Increased Urinary Erythropoietin Excretion in Severe Sleep Apnea–Hipoapnea Syndrome: The Effect of CPAP

Félez, M A; Grau, Núria; Ruiz, Antonia; Guardiola, Encarna; Sanjuas, Carles; Estirado, Cristina; Navarro-Muñoz, Maribel; Pascual, Antoni Gili; Orozco-Levi, Mauricio; Gea, Joaquim

doi:10.1016/j.arbr.2017.10.022

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…A reduction in oxygen supply associated with hypoxia stimulates Epo production. 8,9,12 Thus, the oxidative stress and the hypoxia involved in cisplatin toxicity might increase Epo levels in renal tissue with the consequent Epo excretion in urine. Current experiments are being performed in our laboratory to evaluate the exact molecular mechanisms involved in the increase of urinary Epo after cisplatin-induced AKI.…”

Section: Discussionmentioning

confidence: 99%

“…This hormone is principally synthesized in the renal cortex by peritubular fibroblasts and is excreted in the urine. 8,9 In the past years, few works have been conducted about the detection of endogenous Epo in urine and its possible modifications after a kidney injury. 10,11 Almost all works were focused on purification and detection methods of Epo in urine to detect and control the abuse of recombinant Human Epo (rHuEpo) in endurance athletes as an anti-doping test.…”

Section: Introductionmentioning

confidence: 99%

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Novel Finding of Urinary Erythropoietin as an Early Biomarker of Cisplatin-Induced Nephrotoxicity

Bulacio

Torres

2023

Int J Toxicol

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Cisplatin is a chemotherapeutic drug used to treat a great variety of solid tumors. Its dose is commonly limited by its nephrotoxicity, manifested as acute kidney injury (AKI). Erythropoietin (Epo) is a glycoprotein hormone that regulates the production of red blood cells. This study was performed to evaluate the presence of endogenous Epo in male Wistar rat urine and to analyse changes in urinary Epo levels in response to cisplatin- induced AKI. Dose-dependent studies and time-dependent experiments were performed to evaluate changes in urea nitrogen and creatinine in plasma as well as Epo, neutrophil gelatinase-associated lipocalin (NGAL), alkaline phosphatase (AP) activity, creatinine and total proteins in urine at 2 days post-dosing. Rats received 2, 5 or 10 mg/kg b.w., i.p. of cisplatin. At 5 mg/kg b.w., i.p. cisplatin, significant increases in urinary Epo were detected. Significant increases in urea nitrogen and creatinine in plasma, NGAL, AP, proteins, and Epo were observed in urine from rats that received 10 mg/kg b.w., i.p. of cisplatin. In the time-dependent experiments, rats were injected with a dose of 5 mg/kg b.w., i.p. of cisplatin, and sampling occurred 2, 4, and 14 days post-dosing. In these animals, there were significant increases in urea nitrogen and creatinine in plasma and total proteins, AP activity, Epo, and NGAL in urine on day 4. Urinary Epo was also detected on day 2. Taken together, these findings provide weight of evidence for urinary Epo as a promising early biomarker of cisplatin-induced AKI in male rats.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel Finding of Urinary Erythropoietin as an Early Biomarker of Cisplatin-Induced Nephrotoxicity

Bulacio

Torres

2023

Int J Toxicol

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“…In adults, recent studies have used the combination of glycated haemoglobin, erythropoietin and CRP for the diagnostic screening of OSA and its severity, with sensitivity >80% [25]. CPAP therapy has been shown to correct the increase of urine erythropoietin excretion in individuals with severe OSA [26]. In turn, there is evidence that adenotonsillectomy, a curative treatment in the paediatric population, induces a marked reduction of CRP levels in children independently of obesity, hence evidencing the usefulness of CRP as biomarker for therapeutic monitoring [27].…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width: a new tool for the severity prediction of sleep apnoea syndrome in children

et al. 2020

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IntroductionRed cell distribution width (RDW) is a parameter included in the complete blood count which informs about the size of the circulating red blood cell population and its distribution. In adults, an increase in RDW was shown to be associated both with obstructive sleep apnoea (OSA) and with an increase in cardiovascular mortality. The aim of this study was to determine whether RDW is a potential biomarker for screening children with moderate–severe OSA.MethodsAn observational study in snoring patients was performed. All patients underwent a sleep study and were classified either as simple snorers (apnoea–hypopnoea index (AHI) <1 event·h−1) or as patients with OSA (mild AHI ≥1 to <5 events·h−1; moderate–severe AHI ≥5 events·h−1). Blood analyses (complete blood count and C-reactive protein) were performed for every individual.ResultsA total of 175 individuals were recruited. The mean age was 8.3±3.6 years. Correlation studies between RDW and several sleep-related parameters showed negative significant associations with minimum oxygen saturation, and positive significant associations with oxygen desaturation index (≥3% and ≥4%), AHI and the arousal index. A predictive model for paediatric severe OSA (AHI ≥5 events·h−1) was found based on mean corpuscular haemoglobin concentration (MCHC) <34.9 g·dL−1 and RDW >13.1% values, adjusting for body mass index z-score and age (area under the curve 0.657; p=0.004). In addition, differences were found in eosinophil count and C-reactive protein concentrations among the three subgroups.ConclusionsIn children, RDW stands out as a biomarker associated with the severity of OSA. The use of RDW and MCHC could be a simple but useful tool for the severity prediction of paediatric OSA in snoring patients.

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“…Positive airway pressure (PAP) therapy is well known as the gold standard for treating patients with moderate to severe OSA [ 16 – 18 ]. It has been reported that PAP therapy is effective in correcting endothelial dysfunction and reducing systemic inflammation [ 19 ] and inhibiting enhanced erythropoiesis and changes in some metabolic parameters (e.g., homeostasis model assessment index, glycosylated hemoglobin level) [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Sleep Apnea and Serum Serotonin Level Pre- and Post-PAP Therapy: A Preliminary Study

et al. 2021

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Introduction:The high prevalence of obstructive sleep apnea (OSA), which impairs quality of life for numerous patients and leads to various OSA complications, has contributed to the continued interest in this disorder. The role of serotonin (5-HT) in many physiological processes, studies on its connection with the circadian system, and relationship to changes in sleep architecture are insufficient to assess the interaction of this neurotransmitter with nocturnal hypoxia. The aim of this study was to determine changes in sleep patterns and serum serotonin levels before and after positive airway pressure (PAP) therapy in patients with OSA. Methods: The study involved 30 OSA patients (27 men and 3 women) who were treated with PAP for 3 months. Polysomnography using the GRASS TELEFACTOR (USA) and blood collection were conducted before and after PAP courses. Determination of serum serotonin was performed by high-performance liquid chromatography (HPLC). PAP therapy was performed using an automatic Prisma 20A (Germany) continuous positive airway pressure (CPAP) device. Results: The use of PAP for 3 months revealed a significant improvement as measured by sleep data and serotonin levels (before: apnea index [AI] 17.2 eV/h, after: 2.4 eV/h p = 0.001; SpO 2 \ 90% -45.7 min vs. 6.2 min p = 0.001; serotonin 20.3 ng/mL vs. 26.03 ng/mL p = 0.036]. Conclusion: Our results demonstrate an improvement in sleep patterns. There was an increase in serum serotonin levels in OSA patients following PAP therapy, which could be an effect of intermittent hypoxia decline, and could be used as criteria for the effectiveness of PAP and an improvement in sleep quality.

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Increased Urinary Erythropoietin Excretion in Severe Sleep Apnea–Hipoapnea Syndrome: The Effect of CPAP

Cited by 5 publications

References 21 publications

Novel Finding of Urinary Erythropoietin as an Early Biomarker of Cisplatin-Induced Nephrotoxicity

Novel Finding of Urinary Erythropoietin as an Early Biomarker of Cisplatin-Induced Nephrotoxicity

Red cell distribution width: a new tool for the severity prediction of sleep apnoea syndrome in children

Sleep Apnea and Serum Serotonin Level Pre- and Post-PAP Therapy: A Preliminary Study

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