1
|
Lavalle S, Masiello E, Iannella G, Magliulo G, Pace A, Lechien JR, Calvo-Henriquez C, Cocuzza S, Parisi FM, Favier V, Bahgat AY, Cammaroto G, La Via L, Gagliano C, Caranti A, Vicini C, Maniaci A. Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review. Life (Basel) 2024; 14:425. [PMID: 38672697 PMCID: PMC11050908 DOI: 10.3390/life14040425] [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: 02/02/2024] [Revised: 03/03/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS), affecting approximately 1 billion adults globally, is characterized by recurrent airway obstruction during sleep, leading to oxygen desaturation, elevated carbon dioxide levels, and disrupted sleep architecture. OSAS significantly impacts quality of life and is associated with increased morbidity and mortality, particularly in the cardiovascular and cognitive domains. The cyclic pattern of intermittent hypoxia in OSAS triggers oxidative stress, contributing to cellular damage. This review explores the intricate relationship between OSAS and oxidative stress, shedding light on molecular mechanisms and potential therapeutic interventions. METHODS A comprehensive review spanning from 2000 to 2023 was conducted using the PubMed, Cochrane, and EMBASE databases. Inclusion criteria encompassed English articles focusing on adults or animals and reporting values for oxidative stress and inflammation biomarkers. RESULTS The review delineates the imbalance between pro-inflammatory and anti-inflammatory factors in OSAS, leading to heightened oxidative stress. Reactive oxygen species biomarkers, nitric oxide, inflammatory cytokines, endothelial dysfunction, and antioxidant defense mechanisms are explored in the context of OSAS. OSAS-related complications include cardiovascular disorders, neurological impairments, metabolic dysfunction, and a potential link to cancer. This review emphasizes the potential of antioxidant therapy as a complementary treatment strategy. CONCLUSIONS Understanding the molecular intricacies of oxidative stress in OSAS is crucial for developing targeted therapeutic interventions. The comprehensive analysis of biomarkers provides insights into the complex interplay between OSAS and systemic complications, offering avenues for future research and therapeutic advancements in this multifaceted sleep disorder.
Collapse
Affiliation(s)
- Salvatore Lavalle
- Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (C.G.)
| | - Edoardo Masiello
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy;
| | - Giannicola Iannella
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.I.); (G.M.); (A.P.)
| | - Giuseppe Magliulo
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.I.); (G.M.); (A.P.)
| | - Annalisa Pace
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.I.); (G.M.); (A.P.)
| | - Jerome Rene Lechien
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, 7022 Mons, Belgium;
| | - Christian Calvo-Henriquez
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, 15705 Santiago de Compostela, Spain;
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (S.C.); (F.M.P.)
| | - Federica Maria Parisi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (S.C.); (F.M.P.)
| | - Valentin Favier
- Service d’ORL et de Chirurgie Cervico-Faciale, Centre Hospitalo-Universitaire de Montpellier, 80 Avenue Augustin Fliche, 34000 Montpellier, France
| | - Ahmed Yassin Bahgat
- Department of Otorhinolaryngology, Alexandria University, Alexandria 21577, Egypt;
| | - Giovanni Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy;
| | - Luigi La Via
- Department of Anaesthesia and Intensive Care, University Hospital Policlinico-San Marco, 95125 Catania, Italy;
| | - Caterina Gagliano
- Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (C.G.)
| | - Alberto Caranti
- ENT and Audiology Department, University of Ferrara, 44121 Ferrara, Italy; (A.C.); (C.V.)
| | - Claudio Vicini
- ENT and Audiology Department, University of Ferrara, 44121 Ferrara, Italy; (A.C.); (C.V.)
| | - Antonino Maniaci
- Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (C.G.)
| |
Collapse
|
2
|
Golshah A, Sadeghi E, Sadeghi M. Association of Tumor Necrosis Factor-Alpha, Interleukin-1β, Interleukin-8, and Interferon-γ with Obstructive Sleep Apnea in Both Children and Adults: A Meta-Analysis of 102 Articles. J Clin Med 2024; 13:1484. [PMID: 38592305 PMCID: PMC10932105 DOI: 10.3390/jcm13051484] [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: 01/31/2024] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Cytokines may have a significant impact on sleep regulation. In this meta-analysis, we present the serum/plasma levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-8, IL-1β, and interferon-gamma (IFN-γ) in both children and adults with obstructive sleep apnea (OSA) in comparison to controls. Methods: Four electronic databases were systematically searched (PubMed, Web of Science, Scopus, and Cochrane Library) through 19 October 2023, without any restrictions on language, date, age, and sex. We used Review Manager version 5.3 to perform meta-analysis and presented the data as standardized mean difference (SMD) and 95% confidence interval (CI) values to evaluate the relationships between the levels of cytokines and OSA. Results: A total of 102 articles (150 independent studies) were included in the meta-analysis. The pooled SMDs in adults were 1.42 (95%CI: 1.11, 1.73; p < 0.00001), 0.85 (95%CI: 0.40, 1.31; p = 0.0002), 0.69 (95%CI: 0.22, 1.16; p = 0.004), and 0.39 (95%CI: -0.37, 1.16; p = 0.31) for TNF-α, IL-8, IL-1β, and IFN-γ, respectively. The pooled SMDs in children were 0.84 (95%CI: 0.35, 1.33; p = 0.0008), 0.60 (95%CI: 0.46, 0.74; p < 0.00001), 0.25 (95%CI: -0.44, 0.93; p = 0.49), and 3.70 (95%CI: 0.75, 6.65; p = 0.01) for TNF-α, IL-8, IL-1β, and IFN-γ, respectively. Conclusions: The levels of proinflammatory cytokines of TNF-α, IL-8, and IL-1β in adults, and TNF-α, IL-8, and IFN-γ in children with OSA, are significantly higher than those in controls.
Collapse
Affiliation(s)
- Amin Golshah
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran;
| | - Edris Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran;
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran;
| |
Collapse
|
3
|
Oxidative Stress and Inflammation Biomarker Expression in Obstructive Sleep Apnea Patients. J Clin Med 2021; 10:jcm10020277. [PMID: 33451164 PMCID: PMC7828672 DOI: 10.3390/jcm10020277] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 02/08/2023] Open
Abstract
Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory sleep disorder characterised by repeated episodes of partial or complete obstruction of the upper airway during the night. This obstruction usually occurs with a reduction (hypopnea) or complete cessation (apnea) of the airflow in the upper airways with the persistence of thoracic-diaphragmatic respiratory movements. During the hypopnea/apnea events, poor alveolar ventilation reduces the oxygen saturation in the arterial blood (SaO2) and a gradual increase in the partial arterial pressure of carbon dioxide (PaCO2). The direct consequence of the intermittent hypoxia is an oxidative imbalance, with reactive oxygen species production and the inflammatory cascade’s activation with pro and anti-inflammatory cytokines growth. Tumour necrosis factors, inflammatory cytokines (IL2, IL4, IL6), lipid peroxidation, and cell-free DNA have been found to increase in OSAS patients. However, even though different risk-related markers have been described and analysed in the literature, it has not yet been clarified whether specified inflammatory bio-markers better correlates with OSAS diagnosis and its clinical evolution/comorbidities. We perform a scientific literature review to discuss inflammatory and oxidative stress biomarkers currently tested in OSAS patients and their correlation with the disease’s severity and treatment.
Collapse
|
4
|
Gaspar LS, Sousa C, Álvaro AR, Cavadas C, Mendes AF. Common risk factors and therapeutic targets in obstructive sleep apnea and osteoarthritis: An unexpectable link? Pharmacol Res 2020; 164:105369. [PMID: 33352231 DOI: 10.1016/j.phrs.2020.105369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/11/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Osteoarthritis (OA) and Obstructive Sleep Apnea (OSA) are two highly prevalent chronic diseases for which effective therapies are urgently needed. Recent epidemiologic studies, although scarce, suggest that the concomitant occurrence of OA and OSA is associated with more severe manifestations of both diseases. Moreover, OA and OSA share risk factors, such as aging and metabolic disturbances, and co-morbidities, including cardiovascular and metabolic diseases, sleep deprivation and depression. Whether this coincidental occurrence is fortuitous or involves cause-effect relationships is unknown. This review aims at collating and integrating present knowledge on both diseases by providing a brief overview of their epidemiology and pathophysiology, analyzing current evidences relating OA and OSA and discussing potential common mechanisms by which they can aggravate each other. Such mechanisms constitute potential therapeutic targets whose pharmacological modulation may provide more efficient ways of reducing the consequences of OA and OSA and, thus, lessen the huge individual and social burden that they impose.
Collapse
Affiliation(s)
- Laetitia S Gaspar
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal; PhD Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Cátia Sousa
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Ana Rita Álvaro
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Cláudia Cavadas
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
| | - Alexandrina Ferreira Mendes
- Centre for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal; Centre for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
| |
Collapse
|
5
|
Mogavero MP, DelRosso LM, Fanfulla F, Bruni O, Ferri R. Sleep disorders and cancer: State of the art and future perspectives. Sleep Med Rev 2020; 56:101409. [PMID: 33333427 DOI: 10.1016/j.smrv.2020.101409] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 12/29/2022]
Abstract
A bidirectional connection between sleep and cancer exists; however, the specific associations between individual sleep disorders and particular tumors are not very clear. An accurate assessment of sleep disorders in cancer patients is necessary to improve patient health, survival, response to therapy, quality of life, reduction of comorbidities/complications. Indeed, recent scientific evidence shows that knowledge and management of sleep disorders offer interesting therapeutic perspectives for the treatment of cancer. In light of this need, the objective of this review is to assess the evidence highlighted in the research of the last ten years on the correlation between each specific category of sleep disorder according to the International Classification of Sleep Disorders 3rd Ed. and several types of tumor based on their anatomical location (head-neck, including the brain and thyroid; lung; breast; ovary; endometrium; testes; prostate; bladder; kidney; gastrointestinal tract, subdivided into: stomach, liver, colon, pancreas; skin; bone tumors; hematological malignancies: leukemia, lymphoma, multiple myeloma, polycythemia), in order to evaluate what is currently known about: 1) sleep disorders as cancer risk factor; 2) tumors associated with the onset of sleep disorders; 3) targeted therapies of sleep disorders in cancer patients and new oncological perspectives following the evaluation of sleep.
Collapse
Affiliation(s)
- Maria Paola Mogavero
- Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia, Pavia 27100, Italy
| | - Lourdes M DelRosso
- Pulmonary and Sleep Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Francesco Fanfulla
- Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia, Pavia 27100, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome 00185, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology I.C., Oasi Research Institute, IRCCS, Troina 94018, Italy.
| |
Collapse
|
6
|
Imani MM, Sadeghi M, Khazaie H, Emami M, Sadeghi Bahmani D, Brand S. Serum and Plasma Tumor Necrosis Factor Alpha Levels in Individuals with Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression. Life (Basel) 2020; 10:E87. [PMID: 32545460 PMCID: PMC7345342 DOI: 10.3390/life10060087] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/02/2020] [Accepted: 06/09/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is associated with a variety of inflammatory factors. Specifically, proinflammatory cytokines appear to be associated with the pathogenesis of OSAS. METHODS For the present meta-analysis and meta-regression on serum and plasma tumor necrosis factor alpha (TNF-α) levels in individuals with and without OSAS, we performed a systematic search without any restrictions of the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases to find relevant articles published up to February 1, 2020. RESULTS Fifty-five (adults: 29 studies on serum and 17 studies on plasma; children: 4 studies on serum and 5 studies on plasma) were included and analyzed. Always compared to age-matched healthy controls, the pooled MDs were as follows: adults, serum: 10.22 pg/mL (95% CI = 8.86, 11.58; p < 0.00001); adults, plasma: 5.90 pg/mL (95% CI = 4.00, 7.80; p < 0.00001); children, serum: 0.21 pg/mL (95% CI = 0.05, 0.37; p = 0.01); children, plasma: 5.90 pg/mL (95% CI = 4.00, 7.80; p < 0.00001). CONCLUSIONS Compared to healthy and age-matched controls, adult individuals with OSAS had significantly higher serum/plasma TNF-α levels. For children with OSAS, significantly higher levels were observed for TNF-α in serum but not in plasma.
Collapse
Affiliation(s)
- Mohammad Moslem Imani
- Department of Orthodontics, Kermanshah University of Medical Sciences, 6713954658 Kermanshah, Iran;
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, 6714415185 Kermanshah, Iran;
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, 6719851115 Kermanshah, Iran; (H.K.); (D.S.B.)
| | - Mehrdad Emami
- Students Research Committee, Kermanshah University of Medical Sciences, 6715847141 Kermanshah, Iran;
| | - Dena Sadeghi Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, 6719851115 Kermanshah, Iran; (H.K.); (D.S.B.)
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4001 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, 6715847141 Kermanshah, Iran
- Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35209, USA
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, 6719851115 Kermanshah, Iran; (H.K.); (D.S.B.)
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4001 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, 6715847141 Kermanshah, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, 1416753955 Tehran, Iran
| |
Collapse
|
7
|
Kis A, Meszaros M, Tarnoki DL, Tarnoki AD, Lazar Z, Horvath P, Kunos L, Bikov A. Exhaled carbon monoxide levels in obstructive sleep apnoea. J Breath Res 2019; 13:036012. [DOI: 10.1088/1752-7163/ab231d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
8
|
Platelet activity is negatively modulated by tumor necrosis factor alpha through reductions of cytosolic calcium levels and integrin alphaIIbbeta3 phosphorylation. Thromb Res 2018; 172:44-50. [PMID: 30359790 DOI: 10.1016/j.thromres.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/12/2018] [Accepted: 10/08/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tumor necrosis factor-alpha (TNF-α) exerts a critical role in inflammatory events through two distinct receptors, TNFR1 and TNFR2. Platelets have been recognized as important inflammatory cells, but little is known about the effects of TNF-α on the platelet activity. OBJECTIVES In the present study we have studied the role of TNF-α on ADP-induced platelet aggregation and its downstream signaling (c-Src and fibrinogen receptor phosphorylation, cytosolic Ca2+ mobilization, cAMP and cGMP levels and cell viability). METHODS AND RESULTS Washed rat platelets were incubated with TNF-α (1-3000 pg/ml) for different time-periods (5-60 min) before the addition of ADP (5 μM) to induce platelet aggregation. TNF-α concentration- and time-dependently inhibits ADP-induced aggregation, which was significantly prevented by incubation with the non-selective TNF-α receptor antagonist R7050. TNF-α (300 pg/ml, 30 min) decreases thrombin-induced elevation of cytosolic Ca++ levels by 2.2- fold compared to untreated platelets. TNF-α decreases the cAMP levels, while significantly increases the intracellular cyclic cGMP levels. However, the pre-incubation of platelets with the guanylyl cyclase inhibitor ODQ, despite decreasing the cGMP levels, does not modify the inhibitory effect of TNF-α on ADP-induced platelet aggregation. Additionally, western blotting analysis showed that TNF-α significantly reduced (Tyr 416)-c-Src and (Tyr773)-β3 subunit of αIIbβ3 integrin phosphorylation. TNF-α does not affect the platelet viability in any condition tested. CONCLUSION Therefore, our results show that TNF-α negatively modulates ADP-induced aggregation via TNFR1/TNFR2 receptors by reducing cytosolic Ca++ levels and by inhibiting c-Src and fibrinogen receptor activation, which take place through cAMP- and cGMP-independent mechanisms.
Collapse
|
9
|
Li Q, Zheng X. Tumor necrosis factor alpha is a promising circulating biomarker for the development of obstructive sleep apnea syndrome: a meta-analysis. Oncotarget 2018; 8:27616-27626. [PMID: 28187003 PMCID: PMC5432362 DOI: 10.18632/oncotarget.15203] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/27/2017] [Indexed: 12/16/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is a chronic inflammatory disorder. The relationship between tumor necrosis factor alpha (TNF-alpha) and OSAS has been widely evaluated, but the results thus far remain inconclusive. We thereby decided to quantify the changes of TNF-alpha between OSAS patients and controls by a meta-analysis. This study complies with the MOOSE guidelines. Two reviewers independently searched articles and abstracted relevant data. In total, 47 articles (59 studies) were analyzed, including 2857 OSAS patients and 2115 controls. Overall, OSAS patients had a significantly higher level of circulating TNF-alpha than controls (weighted mean difference [WMD]: 9.66 pg/mL, 95% confidence interval [CI]: 8.66 to 11.24, P<0.001), but with significant heterogeneity (I2: 99.7%). After adjusting for potential missing studies, the overall estimate was weakened but still significant (filled WMD: 2.63 pg/mL, 95% CI: 2.56 to 2.70, P<0.001). When studies were stratified by OSAS severity, the changes in circulating TNF-alpha between patients and controls increased gradually with the more severe grades of OSAS. In patients with mild, mild-to-moderate, moderate, moderate-to-severe and severe OSAS, circulating TNF-alpha was higher than respective controls by 0.99, 1.48. 7.79, 10.08 and 8.85 pg/mL, with significant heterogeneity (I2: 91.2%, 74.5%, 97.6%, 99.0% and 98.1%). In conclusion, our findings demonstrated that circulating TNF-alpha was significantly higher in OSAS patients than in controls, and this difference became more pronounced with the more severe grades of OSAS, indicating that TNF-alpha might be a promising circulating biomarker for the development of OSAS.
Collapse
Affiliation(s)
- Qingsheng Li
- Department of Emergency Pediatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xin Zheng
- Department of Basic Medicine, Fujian Health Collage, Fuzhou, China
| |
Collapse
|
10
|
Bikov A, Losonczy G, Kunos L. Role of lung volume and airway inflammation in obstructive sleep apnea. Respir Investig 2017; 55:326-333. [PMID: 29153412 DOI: 10.1016/j.resinv.2017.08.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 08/06/2017] [Accepted: 08/23/2017] [Indexed: 06/07/2023]
Abstract
Obstructive sleep apnea (OSA) is a prevalent disorder that affects not only the upper airways but also the intrathoracic airways. In this review, we summarize the results of studies on lung function and airway inflammation. We provide evidence that the alterations in intrathoracic airways observed in OSA are not purely consequences of mechanical trauma and oxidative stress during apneic events but have a causal role in the structural changes associated with OSA and increasing severity of this disorder.
Collapse
Affiliation(s)
- Andras Bikov
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
| | - Gyorgy Losonczy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
| | - Laszlo Kunos
- Department of Pulmonology, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
11
|
Jin F, Liu J, Zhang X, Cai W, Zhang Y, Zhang W, Yang J, Lu G, Zhang X. Effect of continuous positive airway pressure therapy on inflammatory cytokines and atherosclerosis in patients with obstructive sleep apnea syndrome. Mol Med Rep 2017; 16:6334-6339. [DOI: 10.3892/mmr.2017.7399] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 03/28/2017] [Indexed: 11/06/2022] Open
|
12
|
Schwarz EI, Engler A, Kohler M. Exhaled breath analysis in obstructive sleep apnea. Expert Rev Respir Med 2017; 11:631-639. [DOI: 10.1080/17476348.2017.1338950] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Esther I Schwarz
- Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Anna Engler
- Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
- Center for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| |
Collapse
|