Consistent with our hypothesis, the presence of SDB was associated with an earlier age at cognitive decline. Our findings in CPAP+ participants suggest that CPAP treatment of SDB may delay progression of cognitive impairment.

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Rationale: Unprecedented pollution control actions during the Beijing Olympics provided a quasi-experimental opportunity to examine biologic responses to drastic changes in air pollution levels. Objectives: To determine whether changes in levels of biomarkers reflecting pulmonary inflammation and pulmonary and systemic oxidative stress were associated with changes in air pollution levels in healthy young adults. Methods: We measured fractional exhaled nitric oxide, a number of exhaled breath condensate markers (H 1 , nitrite, nitrate, and 8-isoprostane), and urinary 8-hydroxy-2-deoxyguanosine in 125 participants twice in each of the pre-(high pollution), during-(low pollution), and post-Olympic (high pollution) periods. We measured concentrations of air pollutants near where the participants lived and worked. We used mixed-effects models to estimate changes in biomarker levels across the three periods and to examine whether changes in biomarker levels were associated with changes in pollutant concentrations, adjusting for meteorologic parameters. Measurements and Main Results: From the pre-to the during-Olympic period, we observed significant and often large decreases (ranging from 24.5% to 272.5%) in levels of all the biomarkers. From the during-Olympic to the post-Olympic period, we observed significant and larger increases (48-360%) in levels of these same biomarkers. Moreover, increased pollutant concentrations were consistently associated with statistically significant increases in biomarker levels. Conclusions: These findings support the important role of oxidative stress and that of pulmonary inflammation in mediating air pollution health effects. The findings demonstrate the utility of novel and noninvasive biomarkers in the general population consisting largely of healthy individuals.Keywords: air pollution; inflammation; oxidative stress; respiratory health; the Beijing Olympics Increased air pollution concentrations have previously been associated with increased cardiorespiratory mortality and morbidity (1-5). However, observational and experimental studies in humans or animals have generated limited and somewhat inconsistent data supporting several postulated pathophysiologic pathways (6-10). One of these is the hypothesis that inhaled pollutants can react rapidly with extracelluar macromolecules or cell constituents in the airway epithelium to generate reactive oxygen or nitrogen species (e.g., free radicals and peroxides), inducing local and systemic oxidative or nitrosative stress and subsequent inflammation (11).Pulmonary inflammation and oxidative stress responses to air pollution have been examined in human studies using several noninvasive biomarkers in exhaled breath and exhaled breath condensate (EBC) (7,(12)(13)(14)(15)(16)(17)(18). Increased air pollution levels have been associated with increased levels of fractional exhaled nitric oxide (FE NO ), reflecting pulmonary inflammation, in children and the elderly (12)(13)(14)(15)(19)(20)(21)(22). Traffic pollution exposure has been associated...

The phenotypic expression of X-linked adrenoleukodystrophy (X-ALD) ranges from the rapidly progressive childhood cerebral form to the milder adrenomyeloneuropathy (AMN) in adults. It is not possible to predict phenotype by mutation analysis or biochemical assays. This study reports on 372 patients ranging in age from less than 3 years to adulthood, who have been followed at the Kennedy Krieger Institute. With the aim of determining whether a method could be developed to predict clinical course by analysis of data available at time of first contact, the patients were subdivided into 18 subgroups on the basis of age and the extent of brain magnetic resonance (MRI) abnormality utilizing the MRI scoring system devised by Loes et al. Scores to grade degree of neurologic and neuropsychologic impairment were also developed. There was strong correlation between MRI and the neurology and neuropsychology scores at baseline. Information based exclusively on age and MRI score at time of first contact was highly predictive of future clinical course and should aid the evaluation of the effects of bone marrow transplantation and the selection of patients for this procedure, as well as the evaluation of other therapies that may be developed in the future.