C-reactive Protein, Obstructive Sleep Apnea, and Cognitive Dysfunction in School-aged Children

Abstract

Rationale: Obstructive sleep apnea (OSA) in children is associated with substantial neurobehavioral and cognitive dysfunction. However, not all children with OSA exhibit altered cognitive performance. Objectives: To assess the magnitude of the systemic inflammatory response, as measured by high-sensitivity C-reactive protein (hsCRP) serum levels which may identify children with OSA at higher susceptibility for cognitive morbidity. Methods: Habitually snoring children and nonsnoring children (total, 278; age range, 5-7 yr) were recruited from the community, and underwent overnight polysomnography and neurocognitive testing and a blood draw the next morning. Snoring children were divided into OSA and no-OSA groups, and children with OSA were further subdivided into those with two or more abnormal cognitive subtests and into those with normal cognitive scores. Serum levels of hsCRP were also measured. Measurements and Main

Obstructive Sleep Apnea in Children: Implications for the Developing Central Nervous System

“…Supportive examples illustrative of the viability of such conceptual framework have recently been published by our laboratory. Indeed, children who exhibited an enhanced inflammatory response, as evidence by increased morning plasma C reactive protein levels, were also more likely to manifest reduced cognitive functioning compared to children with a similar degree of OSA severity but in whom, C reactive protein remained within normal levels (107). Similarly, the presence of apolipoprotein E epsilon 4 allele was associated with an increased propensity to altered cognitive function in the presence of OSA in children (108).…”

Inflammatory cytokines in pediatric obstructive sleep apnea

“…[8][9][10] The most acceptable hypothesis associates occurrence of chronic systemic inflammation with OSA. [11][12] Increase in proinflammatory cytokines (C-reactive protein [CRP], tumor necrosis factor alpha [TNF-a], interleukin 6 [IL -6], and interleukin 10 [IL -10] in adult OSA patients, and high-sensitivity C-reactiveprotein [HS-CRP] in pediatric OSA patients) supports this hypothesis, [13][14][15] with a possible association between the apnea-hypopnea index (AHI) and inflammatory cytokine levels. The inflammatory responses may be reversed after OSA treatment.…”

“…IL-17 is a proinflammatory cytokine secreted predominantly by T helper 17 cells (TH17) and various cells including innate immune cells and nonimmune cells. [15] It is referred to as IL-17A as it is a member of the IL-17 family. [20] The IL-17-producing cells secrete IL-17A and another family member, IL-17F, under the stimulation of cytokines such as IL-1, IL-6, and IL-23 secreted by antigenpresenting cells in response to antigen stimulation.…”

Obstructive sleep apnea and cardiovascular risk in children

“…Повышение показателя С-реактивного белка и иных медиато-ров воспаления на фоне обструктивного апноэ сна у детей, как полагают, во многом модифицируется влиянием генетических факторов [51]. Сам факт по-вышения уровня этого белка у обследованных детей является прогностически значимым для риска воз-никновения в школьном возрасте органных пораже-ний и нейрокогнитивных нарушений [52], которые часто выявляются у детей с расстройствами сна [53].…”