and work performance as well as an increased risk of death. Standard treatment seems to have limited effects on cardiovascular and metabolic aspects of the disease, emphasising the need for early diagnosis and additional therapeutic approaches. Recent evidence suggests that the dysregulation of circadian rhythms, processes with endogenous rhythmicity that are adjusted to the environment through various cues, is involved in the pathogenesis of comorbidities. In patients with obstructive sleep apnea, altered circadian gene expression patterns have been demonstrated. Obstructive respiratory events may promote circadian dysregulation through the effects of sleep disturbance and intermittent hypoxia, with subsequent inflammation and disruption of neural and hormonal homeostasis. In this review, current knowledge on obstructive sleep apnea, circadian rhythm regulation, and circadian rhythm sleep disorders is summarised. Studies that connect obstructive sleep apnea to circadian rhythm abnormalities are critically evaluated. Furthermore, pathogenetic mechanisms that may underlie this association, most notably hypoxia signalling, are presented. A bidirectional relationship between obstructive sleep apnea and circadian rhythm dysregulation is proposed. Approaching obstructive sleep apnea as a circadian rhythm disorder may prove beneficial for the development of new, personalised diagnostic, therapeutic and prognostic tools. However, further studies are needed before the clinical approach to obstructive sleep apnea includes targeting the circadian system.
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Affiliation(s)
- Julija Šmon
- Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Eva Kočar
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadeja Pintar
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Leja Dolenc-Grošelj
- Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Department of Neurology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Damjana Rozman
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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14
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Huang HH, Ma KSK, Wu MY, Hung YM, Tsao CH, Wei JCC, Wen WS, Wang YH, Hung SY, Chao MM. Patients with obstructive sleep apnea are at great risk of flavor disorders: a 15-year population-based cohort study. Clin Oral Investig 2023; 27:183-192. [PMID: 36129542 DOI: 10.1007/s00784-022-04707-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/30/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) results from upper airway remodeling, which has been suggested to alter sensory and motor neuron function due to hypoxia or snore vibration. This study investigated whether OSA was associated with the risk of flavor disorder (FD). MATERIALS AND METHODS Seven thousand and eight hundred sixty-five patients with OSA and 7865 propensity score-matched controls without OSA were enrolled between 1999 and 2013 through a nationwide cohort study. The propensity score matching was based on age, sex, comorbidities including hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD), asthma, ankylosing spondylitis, and Charlson comorbidity index, and co-medications during the study period, including statins and angiotensin-converting enzyme (ACE) inhibitors. The adjusted hazard ratio (aHR) of incident FD following OSA was derived using a Cox proportional hazard model. A log-rank test was used to evaluate the time-dependent effect of OSA on FD. Age, sex, comorbidities, and co-medications were stratified to identify subgroups susceptible to OSA-associated FD. RESULTS Patients with OSA were at a significantly great risk of FD (aHR = 1.91, 95% CI = 1.08-3.38), which was time-dependent (log-rank test p = 0.013). Likewise, patients with hyperlipidemia were at a significant great risk of FD (aHR = 2.99, 95% CI = 1.33-6.69). Subgroup analysis revealed that female patients with OSA were at higher risks of FD (aHR = 2.39, 95%CI = 1.05-5.47). CONCLUSIONS Patients with OSA were at significantly great risk of incident FD during the 15-year follow-up period, especially in female patients with OSA. CLINICAL RELEVANCE Timely interventions for OSA may prevent OSA-associated FD.
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Affiliation(s)
- Hsin-Hsin Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan
| | - Min-You Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yao-Min Hung
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Chien-Han Tsao
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan. .,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - James Cheng-Chung Wei
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan. .,Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan. .,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
| | - Wei-Sheng Wen
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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15
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Liu P, Zhao D, Pan Z, Tang W, Chen H, Hu K. Identification and validation of ferroptosis-related hub genes in obstructive sleep apnea syndrome. Front Neurol 2023; 14:1130378. [PMID: 36937508 PMCID: PMC10018165 DOI: 10.3389/fneur.2023.1130378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Background By 2020, the prevalence of Obstructive Sleep Apnea Syndrome (OSAS) in the US has reached 26. 6-43.2% in men and 8.7-27.8% in women. OSAS promotes hypertension, diabetes, and tumor growth through unknown means. Chronic intermittent hypoxia (CIH), sleep fragmentation, and increased pleural pressure are central mechanisms of OSAS complications. CIH exacerbates ferroptosis, which is closely related to malignancies. The mechanism of ferroptosis in OSAS disease progression remains unknown. Methods OSAS-related datasets (GSE135917 and GSE38792) were obtained from the GEO. Differentially expressed genes (DEGs) were screened using the R software and intersected with the ferroptosis database (FerrDb V2) to get ferroptosis-related DEGs (f-DEGs). GO, DO, KEGG, and GSEA enrichment were performed, a PPI network was constructed and hub genes were screened. The TCGA database was used to obtain the thyroid cancer (THCA) gene expression profile, and hub genes were analyzed for differential and survival analysis. The mechanism was investigated using GSEA and immune infiltration. The hub genes were validated with RT-qPCR, IHC, and other datasets. Sprague-Dawley rats were randomly separated into normoxia and CIH groups. ROS, MDA, and GSH methods were used to detect CIH-induced ferroptosis and oxidative stress. Results GSEA revealed a statistically significant difference in ferroptosis in OSAS (FDR < 0.05). HIF1A, ATM, HSPA5, MAPK8, MAPK14, TLR4, and CREB1 were identified as hub genes among 3,144 DEGs and 74 f-DEGs. HIF1A and ATM were the only two validated genes. F-DEGs were mainly enriched in THCA. HIF1A overexpression in THCA promotes its development. HIF1A is associated with CD8 T cells and macrophages, which may affect the immunological milieu. The result found CIH increased ROS and MDA while lowering GSH indicating that it could cause ferroptosis. In OSAS patients, non-invasive ventilation did not affect HIF1A and ATM expression. Carvedilol, hydralazine, and caffeine may be important in the treatment of OSAS since they suppress HIF1A and ATM. Conclusions Our findings revealed that the genes HIF1A and ATM are highly expressed in OSAS, and can serve as biomarkers and targets for OSAS.
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Affiliation(s)
- Peijun Liu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dong Zhao
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhou Pan
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Weihua Tang
- Department of Radiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
| | - Hao Chen
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
- *Correspondence: Ke Hu
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16
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Liu Q, Hao T, Li L, Huang D, Lin Z, Fang Y, Wang D, Zhang X. Construction of a mitochondrial dysfunction related signature of diagnosed model to obstructive sleep apnea. Front Genet 2022; 13. [PMID: 36468038 PMCID: PMC9714559 DOI: 10.3389/fgene.2022.1056691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background: The molecular mechanisms underlying obstructive sleep apnea (OSA) and its comorbidities may involve mitochondrial dysfunction. However, very little is known about the relationships between mitochondrial dysfunction-related genes and OSA. Methods: Mitochondrial dysfunction-related differentially expressed genes (DEGs) between OSA and control adipose tissue samples were identified using data from the Gene Expression Omnibus database and information on mitochondrial dysfunction-related genes from the GeneCards database. A mitochondrial dysfunction-related signature of diagnostic model was established using least absolute shrinkage and selection operator Cox regression and then verified. Additionally, consensus clustering algorithms were used to conduct an unsupervised cluster analysis. A protein-protein interaction network of the DEGs between the mitochondrial dysfunction-related clusters was constructed using STRING database and the hub genes were identified. Functional analyses, including Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, gene set enrichment analysis (GSEA), and gene set variation analysis (GSVA), were conducted to explore the mechanisms involved in mitochondrial dysfunction in OSA. Immune cell infiltration analyses were conducted using CIBERSORT and single-sample GSEA (ssGSEA). Results: we established mitochondrial dysfunction related four-gene signature of diagnostic model consisted of NPR3, PDIA3, SLPI, ERAP2, and which could easily distinguish between OSA patients and controls. In addition, based on mitochondrial dysfunction-related gene expression, we identified two clusters among all the samples and three clusters among the OSA samples. A total of 10 hub genes were selected from the PPI network of DEGs between the two mitochondrial dysfunction-related clusters. There were correlations between the 10 hub genes and the 4 diagnostic genes. Enrichment analyses suggested that autophagy, inflammation pathways, and immune pathways are crucial in mitochondrial dysfunction in OSA. Plasma cells and M0 and M1 macrophages were significantly different between the OSA and control samples, while several immune cell types, especially T cells (γ/δ T cells, natural killer T cells, regulatory T cells, and type 17 T helper cells), were significantly different among mitochondrial dysfunction-related clusters of OSA samples. Conclusion: A novel mitochondrial dysfunction-related four-gen signature of diagnostic model was built. The genes are potential biomarkers for OSA and may play important roles in the development of OSA complications.
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Affiliation(s)
- Qian Liu
- Shantou University Medical College, Shantou, China
- Department of Cardiology, The Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong Province, China
| | - Tao Hao
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lei Li
- Department of Cardiology, The Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong Province, China
| | - Daqi Huang
- Department of Cardiology, The Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong Province, China
| | - Ze Lin
- Shantou University Medical College, Shantou, China
- Laboratory of Molecular Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yipeng Fang
- Laboratory of Molecular Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Dong Wang
- Department of Cardiology, The Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong Province, China
| | - Xin Zhang
- Shantou University Medical College, Shantou, China
- Laboratory of Molecular Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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17
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Impact of obstructive sleep apnea on cancer risk: a systematic review and meta-analysis. Sleep Breath 2022; 27:843-852. [DOI: 10.1007/s11325-022-02695-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 07/30/2022] [Accepted: 08/04/2022] [Indexed: 10/14/2022]
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18
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Cao Y, Ning P, Li Q, Wu S. Cancer and obstructive sleep apnea: An updated meta-analysis. Medicine (Baltimore) 2022; 101:e28930. [PMID: 35451384 PMCID: PMC8913079 DOI: 10.1097/md.0000000000028930] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 02/08/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The relationship between cancers and obstructive sleep apnea (OSA) has been discussed for decades. However, the previous meta-analysis led to opposite conclusions. To further investigate this controversial issue, we performed this systematic review and meta-analysis update. METHODS PubMed, Embase, and the Cochrane Library were systematically searched and studies on "cancer and OSA" were all included. Two reviewers independently searched articles, extracted data, and assessed the quality of included studies. Moreover, the overall incidence of cancer and OSA in corresponding populations was calculated. RESULTS Of the 1434 titles identified, 22 articles involving more than 32.1 million patients were included in this meta-analysis. An overall incidence of OSA positive individuals in cancer was 46 (95%CI, 27-67)%, and the prevalence of cancers in OSA patients reached 1.53 (95%CI, 1.01-2.31) times higher than non-OSA individuals. CONCLUSION This meta-analysis indicated that there was a high prevalence of OSA in cancer patients, and individuals with OSA were more likely to develop tumors, and the incidence was related to the severity of OSA.
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Affiliation(s)
- Yuan Cao
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Pu Ning
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Qiao Li
- Clinical Laboratory, The Affiliated Children Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Shuang Wu
- Clinical Laboratory, The Affiliated Children Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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19
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Sillah A, Watson NF, Peters U, Biggs ML, Nieto FJ, Li CI, Gozal D, Thornton T, Barrie S, Phipps AI. Sleep problems and risk of cancer incidence and mortality in an older cohort: The Cardiovascular Health Study (CHS). Cancer Epidemiol 2022; 76:102057. [PMID: 34798387 PMCID: PMC8792277 DOI: 10.1016/j.canep.2021.102057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/17/2021] [Accepted: 10/31/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Sleep problems (SP) can indicate underlying sleep disorders, such as obstructive sleep apnea, which may adversely impact cancer risk and mortality. METHODS We assessed the association of baseline and longitudinal sleep apnea and insomnia symptoms with incident cancer (N = 3930) and cancer mortality (N = 4580) in the Cardiovascular Health Study. We used Cox proportional hazards regression to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) to evaluate the associations. RESULTS Overall, 885 incident cancers and 804 cancer deaths were identified over a median follow-up of 12 and 14 years, respectively. Compared to participants who reported no sleep apnea symptoms, the risk of incident cancer was inversely associated [(HR (95%CI)] with snoring [0.84 (0.71, 0.99)]. We noted an elevated prostate cancer incidence for apnea [2.34 (1.32, 4.15)] and snoring [1.69 (1.11, 2.57)]. We also noted an elevated HR for lymphatic or hematopoietic cancers [daytime sleepiness: 1.81 (1.06, 3.08)]. We found an inverse relationship for cancer mortality with respect to snoring [0.73 (0.62, 0.8)] and apnea [(0.69 (0.51, 0.94))]. We noted a significant inverse relationship between difficulty falling asleep and colorectal cancer death [0.32 (0.15, 0.69)] and snoring with lung cancer death [0.56 (0.35, 0.89)]. CONCLUSIONS The relationship between SP and cancer risk and mortality was heterogeneous. Larger prospective studies addressing more cancer sites, molecular type-specific associations, and better longitudinal SP assessments are needed for improved delineation of SP-cancer risk dyad.
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Affiliation(s)
- Arthur Sillah
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States.
| | - Nathaniel F Watson
- Department of Neurology, University of Washington School of Medicine, United States
| | - Ulrike Peters
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States
| | - Mary L Biggs
- University of Washington School of Public Health, United States
| | - F Javier Nieto
- Oregon State University College of Public Health and Human Sciences, Corvallis, OR, United States
| | - Christopher I Li
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States
| | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, United States
| | | | - Sonnah Barrie
- Burrell College of Osteopathic Medicine, University Park, NM, United States
| | - Amanda I Phipps
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States
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20
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He J, Li X, Yu M. The correlation of serum/plasma IGF-1 concentrations with obstructive sleep apnea hypopnea syndrome: A meta-analysis and meta-regression. Front Endocrinol (Lausanne) 2022; 13:922229. [PMID: 36120463 PMCID: PMC9471370 DOI: 10.3389/fendo.2022.922229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that has serious cardiovascular and metabolic effects. Insulin-like growth factor 1 (IGF-1) levels are reportedly reduced in patients with OSAHS; however, this is still a matter of debate. Therefore, we investigated the association between serum/plasma IGF-1 levels and OSAHS in this meta-analysis. METHODS Wan Fang, Excerpta Medica dataBASE, Web of Science, China National Knowledge Infrastructure, VIP, PubMed, and other databases were searched for materials published in any language before April 2, 2022. Two researchers analyzed the studies for quality according to the Newcastle-Ottawa Scale. The acquired data were analyzed using Stata 11.0 and R 3.6.1 software. The effect size was estimated and calculated using standard mean differences and correlation coefficients. Moreover, a combined analysis was conducted using either a random- or fixed-effects model. RESULTS Ultimately, 34 studies met our inclusion criteria. Our findings revealed that the plasma/serum IGF-1 concentrations in patients with OSAHS was significantly reduced compared with those in healthy subjects. Subgroup analyses were performed according to OSAHS severity, ethnicity, age, body mass index, specimen testing method, and study design. The outcomes suggested that nearly all subgroups of patients with OSAHS had reduced serum IGF-1 levels. Disease severity and differences in ethnicity were identified as possible influencing factors of serum IGF-1 levels in patients with OSAHS in the meta-regression analysis, and no other factors were found to alter plasma/serum IGF-1 concentrations. Moreover, plasma/serum IGF-1 concentrations were negatively correlated with apnea-hypopnea index and oxygen desaturation index scores and positively associated with minimum oxygen saturation. CONCLUSION Serum/plasma IGF-1 concentrations in patients with OSAHS were greatly reduced compared with those of patients in the control group, and were negatively correlated with apnea-hypopnea index and oxygen desaturation index scores and positively correlated with minimum oxygen saturation. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022322738.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- *Correspondence: Jie He,
| | - Xiaoyan Li
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Endocrinology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Mi Yu
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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21
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Yang T, He F, Zhang M, Ai L, He M, Liu X, Li Y. MiR-142-3p as an Indicator of OSA Severity Predicts Prognosis in Lung Adenocarcinoma with OSA. Nat Sci Sleep 2022; 14:2047-2054. [PMID: 36394065 PMCID: PMC9656355 DOI: 10.2147/nss.s385755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim was to explore the correlation between Obstructive sleep apnea (OSA) and Lung adenocarcinoma malignant prognosis and evaluate the miR-142-3p was used as an OSA severity indicator to predict the prognosis of Lung adenocarcinoma patients. METHODS This study comprised of 21 diagnosed lung adenocarcinoma patients with or without OSA. The sleep-related variables and tumor pathology were recorded. Hypoxia-inducible factor-1α (HIF1α) and ki67 expression were analyzed by immunohistochemistry in tumor samples. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to assess the level of miR-142-3p. RESULTS Lung adenocarcinoma with OSA showed higher apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and the lower lowest pulse oxygen saturation (LSPO2) compared to Lung adenocarcinoma without OSA (P<0.05), and patients with severer OSA have an advanced TNM stage (P=0.004) and metastasis rate (p=0.032). In addition, OSA may down-regulate the miR-142-3p expression in patients with Lung adenocarcinoma, and the patients with low miR-142-3p expression exhibited severe OSA. MiR-142-3p levels significantly decreased in the advanced TNM stage (p=0.015), and the expression of miR-142-3p was negatively associated with AHI (r= -0.505, p=0.020), ODI (r= -0.513, p=0.017). CONCLUSION OSA severity may increase Lung adenocarcinoma malignant prognosis. OSA may down-regulate the expression of miR-42-3p. The expression of miR-142-3p was inversely correlated with AHI and ODI as a surrogate of OSA severity. Additionally, the low miR-142-3p expression level was significantly associated with advanced TNM stage in Lung adenocarcinoma patients.
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Affiliation(s)
- Ting Yang
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Fang He
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Mingxiang Zhang
- Department of Cardiothoracic Surgery, Children's Hospital affiliated to Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Li Ai
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Meng He
- Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Xin Liu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Yongxia Li
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
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22
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Wei L, Han N, Sun S, Ma X, Zhang Y. Sleep-disordered breathing and risk of the breast cancer: A meta-analysis of cohort studies. Int J Clin Pract 2021; 75:e14793. [PMID: 34482589 DOI: 10.1111/ijcp.14793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) has been related to a higher risk of breast cancer whereas the results of previous studies are inconsistent. We, therefore, performed a meta-analysis to evaluate the association between SDB and subsequent risk of breast cancer in women. METHODS Cohort studies that investigated the temporal relationship between SDB and breast cancer incidence were obtained via search of PubMed, Embase and Web of Science from inception to 30 January 2021. Only studies with multivariate analyses were included. A fixed or a randomised effect model was applied according to the heterogeneity. RESULTS Eight cohort studies with 1 398 113 women were included. Pooled results with a randomised-effect model showed that compared with women without SDB at baseline, women with SDB had a significantly increased risk of breast cancer (risk ratio [RR]: 1.36, 95% confidence interval [CI]: 1.08 to 1.71, P = .01) with significant heterogeneity (P for Cochrane's Q test < .001, I2 = 95%). Subgroup analyses showed that SDB seemed to confer a more remarkably increased risk of breast cancer in elderly women (RR: 3.00, 95% CI: 1.33 to 6.76, P = .008) than that in non-elderly women (RR: 1.15, 95% CI: 1.02 to 1.29, P = .02; P for subgroup difference = .04). However, the association was not significantly affected by country of the study, study design, diagnostic strategy for SDB or adjustment of obesity (P for subgroup analyses all > .05). CONCLUSIONS SDB may be an independent risk factor for breast cancer in women, particularly in elderly females.
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Affiliation(s)
- Linlin Wei
- Department of Radiotherapy, Cancer Hospital of China Medical University, Shenyang, China
| | - Ning Han
- Department of Radiotherapy, Cancer Hospital of China Medical University, Shenyang, China
| | - Shichen Sun
- Department of Radiotherapy, Cancer Hospital of China Medical University, Shenyang, China
| | - Xinchi Ma
- Department of Radiotherapy, Cancer Hospital of China Medical University, Shenyang, China
| | - Yaotian Zhang
- Department of Radiotherapy, Cancer Hospital of China Medical University, Shenyang, China
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23
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Osorio RS, Martínez-García MÁ, Rapoport DM. Sleep apnoea in the elderly: a great challenge for the future. Eur Respir J 2021; 59:13993003.01649-2021. [PMID: 34561285 DOI: 10.1183/13993003.01649-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/25/2021] [Indexed: 11/05/2022]
Abstract
Due in part to overall improvements in health, the population of elderly individuals is increasing rapidly. Similarly, obstructive sleep apnoea (OSA) is both gaining increased recognition and also increasing due to the worldwide obesity epidemic. The overlap of OSA and aging is large, but there is strong plausibility for causation in both directions: OSA is associated with pathological processes that may accelerate aging and aging related processes; aging may cause physical and neurological changes that predispose to obstructive (and central) apnoea. In addition, the common symptoms (e.g. excessive daytime somnolence, defects in memory and cognition), possible physiological consequences of OSA (e.g. accelerated cardiovascular and cerebrovascular atherosclerosis), and changes in metabolic and inflammatory markers overlap with the symptoms and associated conditions seen in aging. There is also the possibility of synergy in the effects of these symptoms and conditions on quality of life, as well as a need to separate treatable consequences of OSA from age-related complaints. Taken together, the above make it essential to review the interaction of OSA and aging, both proven and suspected. The present review examines some aspects of what is known and points to the need for further investigation of the relationships, given the large number of potentially affected subjects.
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Affiliation(s)
- Ricardo S Osorio
- Department of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, New York, USA.,Clinical Research Division, Nathan Kline Institute (NKI), Orangeburg, New York, USA
| | - Miguel Ángel Martínez-García
- Respirology Department, University and Politechnic la Fe Hospital, Valencia, Valencian Community, Spain .,CIBERES de Enfermedades Respiratorias, Madrid, Spain
| | - David M Rapoport
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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24
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Heterogeneity of Melanoma Cell Responses to Sleep Apnea-Derived Plasma Exosomes and to Intermittent Hypoxia. Cancers (Basel) 2021; 13:cancers13194781. [PMID: 34638272 PMCID: PMC8508428 DOI: 10.3390/cancers13194781] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 12/13/2022] Open
Abstract
Obstructive sleep apnea (OSA) is associated with increased cutaneous melanoma incidence and adverse outcomes. Exosomes are secreted by most cells, and play a role in OSA-associated tumor progression and metastasis. We aimed to study the effects of plasma exosomes from OSA patients before and after adherent treatment with continuous positive airway pressure (CPAP) on melanoma cells lines, and also to identify exosomal miRNAs from melanoma cells exposed to intermittent hypoxia (IH) or normoxia. Plasma-derived exosomes were isolated from moderate-to-severe OSA patients before (V1) and after (V2) adherent CPAP treatment for one year. Exosomes were co-incubated with three3 different melanoma cell lines (CRL 1424; CRL 1619; CRL 1675) that are characterized by genotypes involving different mutations in BRAF, STK11, CDKN2A, and PTEN genes to assess the effect of exosomes on cell proliferation and migration, as well as on pAMK activity in the presence or absence of a chemical activator. Subsequently, CRL-1424 and CRL-1675 cells were exposed to intermittent hypoxia (IH) and normoxia, and exosomal miRNAs were identified followed by GO and KEG pathways and gene networks. The exosomes from these IH-exposed melanoma cells were also administered to THP1 macrophages to examine changes in M1 and M2 polarity markers. Plasma exosomes from V1 increased CRL-1424 melanoma cell proliferation and migration compared to V2, but not the other two cell lines. Exposure to CRL-1424 exosomes reduced pAMPK/tAMPK in V1 compared to V2, and treatment with AMPK activator reversed the effects. Unique exosomal miRNAs profiles were identified for CRL-1424 and CRL-1675 in IH compared to normoxia, with six miRNAs being regulated and several KEGG pathways were identified. Two M1 markers (CXCL10 and IL6) were significantly increased in monocytes when treated with exosomes from IH-exposed CRL-1424 and CRL-1625 cells. Our findings suggest that exosomes from untreated OSA patients increase CRL-1424 melanoma malignant properties, an effect that is not observed in two other melanoma cell lines. Exosomal cargo from CRL-1424 cells showed a unique miRNA signature compared to CRL-1675 cells after IH exposures, suggesting that melanoma cells are differentially susceptible to IH, even if they retain similar effects on immune cell polarity. It is postulated that mutations in STK-11 gene encoding for the serine/threonine kinase family that acts as a tumor suppressor may underlie susceptibility to IH-induced metabolic dysfunction, as illustrated by CRL-1424 cells.
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25
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Christensson E, Mkrtchian S, Ebberyd A, Österlund Modalen Å, Franklin KA, Eriksson LI, Jonsson Fagerlund M. Whole blood gene expression signature in patients with obstructive sleep apnea and effect of continuous positive airway pressure treatment. Respir Physiol Neurobiol 2021; 294:103746. [PMID: 34302993 DOI: 10.1016/j.resp.2021.103746] [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: 04/26/2021] [Revised: 06/23/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
The molecular mechanisms of obstructive sleep apnea (OSA), in particular the gene expression patterns in whole blood of patients with OSA, can shed more light on the underlying pathophysiology of OSA and suggest potential biomarkers. In the current study, we have enrolled thirty patients with untreated moderate-severe OSA together with 20 BMI, age, and sex-matched controls and 15 normal-weight controls. RNA-sequencing of whole blood and home sleep apnea testing were performed in the untreated state and after three and twelve months of continuous positive airway pressure (CPAP) treatment. Analysis of the whole blood transcriptome of the patients with OSA revealed a unique pattern of differential expression with a significant number of downregulated immune-related genes including many heavy and light chain immunoglobulins and interferon-inducible genes. This was confirmed by the gene ontology analysis demonstrating enrichment with the biological processes associated with various immune functions. Expression of these genes was recovered after three months of CPAP treatment. After 12 months of CPAP treatment, the overall gene expression profile returns to the initial, untreated level. In addition, we have confirmed the importance of choosing BMI-matched controls as a reference group as opposed to normal-weight healthy individuals based on the significantly different gene expression signatures between these two groups.
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Affiliation(s)
- Eva Christensson
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Souren Mkrtchian
- Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anette Ebberyd
- Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Lars I Eriksson
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Malin Jonsson Fagerlund
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden
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26
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Conte L, Greco M, Toraldo DM, Arigliani M, Maffia M, De Benedetto M. A review of the "OMICS" for management of patients with obstructive sleep apnoea. ACTA ACUST UNITED AC 2021; 40:164-172. [PMID: 32773777 PMCID: PMC7416376 DOI: 10.14639/0392-100x-n0409] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/21/2019] [Indexed: 12/11/2022]
Abstract
Obstructive sleep apnaea (OSA) syndrome is a condition characterised by the presence of complete or partial collapse of the upper airways during sleep, resulting in fragmentation of sleep associated with rapid episodes of intermittent hypoxia (IH), activation of the sympathetic nervous system and oxidative stress. OSA is associated with a broad spectrum of cardiovascular, metabolic and neurocognitive comorbidities that appear to be particularly evident in obese patients, while affecting both sexes in a different manner and varying in severity according to gender and age. In recent years, studies on OSA have increased considerably, but in clinical practice, it is still a highly underdiagnosed disease. To date, the gold standard for the diagnosis of OSA is nocturnal polysomnography (PSG). However, since it is not well suited for a large number of patients, the Home Sleep Test (HST) is also an accepted diagnostic method. Currently, the major aim of research is to identify non-invasive methods to achieve a highly predictive, non-invasive screening system for these subjects. The most recent reports indicate that research in this field has made significant progress in identifying possible biomarkers in OSA, using -OMIC approaches, particularly in the fields of proteomics and metabolomics. In this review, we analyse these OMIC biomarkers found in the literature.
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Affiliation(s)
- Luana Conte
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), University of Salento, Lecce, Italy.,Laboratory of Advanced Data Analysis for Medicine (ADAM), Department of Mathematics and Physics "E. De Giorgi", University of Salento, Lecce, Italy
| | - Marco Greco
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), University of Salento, Lecce, Italy.,Laboratory of Physiology, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - Domenico Maurizio Toraldo
- Department Rehabilitation "V. Fazzi" Hospital, Cardio-Respiratory Unit Care, ASL-Lecce, San Cesario di Lecce (LE), Italy
| | | | - Michele Maffia
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), University of Salento, Lecce, Italy.,Laboratory of Physiology, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy.,Laboratory of Clinical Proteomic, "Giovanni Paolo II" Hospital, ASL-Lecce, Italy
| | - Michele De Benedetto
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), University of Salento, Lecce, Italy
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27
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Initiation of therapy for obstructive sleep apnea syndrome: a randomized comparison of outcomes of telemetry-supported home-based vs. sleep lab-based therapy initiation. Sleep Breath 2021; 26:269-277. [PMID: 33993394 PMCID: PMC8857114 DOI: 10.1007/s11325-021-02371-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/01/2021] [Accepted: 04/02/2021] [Indexed: 11/23/2022]
Abstract
Purpose Diagnosis and treatment of obstructive sleep apnea are traditionally performed in sleep laboratories with polysomnography (PSG) and are associated with significant waiting times for patients and high cost. We investigated if initiation of auto-titrating CPAP (APAP) treatment at home in patients with obstructive sleep apnea (OSA) and subsequent telemonitoring by a homecare provider would be non-inferior to in-lab management with diagnostic PSG, subsequent in-lab APAP initiation, and standard follow-up regarding compliance and disease-specific quality of life. Methods This randomized, open-label, single-center study was conducted in Germany. Screening occurred between December 2013 and November 2015. Eligible patients with moderate-to-severe OSA documented by polygraphy (PG) were randomized to home management or standard care. All patients were managed by certified sleep physicians. The home management group received APAP therapy at home, followed by telemonitoring. The control group received a diagnostic PSG, followed by therapy initiation in the sleep laboratory. The primary endpoint was therapy compliance, measured as average APAP usage after 6 months. Results The intention-to-treat population (ITT) included 224 patients (110 home therapy, 114 controls); the per-protocol population (PP) included 182 patients with 6-month device usage data (89 home therapy, 93 controls). In the PP analysis, mean APAP usage at 6 months was not different in the home therapy and control groups (4.38 ± 2.04 vs. 4.32 ± 2.28, p = 0.845). The pre-specified non-inferiority margin (NIM) of 0.3 h/day was not achieved (p = 0.130); statistical significance was achieved in a post hoc analysis when NIM was set at 0.5 h/day (p < 0.05). Time to APAP initiation was significantly shorter in the home therapy group (7.6 ± 7.2 vs. 46.1 ± 23.8 days; p < 0.0001). Conclusion Use of a home-based telemonitoring strategy for initiation of APAP in selected patients with OSA managed by sleep physicians is feasible, appears to be non-inferior to standard sleep laboratory procedures, and facilitates faster access to therapy.
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28
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Zhang ZL, Duolikun D, Yao QL. Top 100 influential manuscripts in obstructive sleep apnea: a bibliometric analysis. Sleep Breath 2021; 26:37-45. [PMID: 33991308 DOI: 10.1007/s11325-021-02378-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/11/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to explore the characteristics of the top 100 influential manuscripts on obstructive sleep apnea (OSA). METHODS All manuscripts in English were searched from the Thomson Reuters Web of Science database by using OSA-related terms and ranked based on citation frequency. The top 100 influential manuscripts were selected and further analyzed by author, subject, journal, year of publication, country of origin, and institution. RESULTS A total of 42,878 manuscripts were searched from the Web of Science. The top 100 influential manuscripts were published from 2005 to 2017, with a total citation frequency of 38,463 and a median citation frequency of 303 (range: from 210 to 2, 707). The American Journal of Respiratory and Critical Care Medicine published the largest number of manuscripts from the top 100 (n = 18; 5340 citations), followed by Sleep (n = 11; 3516 citations) and Chest (n = 7; 1784 citations). The most cited manuscript (Marin, J.M et al., Lancet 2005; 2707 citations) mainly analyzed long-term cardiovascular outcomes in men with OSA with/without continuous positive airway pressure. The most prevalent subject was associated diseases (n = 41), followed by treatments (n = 40). Most of the manuscripts were original articles (n = 63) based on observational clinical studies and published from American institutions (n = 60). CONCLUSIONS Our study identified the top 100 influential manuscripts on OSA and provides insights into the characteristics of the most highly cited manuscripts to improve our understanding and management of OSA.
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Affiliation(s)
- Zhen-Lian Zhang
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, No. 393 Xinyi Road, Urumqi, Xinjiang, China
| | - Dilihumaier Duolikun
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, No. 393 Xinyi Road, Urumqi, Xinjiang, China
| | - Qiao-Ling Yao
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, No. 393 Xinyi Road, Urumqi, Xinjiang, China.
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29
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Huang T, Lin BM, Stampfer MJ, Schernhammer ES, Saxena R, Tworoger SS, Redline S. Associations of self-reported obstructive sleep apnea with total and site-specific cancer risk in older women: a prospective study. Sleep 2021; 44:5917873. [PMID: 33015707 DOI: 10.1093/sleep/zsaa198] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic intermittent hypoxia resulting from obstructive sleep apnea (OSA) may activate multiple carcinogenic pathways and lead to cancer development. METHODS We prospectively examined the association between OSA and cancer risk among 65,330 women in the Nurses' Health Study who were free of cancer in 2008 (mean age: 73.3 years). Incident cancer diagnoses were collected until 2016 and confirmed by pathology reports. Clinically diagnosed OSA was self-reported in 2008 and updated in 2012. We used time-dependent Cox regression to estimate hazard ratios (HR) for the associations of OSA with total and site-specific cancer risk. RESULTS We documented 5,257 incident cancer diagnoses during follow-up. In the age-adjusted model, OSA was associated with a 15% (95% CI: 1.03, 1.29) increase in total cancer risk. The association became nonsignificant after adjustment for multiple cancer risk factors (HR: 1.08; 95% CI: 0.96, 1.21). When examining cancer risk by site, OSA was associated with significantly increased risk for lung (fully adjusted HR: 1.52; 95% CI: 1.07, 2.17), bladder (fully adjusted HR: 1.94; 95% CI: 1.12, 3.35), and thyroid cancer (fully adjusted HR: 2.06; 95% CI: 1.01, 4.22) and possibly increased risk for kidney cancer (fully adjusted HR: 1.59; 95% CI: 0.84, 3.01). When grouping cancer sites by risk factor profiles, OSA was positively associated with smoking-related cancers (fully adjusted HR: 1.37; 95% CI: 1.11, 1.67), and this association was stronger in never smokers than ever smokers. CONCLUSION While OSA was not independently associated with overall cancer risk in older women, significant associations were observed for smoking-related cancers, especially in nonsmokers.
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Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Brian M Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Meir J Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eva S Schernhammer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Richa Saxena
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA.,Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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30
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Lee EJ, Suh JD, Cho JH. The incidence of prostate cancer is increased in patients with obstructive sleep apnea: Results from the national insurance claim data 2007-2014. Medicine (Baltimore) 2021; 100:e24659. [PMID: 33578596 PMCID: PMC10545413 DOI: 10.1097/md.0000000000024659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT Some studies have demonstrated an increased risk of prostate cancer in patients with obstructive sleep apnea (OSA). However, the relationship is unclear and the results are conflicting. This study aims to investigate associations between OSA and prostate cancer using the Korea National Health Insurance Service database.A total of 152,801 men (≥ 20 years of age) newly diagnosed with OSA between 2007 and 2014 were included. A control group of 764,005 subjects was selected using propensity score matching by age and sex. The mean follow-up time was 4.6 years (range 2.3-6.9). The primary endpoint was newly diagnosed prostate cancer. The prostate cancer hazard ratio (95% confidence interval) was calculated for patients with OSA and compared to the control group.The incidence of prostate cancer among patients with OSA was significantly higher than that in controls (1.34 [1.23-1.49]). In particular, the incidence of prostate cancer was highest in patients aged 40-65 years (1.51 [1.32-1.72]).This study provides additional evidence for a link between OSA and prostate cancer.
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Affiliation(s)
- Eun Jung Lee
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jeffrey D. Suh
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Jae Hoon Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University, Seoul, Korea
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31
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Li HP, Wang HQ, Li N, Zhang L, Li SQ, Yan YR, Lu HH, Wang Y, Sun XW, Lin YN, Zhou JP, Li QY. Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea. Nat Sci Sleep 2021; 13:493-501. [PMID: 33911906 PMCID: PMC8071699 DOI: 10.2147/nss.s299646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/07/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The carotid body (CB) is a major peripheral respiratory chemoreceptor. In patients with obstructive sleep apnea (OSA), high CB chemosensitivity (CBC) is associated with refractory hypertension and insulin resistance and known to further aggravate OSA. Thus, the identification of high CB (hCBC) among OSA patients is of clinical significance, but detection methods are still limited. Therefore, this study aimed to explore the association of CBC with OSA severity and to develop a simplified model that can identify patients with hCBC. METHODS In this cross-sectional study of subjects who underwent polysomnography (PSG), CBC was measured using the Dejours test. We defined hCBC as a decrease of >12% in respiratory rate (RR) after breathing of pure O2. The association of CBC with OSA severity was explored by logistic regression, and a model for identifying hCBC was constructed and confirmed using receiver operating characteristic analysis. RESULTS Patients with OSA (n=142) and individuals without OSA (n=38) were enrolled. CBC was higher in patients with OSA than in those without OSA (% decrease in RR, 15.2%±13.3% vs 9.1%±7.5%, P<0.05). Apnea-hypopnea index (AHI), fraction of apnea-hypopnea events in rapid-eye-movement sleep (Fevents-in-REM), and longest time of apnea (LTA) were associated with hCBC independently (odds ratio [OR]=1.048, OR=1.082, and OR=1.024 respectively; all P<0.05). The model for identifying hCBC allocated a score to each criterion according to its OR values, ie, 1 (LTA >48.4 s), 2 (AHI >15.7 events/hour), and 3 (Fevents-in-REM >12.7%). A score of 3 or greater indicated hCBC with a sensitivity of 79.4% and specificity of 88.2%. CONCLUSION High CBC is associated with the severity of OSA. A simplified scoring system based on clinical variables from PSG can be used to identify hCBC.
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Affiliation(s)
- Hong Peng Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Hai Qin Wang
- Xietu Community Health Service Center of Xuhui District, Shanghai, 200231, People's Republic of China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Ya Ru Yan
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Huan Huan Lu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
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Kendzerska T, Povitz M, Leung RS, Boulos MI, McIsaac DI, Murray BJ, Bryson GL, Talarico R, Hilton JF, Malhotra A, Gershon AS. Obstructive Sleep Apnea and Incident Cancer: A Large Retrospective Multicenter Clinical Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 30:295-304. [PMID: 33268490 DOI: 10.1158/1055-9965.epi-20-0975] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/01/2020] [Accepted: 11/20/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To examine the association between the severity of obstructive sleep apnea (OSA) and nocturnal hypoxemia with incident cancer. METHODS This was a multicenter retrospective clinical cohort study using linked clinical and provincial health administrative data on consecutive adults who underwent a diagnostic sleep study between 1994 and 2017 in four academic hospitals (Canada) who were free of cancer at baseline. Cancer status was derived from the Ontario Cancer Registry. Cox cause-specific regressions were utilized to address the objective and to calculate the 10-year absolute risk difference (ARD) in the marginal probability of incident cancer and the number needed to harm (NNH). RESULTS Of 33,997 individuals considered, 33,711 with no missing OSA severity were included: median age, 50 years; 58% male; and 23% with severe OSA (apnea-hypopnea index >30). Of the 18,458 individuals with information on sleep time spent with oxygen saturation (SaO2) <90%, 5% spent >30% of sleep with SaO2 <90% (severe nocturnal hypoxemia). Over a median of 7 years, 2,498 of 33,711 (7%) individuals developed cancer, with an incidence rate of 10.3 (10.0-10.8) per 1,000 person-years. Controlling for confounders, severe OSA was associated with a 15% increased hazard of developing cancer compared with no OSA (HR = 1.15, 1.02-1.30; ARD = 1.28%, 0.20-2.37; and NNH = 78). Severe hypoxemia was associated with about 30% increased hazard (HR = 1.32, 1.08-1.61; ARD = 2.38%, 0.47-4.31; and NNH = 42). CONCLUSIONS In a large cohort of individuals with suspected OSA free of cancer at baseline, the severity of OSA and nocturnal hypoxemia was independently associated with incident cancer. IMPACT These findings suggest the need for more targeted cancer risk awareness in individuals with OSA.
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Affiliation(s)
- Tetyana Kendzerska
- Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada.
- ICES (formerly the Institute for Clinical Evaluative Sciences), Ottawa, Toronto, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Marcus Povitz
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Richard S Leung
- Department of Medicine, the University of Toronto, Toronto, Ontario, Canada
- St. Michael's Hospital, Toronto, Ontario, Canada
| | - Mark I Boulos
- Department of Medicine, the University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Daniel I McIsaac
- ICES (formerly the Institute for Clinical Evaluative Sciences), Ottawa, Toronto, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Departments of Anesthesiology and Pain Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
| | - Brian J Murray
- Department of Medicine, the University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gregory L Bryson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Departments of Anesthesiology and Pain Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
| | - Robert Talarico
- ICES (formerly the Institute for Clinical Evaluative Sciences), Ottawa, Toronto, Ontario, Canada
| | - John F Hilton
- Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
| | - Atul Malhotra
- Department of Medicine, the University of California, San Diego, California
| | - Andrea S Gershon
- ICES (formerly the Institute for Clinical Evaluative Sciences), Ottawa, Toronto, Ontario, Canada
- Department of Medicine, the University of Toronto, Toronto, Ontario, Canada
- Division of Respirology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Gozal D, Almendros I, Phipps AI, Campos-Rodriguez F, Martínez-García MA, Farré R. Sleep Apnoea Adverse Effects on Cancer: True, False, or Too Many Confounders? Int J Mol Sci 2020; 21:ijms21228779. [PMID: 33233617 PMCID: PMC7699730 DOI: 10.3390/ijms21228779] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023] Open
Abstract
Obstructive sleep apnoea (OSA) is a prevalent disorder associated with increased cardiovascular, metabolic and neurocognitive morbidity. Recently, an increasing number of basic, clinical and epidemiological reports have suggested that OSA may also increase the risk of cancer, and adversely impact cancer progression and outcomes. This hypothesis is convincingly supported by biological evidence linking certain solid tumours and hypoxia, as well as by experimental studies involving cell and animal models testing the effects of intermittent hypoxia and sleep fragmentation that characterize OSA. However, the clinical and epidemiological studies do not conclusively confirm that OSA adversely affects cancer, even if they hold true for specific cancers such as melanoma. It is likely that the inconclusive studies reflect that they were not specifically designed to test the hypothesis or because of the heterogeneity of the relationship of OSA with different cancer types or even sub-types. This review critically focusses on the extant basic, clinical, and epidemiological evidence while formulating proposed directions on how the field may move forward.
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Affiliation(s)
- David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO 65201, USA
- Correspondence: (D.G.); (R.F.)
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain;
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain;
- Institut d’Investigacions Biomediques August Pi Sunyer, 08036 Barcelona, Spain
| | - Amanda I. Phipps
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA;
- Epidemiology Program, Fred Hutchinson Research Cancer Research Center, Seattle, WA 98109, USA
| | - Francisco Campos-Rodriguez
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain;
- Respiratory Department, Hospital Valme (Seville, Spain), Institute of Biomedicine of Seville (IBiS), 41014 Seville, Spain
| | - Miguel A. Martínez-García
- Pneumology Department, Sleep-Disordered Breathing and Research Unit, Polytechnic and University La Fe Hospital, 46026 Valencia, Spain;
| | - Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain;
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain;
- Institut d’Investigacions Biomediques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence: (D.G.); (R.F.)
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Gao J, Cao H, Zhang Q, Wang B. The effect of intermittent hypoxia and fecal microbiota of OSAS on genes associated with colorectal cancer. Sleep Breath 2020; 25:1075-1087. [PMID: 33029691 PMCID: PMC8195781 DOI: 10.1007/s11325-020-02204-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 12/29/2022]
Abstract
Purpose Colorectal cancer (CRC) is one of the common causes of cancer death worldwide. Obstructive sleep apnea syndrome (OSAS), sharing many risk factors in common with CRC, is prevalent among CRC patients. OSAS may promote the CRC development independently but the mechanism is still unknown. Intermittent hypoxia (IH) is one of the characteristics of OSAS, and hypoxia may influence the genes associated with CRC. Intestinal microbiota plays important role in CRC carcinogenesis, and OSAS patients have been shown to have intestinal microbiota dysbiosis. We hypothesized that IH and intestinal microbiota dysbiosis may be involved for CRC in patients with OSAS. Methods We established precancerous cell models of CRC with Immorto-Min colonic epithelial (IMCE) cells. First, the cells were exposed to IH in a special chamber for 4 h, 8 h, and 12 h. Feces from 6 patients with OSAS and 6 healthy controls were collected and made into sterile fecal fluid for incubation with IMCE cells for 12 h. The cells were then exposed to IH for 4 h, 8 h, and 12 h. After IH exposure, the expressions of genes and inflammation cytokines associated with CRC, such as β-catenin, STAT3, HIF-1α, IL-6, TNF-α, c-myc, and cyclinD1, were tested. Results IH activated the expression of HIF-1α and STAT3 both in mRNA and protein level (HIF-1α: P = 0.015 for mRNA level, P = 0.027 for protein level; STAT3: P = 0.023 for mRNA level, P = 0.023 for protein level), and promoted p-STAT3 shifting to the nucleus (P = 0.023). The mRNA of β-catenin (P = 0.022) and cyclinD1 (P = 0.023) was elevated, but there was no change for the β-catenin protein in the nucleus. Gut microbiota of OSAS patients promoted the expression of STAT3 (protein level: 0 h: P = 0.037; 4 h: P = 0.046; 8 h: P = 0.049; 12 h: P = 0.037), promoted p-STAT3 (4 h: P = 0.049; 8 h: P = 0.046; 12 h: P = 0.046) shifting to the nucleus, and also elevated the expression of IL-6 and TNF-α in mRNA level at 4 h (IL-6: P = 0.037, TNF-α: P = 0.037) and 8 h (IL-6: P = 0.037, TNF-α: P = 0.037). The protein of β-catenin in the nucleus was not affected by IH and gut microbiota from OSAS. Conclusions Our study demonstrated that IH and gut microbiota of patients with OSAS activated HIF-1α expression and STAT3 pathway in IMCE cells, with no influence on β-catenin pathway, which suggested that IH, STAT3 pathway, chronic inflammation, and intestinal microbiota dysbiosis may be involved in CRC carcinogenesis correlated with OSAS These findings must be interpreted cautiously and further research is necessary to clarify the causative steps in CRC development.
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Affiliation(s)
- Jia Gao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No.154, Anshan Road, Heping District, Tianjin, China
- Department of Geriatrics, Tianjin Geriatrics Institute, Tianjin Medical University General Hospital, No.154, Anshan Road, Heping District, Tianjin, China
| | - Hailong Cao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No.154, Anshan Road, Heping District, Tianjin, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Geriatrics Institute, Tianjin Medical University General Hospital, No.154, Anshan Road, Heping District, Tianjin, China
| | - Bangmao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No.154, Anshan Road, Heping District, Tianjin, China.
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Choi JH, Kim SY, Han KD, Cho JH. The incidence of non-Hodgkin lymphoma is increased in patients with obstructive sleep apnea. Leuk Res 2020; 98:106455. [PMID: 32950825 DOI: 10.1016/j.leukres.2020.106455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 11/26/2022]
Abstract
Obstructive sleep apnea (OSA) is known to be associated with several cancers, but studies assessing the association between OSA and lymphoma have not been conducted yet. This study aimed to investigate the associations between OSA and non-Hodgkin lymphoma, which accounts for the majority of lymphoma, using the Korea National Health Insurance Service database. This retrospective cohort study analyzed the data from the Korea National Health Insurance Service database. A total of 198,574 patients aged ≥ 20 years who were newly diagnosed with OSA between 2007 and 2014 were included. The control group comprising 992,870 subjects was selected using propensity score matching by age and sex. The mean follow-up duration was 4.8 ± 2.3 years. The primary endpoint was newly diagnosed non-Hodgkin lymphoma. The hazard ratio [95 % confidence interval] of OSA for the incidence of non-Hodgkin lymphoma was calculated based on Cox proportional hazard model. The incidence of non-Hodgkin lymphoma among patients with OSA was significantly higher than that among the controls (1.40 [1.16-1.69]). In particular, the incidence was higher in women than that in men (1.62 vs. 1.28). There was no difference in hazard ratio by age. In conclusion, OSA may be a risk factor for non-Hodgkin lymphoma.
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Affiliation(s)
- Ji Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea
| | - Sung-Yong Kim
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jae Hoon Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University, Seoul, Republic of Korea.
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Dodds S, Williams LJ, Roguski A, Vennelle M, Douglas NJ, Kotoulas SC, Riha RL. Mortality and morbidity in obstructive sleep apnoea-hypopnoea syndrome: results from a 30-year prospective cohort study. ERJ Open Res 2020; 6:00057-2020. [PMID: 32963994 PMCID: PMC7487348 DOI: 10.1183/23120541.00057-2020] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background Obstructive sleep apnoea–hypopnoea syndrome (OSAHS) carries substantial negative health consequences. This study examines factors affecting mortality and morbidity according to continuous positive airway pressure (CPAP) use and predictors affecting CPAP adherence in a longitudinal cohort of OSAHS patients. Materials and methods This prospective, cohort study comprised 4502 patients who were diagnosed with OSAHS at a tertiary sleep disorders centre between 1982 and 2003. Of these, 1174 patients completed follow-up in 2012. Data collected included anthropometric, sleep and demographic characteristics, including comorbidities, ongoing medications and CPAP adherence. Patients were followed up for an average of 14.8±3.7 years. Results Imputation analysis showed that long-term CPAP users (>5 years) were 5.63 times more likely to be alive at study end than non-CPAP users (95% CI: 4.83–6.58, p<0.001) and 1.74-times more likely than short-term CPAP users (≤5 years) (95% CI: 1.49–2.02, p<0.001). Females had a significantly higher mortality rate during the follow-up period (26.8% versus 19.6%, p<0.001). Respiratory mortality was more common in patients with OSAHS, in particular those who did not use CPAP, compared to the general population (17.2% versus 12.2%, p=0.002 respectively), whereas deaths from cancer were less common compared to the general population (16.2% versus 25.6%, p<0.001). Compared to CPAP users, non-CPAP-users had a significantly increased incidence of type II diabetes mellitus (DMII) (27.9% versus 18.7%, p=0.003), ischaemic heart disease (IHD) (25.5% versus 12.7%, p<0.001) and myocardial infarction (MI) (14.7% versus 4.2%, p<0.001) at long-term follow-up. Conclusions Long-term CPAP use in men and women with OSAHS reduces mortality and decreases the incidence of DMII and cardiovascular disease. In this first long-term prospective cohort study to use imputation analysis in OSAHS patients, all-cause morbidity and mortality were significantly reduced in long-term CPAP users (>5 years), and equivalent for both males and femaleshttps://bit.ly/3cKL2HK
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Affiliation(s)
- Sophie Dodds
- Dept of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Linda J Williams
- Dept of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Amber Roguski
- Dept of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | - Neil J Douglas
- Dept of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | - Renata L Riha
- Dept of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
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Guadagni V, Pun M. Untangling sex differences in obstructive sleep apnea: a significant step toward precision medicine. Sleep 2020; 43:5736395. [PMID: 32060516 DOI: 10.1093/sleep/zsaa022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/02/2020] [Indexed: 12/27/2022] Open
Affiliation(s)
- Veronica Guadagni
- Laboratory of Human Cerebrovascular Physiology Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matiram Pun
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Ralli M, Campo F, Angeletti D, Allegra E, Minni A, Polimeni A, Greco A, de Vincentiis M. Obstructive Sleep Apnoea in Patients Treated for Head and Neck Cancer: A Systematic Review of the Literature. ACTA ACUST UNITED AC 2020; 56:medicina56080399. [PMID: 32784361 PMCID: PMC7466207 DOI: 10.3390/medicina56080399] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/30/2020] [Accepted: 08/06/2020] [Indexed: 11/24/2022]
Abstract
Background and objectives: Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The literature is still controversial on the incidence and aetiology of OSA secondary to head and neck cancer treatment. The aim of this systematic review is to evaluate and discuss the prevalence of OSA in patients treated with surgery and/or chemo/radiotherapy for head and neck cancer. Materials and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed on May 2020 using the MEDLINE database, Scopus, and Google Scholar. The searches were conducted using combinations of the following terms: head and neck cancer, OSA, radiotherapy, chemotherapy, partial laryngectomy, laryngeal cancer, neoplasm, tumour, carcinoma, and oropharyngeal cancer. Results: Our results suggest that head and neck cancer patients have a higher incidence of OSA (59.78%) compared to the general population; differences may occur based on the type of treatment. Conclusions: Clinicians should recognise the higher prevalence of OSA in patients treated for head and neck cancer and should consider a comprehensive sleep history as part of the evaluation and management of these patients. Further research is needed to evaluate the exact prevalence, aetiology, and correct management of OSA after treatment for head and neck cancer.
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Affiliation(s)
- Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
- Correspondence: ; Tel.: +39-0649976808
| | - Flaminia Campo
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Diletta Angeletti
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Eugenia Allegra
- Otolaryngology Department of Health Science, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (A.P.); (M.d.V.)
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (D.A.); (A.M.); (A.G.)
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (A.P.); (M.d.V.)
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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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Saconi B, Yang H, Watach AJ, Sawyer AM. Coping Processes, Self-Efficacy, and CPAP Use in Adults With Obstructive Sleep Apnea. Behav Sleep Med 2020; 18:68-80. [PMID: 30477340 PMCID: PMC6535371 DOI: 10.1080/15402002.2018.1545651] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Coping strategies are predictive of 1 week CPAP use. Coping strategies may predict longer-term CPAP use among adults with obstructive sleep apnea (OSA). Objectives: To investigate the influence of two coping styles (active and passive) and individual coping processes on CPAP use at 1 week and 1 month; and explore the association between self-efficacy and coping on CPAP use. Participants: CPAP-naïve adults (52.3% male, 90.9% White) newly diagnosed with OSA (AHI ≥ 5 events/hr) from two U.S. clinical sleep centers (n = 66). Methods: A post-hoc analysis from a prospective, longitudinal study that examined influential factors on CPAP use among CPAP-naïve patients with newly diagnosed OSA. The Ways of Coping Questionnaire and the Self-Efficacy Measure for Sleep Apnea were completed immediately after CPAP titration polysomnography. Objective 1 week and 1 month CPAP use (mean hr/night) were the primary outcomes. Descriptive analyses and stepwise multiple linear regression analyses modeling for CPAP use (mean hr/night). Results: Active coping was significantly associated with greater CPAP use (mean hr/night) at 1 week, but not at 1 month (p = 0.0397; p = 0.0556, respectively). Higher Planful Problem Solving was significantly associated with greater average CPAP use at 1 week and 1 month (p = 0.0117, p = 0.0378, respectively). Self-efficacy was significantly associated with greater average CPAP use at 1 week (p = 0.0056) and 1 month (p = 0.0056). Conclusions: Self-efficacy and Planful Problem Solving coping are promising behavioral intervention targets to promote CPAP use in newly diagnosed OSA.
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Affiliation(s)
- Bruno Saconi
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hyunju Yang
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Alexa J Watach
- Department of Medicine, Center for Sleep & Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Amy M Sawyer
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Evidence Based Practice & Nursing Science, Philadelphia, Pennsylvania,Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Martinez-Garcia MA, Campos-Rodriguez F, Almendros I, Garcia-Rio F, Sanchez-de-la-Torre M, Farre R, Gozal D. Cancer and Sleep Apnea: Cutaneous Melanoma as a Case Study. Am J Respir Crit Care Med 2019; 200:1345-1353. [PMID: 31339332 PMCID: PMC6884053 DOI: 10.1164/rccm.201903-0577pp] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/19/2019] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Francisco Campos-Rodriguez
- Respiratory Department, Hospital Valme, Instituto de Biomedicina de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
| | - Isaac Almendros
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Francisco Garcia-Rio
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Manuel Sanchez-de-la-Torre
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Respiratory Department, Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, Institut de Recerca Biomèdica de Lleida, Lleida, Spain; and
| | - Ramon Farre
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri
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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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Liu W, Luo M, Fang YY, Wei S, Zhou L, Liu K. Relationship between Occurrence and Progression of Lung Cancer and Nocturnal Intermittent Hypoxia, Apnea and Daytime Sleepiness. Curr Med Sci 2019; 39:568-575. [DOI: 10.1007/s11596-019-2075-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 07/04/2019] [Indexed: 01/04/2023]
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Kyotani Y, Takasawa S, Yoshizumi M. Proliferative Pathways of Vascular Smooth Muscle Cells in Response to Intermittent Hypoxia. Int J Mol Sci 2019; 20:ijms20112706. [PMID: 31159449 PMCID: PMC6600262 DOI: 10.3390/ijms20112706] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 05/20/2019] [Accepted: 05/30/2019] [Indexed: 12/13/2022] Open
Abstract
Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia (IH) and is a risk factor for cardiovascular diseases (e.g., atherosclerosis) and chronic inflammatory diseases (CID). The excessive proliferation of vascular smooth muscle cells (VSMCs) plays a pivotal role in the progression of atherosclerosis. Hypoxia-inducible factor-1 and nuclear factor-κB are thought to be the main factors involved in responses to IH and in regulating adaptations or inflammation pathways, however, further evidence is needed to demonstrate the underlying mechanisms of this process in VSMCs. Furthermore, few studies of IH have examined smooth muscle cell responses. Our previous studies demonstrated that increased interleukin (IL)-6, epidermal growth factor family ligands, and erbB2 receptor, some of which amplify inflammation and, consequently, induce CID, were induced by IH and were involved in the proliferation of VSMCs. Since IH increased IL-6 and epiregulin expression in VSMCs, the same phenomenon may also occur in other smooth muscle cells, and, consequently, may be related to the incidence or progression of several diseases. In the present review, we describe how IH can induce the excessive proliferation of VSMCs and we develop the suggestion that other CID may be related to the effects of IH on other smooth muscle cells.
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Affiliation(s)
- Yoji Kyotani
- Department of Pharmacology, Nara Medical University School of Medicine, Kashihara 634-8521, Japan.
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University School of Medicine, Kashihara 634-8521, Japan.
| | - Masanori Yoshizumi
- Department of Pharmacology, Nara Medical University School of Medicine, Kashihara 634-8521, Japan.
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Polonis K, Sompalli S, Becari C, Xie J, Covassin N, Schulte PJ, Druliner BR, Johnson RA, Narkiewicz K, Boardman LA, Singh P, Somers VK. Telomere Length and Risk of Major Adverse Cardiac Events and Cancer in Obstructive Sleep Apnea Patients. Cells 2019; 8:cells8050381. [PMID: 31027347 PMCID: PMC6562838 DOI: 10.3390/cells8050381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/15/2019] [Accepted: 04/24/2019] [Indexed: 12/11/2022] Open
Abstract
Telomere length (TL) is associated with cardiovascular disease (CVD) and cancer. Obstructive sleep apnea (OSA) is also linked to higher risk of CVD and cancer, and to TL. We investigated the association between TL and risk of major adverse cardiac events (MACE) and cancer in OSA patients. We studied 210 individuals undergoing sleep-related studies between 2000 and 2007. Baseline characteristics and follow-up data (available in 164 subjects) were obtained from clinic records. Incidence rates were calculated for the entire group and by OSA status. Hazard ratios were calculated to estimate effects of OSA and TL on risk of MACE and cancer. In total, 32 individuals (20%) developed MACE and/or cancer during 12.7-year follow-up. The OSA group had a higher likelihood of cancer (16.0 vs. 4.9 events per 1000 person-years, P = 0.044) but no clear evidence of an elevated incidence of MACE (10.8 vs. 4.8 events per 1000 person-years, P = 0.293) compared to the non-OSA group. There was no association between TL and MACE- (HR = 1.01, 95% CI 0.78–1.28), or cancer-risk (HR = 1.18, 95% CI 0.96–1.43). Our study warrants further investigation of any modulating effect of OSA on TL and the risk of MACE and cancer.
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Affiliation(s)
- Katarzyna Polonis
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, 80 210 Gdansk, Poland.
| | - Sreeja Sompalli
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Christiane Becari
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
- Department of Surgery and Anatomy, Ribeirao Preto Medical School, Ribeirão Preto-SP 14049-900, Brazil.
| | - Jiang Xie
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Phillip J Schulte
- Division of Biomedical Statistics and Informatics, Mayo Clinic, MN55 905, USA.
| | - Brooke R Druliner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Ruth A Johnson
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, 80 210 Gdansk, Poland.
| | - Lisa A Boardman
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Prachi Singh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55 905, USA.
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Syndrome d’apnées du sommeil : caractéristiques cliniques des patients atteints dans la population hospitalière de Château-Thierry. Rev Mal Respir 2019; 36:326-332. [DOI: 10.1016/j.rmr.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/14/2018] [Indexed: 11/30/2022]
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Martinez-Garcia MA, Campos-Rodriguez F, Nagore E, Martorell A, Rodriguez-Peralto JL, Riveiro-Falkenbach E, Hernandez L, Bañuls J, Arias E, Ortiz P, Cabriada V, Gardeazabal J, Montserrat JM, Carrera C, Corral J, Masa JF, de Terreros JG, Abad J, Boada A, Mediano O, de Eusebio E, Chiner E, Landete P, Mayos M, Fortuño A, Barbé F, Sánchez de la Torre M, Sanchez de la Torre A, Cano I, Gonzalez C, Pérez-Gil A, Gómez-García T, Cullen D, Somoza M, Formigón M, Aizpuru F, Navarro C, Selma-Ferrer MJ, Garcia-Ortega A, de Unamuno B, Almendros I, Farré R, Gozal D. Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma: A Multicenter Observational Study in 443 Patients. Chest 2018; 154:1348-1358. [PMID: 30059679 DOI: 10.1016/j.chest.2018.07.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/22/2018] [Accepted: 07/10/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) has been associated with a greater incidence and mortality of cancer, although such findings are inconsistent. However, no large studies are currently available to investigate this association in patients with a specific type of cancer. This study seeks to assess potential relationships between SDB severity and aggressiveness markers of cutaneous melanoma. METHODS Four hundred and forty-three patients with a diagnosis of melanoma underwent a sleep study within 6 months of diagnosis. General demographics were collected, along with melanoma characteristics and polygraphic parameters consisting of the apnea-hypopnea index (AHI) and indices of both continuous and intermittent night-time oxyhemoglobin desaturation (DI4%). An exploration of independent relationships between SDB and various objective melanoma aggressiveness markers (Breslow index, presence of ulceration, presence of regression, mitotic index, stage of severity, damage to the sentinel lymph, and spreading of the melanoma) was performed. RESULTS Patients in the upper tertiles of AHI or DI4% were 1.94 (95% CI, 1.14-3.32; P = .022) and 1.93 (95% CI, 1.14-3.26; P = .013) times more likely, respectively, to present with aggressive melanoma (Breslow index > 1 mm) than those in the lowest tertiles of these sleep attributes after adjustment for age, sex, tumor location, and BMI. This association was particularly prominent among patients < 56 years of age with Breslow index > 2 mm. The presence of the additional markers of aggressiveness was also associated with higher AHI and DI4% values. CONCLUSIONS The severity of SDB was independently associated with greater aggressiveness of cutaneous melanoma, particularly among younger patients.
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Affiliation(s)
| | | | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | | | | | | - Luis Hernandez
- Respiratory Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Jose Bañuls
- Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Eva Arias
- Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pablo Ortiz
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Valentin Cabriada
- Respiratory Department, Hospital Universitario Cruces de Bilbao, Bilbao, Spain
| | - Jose Gardeazabal
- Dermatology Department, Hospital Universitario Cruces de Bilbao, Bilbao, Spain
| | - Josep Maria Montserrat
- Respiratory Department, Hospital Clinic-IDIBAPS, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Cristina Carrera
- Dermatology Department, Hospital Clinic-IDIBAPS, Barcelona, Spain
| | - Jaime Corral
- Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Juan Fernando Masa
- Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Javier Gomez de Terreros
- Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Jorge Abad
- Respiratory Department, Hospital Universitario Germans Trials I Pujol, Barcelona, Spain
| | - Adam Boada
- Dermatology Department, Hospital Universitario Germans Trials I Pujol, Barcelona, Spain
| | - Olga Mediano
- Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Esther de Eusebio
- Dermatology Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Eusebi Chiner
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Pedro Landete
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Mercedes Mayos
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Ana Fortuño
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Ferrán Barbé
- Respiratory Department, IRBLleida, Lleida, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Manuel Sánchez de la Torre
- Respiratory Department, IRBLleida, Lleida, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Alicia Sanchez de la Torre
- Respiratory Department, IRBLleida, Lleida, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Irene Cano
- Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain
| | - Cristina Gonzalez
- Dermatology Department, Hospital Universitario de Getafe, Madrid, Spain
| | | | - Teresa Gómez-García
- Respiratory Department, Fundación Jimenez Diaz, Madrid, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Daniela Cullen
- Dermatology Department, Fundación Jimenez Diaz, Madrid, Spain
| | - Maria Somoza
- Respiratory Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | - Manuel Formigón
- Dermatology Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | - Felipe Aizpuru
- Biostatistical Service, BioAraba, Health Research Institute, OSI Araba University Hospital, Basque Health Service, University of the Basque Country, Bilbao, Spain
| | - Cristina Navarro
- Respiratory Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | | | - Blanca de Unamuno
- Dermatology Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain, and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Ramón Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain, and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - David Gozal
- Department of Pediatrics, University of Chicago, Chicago, IL
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Campos-Rodriguez F, Cruz-Medina A, Selma MJ, Rodriguez-de-la-Borbolla-Artacho M, Sanchez-Vega A, Ripoll-Orts F, Almeida-Gonzalez CV, Martinez-Garcia MA. Association between sleep-disordered breathing and breast cancer aggressiveness. PLoS One 2018; 13:e0207591. [PMID: 30462710 PMCID: PMC6248981 DOI: 10.1371/journal.pone.0207591] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/03/2018] [Indexed: 12/18/2022] Open
Abstract
Background Sleep-disordered breathing (SDB) has been associated with cancer aggressiveness, but studies focused on specific tumors are lacking. In this pilot study we investigated whether SDB is associated with breast cancer (BC) aggressiveness. Methods 83 consecutive women <65 years diagnosed with primary BC underwent a home respiratory polygraphy. Markers of SDB severity included the apnea-hypopnea index (AHI) and the 4% oxygen desaturation index (ODI4). The Ki67 proliferation index, lack of hormone receptors (HR-), Nottingham Histological Grade (NHG), and tumor stage were used as markers of BC aggressiveness. The association between SDB and molecular subtypes of BC was also assessed. Results The mean (SD) age was 48.8 (8.8) years and body mass index was 27.4 (5.4) Kg/m2. 42 women (50.6%) were post-menopausal. The median (IQR) AHI was 5.1 (2–9.4), and ODI4 was 1.5 (0.5–5.8). The median (IQR) AHI did not differ between the groups with Ki67>28% and Ki67<29% [5.1 (2.6–8.3) vs 5.0 (1.5–10), p = 0.89)], HR- and HR+ [5.7 (1.6–12.4) vs 4.9 (2–9.4), p = 0.68], NHG (Grade3, Grade2, and Grade1; p = 0.86), tumor stage (stage III-IV, stage II, and stage I; p = 0.62), or molecular subtypes (Luminal A, Luminal B, HER2, and triple negative; p = 0.90). The prevalence of an AHI≥5 did not differ between the groups with Ki67>28% and Ki67<29% (51.2% vs 52.3%, p = 0.90), HR- and HR+ (58.3% vs 49.1%, p = 0.47), NHG categories (p = 0.89), different tumor stages (p = 0.71), or molecular subtypes (p = 0.73). These results did not change when the ODI4 was used instead of the AHI. Conclusion Our results do not support an association between the presence or severity of SDB and BC aggressiveness.
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Affiliation(s)
- Francisco Campos-Rodriguez
- Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBIS), Universidad de Sevilla, Sevilla, Spain
- CIBERES. Instituto de Salud Carlos III. Madrid, Spain
- * E-mail:
| | | | - Maria Jose Selma
- Respiratory Department, Hospital Universitario y Politécnico La Fé, Valencia, Spain
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Lacedonia D, Scioscia G, Pia Palladino G, Gallo C, Carpagnano GE, Sabato R, Foschino Barbaro MP. MicroRNA expression profile during different conditions of hypoxia. Oncotarget 2018; 9:35114-35122. [PMID: 30416683 PMCID: PMC6205556 DOI: 10.18632/oncotarget.26210] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/21/2018] [Indexed: 02/05/2023] Open
Abstract
Introduction MicroRNAs (miRNAs) are small non coding RNAs which play a role in several cellular processes. MiRNA expression is influenced by oxidative stress, inflammatory cascade and hypoxia. Effects of different types of hypoxia (intermittent and chronic) have been poorly investigated. The aim of this study was to evaluate how intermittent and chronic hypoxia influence the expression of a pool of miRNAs. Results Subjects with HI presented higher levels of miR-21, miR-23b, miR-145 and miR-210 compared to the other groups, while higher levels of miR-26 was observed in the HC group. Subjects with HCHI had lower levels of all selected miRNAs. A strong correlation was found between miR-23b and miR-210 and both correlated with PaO2, age and FEV1. MiR-145 is correlated with miR-21 but no correlations were found with other parameters. The level of miR-26a seems to be correlated only with BMI. Materials and Methods We used RT-PCR to detect the miRNAs expression in three different models of hypoxemia: intermittent (HI), chronic (HC) and both of them (HCHI). Expression of miRNAs was analyzed using ANOVA and post hoc analysis, moreover, Spearman correlation and Cluster analysis were applied to study the relationship between miRNAs and main clinical parameters. Conclusions Intermittent hypoxia induces the expression of some miRNAs more than chronic hypoxia. These miRNAs may play an important role in the development of different diseases usually associated with OSA such as cardiovascular disease. In addition, mechanisms involved in cancer progression may be induced in the presence of chronic and more often intermittent hypoxia.
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Affiliation(s)
- Donato Lacedonia
- Department of Medical and Surgical Sciences, University of Foggia, Policlinico "OO. Riuniti", Foggia, Italy
| | - Giulia Scioscia
- Department of Medical and Surgical Sciences, University of Foggia, Policlinico "OO. Riuniti", Foggia, Italy
| | - Grazia Pia Palladino
- Department of Medical and Surgical Sciences, University of Foggia, Policlinico "OO. Riuniti", Foggia, Italy
| | - Crescenzio Gallo
- Department of Clinical and Experimental Medicine, University of Foggia, Policlinico "OO. Riuniti", Foggia, Italy
| | | | - Roberto Sabato
- Department of Medical and Surgical Sciences, University of Foggia, Policlinico "OO. Riuniti", Foggia, Italy
| | - Maria Pia Foschino Barbaro
- Department of Medical and Surgical Sciences, University of Foggia, Policlinico "OO. Riuniti", Foggia, Italy
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Sillah A, Watson NF, Schwartz SM, Gozal D, Phipps AI. Sleep apnea and subsequent cancer incidence. Cancer Causes Control 2018; 29:987-994. [PMID: 30120643 DOI: 10.1007/s10552-018-1073-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/12/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE In vitro and animal models suggest that the physiological effects of sleep apnea could contribute to cancer risk, yet epidemiologic studies have been inconsistent. METHODS We identified a cohort of adults diagnosed with sleep apnea between 2005 and 2014 using regional administrative databases. Linking this cohort to a population-based cancer registry, we identified first incident cancers diagnosed after sleep apnea diagnosis through 2015. We calculated age-sex standardized cancer incidence ratios (SIRs) to compare the observed number of cancers among those with sleep apnea with expected population estimates over a comparable period. RESULTS Among 34,402 individuals with sleep apnea, 1,575 first incident cancers were diagnosed during follow-up (mean ± SD; 5.3 ± 2.0 years). Compared to the general population, cancer incidence (SIR 1.26, 95% CI 1.20-1.32) was elevated among sleep apnea patients. We observed significantly elevated incidence for kidney (SIR 2.24, 95% CI 1.82-2.72), melanoma (SIR 1.71, 95% CI 1.42-2.03), breast (SIR 1.43, 95% CI 1.76-2.00), and corpus uteri (SIR 2.80, 95% CI 2.24-2.47) while risk for lung (SIR 0.66, 95% CI 0.54-0.79) and colorectal cancer (SIR 0.71, 95% CI 0.56-0.89) was lower. CONCLUSION These findings suggest an elevated cancer burden, particularly at certain sites, among individuals with diagnosed sleep apnea. Results should be interpreted with caution due to unmeasured confounders (e.g., BMI, diabetes).
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Affiliation(s)
- Arthur Sillah
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA. .,Epidemiology Program, Fred Hutchinson Research Cancer Research Center, Seattle, WA, USA.
| | - Nathaniel F Watson
- Department of Neurology, University of Washington Medicine Sleep Center, University of Washington School of Medicine, Seattle, WA, USA
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.,Epidemiology Program, Fred Hutchinson Research Cancer Research Center, Seattle, WA, USA
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO, USA
| | - Amanda I Phipps
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.,Epidemiology Program, Fred Hutchinson Research Cancer Research Center, Seattle, WA, USA
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