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Iordache MM, Belu AM, Vlad SE, Aivaz KA, Dumitru A, Tocia C, Dumitru E. Calprotectin, Biomarker of Depression in Patients with Inflammatory Bowel Disease? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1240. [PMID: 37512053 PMCID: PMC10383955 DOI: 10.3390/medicina59071240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Calprotectin is a marker for intestinal inflammation. Recent research suggests a link between inflammation and depression. This study assessed the association between the levels of calprotectin in patients from South-Eastern Europe and the severity of depression, anxiety, and quality of life. Materials and Methods: This cross-sectional study included 30 confirmed patients with Crohn's disease (CD) and ulcerative colitis (UC) who were assessed using clinical interviews for determining the severities of mental disorders (i.e., depression severity-PHQ-9, anxiety-GAD-7) and the quality of life (EQ-5D). Stool samples were collected from all participants for measuring their levels of calprotectin. Results: The level of calprotectin is correlated with PHQ-9 (ρ = 0.416, p = 0.022) and EQ-5D (ρ = -0.304, p = 0.033) but not with GAD 7 (ρ = 0.059, p = 0.379). Calprotectin levels in patients with mild, moderate, and moderately severe depression were significantly higher than in patients with minimal depression (198 µg/g vs. 66,9 µg/g, p = 0.04). Calprotectin level was corelated with the following depressive symptoms: autolytic ideation (ρ = 0.557, p = 0.001), fatigue (ρ = 0.514, p = 0.002), slow movement (ρ = 0.490, p = 0.003), and sleep disorders (ρ = 0.403, p = 0.014). Calprotectin was an independent predictor of depression with an odds ratio of 1.01 (95%: 1.002-1.03, p < 0.01). An ROC analysis showed that a level of calprotectin of 131 µg/g or higher has a sensitivity of 82%, a specificity of 61%, and an accuracy of 70% for predicting depression. In this study, no significant correlations were found between calprotectin level and anxiety. Conclusions: Calprotectin levels are associated with the severity of depression, and checking for a calprotectin level of 131 µg/g or higher may be a potential accessible screening test for depression in patients with inflammatory bowel disease.
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Affiliation(s)
- Miorita Melina Iordache
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Alley, 900470 Constanta, Romania
- Prof. Alexandru Obregia Psychiatry Hospital, 10 Berceni Str., 041914 Bucharest, Romania
| | - Anca Mihaela Belu
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Alley, 900470 Constanta, Romania
- "St. Apostol Andrew" Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania
| | - Sabina E Vlad
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanta, 900591 Constanta, Romania
| | - Kamer Ainur Aivaz
- Faculty of Economics, Ovidius University of Constanta, 1 Universitatii Street, 900470 Constanta, Romania
| | - Andrei Dumitru
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Alley, 900470 Constanta, Romania
- "St. Apostol Andrew" Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania
| | - Cristina Tocia
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Alley, 900470 Constanta, Romania
- "St. Apostol Andrew" Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania
| | - Eugen Dumitru
- Faculty of Medicine, Ovidius University of Constanta, 1 Universitatii Alley, 900470 Constanta, Romania
- "St. Apostol Andrew" Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology-CEDMOG, "Ovidius" University of Constanta, 900591 Constanta, Romania
- Academy of Romanian Scientists, 3 Ilfov Street, 050045 Bucharest, Romania
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Meszaros M, Bikov A. Obstructive Sleep Apnoea and Lipid Metabolism: The Summary of Evidence and Future Perspectives in the Pathophysiology of OSA-Associated Dyslipidaemia. Biomedicines 2022; 10:2754. [PMID: 36359273 PMCID: PMC9687681 DOI: 10.3390/biomedicines10112754] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 09/29/2023] Open
Abstract
Obstructive sleep apnoea (OSA) is associated with cardiovascular and metabolic comorbidities, including hypertension, dyslipidaemia, insulin resistance and atherosclerosis. Strong evidence suggests that OSA is associated with an altered lipid profile including elevated levels of triglyceride-rich lipoproteins and decreased levels of high-density lipoprotein (HDL). Intermittent hypoxia; sleep fragmentation; and consequential surges in the sympathetic activity, enhanced oxidative stress and systemic inflammation are the postulated mechanisms leading to metabolic alterations in OSA. Although the exact mechanisms of OSA-associated dyslipidaemia have not been fully elucidated, three main points have been found to be impaired: activated lipolysis in the adipose tissue, decreased lipid clearance from the circulation and accelerated de novo lipid synthesis. This is further complicated by the oxidisation of atherogenic lipoproteins, adipose tissue dysfunction, hormonal changes, and the reduced function of HDL particles in OSA. In this comprehensive review, we summarise and critically evaluate the current evidence about the possible mechanisms involved in OSA-associated dyslipidaemia.
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Affiliation(s)
- Martina Meszaros
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, 8091 Zurich, Switzerland
- Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
| | - Andras Bikov
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester M13 9MT, UK
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Kotsiou OS, Papagiannis D, Papadopoulou R, Gourgoulianis KI. Calprotectin in Lung Diseases. Int J Mol Sci 2021; 22:ijms22041706. [PMID: 33567747 PMCID: PMC7915440 DOI: 10.3390/ijms22041706] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 12/14/2022] Open
Abstract
Calprotectin (CLP) is a heterodimer formed by two S-100 calcium-binding cytosolic proteins, S100A8 and S100A9. It is a multifunctional protein expressed mainly by neutrophils and released extracellularly by activated or damaged cells mediating a broad range of physiological and pathological responses. It has been more than 20 years since the implication of S100A8/A9 in the inflammatory process was shown; however, the evaluation of its role in the pathogenesis of respiratory diseases or its usefulness as a biomarker for the appropriate diagnosis and prognosis of lung diseases have only gained attention in recent years. This review aimed to provide current knowledge regarding the potential role of CLP in the pathophysiology of lung diseases and describe how this knowledge is, up until now, translated into daily clinical practice. CLP is involved in numerous cellular processes in lung health and disease. In addition to its anti-microbial functions, CLP also serves as a molecule with pro- and anti-tumor properties related to cell survival and growth, angiogenesis, DNA damage response, and the remodeling of the extracellular matrix. The findings of this review potentially introduce CLP in daily clinical practice within the spectrum of respiratory diseases.
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Affiliation(s)
- Ourania S. Kotsiou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
- Department of Nursing, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
- Correspondence:
| | - Dimitrios Papagiannis
- Department of Nursing, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Rodanthi Papadopoulou
- Human Nutrition, School of Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER, UK;
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Yurtsever Kum N, Kum RO, Candar T, Baklaci D, Guler I, Kuzucu I, Ozcan KM, Ozcan M, Dere H. Elevated serum calprotectin as an inflammatory marker in obstructive sleep apnea. Cranio 2020; 41:160-166. [PMID: 33084533 DOI: 10.1080/08869634.2020.1839721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the serum calprotectin (SCal) levels and neutrophil/lymphocyte ratio (NLR) values in patients with obstructive sleep apnea (OSA). METHODS Sixty-seven OSA patients and 46 healthy volunteers without any sleep disorders were included in the study. The patient group was divided into three subgroups according to the severity of OSA. The SCal levels and NLR values were compared among subgroups and between the experimental and control groups. RESULTS The mean SCal level and NLR value were higher in the study group than in the control group (p = 0.002 and p = 0.001, respectively). The SCal levels were significantly higher in patients with severe OSA than in those with moderate and mild OSA (p = 0.004 and p = 0.001, respectively). DISCUSSION Unlike NLR, the SCal level may inform the severity of OSA and could be used as an indicator for OSA.
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Affiliation(s)
- Nurcan Yurtsever Kum
- Department of Otolaryngology, Ankara Sehir Hospital (Formerly Ankara Numune Education and Research Hospital), Ankara, Turkey
| | - Rauf Oguzhan Kum
- Department of Otolaryngology, Ankara Sehir Hospital (Formerly Ankara Numune Education and Research Hospital), Ankara, Turkey
| | - Tuba Candar
- Department of Biochemistry, Ufuk University, Ankara, Turkey
| | - Deniz Baklaci
- ENT Clinic, Kahramankazan State Hospital, Ankara, Turkey
| | - Ismail Guler
- Department of Otolaryngology, Ankara Medipol University, Ankara, Turkey
| | - Ihsan Kuzucu
- ENT Clinic, Medisun Cayyolu Hospital, Ankara, Turkey
| | - Kursat Murat Ozcan
- Department of Otolaryngology, Ankara Sehir Hospital (Formerly Ankara Numune Education and Research Hospital), Ankara, Turkey
| | - Muge Ozcan
- Department of Otolaryngology, Ankara Sehir Hospital (Formerly Ankara Numune Education and Research Hospital), Ankara, Turkey
| | - Huseyin Dere
- Department of Otolaryngology, Ankara Sehir Hospital (Formerly Ankara Numune Education and Research Hospital), Ankara, Turkey.,Department of Otolaryngology, Yıldırım Beyazıt University, Ankara, Turkey
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Torun MT, Ünver E, Yalçın Y, Kanmaz L, Seçkin E. The importance of calprotectin levels in obstructive sleep apnea syndrome severity. Curr Med Res Opin 2018; 34:401-405. [PMID: 28933970 DOI: 10.1080/03007995.2017.1383890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is mostly seen in adult populations. It is known that increased levels of several inflammatory mediators play roles in OSAS and related comorbidities. Calprotectin is an inflammatory mediator that increases in some diseases such as Behçet's syndrome, bowel diseases and cardiovascular and cerebrovascular diseases. AIMS The purpose of this study was to investigate whether calprotectin can be used as a biomarker in OSAS by determining the relation between serum calprotectin levels and OSAS severity. STUDY DESIGN Cohort study. METHODS A prospective study was planned. Eighty-three patients undergoing polysomnography were included in the study and evaluated prospectively. Thirty patients were classified as non-OSAS (group 1), 18 as mild OSAS (group 2), 15 as moderate OSAS (group 3) and 20 as severe OSAS (group 4). Calprotectin values were measured in the non-OSAS patients (group 1) and in the patients with OSAS (groups 2, 3 and 4). The OSAS groups were also compared with each other. RESULTS Serum calprotectin values ranged between 70.61 and 1468.04 ng/ml. No significant difference in calprotectin levels was found between the OSAS and normal groups. However, statistically significantly increased calprotectin values were determined in the severe OSAS group (group 4) when all groups were compared. CONCLUSION Calprotectin values were elevated in OSAS patients and it can be used as a marker of severe OSAS. Future studies can support our study.
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Affiliation(s)
- Mümtaz Taner Torun
- a Department of Otorhinolaryngology, Head and Neck Surgery , Bandırma State Hospital , Bandırma , Balıkesir , Turkey
| | - Ethem Ünver
- b Department of Chest Diseases , Erzincan University , Erzincan , Turkey
| | - Yusuf Yalçın
- c Department of Otorhinolaryngology, Head and Neck Surgery , Soma Fer Hospital , Soma , Manisa , Turkey
| | - Lutfi Kanmaz
- d Department of Otorhinolaryngology, Head and Neck Surgery , Erzincan University , Erzincan , Turkey
| | - Ender Seçkin
- d Department of Otorhinolaryngology, Head and Neck Surgery , Erzincan University , Erzincan , Turkey
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Riad E, Nasser M, Hussein MH, Toraih EA, Fawzy MS. Serum S100B: A possible biomarker for severity of obstructive sleep apnea. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2017. [DOI: 10.1016/j.ejcdt.2017.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Feliciano A, Oliveira MJ, Cysneiros A, Martinho C, Reis RP, Penque D, Pinto P, Bárbara C. Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apnea. REVISTA PORTUGUESA DE PNEUMOLOGIA 2017; 23:193-202. [PMID: 28596012 DOI: 10.1016/j.rppnen.2017.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/02/2017] [Accepted: 02/25/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular/metabolic complications. Some analytical parameters (homocysteine, glycemic and lipidic profiles) are recognized markers of these consequences. Limited data is available on the association of these markers and OSAS's severity/response to positive airway pressure therapy (PAP). MATERIAL AND METHODS In this prospective study we analyzed polysomnographic and analytical data of male patients admitted to sleep laboratory. The aim was to evaluate metabolic/cardiovascular markers in snorers and OSAS patients, to relate with sleep parameters and PAP response. One-hundred and three patients were included, and 73 (71%) were OSAS patients. OSAS patients were similar to snorers except for higher body mass index (BMI) and dyslipidemia. Severe OSAS patients showed higher glycemia, HbA1c, insulin, and insulin resistance, and lower HDL cholesterol in comparison to mild-moderate (p<0.05, p<0.05, p<0.001, p<0.001, p<0.05, respectively). Glycemic profile and triglycerides were slightly correlated with OSAS severity. 46 OSAS patients were submitted to 6 months of PAP, with a statistical decrease in mean values of homocysteine, glycemia, total and LDL cholesterol (p<0.05, p<0.05, p<0.05, respectively), and in glycemia and LDL cholesterol in severe group only (p<0.05, p<0.05, respectively). RESULTS This study demonstrated an association between glucose metabolism parameters and triglycerides with OSAS severity underlying the complexity of the process leading to cardiovascular/metabolic complications in this disorder. Moreover, homocysteine, glycemic and lipidic profiles changed significantly after 6 months of PAP therapy in OSAS, supporting its cardiovascular and metabolic protective effect. CONCLUSION Our study has reinforced the importance of analytical cardiovascular/metabolic evaluation as complementary tool of diagnosis/treatment response in OSAS.
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Affiliation(s)
- A Feliciano
- Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - M J Oliveira
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - A Cysneiros
- Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - C Martinho
- Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - R P Reis
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal; Cardiology Unit, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - D Penque
- Proteomics Laboratory, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
| | - P Pinto
- Sleep and Non Invasive Ventilation Unit, Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - C Bárbara
- Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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Kiernan EA, Smith SMC, Mitchell GS, Watters JJ. Mechanisms of microglial activation in models of inflammation and hypoxia: Implications for chronic intermittent hypoxia. J Physiol 2017; 594:1563-77. [PMID: 26890698 DOI: 10.1113/jp271502] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 01/16/2016] [Indexed: 12/12/2022] Open
Abstract
Chronic intermittent hypoxia (CIH) is a hallmark of sleep apnoea, a condition associated with diverse clinical disorders. CIH and sleep apnoea are characterized by increased reactive oxygen species formation, peripheral and CNS inflammation, neuronal death and neurocognitive deficits. Few studies have examined the role of microglia, the resident CNS immune cells, in models of CIH. Thus, little is known concerning their direct contributions to neuropathology or the cellular mechanisms regulating their activities during or following pathological CIH. In this review, we identify gaps in knowledge regarding CIH-induced microglial activation, and propose mechanisms based on data from related models of hypoxia and/or hypoxia-reoxygenation. CIH may directly affect microglia, or may have indirect effects via the periphery or other CNS cells. Peripheral inflammation may indirectly activate microglia via entry of pro-inflammatory molecules into the CNS, and/or activation of vagal afferents that trigger CNS inflammation. CIH-induced release of damage-associated molecular patterns from injured CNS cells may also activate microglia via interactions with pattern recognition receptors expressed on microglia. For example, Toll-like receptors activate mitogen-activated protein kinase/transcription factor pathways required for microglial inflammatory gene expression. Although epigenetic effects from CIH have not yet been studied in microglia, potential epigenetic mechanisms in microglial regulation are discussed, including microRNAs, histone modifications and DNA methylation. Epigenetic effects can occur during CIH, or long after it has ended. A better understanding of CIH effects on microglial activities may be important to reverse CIH-induced neuropathology in patients with sleep disordered breathing.
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Affiliation(s)
- Elizabeth A Kiernan
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Stephanie M C Smith
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Gordon S Mitchell
- Department of Physical Therapy, University of Florida, Gainesville, FL, 32610, USA
| | - Jyoti J Watters
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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Ohlsson B, Darwiche G, Roth B, Höglund P. Two meals with different carbohydrate, fat and protein contents render equivalent postprandial plasma levels of calprotectin, cortisol, triglycerides and zonulin. Int J Food Sci Nutr 2016; 67:872-80. [PMID: 27354090 DOI: 10.1080/09637486.2016.1202214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim was to compare postprandial plasma levels of calprotectin, cortisol, triglycerides and zonulin between a control breakfast and a moderately low-carbohydrate test breakfast, given randomly after 10-h fast. Blood samples were collected before and repeatedly after the meal. Plasma calprotectin, cortisol, triglycerides and zonulin were analyzed. The total area under the curve (tAUC) and change in AUC from baseline (dAUC) were calculated. Ratios between the test and control values were calculated to investigate equivalence. Healthy volunteers (8 men and 12 women; 46.0 ± 14.5 years) were included. tAUCs of cortisol and triglycerides did not differ between the breakfasts (p = 0.158 versus p = 0.579). Cortisol dAUCs were decreased and triglyceride dAUCs were increased after both breakfasts, with no differences between the breakfasts (p = 0.933 versus p = 0.277). Calprotectin and zonulin levels were unaffected. The meals were bioequivalent for cortisol, triglycerides and zonulin, but not for calprotectin.
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Affiliation(s)
- Bodil Ohlsson
- a Department of Internal Medicine , Lund University, Skane University Hospital , Malmö , Sweden
| | - Gassan Darwiche
- a Department of Internal Medicine , Lund University, Skane University Hospital , Malmö , Sweden
| | - Bodil Roth
- a Department of Internal Medicine , Lund University, Skane University Hospital , Malmö , Sweden
| | - Peter Höglund
- b Department of Laboratory Medicine, Division of Clinical Chemistry & Pharmacology , Lund University, Skane University Hospital , Lund , Sweden
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Barros AF, Borges NA, Ferreira DC, Carmo FL, Rosado AS, Fouque D, Mafra D. Is there interaction between gut microbial profile and cardiovascular risk in chronic kidney disease patients? Future Microbiol 2016; 10:517-26. [PMID: 25865191 DOI: 10.2217/fmb.14.140] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIM To evaluate the gut microbial profile in chronic kidney disease (CKD) patients and evaluate the possible relationship with inflammation and cardiovascular risk. PATIENTS & METHODS Markers inflammation plasma and bacterial community profile (denaturing gradient gel electrophoresis) were analyzed. RESULTS The average number of bands was not different in healthy individuals and CKD patients. The number of bands was negatively associated with plasma levels of VCAM-1 in patients. Flavobacteriaceae bacterium and Listeria monocytogenes were found in patients and Lachnospiraceae bacterium and Butyrivibrio crossotus in healthy individuals. CONCLUSION Although CKD patients did not present altered gut microbial profile, the sequencing of bands suggested a different microbiota between groups. The result suggests a possible relationship between gut microbiota and cardiovascular risk in CKD patients.
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Affiliation(s)
- Amanda F Barros
- Cardiovascular Sciences Graduate Program, Federal University Fluminense (UFF), Niterói-RJ, Brazil
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Frasnelli M, Baty F, Niedermann J, Brutsche MH, Schoch OD. Effect of telemetric monitoring in the first 30 days of continuous positive airway pressure adaptation for obstructive sleep apnoea syndrome – a controlled pilot study. J Telemed Telecare 2015; 22:209-14. [DOI: 10.1177/1357633x15598053] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/07/2015] [Indexed: 11/16/2022]
Abstract
Obstructive sleep apnoea syndrome (OSAS) is characterised by repetitive collapse of the upper airway during sleep. Continuous positive airway pressure (CPAP) applied via a mask is the standard treatment for OSAS. CPAP adherence is crucial in therapy to prevent the deleterious consequences of OSAS. We hypothesised that a combination of supervision by telemetry together with targeted telephone support in the first month of CPAP would increase CPAP adherence and treatment success. A total of 113 OSAS patients followed by telemetry-triggered interventions used the device for 5.3 h/night on 28/30 nights, significantly more than the 110 OSAS patients in the control group with 4.6 h/night and 27/30 nights. Telemetry-triggered interventions have a significant impact on adherence rate in early CPAP treatment. These results can be reached with an acceptable additional effort.
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Affiliation(s)
- Matthias Frasnelli
- Klinik für Pneumologie und Schlafmedizin, Zentrum für Schlafmedizin, Kantonsspital St Gallen, Switzerland
| | - Florent Baty
- Klinik für Pneumologie und Schlafmedizin, Zentrum für Schlafmedizin, Kantonsspital St Gallen, Switzerland
| | - Jolanda Niedermann
- Klinik für Pneumologie und Schlafmedizin, Zentrum für Schlafmedizin, Kantonsspital St Gallen, Switzerland
| | - Martin H Brutsche
- Klinik für Pneumologie und Schlafmedizin, Zentrum für Schlafmedizin, Kantonsspital St Gallen, Switzerland
| | - Otto D Schoch
- Klinik für Pneumologie und Schlafmedizin, Zentrum für Schlafmedizin, Kantonsspital St Gallen, Switzerland
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De Luca Canto G, Pachêco-Pereira C, Aydinoz S, Major PW, Flores-Mir C, Gozal D. Biomarkers associated with obstructive sleep apnea and morbidities: a scoping review. Sleep Med 2015; 16:347-57. [PMID: 25747333 DOI: 10.1016/j.sleep.2014.12.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/16/2014] [Accepted: 12/27/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To map potential biomarkers of obstructive sleep apnea (OSA)-associated morbidities in both adults and children, to identify gaps in current evidence, and to determine the value of conducting a full systematic review. METHODS A scoping review was undertaken of studies in patients with OSA that evaluated the potential value of biological markers in identifying OSA-associated morbidities. Retained articles were only those studies whose main objective was to identify morbidity biomarkers in subjects with OSA, the latter being confirmed with a full overnight polysomnography (PSG) in a laboratory or at-home settings. The methodology of the selected studies was classified using an adaptation of the evidence quality criteria recommended by the American Academy of Pediatrics. Additionally the biomarkers were categorized according to their potential clinical applicability. RESULTS 572 citations were identified of which 48 met inclusion criteria. Thirty-four studies were conducted in adults and 14 involved children. Most of the studies evaluated blood biomarkers, and presented 31 potential diagnostic biomarkers. CONCLUSION The majority of studies that performed explored blood-based biomarkers, with most not identifying definitive morbidity biomarkers. Of the potentially promising morbidity biomarkers, plasma IL-6 and high sensitivity C-reactive protein appear to exhibit a favorable profile, and may discriminate OSA patients with and without morbidities in both adults and children. MRP 8/14 was retained in children as well as cardiovascular morbidity-associated biomarker. Urinary neurotransmitters may also provide a good tool for screening OSA cognitive morbidity in children.
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Affiliation(s)
- Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil; School of Dentistry, Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Camila Pachêco-Pereira
- School of Dentistry, Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Secil Aydinoz
- GATA Haydarpasa Teaching Hospital, Istanbul, Turkey; Section of Pediatric Sleep Medicine, Department of Pediatrics, The University of Chicago, USA
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, 5721 S. Maryland Avenue, MC 8000, Suite K-160, Chicago, IL 60637, USA.
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De Luca Canto G, Pachêco-Pereira C, Aydinoz S, Major PW, Flores-Mir C, Gozal D. Diagnostic capability of biological markers in assessment of obstructive sleep apnea: a systematic review and meta-analysis. J Clin Sleep Med 2015; 11:27-36. [PMID: 25325575 DOI: 10.5664/jcsm.4358] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/11/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The purpose of this systematic review is to evaluate the diagnostic value of biological markers (exhaled breath condensate, blood, salivary and urinary) in the diagnosis of OSA in comparison to the gold standard of nocturnal PSG. METHODS Studies that differentiated OSA from controls based on PSG results, without age restriction, were eligible for inclusion. The sample of selected studies could include studies in obese patients and with known cardiac disease. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed, and LILACS. The references cited in these articles were also crosschecked and a partial grey literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. RESULTS After a two-step selection process, nine articles were identified and subjected to qualitative and quantitative analyses. Among them, only one study conducted in children and one in adults found biomarkers that exhibit sufficiently satisfactory diagnostic accuracy that enables application as a diagnostic method for OSA. CONCLUSION Kallikrein-1, uromodulin, urocotin-3, and orosomucoid-1 when combined have enough accuracy to be an OSA diagnostic test in children. IL-6 and IL-10 plasma levels have potential to be good biomarkers in identifying or excluding the presence of OSA in adults.
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Affiliation(s)
- Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil.,School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | | | - Secil Aydinoz
- GATA Haydarpasa Teaching Hospital, Istanbul, Turkey.,Department of Pediatrics, University of Chicago, Chicago, IL
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - David Gozal
- Department of Pediatrics, University of Chicago, Chicago, IL
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Nadeem R, Singh M, Nida M, Kwon S, Sajid H, Witkowski J, Pahomov E, Shah K, Park W, Champeau D. Effect of CPAP treatment for obstructive sleep apnea hypopnea syndrome on lipid profile: a meta-regression analysis. J Clin Sleep Med 2014; 10:1295-302. [PMID: 25325596 DOI: 10.5664/jcsm.4282] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/21/2014] [Indexed: 01/05/2023]
Abstract
STUDY OBJECTIVE Patients with obstructive sleep apnea (OSA) frequently exhibit higher rates of dyslipidemia, a risk factor for cardiovascular and cerebrovascular disorders. Treatment for OSA by CPAP may improve cholesterol metabolism. This meta-regression analysis (MA) estimates the effect of CPAP treatment on dyslipidemia. METHODS PubMed and Cochrane libraries were searched by utilizing different combinations of keywords: CPAP, obstructive sleep apnea, serum lipids, dyslipidemia, cholesterol, total cholesterol (TC), low density lipoprotein, LDL, high density lipoprotein, HDL, triglyceride, and TG. Inclusion criteria were: (1) English articles and (2) studies with an adult population with the diagnosis of OSA who were treated with CPAP. The OSA group must have cholesterol profile including TC, LDLc, HDLc, and TG, without and with CPAP treatment. Fifty-four studies were reviewed, while 29 studies pooled for MA. RESULTS Thirty-four datasets from 29 studies with 1,958 subjects pooled. Treatment duration range was from 2 days to 1 year. TC standardized mean differences (SMD) ranged from -41.5 to -0.077, pooled mean difference (PMD) was -5.660 (LL -6.715 to UL -4.606, p < 0.001). SMD in LDL ranged from -3.7 to 0; PMD was -0.488 (LL -0.715 to UL -0.261, p < 0.001). HDL SMD ranged from -0.498 to 1.94. The PMD was 0.207 (LL 0.05 to UL 0.364, p < 0.01). TG SMD ranged from -9.327 to 1.98; PMD was -0.054 (LL -0.124 to UL 0.016, p < 0.129). CONCLUSIONS CPAP treatment for OSA seems to improve dyslipidemia (decrease in total cholesterol and LDL, and increase in HDL). It does not appear to affect TG levels.
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Affiliation(s)
- Rashid Nadeem
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Mukesh Singh
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Mahwish Nida
- Rematul lil Alameen Institute of Cardiology, Lahore, Pakistan
| | - Sarah Kwon
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | | | - Julie Witkowski
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Elizabeth Pahomov
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Kruti Shah
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - William Park
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Dan Champeau
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
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Canto GDL, Pachêco-Pereira C, Aydinoz S, Major PW, Flores-Mir C, Gozal D. Biomarkers associated with obstructive sleep apnea: A scoping review. Sleep Med Rev 2014; 23:28-45. [PMID: 25645128 DOI: 10.1016/j.smrv.2014.11.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 12/31/2022]
Abstract
The overall validity of biomarkers in the diagnosis of obstructive sleep apnea (OSA) remains unclear. We conducted a scoping review to provide assessments of biomarkers characteristics in the context of obstructive sleep apnea (OSA) and to identify gaps in the literature. A scoping review of studies in humans without age restriction that evaluated the potential diagnostic value of biological markers (blood, exhaled breath condensate, salivary, and urinary) in the OSA diagnosis was undertaken. Retained articles were those focused on the identification of biomarkers in subjects with OSA, the latter being confirmed with a full overnight or home-based polysomnography (PSG). Search strategies for six different databases were developed. The methodology of selected studies was classified using an adaptation of the evidence quality criteria from the American Academy of Pediatrics. Additionally the biomarkers were classified according to their potential clinical application. We identified 572 relevant studies, of which 117 met the inclusion criteria. Eighty-two studies were conducted in adults, 34 studies involved children, and one study had a sample composed of both adults and children. Most of the studies evaluated blood biomarkers. Potential diagnostic biomarkers were found in nine pediatric studies and in 58 adults studies. Only nine studies reported sensitivity and specificity, which varied substantially from 43% to 100%, and from 45% to 100%, respectively. Studies in adults have focused on the investigation of IL-6, TNF-α and hsCRP. There was no specific biomarker that was tested by a majority of authors in pediatric studies, and combinatorial urine biomarker approaches have shown preliminary promising results. In adults IL-6 and IL-10 seem to have a favorable potential to become a good biomarker to identify OSA.
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Affiliation(s)
- Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil; School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | | | - Secil Aydinoz
- GATA Haydarpasa Teaching Hospital, Istanbul, Turkey; Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, USA
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, USA; Comer Children's Hospital, USA.
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Kostikas K, Loukides S, Bakakos P. Biomarkers in COPD: Is Mortality the Holy Grail? COPD 2013; 10:557-9. [DOI: 10.3109/15412555.2013.832092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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