Obstructive Sleep Apnea and Immunity: Relationship of Lymphocyte Count and Apnea Hypopnea Index

Freire, Amado X.; Kadaria, Dipen; Avecillas, Jaime F.; Murillo, Luis C.; Yataco, Jose C.

doi:10.1097/smj.0b013e3181e6dabf

Cited by 17 publications

(20 citation statements)

References 17 publications

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“…In accordance to our results, Freire et al found no association of AHI with total lymphocyte, neutrophil, or peripheral blood cell count alterations [9]. Recently, many investigators raised the notion of a Th17/Treg balance and reported an imbalance in patients with various autoimmune and inflammatory diseases [14–17].…”

Section: Discussionsupporting

confidence: 91%

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The Treg/Th17 Imbalance in Patients with Obstructive Sleep Apnoea Syndrome

Liu

Zhang

Wang

et al. 2012

Mediators of Inflammation

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Obstructive sleep apnoea syndrome (OSAS) is a chronic inflammatory disease regulated by T lymphocytes. Our purpose is to assess the pattern of Th17 cells and CD4+CD25+Foxp3+ regulatory T (Treg) cells in peripheral blood of patients with OSAS. Fourty-four OSAS men and 20 healthy volunteers were enrolled. Twenty-three patients were classified into mild to moderate group and 21 cases were classified into severe group according to the severity of OSAS. We detected the frequencies of Th17 and Treg and related serum cytokines secretion and expressions of key transcription factors. OSAS patients revealed significant increase in peripheral Th17 number, Th17-related cytokines (IL-17 and IL-6), and RORγt mRNA levels. They also presented a significant decrease in Treg number, Treg-related cytokines (TGF-β 1), and Foxp3 mRNA levels as compared with normal persons. As a result, the Th17/Treg ratios were markedly more upregulated in OSAS patients than those in control group. Furthermore, the Th17/Treg ratio was positively related to the severity of OSAS and serum levels of C-reactive protein. The development of OSAS may be associated with peripheral Th17/Treg imbalance and characterized by a proinflammatory cytokine microenvironment. These results opened an alternative explanation for the substantial activation of immune cells in OSAS and the development of related complications.

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Section: Discussionsupporting

confidence: 91%

“…OSAS is involving various immune cells, particularly T lymphocytes [9, 10]. Activation of T lymphocytes is among the crucial steps leading to the release of inflammatory mediators and adhesion molecules.…”

Section: Introductionmentioning

confidence: 99%

The Treg/Th17 Imbalance in Patients with Obstructive Sleep Apnoea Syndrome

Liu

Zhang

Wang

et al. 2012

Mediators of Inflammation

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“…This point can be viewed as a limitation of our study. Otherwise, some researchers suggested that obesity, rather than 'hypoxia/reoxygenation' phenomenon, may be the main origin of inflammation in OSA [3,4,[18][19][20][21][22]. Additionally, there are contradictory opinions regarding this phenomenon [13,14].…”

Section: Discussionmentioning

confidence: 96%

“…While the sudden opening of the upper airway, inspiratory air pressure causes tissue damage and local inflammation due to mechanical trauma, episodic hypoxemia, and reoxygenation induces the tonic elevation of sympathetic nervous system, oxidative stress, hypercoagulable, endothelial dysfunction, and systemic inflammation [2,3].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the role of serum ischemia-modified albumin in obstructive sleep apnea in comparison with interleukin-6

Doğan

Öcal

Aydoğan

et al. 2016

Postgraduate Medicine

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“…Furthermore, intermittent and chronic hypoxia has been associated with glucose intolerance and insulin resistance [41, 42], and the adverse effects of hypoxia on glucose metabolism appear to be mediated via the sympathetic nervous system [39, 43]. In addition, to effects on physiological processes, the sleep disruption associated with SDB has effects that are often very debilitating, including daytime sleepiness [44], cognitive impairment [45, 46], depression [47], relationship difficulties [48] and dementia [46] to appetite changes/obesity [49] and reduced immunity [50]. …”

Section: Pathophysiological Mechanismsmentioning

confidence: 99%

Recognition and treatment of sleep-disordered breathing: an important component of chronic disease management

Farrell

Richards

2017

J Transl Med

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Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status. Severe OSA increases the risk of arrhythmias, including atrial fibrillation, influences risk management in stroke, and is highly prevalent in patients with type 2 diabetes. Effective treatment with CPAP improves the success of antiarrhythmic interventions, improves outcomes in stroke and reduces hyperglycemia in diabetes. Patients with coronary artery disease also have a high prevalence of SDB, which is independently associated with worse outcomes. The role of CPAP for secondary cardiovascular prevention remains to be determined. Data from large, well-conducted clinical trials have shown that noninvasive ventilation, targeted to markedly reduce hypercapnia, significantly improves survival and reduces readmission in stable hypercapnic chronic obstructive pulmonary disease. The association of SDB with chronic diseases contributes to the high healthcare costs incurred by SDB patients. SDB also has an important negative impact on quality of life, which is reversed by CPAP treatment. The high prevalence of SDB, and its association with diseases that cause significant morbidity and mortality, suggest that the diagnosis and management of SDB is an important therapeutic goal. First, adherent CPAP treatment significantly improves the quality of life of all patients with SDB; second, it eliminates the negative impact of untreated SDB on any associated chronic diseases; and third, it significantly reduces the increased costs of all hospital and medical services directly associated with untreated SDB. In short, the recognition and treatment of SDB is vital for the continued health and wellbeing of individual patients with SDB.

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Obstructive Sleep Apnea and Immunity: Relationship of Lymphocyte Count and Apnea Hypopnea Index

Abstract: We found OSA-induced sleep interruption not associated with lymphocyte, neutrophil, or peripheral blood cell count alterations. This information is useful for researchers evaluating the influence of sleep disruption on immunity.

Cited by 17 publications

References 17 publications

The Treg/Th17 Imbalance in Patients with Obstructive Sleep Apnoea Syndrome

The Treg/Th17 Imbalance in Patients with Obstructive Sleep Apnoea Syndrome

Assessment of the role of serum ischemia-modified albumin in obstructive sleep apnea in comparison with interleukin-6

Recognition and treatment of sleep-disordered breathing: an important component of chronic disease management

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