Analysis of the dynamic changes in the soft palate and uvula in obstructive sleep apnea-hypopnea using ultrafast magnetic resonance imaging

Yl, Wang; McDonald, James; Yh, Liu; Kf, Pan; Xh, Zhang; Rd, Hu

doi:10.4238/2014.january.24.16

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…Besides structural changes in the uvula and soft palate [ 13 ], the influence of the upper airway lining liquid on surface tension is a factor contributing to upper airway collapsibility [ 4 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and rhonchopathy are associated with downregulation of trefoil factor family peptide 3 (TFF3)—Implications of changes in oral mucus composition

et al. 2017

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Study objectivesTrefoil factor family (TFF) peptides belong to the family of mucin-associated peptides and are expressed in most mucosal surfaces. TFF peptides carry out functions such as proliferation and migration enhancement, anti-apoptosis, and wound healing. Moreover, TFFs are associated with mucins and interact with them as “linker peptides”, thereby influencing mucus viscosity.To test the hypothesis that in rhonchopathy and obstructive sleep apnea (OSA) changes occur in the expression of TFF3 and -2 that could contribute to changes in mucus viscosity, leading to an increase in upper airway resistance during breathing.MethodsRT-PCR, Western-blot, immunohistochemistry and ELISA were performed to detect and quantify TFF3 and -2 in uvula samples. In addition, 99 saliva samples from patients with mild, moderate or severe OSA, as well as samples from rhonchopathy patients and from healthy volunteers, were analyzed by ELISA.ResultsTFF3 was detected in all uvula samples. Immunohistochemistry revealed a subjectively decreasing antibody reactivity of the uvula epithelia with increasing disease severity. ELISA demonstrated significantly higher TFF3 saliva protein concentrations in the healthy control group compared to cases with rhonchopathy and OSA. Predisposing factors of OSA such as BMI or age showed no correlation with TFF3. No significant changes were observed with regard to TFF2.ConclusionsThe results suggest the involvement of TFF3 in the pathogenesis of rhonchopathy and OSA and lead to the hypothesis that reduction of TFF3 production by the epithelium and subepithelial mucous glands of the uvula contribute to an increase in breathing resistance due to a change in mucus organization.

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Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and rhonchopathy are associated with downregulation of trefoil factor family peptide 3 (TFF3)—Implications of changes in oral mucus composition

et al. 2017

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“…Previous studies using dynamic MRI have also observed the dynamic changes in the tongue, soft palate, and uvula, showing that the range of tongue and soft palate movements during sleep was greater in OSA patients than in healthy individuals. 27 , 28 However, these studies have not analyzed the movements and morphological changes of tissues during airway collapse, which is of great significance for understanding the mechanism of different types of airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea

Li,

Ji,

Sun

et al. 2023

NSS

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Purpose Upper airway collapse during sleep in patients with obstructive sleep apnea (OSA) is a complex and dynamic phenomenon. By observing and analyzing the dynamic changes in the upper airway and its surrounding tissues during airway obstruction, we aim to reveal dynamic characteristics in different obstruction patterns, and the relationship between anatomical features during normal breathing and dynamic characteristics of airway obstruction. Patients and Methods Dynamic MRI was performed in 23 male patients (age range 26–63) with severe OSA diagnosed by overnight polysomnography, and obstruction events were identified from their images. Dynamic changes in parameters of the upper airway and surrounding tissues were measured to assess the key characteristics in different obstruction patterns. Results We categorized airway obstruction into four types based on the obstruction location and motion characteristics of tissues during collapse, and detailed the alterations in the airway and surrounding tissues under each obstruction pattern. In all 112 obstruction events extracted from the dynamic images of 23 patients, type A (retropalatal obstruction caused by the soft palate separated from the tongue), BI, BII (both retropalatal obstructions caused by the soft palate attached to the tongue, and C (retropalatal and retroglossal obstruction caused by the soft palate and the tongue), accounted for 28.6%, 44.6%, 12.5%, and 14.3% respectively. In severe OSA patients with tongue and palatal obstruction related to type B or C, the more posterior hyoid position, shorter distance between tongue and uvula, and wider retropalatal space, the larger the tongue displacement and deformation during collapse, and the greater the reduction in airway space. Conclusion There are multiple airway obstruction patterns, each with its own anatomical characteristics and behaviors during collapse. Hyoid position, tongue and uvula distance, and retropalatal space play an important role in airway collapse and should be paid more attention in the treatment of OSA.

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“…Intraorally, OSA is associated with structural changes in the uvula and soft palate (Paulsen et al, 2002 ), the influence of the upper airway lining liquid on surface tension is a factor contributing to upper airway collapsibility (Kirkness et al, 1985 , 2005 ; Paulsen et al, 2002 ; Wang et al, 2014 ) due to increased airway resistance (Lévy et al, 2015 ). Previous studies reported trefoil factor family (TFF) peptides: TFF1, TFF2, and TFF3 have lectin activities and are predominantly co‐secreted together with mucins from mucous epithelia (Hoffmann, 2020 ; Hoffmann et al, 2001 ).…”

Section: Introductionmentioning

confidence: 99%

Salivary trefoil factor family peptide 3 (TFF3) and flow rate in persons with and without obstructive sleep apnea: A preliminary study

Ruangsri,

Doolgindachbaporn,

Chokwatwikul

et al. 2023

Clinical & Exp Dental Res

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ObjectivesObstructive sleep apnea (OSA) is one of the most common chronic diseases. Trefoil factor family 3 (TFF3) peptides are secreted by major and minor salivary glands and may be involved in the pathogenesis of OSA. This study aimed to evaluate salivary TFF3 and flow rate between those with and without OSA.Material and methodsThis was a prospective experimental study that enrolled patients with OSA and non‐OSA. Total unstimulated saliva was collected, the salivary flow rate was measured, and the TFF3 level was analyzed by using a modified sandwich enzyme‐linked immunosorbent assay. Baseline characteristics, TFF3 level, and salivary flow rate were compared between both groups. Factors associated with the TFF3 level and flow rate were computed by using multivariate linear regression analysis.ResultsTwenty‐eight participants were recruited in the study: 20 patients with OSA (71.42%) and 8 non‐OSA as control. The TFF3 and salivary flow rates between both groups of non‐OSA versus OSA were comparable (TFF3 non‐OSA 61.06 vs. OSA 96.00 ng/mg; p = .276 and flow rate non‐OSA 0.40 vs. OSA 0.35 mL/min; p = .320). Factors associated with the TFF3 level were neck circumference with a negative coefficient of −16.419 (p = .042). For the salivary flow rate, only age was a significant factor with the coefficient of −0.013 (p = .044).ConclusionsTFF3 and salivary flow rate were comparable between patients with OSA and non‐OSA. The factor associated with TFF3 level was neck circumference, while age was negatively associated with the salivary flow rate in patients with OSA.

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Analysis of the dynamic changes in the soft palate and uvula in obstructive sleep apnea-hypopnea using ultrafast magnetic resonance imaging

Cited by 7 publications

References 29 publications

Obstructive sleep apnea and rhonchopathy are associated with downregulation of trefoil factor family peptide 3 (TFF3)—Implications of changes in oral mucus composition

Obstructive sleep apnea and rhonchopathy are associated with downregulation of trefoil factor family peptide 3 (TFF3)—Implications of changes in oral mucus composition

Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea

Salivary trefoil factor family peptide 3 (TFF3) and flow rate in persons with and without obstructive sleep apnea: A preliminary study

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