Lower Frequency of Obstructive Sleep Apnea in Spondyloarthritis Patients Taking TNF-Inhibitors

Walsh, Jessica A.; Duffin, Kristina Callis; Crim, Julia R.; Clegg, Daniel O.

doi:10.5664/jcsm.2254

Cited by 29 publications

(22 citation statements)

References 36 publications

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“…We have previously reported that, compared to placebo, a three-week trial of the TNFa antagonist etanercept significantly reduces AHI and IL-6 levels in obese men with OSA (Vgontzas et al, 2004). In patients with spondyloarthritis, those who take TNF-inhibitors have a significantly lower prevalence of OSA than those who do not (Walsh et al, 2012). In children, recent evidence suggests that anti-inflammatory therapy is effective in reducing apnea severity in children with mild OSA (Kheirandish-Gozal et al, 2014).…”

Section: Discussionmentioning

confidence: 94%

Increased inflammation from childhood to adolescence predicts sleep apnea in boys: A preliminary study

Gaines

Vgontzas

Fernández-Mendoza

et al. 2017

Brain, Behavior, and Immunity

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While chronic systemic inflammation in obstructive sleep apnea (OSA) has been traditionally considered a consequence of intermittent hypoxia, several treatment studies targeting inflammation suggest that this process may precede the development of the disorder. A recent cross-sectional study in the Penn State Child Cohort (PSCC) revealed that inflammation largely mediates the association between visceral adiposity and OSA in adolescence. The purpose of this study was to examine for the first time whether, longitudinally, inflammation precedes OSA during this developmental period. A subsample of the PSCC with longitudinal sleep and inflammation data (n=51) was included in this study. Participants underwent 9-h polysomnography (22:00-7:00), physical exam, and fasting morning blood draw at both time points. Plasma C-reactive protein (CRP) was measured via ELISA. At follow-up, visceral, subcutaneous, and total fat area were assessed via dual X-ray absorptiometry. Sex differences in body composition emerged in adolescence, with boys having more visceral adiposity than girls. Longitudinal increases in waist circumference from childhood to adolescence were associated with increases in CRP (ΔCRP) and follow-up CRP in boys, but not girls. Furthermore, in boys, ΔCRP was associated with higher follow-up apnea/hypopnea index (AHI). When ΔCRP was entered into a model predicting follow-up AHI, Δwaist circumference was no longer significant, indicating that inflammation largely explains the association between increasing central obesity and OSA severity. These preliminary findings, in a longitudinal, non-clinical sample of children developing OSA, suggest that inflammation derived from visceral adipose tissue precedes the development of the disorder, suggesting a potential causal mechanism.

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Section: Discussionmentioning

confidence: 94%

Increased inflammation from childhood to adolescence predicts sleep apnea in boys: A preliminary study

Gaines

Vgontzas

Fernández-Mendoza

et al. 2017

Brain, Behavior, and Immunity

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“…This could result in activation of endothelial protein kinase C beta 2 (PKC ␤2) pathways and loss of the endothelium's ability to resist TNF␣ mediated expression of adhesion molecules (45). It would be of interest to examine the effect of TNF␣ inhibition in obesity-induced OSA as has been done in spondyloarthritis (10).…”

Section: Discussionmentioning

confidence: 98%

“…Increased circulating tumor necrosis factor (TNF) ␣ (TNF␣) and intercellular adhesion molecule 1(ICAM-1) have recently been reported in obesityrelated OSA, but people with and without OSA were not matched for the degree of obesity (9). Recently OSA due to spondyloarthritis was found to be ameliorated by TNF␣ inhibition (10). This raises the possibility that TNF␣ may be directly involved in OSA from other causes, such as obesity.…”

mentioning

confidence: 98%

Impairment of High-Density Lipoprotein Resistance to Lipid Peroxidation and Adipose Tissue Inflammation in Obesity Complicated by Obstructive Sleep Apnea

Yadav

Aghamohammadzadeh

Liu

et al. 2014

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…W e read with a keen interest the article published by Walsh et al 1 These researchers analyzed 63 subjects with ankylosing spondylitis (SpA) and found that patients using TNF-inhibitors were less likely to have obstructive sleep apnea (OSA). Moreover, a nonstatistically signifi cant trend toward an improvement of OSA severity was found.…”

mentioning

confidence: 99%

“…2 Walsh et al 1 discussed that both OSA and SpA share systemic infl ammation as a pathophysiologic feature. On the other hand, a research group from Taiwan showed that OSA increases the risk for the incidence of autoimmune diseases in a prospective epidemiological studies.…”

mentioning

confidence: 99%

Obstructive Sleep Apnea and Autoimmune Disease: A Two-Way Process

Mirrakhimov

2013

Journal of Clinical Sleep Medicine

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Lower Frequency of Obstructive Sleep Apnea in Spondyloarthritis Patients Taking TNF-Inhibitors

Cited by 29 publications

References 36 publications

Increased inflammation from childhood to adolescence predicts sleep apnea in boys: A preliminary study

Increased inflammation from childhood to adolescence predicts sleep apnea in boys: A preliminary study

Impairment of High-Density Lipoprotein Resistance to Lipid Peroxidation and Adipose Tissue Inflammation in Obesity Complicated by Obstructive Sleep Apnea

Obstructive Sleep Apnea and Autoimmune Disease: A Two-Way Process

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