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Zhao HH, Ma Z, Guan DS. Causal role of immune cells in obstructive sleep apnea hypopnea syndrome: Mendelian randomization study. World J Clin Cases 2024; 12:1227-1234. [PMID: 38524502 PMCID: PMC10955532 DOI: 10.12998/wjcc.v12.i7.1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/02/2024] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Despite being one of the most prevalent sleep disorders, obstructive sleep apnea hypoventilation syndrome (OSAHS) has limited information on its immunologic foundation. The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies (GWAS) and genotyping techniques using high-density genetic markers (e.g., SNP or CNVs). But this tactic hasn't yet been applied to OSAHS. Using a Mendelian randomization analysis, we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS. AIM To investigate the immune cells' association with OSAHS via genetic methods, guiding future clinical research. METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS. Summary statistics for each immune cell feature were obtained from the GWAS catalog. Information on 731 immune cell properties, such as morphologic parameters, median fluorescence intensity, absolute cellular, and relative cellular, was compiled using publicly available genetic databases. The results' robustness, heterogeneity, and horizontal pleiotropy were confirmed using extensive sensitivity examination. RESULTS Following false discovery rate (FDR) correction, no statistically significant effect of OSAHS on immunophenotypes was observed. However, two lymphocyte subsets were found to have a significant association with the risk of OSAHS: Basophil %CD33dim HLA DR- CD66b- (OR = 1.03, 95%CI = 1.01-1.03, P < 0.001); CD38 on IgD+ CD24- B cell (OR = 1.04, 95%CI = 1.02-1.04, P = 0.019). CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach, thus offering direction for potential future medical research.
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Affiliation(s)
- Huang-Hong Zhao
- Department of Encephalopathy, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
| | - Zhen Ma
- Department of Personnel, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
| | - Dong-Sheng Guan
- Department of Neurology, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
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Saran S, Saccomanno S, Viti S, Mastrapasqua RF, Viti G, Giannotta N, Fioretti P, Lorenzini E, Raffaelli L, Levrini L. Analysis of General Knowledge on Obstructive Sleep Apnea Syndrome (OSAS) among Italian Pediatricians. CHILDREN (BASEL, SWITZERLAND) 2024; 11:148. [PMID: 38397260 PMCID: PMC10887165 DOI: 10.3390/children11020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by partial or total airway obstruction during sleep. Studies have shown variability in the level of knowledge and awareness about OSAS among pediatricians. The management of childhood obstructive sleep apnea syndrome (OSAS) depends on the severity of the disease, the presence of comorbidities, and the child's age. The American Pediatric Academy recommends a multidisciplinary approach involving a pediatrician, a sleep specialist, and an otolaryngologist to provide comprehensive care for children with OSAS. The aim of this cross-sectional study is to evaluate the level of knowledge among pediatricians in Italy regarding the diagnosis of pediatric OSAS. MATERIAL AND METHODS An anonymized survey was conducted among Italian pediatricians. The survey was administered electronically using Google Forms, and a total of 350 pediatricians were invited to participate. Out of the 350 invitations, 299 pediatricians responded to the survey. The statistical analysis performed consisted of descriptive analysis. The study included 297 pediatricians. RESULTS Pediatricians demonstrated proficiency in identifying common nocturnal and day symptoms of OSAS. A majority (68.9%) considered the oral and otorhinolaryngologist areas during checkups. Approximately 70.6% took patient weight into account, and 62.8% were aware of the regional diagnostic-therapeutic-assistance pathway. CONCLUSIONS According to the results of this manuscript, there is evidence of a good level of knowledge about OSAS, but disseminating more information about OSAS and all the health issues associated with this syndrome is suggested. This study also has limitations caused by the complexity of the pathology.
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Affiliation(s)
- Stefano Saran
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
| | - Sabina Saccomanno
- Orthodontic Residency, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Simonetta Viti
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | | | - Grazia Viti
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
| | - Nicola Giannotta
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
| | - Paola Fioretti
- Department of Medicine and Surgery, Hygiene and Public Health Section, University of Perugia, 06123 Perugia, Italy; (P.F.); (E.L.)
| | - Elisa Lorenzini
- Department of Medicine and Surgery, Hygiene and Public Health Section, University of Perugia, 06123 Perugia, Italy; (P.F.); (E.L.)
| | - Luca Raffaelli
- Dental School, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Luca Levrini
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
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Aubertin G, Akkari M, Andrieux A, Colas des Francs C, Fauroux B, Franco P, Gagnadoux F, de Santerre OG, Grollemund B, Hartley S, Jaffuel D, Lafond L, Schröder CM, Schweitzer C, Charley-Monaca C. Management of obstructive sleep apnea syndrome type 1 in children and adolescents - A French consensus. Arch Pediatr 2023; 30:510-516. [PMID: 37537084 DOI: 10.1016/j.arcped.2023.06.009] [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: 03/28/2023] [Revised: 04/23/2023] [Accepted: 06/04/2023] [Indexed: 08/05/2023]
Abstract
This document is the outcome of a group of experts brought together at the request of the French Society of Sleep Research and Medicine to provide recommendations for the management of obstructive sleep apnea syndrome type 1 (OSA1) in children. The recommendations are based on shared experience and published literature. OSA1 is suspected when several nighttime respiratory symptoms related to upper airway obstruction are identified on clinical history taking. A specialist otolaryngologist examination, including nasofibroscopy, is essential during diagnosis. A sleep study for OSA1 is not mandatory when at least two nighttime symptoms (including snoring) are noted. Therapeutic management must be individualized according to the location of the obstruction. Ear, nose, and throat (ENT) surgery is often required, as hypertrophy of the lymphoid tissues is the main cause of OSA1 in children. According to clinical findings, orthodontic treatment generally associated with specialized orofacial-myofunctional therapy might also be indicated. Whatever treatment is chosen, follow-up must be continuous and multidisciplinary, in a network of trained specialists.
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Affiliation(s)
- G Aubertin
- Pediatric Pulmonology, Armand Trousseau Hospital, AP-HP Hospital, Sorbonne University, Paris, 75012, France; Centre de recherche Saint Antoine (CRSA), INSERM UMR-S 938, Paris, 75012, France; Centre de pneumologie de l'enfant, Ramsay Générale de Santé, Boulogne-Billancourt, 92100, France.
| | - M Akkari
- Ear, Nose and Throat & Head and Neck Surgery, University Hospital Gui de Chauliac, University of Montpellier, Montpellier, 34000, France
| | - A Andrieux
- Cabinet de pneumo-pédiatrie et somnologie pédiatrique, Mérignac, 33700, France; Pôle d'Exploration des Apnées du Sommeil (PEAS), Nouvelle Clinique Bel Air, Bordeaux, 33200, France; Pediatric Pulmonology Unit, University Hospital Pellegrin - Enfants, University of Bordeaux, Bordeaux, 33000, France
| | - C Colas des Francs
- Pediatric Sleep Unit, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, 69500, France; Réseau Morphée, Garches, 92380, France
| | - B Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, Paris, 75015, France; VIFASOM, University of Paris Cité, Paris, 75004, France
| | - P Franco
- Pediatric Sleep Unit, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, 69500, France; Integrative Physiology of the Brain Arousal Systems, CRNL, INSERM U1028, CNRS UMR5292 University of Lyon 1, Bron, 69675, France
| | - F Gagnadoux
- Department of Pulmonary and Sleep Medicine, University Hospital of Angers, Angers, 49000, France; INSERM 1083, UMR CNRS 6015, MITOVASC, Equipe CarME, SFR ICAT, University of Angers, Angers, 49000, France
| | | | - B Grollemund
- Department of Dental-Facial Orthopedics, Pole of Bucco Dentaries' Medicine and Surgery, Cleft Competence Center, Strasbourg University Hospital, Strasbourg, 67000, France
| | - S Hartley
- Réseau Morphée, Garches, 92380, France; Sleep Unit, Department of Physiology, Raymond Poincaré Hospital, AP-HP, Garches, 92380, France
| | - D Jaffuel
- Department of Respiratory Diseases, University Hospital of Montpellier, Montpellier, 34000, France; PhyMedExp, CNRS, INSERM, Montpellier University, Montpellier, 34000, France
| | - L Lafond
- Oro-myofunctional Therapy Office, Bordeaux, 33000, France
| | - C M Schröder
- Department of Child and Adolescent Psychiatry, Strasbourg University and Strasbourg University Hospitals, Strasbourg, 67000, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, 67000, France; Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), Strasbourg University Hospitals, Strasbourg, 67000, France
| | - C Schweitzer
- Children's Medicine, Department of Pediatric Lung Function Testing, Children's Hospital, University Hospital of Nancy, Vandoeuvre les Nancy, 54501, France; EA3450 Développement Adaptation et Handicap (DevAH), University of Lorraine, Vandoeuvre les Nancy, 54505, France
| | - C Charley-Monaca
- Department of Clinical Neurophysiology-Sleep Disorders Unit, University of Lille, University Hospital of Lille, and U1172 - LilNCog - Lille Neurosciences & Cognition, Lille, 59000, France
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Guo L, Hu Y. Clinical Observation of Low-Temperature Plasma Knife Tonsil Adenoidectomy for Pediatric Snoring and Analysis of Influencing Factors. Emerg Med Int 2022; 2022:1691583. [PMID: 36467863 PMCID: PMC9715336 DOI: 10.1155/2022/1691583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/28/2022] [Indexed: 09/05/2023] Open
Abstract
Objective To investigate the clinical efficacy of low-temperature plasma knife tonsil adenoidectomy for pediatric snoring and to analyze the factors influencing the efficacy. Methods 90 children with snoring who were scheduled for surgical treatment in our hospital from June 2020 to December 2021 were selected as the research objects. According to the random number table method, they were divided into control group (group C) and observation group (group O), with 45 cases in each group. The children in group C were treated with power cutting system to remove adenoids combined with conventional peeling of bilateral tonsils, while the children in group O were treated with low-temperature plasma adenoidectomy combined with bilateral tonsillectomy, and both the groups received psychological care, preoperative preparation, health guidance, postoperative posture care and close monitoring of vital signs during the perioperative period. The clinical efficacy, perioperative related indexes (including operation time, intraoperative bleeding, postoperative pain time, and hospital stay) were compared between the two groups. The apnea-hypopnea index (AHI), oxygen decrement index (ODI), longest apnea time (LAT), and lowest oxygen saturation (LSaO2) were measured before operation and 1 week after operation to evaluate the ventilatory function of the two groups. According to the curative effect, 90 children with snoring were divided into cure + significant effective group and valid + invalid group. The general data and preoperative biochemical indexes of the two groups were collected, and logistic regression model was used to analyze the related influencing factors of the curative effect. Results The total effective rate of group O (100.00%, 45 cases) was significantly higher than that of group C (91.11%, 41 cases) (P < 0.05); the operative time, intraoperative bleeding, postoperative pain time, and hospitalization time of group O were shorter/less than those of group C; the AHI, ODI, and LAT of group O at 1 week after surgery were shorter/less than those of the control group; and LSaO2 was higher than that of group C. The differences were statistically significant (P < 0.05). Univariate analysis showed that there were significant differences in age, BMI, course of disease, preoperative AHI, preoperative LsaO2, and surgical method between cure + significant effective group and valid + invalid group (P < 0.05). Multivariate analysis showed that high BMI, high preoperative AHI, and power cutting system for adenoids combined with routine peeling of the bilateral tonsils were independent risk factors for postoperative outcome in children with obstructive sleep apnea syndrome (OSAS) (P < 0.05).
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Affiliation(s)
- Li Guo
- Department of Otorhinolaryngology, Zhejiang Zhuji People Hospital, Zhuji 311800, Zhejiang, China
| | - Yirong Hu
- Department of Maternal and Children Health, Chongqing Liangjiang New Area People's Hospital, Chongqing 401121, China
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