Cellular Immune Dysfunction in Obstructive Sleep Apnea

Ludwig, Katharina; Huppertz, Tilman; Radsak, Markus P.; Gouveris, Haralampos

doi:10.3389/fsurg.2022.890377

Cited by 24 publications

(16 citation statements)

References 53 publications

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“…While this may contribute to some variation in tonsil or adenoid immune cell proportions 18 , the effect of this underlying condition on results obtained from distal sample types in these children (nasal brushings, bronchial brushings, blood) is unclear. A recent review revealed conflicting evidence of immune cell alterations in adult and paediatric OSA, with some studies reporting an inflammatory effect while others reported normal immune responses in these patients 19 . All children in our cohort were clinically well at the time of sample collection and there was limited evidence of wheezing or respiratory infection in the week leading up to sample collection.…”

Section: Discussionmentioning

confidence: 99%

A cross-tissue, age-specific flow cytometry reference for immune cells in the airways and blood of children

Shanthikumar,

Gubbels,

Davies

et al. 2024

Preprint

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Respiratory diseases are a common cause of morbidity and hospitalisation for children. Despite this, treatment options are limited and are often ineffective. The development of curative or disease-modifying treatments for children relies on a better understanding of underlying immunity in the early airway. To establish a flow cytometry reference for immune cells in the paediatric airway, we analysed 178 samples from 66 children aged between 1-15 years. This included five tissues of the upper (nasal brushings, palatine tonsils, adenotonsil) and lower (bronchial brushings, bronchoalveolar lavage (BAL)) airway, as well as whole blood for paired analysis of local and systemic immune response. Nasal, bronchial, and alveolar samples were analysed using a 17-plex antibody panel that captures cells of immune and epithelial lineage, while tonsil, adenoid, and blood samples were analysed using a 31-plex antibody panel that extensively phenotypes mononuclear immune cells. All protocols, panels, and data are openly available, to facilitate implementation in paediatric clinical laboratories. We provide age-specific cell reference data for infancy (0-2 years), preschool (3-5 years), childhood (6-10 years) and adolescence (11-15 years) for 37 cell populations. We show tissue-specific maturation of the airway immune system across childhood, further highlighting the importance of developing age-specific references of the paediatric airway. Intra-individual, cross-tissue analysis of paired samples revealed marked correlation in immune cell proportions between paired nasal-bronchial samples, paired tonsil-adenoid samples, and paired adenoid-blood samples, which may have implications for clinical testing. Our study advances knowledge of airway immunity from infancy through to adolescence and provides an openly available control dataset to aid in interpretation of clinical findings in samples obtained from children with respiratory diseases.

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Section: Discussionmentioning

confidence: 99%

A cross-tissue, age-specific flow cytometry reference for immune cells in the airways and blood of children

Shanthikumar,

Gubbels,

Davies

et al. 2024

Preprint

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“…14,26 In addition, abnormalities in cellular immunity have been documented in PASC; 14 OSA also has been associated with cellular immune dysfunction and therefore may be a contributing factor to the abnormal immune function in PASC. 29…”

Section: Discussionmentioning

confidence: 99%

Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 infection (PASC)

Quan,

Weaver,

Czeisler

et al. 2023

Preprint

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Background: Obstructive sleep apnea (OSA) is associated with COVID-19 infection. Fewer investigations have assessed OSA as a possible risk for the development of Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Research Question: In a general population, is OSA associated with increased odds of PASC-related symptoms and with an overall definition of PASC? Study Design: Cross-sectional survey of a general population of 24,803 U.S. adults. Results: COVID-19 infection occurred in 10,324 (41.6%) participants. Prevalence rates for a wide variety of persistent (> 3 months post infection) putative PASC-related physical and mental health symptoms ranged from 6.5% (peripheral edema) to 19.6% (nervous/anxious). In logistic regression models adjusted for demographic, anthropometric, comorbid medical and socioeconomic factors, OSA was associated with all putative PASC-related symptoms with the highest adjusted odds ratios (aOR) being fever (2.053) and nervous/anxious (1.939) respectively. Elastic net regression identified the 13 of 37 symptoms most strongly associated with COVID-19 infection. Four definitions of PASC were developed using these symptoms either weighted equally or proportionally by their regression coefficients. In all 4 logistic regression models using these definitions, OSA was associated with PASC (range of aORs: 1.934-2.071); this association was mitigated in those with treated OSA. In the best fitting overall model requiring ≥3 symptoms, PASC prevalence was 21.9%. Conclusion: In a general population sample, OSA is associated with the development of PASC-related symptoms and a global definition of PASC. A PASC definition requiring the presence of 3 or more symptoms may be useful in identifying cases and for future research.

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“…Children with OSA are more likely to have cardiovascular morbidity and neurobehavioral impairment, emphasizing the urgency of early detection, diagnosis, and treatment 6 . Untreated OSA has been associated with alterations in various immune parameters, including decreased levels of certain immune cells and cytokines, making patients more prone to infectious disease 7 . OSA patients suffer from chronic sleeping deprivation, accompanied by chronic inflammation and affecting host defense abilities.…”

Section: Introductionmentioning

confidence: 99%

“…6 Untreated OSA has been associated with alterations in various immune parameters, including decreased levels of certain immune cells and cytokines, making patients more prone to infectious disease. 7 OSA patients suffer from chronic sleeping deprivation, accompanied by chronic inflammation and affecting host defense abilities. The weakened host defense abilities increase the risk of vulnerability to the viral pathogen infections, such as the influenza virus.…”

mentioning

confidence: 99%

Impact of obstructive sleep apnea on clinical outcomes of hospitalization due to influenza in children: A propensity score‐matched analysis of the US Nationwide Inpatient Sample 2005–2018

Wang,

Chiu

2024

Pediatric Pulmonology

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BackgroundPrevious studies have explored the association between obstructive sleep apnea (OSA) and clinical outcomes of influenza in adults, whereas limited research examined this relationship in pediatric populations. This study aimed to evaluate the clinical impact of OSA on the outcomes of pediatric influenza hospitalizations.MethodsThis was a population‐based, retrospective study. Data of children aged 1–19 years hospitalized for influenza infection were extracted from the United States (US) Nationwide Inpatient Sample Database 2005–2018. Univariable and multivariable regression analyses determined associations between OSA, length of stay (LOS), total hospital costs, pneumonia, and life‐threatening events.ResultsAfter propensity‐score matching, a total of 2100 children were analyzed. The logistic analysis revealed that children with OSA had a significantly increased LOS (β = 2.29 days; 95% confidence interval, CI: 1.01–3.57, p < .001) and total hospital costs (β = 26.06 thousand dollars; 95% CI: 6.62–45.51, p = .009), and higher odds of pneumonia (aged 6–10 years: odds ratio [OR] = 1.52; 95% CI: 1.01–2.27, p = .043; aged ≥ 11 years: OR = 1.83; 95% CI: 1.33–2.53, p < .001).ConclusionsDuring influenza admissions, children with OSA had longer LOS, higher hospital costs, and an increased risk of pneumonia compared to those without OSA. These findings underscore the importance of recognizing and managing OSA in influenza‐related infections among children.

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Cellular Immune Dysfunction in Obstructive Sleep Apnea

Cited by 24 publications

References 53 publications

A cross-tissue, age-specific flow cytometry reference for immune cells in the airways and blood of children

A cross-tissue, age-specific flow cytometry reference for immune cells in the airways and blood of children

Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 infection (PASC)

Impact of obstructive sleep apnea on clinical outcomes of hospitalization due to influenza in children: A propensity score‐matched analysis of the US Nationwide Inpatient Sample 2005–2018

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