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Kim HJ. A New Simpler and More Accurate Approach to the Diagnosis of Sleep Apnea. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:276-278. [PMID: 37188484 DOI: 10.4168/aair.2023.15.3.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Hyun Jun Kim
- Department of Otorhinolaryngology, Ajou University School of Medicine, Suwon, Korea.
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Kim J, An S, Kim Y, Yoon DW, Son SA, Park JW, Jhe W, Park CS, Shin HW. Surface Active Salivary Metabolites Indicate Oxidative Stress and Inflammation in Obstructive Sleep Apnea. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:316-335. [PMID: 37075797 DOI: 10.4168/aair.2023.15.3.316] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 05/17/2023]
Abstract
PURPOSE Obstructive sleep apnea (OSA), a highly prevalent and potentially serious sleep disorder, requires effective screening tools. Saliva is a useful biological fluid with various metabolites that might also influence upper airway patency by affecting surface tension in the upper airway. However, little is known about the composition and role of salivary metabolites in OSA. Therefore, we investigated the metabolomics signature in saliva from the OSA patients and evaluated the associations between identified metabolites and salivary surface tension. METHODS We studied 68 subjects who visited sleep clinic due to the symptoms of OSA. All underwent full-night in-lab polysomnography. Patients with apnea-hypopnea index (AHI) < 10 were classified to the control, and those with AHI ≥ 10 were the OSA groups. Saliva samples were collected before and after sleep. The centrifuged saliva samples were analyzed by liquid chromatography with high-resolution mass spectrometry (ultra-performance liquid chromatography-tandem mass spectrometry; UPLC-MS/MS). Differentially expressed salivary metabolites were identified using open source software (XCMS) and Compound Discoverer 2.1. Metabolite set enrichment analysis (MSEA) was performed using MetaboAnalyst 5.0. The surface tension of the saliva samples was determined by the pendant drop method. RESULTS Three human-derived metabolites (1-palmitoyl-2-[5-hydroxyl-8-oxo-6-octenoyl]-sn-glycerol-3-phosphatidylcholine [PHOOA-PC], 1-palmitoyl-2-[5-keto-8-oxo-6-octenoyl]-sn-glycerol-3-phosphatidylcholine [KPOO-PC], and 9-nitrooleate) were significantly upregulated in the after-sleep salivary samples from the OSA patients compared to the control group samples. Among the candidate metabolites, only PHOOA-PC was correlated with the AHI. In OSA samples, salivary surface tension decreased after sleep. The differences in surface tension were negatively correlated with PHOOA-PC and 9-nitrooleate concentrations. Furthermore, MSEA revealed that arachidonic acid-related metabolism pathways were upregulated in the after-sleep samples from the OSA group. CONCLUSIONS This study revealed that salivary PHOOA-PC was correlated positively with the AHI and negatively with salivary surface tension in the OSA group. Salivary metabolomic analysis may improve our understanding of upper airway dynamics and provide new insights into novel biomarkers and therapeutic targets in OSA.
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Affiliation(s)
- Jiyoung Kim
- Obstructive Upper Airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine, Seoul, Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sangmin An
- Department of Physics and Astronomy, Institute of Applied Physics, Seoul National University, Seoul, Korea
- Department of Physics, Research institute of Physics and Chemistry, Jeonbuk National University, Jeonju, Korea
| | - Yisook Kim
- Obstructive Upper Airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine, Seoul, Korea
| | - Dae-Wui Yoon
- Obstructive Upper Airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Ah Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Wan Park
- Obstructive Upper Airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine, Seoul, Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wonho Jhe
- Department of Physics and Astronomy, Institute of Applied Physics, Seoul National University, Seoul, Korea.
| | - Chan-Soon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
| | - Hyun-Woo Shin
- Obstructive Upper Airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine, Seoul, Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
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Samaha CJ, Tannous HJ, Salman D, Ghafari JG, Amatoury J. Role of surgical hyoid bone repositioning in modifying upper airway collapsibility. Front Physiol 2022; 13:1089606. [PMID: 36582357 PMCID: PMC9792595 DOI: 10.3389/fphys.2022.1089606] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Surgical hyoid bone repositioning procedures are being performed to treat obstructive sleep apnea (OSA), though outcomes are highly variable. This is likely due to lack of knowledge regarding the precise influence of hyoid bone position on upper airway patency. The aim of this study is to determine the effect of surgical hyoid bone repositioning on upper airway collapsibility. Methods: Seven anaesthetized, male, New Zealand White rabbits were positioned supine with head/neck position controlled. The rabbit's upper airway was surgically isolated and hyoid bone exposed to allow manipulation of its position using a custom-made device. A sealed facemask was fitted over the rabbit's snout, and mask/upper airway pressures were monitored. Collapsibility was quantified using upper airway closing pressure (Pclose). The hyoid bone was repositioned within the mid-sagittal plane from 0 to 5 mm (1 mm increments) in anterior, cranial, caudal, anterior-cranial (45°) and anterior-caudal (45°) directions. Results: Anterior displacement of the hyoid bone resulted in the greatest decrease in Pclose amongst all directions (p = 0.002). Pclose decreased progressively with each increment of anterior hyoid bone displacement, and down by -4.0 ± 1.3 cmH2O at 5 mm. Cranial and caudal hyoid bone displacement did not alter Pclose (p > 0.35). Anterior-cranial and anterior-caudal hyoid bone displacements decreased Pclose significantly (p < 0.004) and at similar magnitudes to the anterior direction (p > 0.68). Conclusion: Changes in upper airway collapsibility following hyoid bone repositioning are both direction and magnitude dependent. Anterior-based repositioning directions have the greatest impact on reducing upper airway collapsibility, with no effect on collapsibility by cranial and caudal directions. Findings may have implications for guiding and improving the outcomes of surgical hyoid interventions for the treatment of OSA.
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Affiliation(s)
- Corine J. Samaha
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hiba J. Tannous
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Diane Salman
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture (MSFEA), American University of Beirut, Beirut, Lebanon
| | - Joseph G. Ghafari
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon,Department of Orthodontics, University of Pennsylvania, Philadelphia, PA, United States
| | - Jason Amatoury
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture (MSFEA), American University of Beirut, Beirut, Lebanon,*Correspondence: Jason Amatoury,
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Hughes DA, Szkuta B, van Oorschot RA, Yang W, Conlan XA. Impact of surface roughness on the deposition of saliva and fingerprint residue on non-porous substrates. Forensic Chem 2021. [DOI: 10.1016/j.forc.2021.100318] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Relationship between surfactant proteins B and C and obstructive sleep apnea: is serum SP-B concentration a potential biomarker of obstructive sleep apnea? Sleep Breath 2015; 20:25-31. [DOI: 10.1007/s11325-015-1179-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/25/2015] [Accepted: 04/06/2015] [Indexed: 11/26/2022]
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Kairaitis K, Foster S, Amatoury J, Verma M, Wheatley JR, Amis TC. Pharyngeal mucosal wall folds in subjects with obstructive sleep apnea. J Appl Physiol (1985) 2015; 118:707-15. [PMID: 25635002 DOI: 10.1152/japplphysiol.00691.2014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Mechanical processes underlying pharyngeal closure have not been examined. We hypothesized that the pharyngeal mucosal surface would fold during closure, and lowering the upper airway lining liquid surface tension would unfold areas of mucosal apposition, i.e., folds. We compared baseline pharyngeal fold numbers and response to reduction in upper airway liquid surface tension in healthy and obstructive sleep apnea (OSA) subjects. Awake, gated magnetic resonance pharyngeal airway images of 10 healthy and 11 OSA subjects were acquired before and after exogenous surfactant administration (beractant). Upper airway liquid surface tension was measured at the beginning and end of image acquisition and averaged. Velopharyngeal and oropharyngeal images were segmented and analyzed separately for average cross-sectional area, circumference, and fold number. Compared with healthy subjects, at baseline, velopharynx for OSA subjects had a smaller cross-sectional area (98.3 ± 32.5 mm(2) healthy, 52.3 ± 23.6 mm(2) OSA) and circumference (46.5 ± 8.1 mm healthy, 30.8 ± 6.1 mm OSA; both P < 0.05, unpaired t-test), and fewer folds (4.9 ± 1.6 healthy, 3.1 ± 1.8 OSA, P < 0.03). There were no differences in oropharynx for cross-sectional area, circumference, or folds. Reduction in upper airway liquid surface tension from 61.3 ± 1.2 to 55.3 ± 1.5 mN/m (P < 0.0001) did not change cross-sectional area or circumference for velopharynx or oropharynx in either group; however, in OSA subjects, oropharyngeal folds fell from 6.8 ± 3.1 to 4.7 ± 1.2 (n = 8, P < 0.05), and velopharyngeal folds from 3.3 ± 1.9 to 2.3 ± 1.2 (P = 0.08), and were unchanged in healthy subjects. Subjects with OSA have fewer velopharyngeal wall folds, which decrease further when surface tension falls. We speculate that reduced pharyngeal wall folds contribute to an increase in pharyngeal collapsibility.
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Affiliation(s)
- Kristina Kairaitis
- Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute, Westmead, New South Wales, Australia; University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Sheryl Foster
- Department of Radiology, Westmead Hospital, Westmead, New South Wales, Australia; and University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Jason Amatoury
- Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute, Westmead, New South Wales, Australia; University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Manisha Verma
- Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute, Westmead, New South Wales, Australia
| | - John R Wheatley
- Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute, Westmead, New South Wales, Australia; University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Terence C Amis
- Ludwig Engel Centre for Respiratory Research, Westmead Millennium Institute, Westmead, New South Wales, Australia; University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
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Kavcic P, Koren A, Koritnik B, Fajdiga I, Groselj LD. Sleep magnetic resonance imaging with electroencephalogram in obstructive sleep apnea syndrome. Laryngoscope 2014; 125:1485-90. [DOI: 10.1002/lary.25085] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Pavel Kavcic
- Clinical Radiology Institute; University Medical Centre Ljubljana; Ljubljana Slovenia
| | - Ales Koren
- Clinical Radiology Institute; University Medical Centre Ljubljana; Ljubljana Slovenia
| | - Blaz Koritnik
- Institute of Clinical Neurophysiology; Division of Neurology, University Medical Centre Ljubljana; Ljubljana Slovenia
- Department of Neurology, Faculty of Medicine; University Medical Centre Ljubljana; Ljubljana Slovenia
| | - Igor Fajdiga
- Clinic of Otorhinolaryngology and Cervicofacial Surgery; University Medical Centre Ljubljana; Ljubljana Slovenia
| | - Leja D. Groselj
- Institute of Clinical Neurophysiology; Division of Neurology, University Medical Centre Ljubljana; Ljubljana Slovenia
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Sutherland K, Cistulli PA. Recent advances in obstructive sleep apnea pathophysiology and treatment. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12098] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Kate Sutherland
- Department of Respiratory and Sleep Medicine; Center for Sleep Health and Research; Royal North Shore Hospital; University of Sydney; Sydney New South Wales Australia
- Discipline of Sleep Medicine; Sydney Medical School; University of Sydney; Sydney New South Wales Australia
- Woolcock Institute of Medical Research; University of Sydney; Sydney New South Wales Australia
| | - Peter A Cistulli
- Department of Respiratory and Sleep Medicine; Center for Sleep Health and Research; Royal North Shore Hospital; University of Sydney; Sydney New South Wales Australia
- Discipline of Sleep Medicine; Sydney Medical School; University of Sydney; Sydney New South Wales Australia
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Kazakov V, Udod A, Zinkovych II, Fainerman V, Miller R. Dynamic surface tension of saliva: General relationships and application in medical diagnostics. Colloids Surf B Biointerfaces 2009; 74:457-61. [DOI: 10.1016/j.colsurfb.2009.06.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 05/28/2009] [Accepted: 06/08/2009] [Indexed: 11/16/2022]
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