Long-Term Effect of Continuous Positive Airway Pressure Therapy on Inflammation Markers of Patients with Obstructive Sleep Apnea Syndrome

Steiropoulos, Paschalis; Kotsianidis, Ιoannis; Nena, Evangelia; Tsara, Venetia; Gounari, Evdoxia; Hatzizisi, Olga; Kyriazis, George A.; Christaki, Pandora; Froudarakis, Marios; Bouros, Demosthenes

doi:10.1093/sleep/32.4.537

Cited by 124 publications

(79 citation statements)

References 23 publications

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“…Our group and others have shown a gradual decrease of CRP levels with effective PAP therapy, which could subsequently improve cardiovascular morbidity associated with OSAS [19,[65][66][67][68][69] , whereas others found that PAP therapy did not significant change CRP levels, regardless of PAP therapy duration [39,42,65,[70][71][72][73][74] . Furthermore our study [60] showed that after PAP therapy CRP was decreased more slowly in females compared to matched for OSAS severity males.…”

Section: Effect Of Positive Airway Pressure Therapy On Levels Of Crpmentioning

confidence: 66%

Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein

Bouloukaki¹,

Mermigkis²,

Kallergis³

et al. 2015

WJEM

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Obstructive sleep apnea syndrome (OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease (CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein (CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.

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Section: Effect Of Positive Airway Pressure Therapy On Levels Of Crpmentioning

confidence: 66%

Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein

Bouloukaki¹,

Mermigkis²,

Kallergis³

et al. 2015

WJEM

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show abstract

“…21) And another research reported that TNF-α and IL-6 levels were decreased in OSA patient after surgical treatment and IL-6 level showed more improvement than TNF-α. Elevated TNF-α level predicts the incidence of cardiovascular event in several conditions like heart failure and acute coronary syndrome.…”

Section: )mentioning

confidence: 98%

Inflammatory Cytokine Level in Patients with Obstructive Sleep Apnea and Treatment Outcome of Oral Appliance Therapy

Oh¹,

Chung²

2016

Journal of Oral Medicine and Pain

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Purpose:The aims of this study were to analyze the association between inflammatory cytokine and obstructive sleep apnea (OSA), and to evaluate treatment outcome and changes of plasma inflammatory cytokine levels after oral appliance therapy.Methods: Twenty-seven subjects who visited Department of Oral Medicine in Seoul National University Dental Hospital were performed nocturnal polysomnography and analyzed plasma C-reactive protein (CRP), interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α levels. Each subject was evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The subjects were classified into 12 OSA patients (apnea-hypopnea index [AHI] >5) and 15 control (AHI ≤5) groups. The OSA group was treated with mandibular advancement device (MAD) for 3 months and re-evaluated nocturnal polysomnography and plasma inflammatory cytokine levels.Results: Plasma TNF-α, IL-10, and IL-6 levels were significantly higher in OSA patients compared to controls. Total AHI showed significant positive correlations with plasma IL-6 and TNF-α levels. Percentage time of SpO 2 <90 and lowest SpO 2 were significantly correlated with plasma TNF-α level. ESS showed significant positive correlation with plasma IL-10 level. Total AHI, percentage time of SpO 2 <90, lowest SpO 2 , and mean SpO 2 were significantly improved after the MAD therapy. Plasma TNF-α level was significantly decreased after MAD therapy. Conclusions:We suggest that MAD therapy is an effective treatment modality for patients with OSA and can decrease plasma cytokine level.

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“…the initiation of therapy. In the long-term, STEIROPOULOS et al [41] reported significant improvements in systemic inflammatory markers, including total lymphocyte counts, CD4+ cells, tumour necrosis factor (TNF)-a levels and uric acid levels after 6 months in patients with good compliance to CPAP therapy; however, no such improvements were identified in patients with poor compliance. In contrast, KOHLER et al [35] did not find any differences in systemic inflammatory markers, highsensitive C-reactive protein (CRP), plasma IL-6, interferon-c, and adiponectin levels between patients receiving therapeutic and sub-therapeutic CPAP treatments for 4 weeks.…”

Section: Sleep-related Disorders MD Alahmari Et Almentioning

confidence: 99%

Dose response of continuous positive airway pressure on nasal symptoms, obstruction and inflammationin vivoandin vitro

AlAhmari¹,

Sapsford²,

Wedzicha³

et al. 2012

Eur Respir J

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Obstructive sleep apnoea is a common condition associated with cardiovascular risk. Continuous positive airway pressure (CPAP) is an effective treatment but is associated with nasal side-effects, which hinder compliance and may result from inflammation.We investigated whether CPAP was pro-inflammatory to human subjects in vivo, and to cultured bronchial epithelial cells in vitro. In vivo, we further investigated whether induction of nasal inflammation was associated with the development of systemic inflammation, nasal symptoms and changes in nasal mucociliary clearance.In vitro, CPAP resulted in cytokine release from cultured BEAS-2B cells in a time-and dose (pressure)-dependent manner. In vivo, CPAP resulted in dose-dependent upregulation of nasal inflammatory markers associated with the development of nasal symptoms, and reduced mucociliary clearance. CPAP also upregulated selected markers of systemic inflammation.CPAP results in dose-dependent release of inflammatory cytokines from human epithelial cells in vitro and in vivo. In vivo responses were associated with systemic inflammation, reductions in nasal mucociliary function and the development of nasal symptoms. This emphasises the need for novel strategies to reduce nasal inflammation and therefore aid compliance.

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Long-Term Effect of Continuous Positive Airway Pressure Therapy on Inflammation Markers of Patients with Obstructive Sleep Apnea Syndrome

Abstract: The selective reduction of soluble and cellular immune response factors only in those OSAS patients who exhibited good compliance to CPAP therapy provides further evidence for an ongoing systemic immune process in OSAS.

Cited by 124 publications

References 23 publications

Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein

Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein

Inflammatory Cytokine Level in Patients with Obstructive Sleep Apnea and Treatment Outcome of Oral Appliance Therapy

Dose response of continuous positive airway pressure on nasal symptoms, obstruction and inflammationin vivoandin vitro

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