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Vrooman OPJ, van Kerrebroeck PEV, van Balken MR, van Koeveringe GA, Rahnama'i MS. Nocturia and obstructive sleep apnoea. Nat Rev Urol 2024:10.1038/s41585-024-00887-7. [PMID: 38783115 DOI: 10.1038/s41585-024-00887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
Nocturia, the need to urinate at night, is a common symptom in patients with obstructive sleep apnoea (OSA). Continuous positive airway pressure treatment can reduce nocturia in some patients, but the underlying mechanisms are complex and not fully understood. OSA affects the autonomic nervous system, oxidative stress and endothelial damage. Furthermore, the commonly held theory attributing polyuria to a false signal of cardiac overload and response natriuresis has limitations. A comprehensive approach to the management of nocturia in OSA, considering factors such as comorbidities, medication use, alcohol consumption and lifestyle, is needed. Effective management of nocturia in OSA requires a multidisciplinary approach, and urologists should be aware of the potential effect of OSA on physiology and refer patients for further testing at a sleep centre. In addition to continuous positive airway pressure, other interventions such as oral appliances and surgical obstruction treatment could be beneficial for some patients. Overall, understanding the complex interplay between OSA and nocturia is crucial for optimizing patient outcomes.
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Affiliation(s)
- Olaf P J Vrooman
- Department of Urology, Hospital Rijnstate Arnhem, Arnhem, Netherlands.
| | | | | | | | - Mohammad S Rahnama'i
- Department of Urology Nij Smellinghe Hospital, Drachten, Netherlands
- Society of Urological research and education (SURE), Maastricht, Netherlands
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2
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Le Guével X, Josserand V, Harki O, Baulin VA, Henry M, Briançon-Marjollet A. Real-time visualization of dextran extravasation in intermittent hypoxia mice using noninvasive SWIR imaging. Am J Physiol Heart Circ Physiol 2024; 326:H900-H906. [PMID: 38363213 DOI: 10.1152/ajpheart.00787.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
Imaging tools are crucial for studying the vascular network and its barrier function in various physiopathological conditions. Shortwave infrared (SWIR) window optical imaging allows noninvasive, in-depth exploration. We applied SWIR imaging, combined with vessel segmentation and deep learning analyses, to study real-time dextran probe extravasation in mice experiencing intermittent hypoxia (IH)-a characteristic of obstructive sleep apnea associated with potential cardiovascular alterations due to early vascular permeability. Evidence for permeability in this context is limited, making our investigation significant. C57Bl/6 mice were exposed to normoxia or intermittent hypoxia for 14 days. Then SWIR imaging between 1,250 and 1,700 nm was performed on the saphenous artery and vein and on the surrounding tissue after intravenous injection of labeled dextrans of two different sizes (10 or 70 kDa). Postprocessing and segmentation of the SWIR images were conducted using deep learning treatment. We monitored high-resolution signals, distinguishing arteries, veins, and surrounding tissues. In the saphenous artery and vein, after 70-kD dextran injection, tissue/vessel ratio was higher after intermittent hypoxia (IH) than normoxia (N) over 500 seconds (P < 0.05). However, the ratio was similar in N and IH after 10-kD dextran injection. The SWIR imaging technique allows noninvasive, real-time monitoring of dextran extravasation in vivo. Dextran 70 extravasation is increased after exposure to IH, suggesting an increased vessel permeability in this mice model of obstructive sleep apnea.NEW & NOTEWORTHY We demonstrate that SWIR imaging technique is a useful tool to monitor real-time dextran extravasation from vessels in vivo, with a high resolution. We report for the first time an increased real-time dextran (70 kD) extravasation in mice exposed to intermittent hypoxia for 14 days compared with normoxic controls.
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Affiliation(s)
- Xavier Le Guével
- University grenoble alpes, Institute for Advanced Biosciences, NSERM1209/CNRS-UMR5309, Grenoble, France
| | - Véronique Josserand
- University grenoble alpes, Institute for Advanced Biosciences, NSERM1209/CNRS-UMR5309, Grenoble, France
| | - Olfa Harki
- University grenoble alpes, INSERM U1300, HP2 Laboratory, Grenoble, France
| | - Vladimir A Baulin
- Departament Química Física i Inorgànica, Universitat Rovira i Virgili, Tarragona, Spain
| | - Maxime Henry
- University grenoble alpes, Institute for Advanced Biosciences, NSERM1209/CNRS-UMR5309, Grenoble, France
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3
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Breville G, Herrmann F, Adler D, Deffert C, Bommarito G, Stancu P, Accorroni A, Uginet M, Assal F, Tamisier R, Lalive PH, Pepin JL, Lövblad KO, Allali G. Obstructive sleep apnea: a major risk factor for COVID-19 encephalopathy? BMC Neurol 2023; 23:340. [PMID: 37752429 PMCID: PMC10523731 DOI: 10.1186/s12883-023-03393-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND This study evaluates the impact of high risk of obstructive sleep apnea (OSA) on coronavirus disease 2019 (COVID-19) acute encephalopathy (AE). METHODS Between 3/1/2020 and 11/1/2021, 97 consecutive patients were evaluated at the Geneva University Hospitals with a neurological diagnosis of COVID-19 AE. They were divided in two groups depending on the presence or absence of high risk for OSA based on the modified NOSAS score (mNOSAS, respectively ≥ 8 and < 8). We compared patients' characteristics (clinical, biological, brain MRI, EEG, pulmonary CT). The severity of COVID-19 AE relied on the RASS and CAM scores. RESULTS Most COVID-19 AE patients presented with a high mNOSAS, suggesting high risk of OSA (> 80%). Patients with a high mNOSAS had a more severe form of COVID-19 AE (84.8% versus 27.8%), longer mean duration of COVID-19 AE (27.9 versus 16.9 days), higher mRS at discharge (≥ 3 in 58.2% versus 16.7%), and increased prevalence of brain vessels enhancement (98.1% versus 20.0%). High risk of OSA was associated with a 14 fold increased risk of developing a severe COVID-19 AE (OR = 14.52). DISCUSSION These observations suggest an association between high risk of OSA and COVID-19 AE severity. High risk of OSA could be a predisposing factor leading to severe COVID-19 AE and consecutive long-term sequalae.
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Affiliation(s)
- Gautier Breville
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland.
| | - François Herrmann
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Dan Adler
- Division of Pneumology, La Tour Hospital, Geneva, Switzerland
| | - Christine Deffert
- Laboratory of Biological Fluids, Laboratory Medicine Division, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
- Laboratory Medicine Division, Department of Medical Specialties, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Giulia Bommarito
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrick Stancu
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Alice Accorroni
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Marjolaine Uginet
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Assal
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Renaud Tamisier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, 38000, Grenoble, France
| | - Patrice H Lalive
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Diagnostic Department, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Louis Pepin
- Division of Pneumology, La Tour Hospital, Geneva, Switzerland
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, 38000, Grenoble, France
| | - Karl-Olof Lövblad
- Division of Neuroradiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Gilles Allali
- Department of Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
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Chen B, Dong L, Zhang J, Hao Y, Chi W, Song D. Exploring shared pathways and the shared biomarker ERRFI1 in Obstructive sleep apnoea and atherosclerosis using integrated bioinformatics analysis. Sci Rep 2023; 13:15103. [PMID: 37699925 PMCID: PMC10497545 DOI: 10.1038/s41598-023-42184-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/06/2023] [Indexed: 09/14/2023] Open
Abstract
Obstructive sleep apnea (OSA) is an upper airway disorder occurring during sleep and is associated with atherosclerosis (AS). AS is a cardiovascular disease caused by environmental and genetic factors, with a high global mortality rate. This study investigated common pathways and potential biomarkers of OSA and AS. Microarray data were downloaded from the Gene Expression Omnibus (GEO) database and used to screen for differentially expressed genes (DEGs) in the OSA and AS datasets. A weighted gene co-expression network analysis (WGCNA) was used to identify the co-expression modules of OSA and AS. The least absolute shrinkage and selection operators (LASSO) were used to determine critical biomarkers. Immune cell infiltration analysis was used to investigate the correlation between immune cell infiltration and common biomarkers of OSA and AS. Results revealed that differentially expressed genes may be involved in inflammatory processes, chemokine signaling pathways, and molecular changes in cell adhesion. ERBB receptor feedback inhibitor 1 (ERRFI1) was the best-shared biomarker for OSA and AS. Immune infiltration analysis showed that ERRFI1 expression was correlated with immune cell changes. Changes in immune pathways, inflammatory processes, and cell adhesion molecules may underlie the pathogenesis of both diseases, and ERRFI1 may be a potential diagnostic marker for patients with OSA and AS.
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Affiliation(s)
- Bowen Chen
- Clinical Biobank, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liping Dong
- Clinical Biobank, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jihua Zhang
- Department of Otolaryngology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ying Hao
- Clinical Biobank, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Weiwei Chi
- Clinical Biobank, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dongmei Song
- Clinical Biobank, The First Hospital of Hebei Medical University, Shijiazhuang, China.
- Department of Otolaryngology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
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Sohal SS. Endothelial to mesenchymal transition: a novel pathological feature of pulmonary fibrosis. Eur Respir J 2023; 62:2301178. [PMID: 37770090 DOI: 10.1183/13993003.01178-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Sukhwinder Singh Sohal
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
- Launceston Respiratory and Sleep Centre, Launceston, Australia
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Bouillet L, Deroux A, Benmarce M, Guérin C, Bouvet L, Garnier O, Martin DK, Vilgrain I. Molecular Mechanisms of Endothelialitis in SARS-CoV-2 Infection: Evidence for VE-Cadherin Cleavage by ACE2. Int J Mol Sci 2023; 24:12525. [PMID: 37569899 PMCID: PMC10419376 DOI: 10.3390/ijms241512525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Long COVID-19 syndrome appears after Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2) infection with acute damage to microcapillaries, microthrombi, and endothelialitis. However, the mechanisms involved in these processes remain to be elucidated. All blood vessels are lined with a monolayer of endothelial cells called vascular endothelium, which provides a the major function is to prevent coagulation. A component of endothelial cell junctions is VE-cadherin, which is responsible for maintaining the integrity of the vessels through homophilic interactions of its Ca++-dependent adhesive extracellular domain. Here we provide the first evidence that VE-cadherin is a target in vitro for ACE2 cleavage because its extracellular domain (hrVE-ED) contains two amino acid sequences for ACE2 substrate recognition at the positions 256P-F257 and 321PMKP-325L. Indeed, incubation of hrVE-ED with the active ectopeptidase hrACE2 for 16 hrs in the presence of 10 μM ZnCl2 showed a dose-dependent (from 0.2 ng/μL to 2 ng/μL) decrease of the VE-cadherin immunoreactive band. In vivo, in the blood from patients having severe COVID-19 we detected a circulating form of ACE2 with an apparent molecular mass of 70 kDa, which was barely detectable in patients with mild COVID-19. Of importance, in the patients with severe COVID-19 disease, the presence of three soluble fragments of VE-cadherin (70, 62, 54 kDa) were detected using the antiEC1 antibody while only the 54 kDa fragment was present in patients with mild disease. Altogether, these data clearly support a role for ACE2 to cleave VE-cadherin, which leads to potential biomarkers of SARS-CoV-2 infection related with the vascular disease in "Long COVID-19".
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Affiliation(s)
- Laurence Bouillet
- University Grenoble Alpes, CNRS, TIMC-IMAG/T-RAIG (UMR 5525), 38000 Grenoble, France; (L.B.)
- Grenoble Hospital Grenoble Alpes (CHUGA), University Grenoble Alpes, 38000 Grenoble, France;
- Internal Medicine, University Hospital Centre Grenoble Alpes, CEDEX 9, 38043 Grenoble, France;
| | - Alban Deroux
- Grenoble Hospital Grenoble Alpes (CHUGA), University Grenoble Alpes, 38000 Grenoble, France;
| | - Meryem Benmarce
- University Grenoble Alpes, CNRS, TIMC-IMAG/SyNaBi (UMR 5525), 38000 Grenoble, France (D.K.M.)
| | - Chloé Guérin
- Internal Medicine, University Hospital Centre Grenoble Alpes, CEDEX 9, 38043 Grenoble, France;
- University Grenoble Alpes, INSERM U13, CEA, Institute of Interdisciplinary Research of Grenoble (IRIG), Laboratory of Biosciences et Bioingénierie Pour la Santé (BGE)-Biomics, 38000 Grenoble, France
| | - Laura Bouvet
- University Grenoble Alpes, CNRS, TIMC-IMAG/T-RAIG (UMR 5525), 38000 Grenoble, France; (L.B.)
| | - Olivia Garnier
- University Grenoble Alpes, INSERM U13, CEA, Institute of Interdisciplinary Research of Grenoble (IRIG), Laboratory of Biosciences et Bioingénierie Pour la Santé (BGE)-Biomics, 38000 Grenoble, France
| | - Donald K. Martin
- University Grenoble Alpes, CNRS, TIMC-IMAG/SyNaBi (UMR 5525), 38000 Grenoble, France (D.K.M.)
| | - Isabelle Vilgrain
- University Grenoble Alpes, INSERM U13, CEA, Institute of Interdisciplinary Research of Grenoble (IRIG), Laboratory of Biosciences et Bioingénierie Pour la Santé (BGE)-Biomics, 38000 Grenoble, France
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Mastino P, Rosati D, de Soccio G, Romeo M, Pentangelo D, Venarubea S, Fiore M, Meliante PG, Petrella C, Barbato C, Minni A. Oxidative Stress in Obstructive Sleep Apnea Syndrome: Putative Pathways to Hearing System Impairment. Antioxidants (Basel) 2023; 12:1430. [PMID: 37507968 PMCID: PMC10376727 DOI: 10.3390/antiox12071430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION OSAS is a disease that affects 2% of men and 4% of women of middle age. It is a major health public problem because untreated OSAS could lead to cardiovascular, metabolic, and cerebrovascular complications. The more accepted theory relates to oxidative stress due to intermittent hypoxia, which leads, after an intense inflammatory response through multiple pathways, to endothelial damage. The objective of this study is to demonstrate a correlation between OSAS and hearing loss, the effect of the CPAP on hearing function, and if oxidative stress is also involved in the damaging of the hearing system. METHODS A review of the literature has been executed. Eight articles have been found, where seven were about the correlation between OSAS and the hearing system, and only one was about the CPAP effects. It is noted that two of the eight articles explored the theory of oxidative stress due to intermittent hypoxia. RESULTS All studies showed a significant correlation between OSAS and hearing function (p < 0.05). CONCLUSIONS Untreated OSAS affects the hearing system at multiple levels. Oxidative stress due to intermittent hypoxia is the main pathogenetic mechanism of damage. CPAP has no effects (positive or negative) on hearing function. More studies are needed, with the evaluation of extended high frequencies, the execution of vocal audiometry in noisy environments, and the evaluation of potential biomarkers due to oxidative stress.
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Affiliation(s)
- Pierluigi Mastino
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Davide Rosati
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Giulia de Soccio
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Martina Romeo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Daniele Pentangelo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Stefano Venarubea
- Division of Clinical Pathology, Director of analysis Laboratory of De Lellis Hospital, Viale Kennedy, 02100 Rieti, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Piero Giuseppe Meliante
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Antonio Minni
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
- Clinical Pathology Physician, Director of Analysis Laboratory of De Lellis Hospital, Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
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Molecular Pathology, Oxidative Stress, and Biomarkers in Obstructive Sleep Apnea. Int J Mol Sci 2023; 24:ijms24065478. [PMID: 36982552 PMCID: PMC10058074 DOI: 10.3390/ijms24065478] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia (IH) during sleep due to recurrent upper airway obstruction. The derived oxidative stress (OS) leads to complications that do not only concern the sleep-wake rhythm but also systemic dysfunctions. The aim of this narrative literature review is to investigate molecular alterations, diagnostic markers, and potential medical therapies for OSAS. We analyzed the literature and synthesized the evidence collected. IH increases oxygen free radicals (ROS) and reduces antioxidant capacities. OS and metabolic alterations lead OSAS patients to undergo endothelial dysfunction, osteoporosis, systemic inflammation, increased cardiovascular risk, pulmonary remodeling, and neurological alterations. We treated molecular alterations known to date as useful for understanding the pathogenetic mechanisms and for their potential application as diagnostic markers. The most promising pharmacological therapies are those based on N-acetylcysteine (NAC), Vitamin C, Leptin, Dronabinol, or Atomoxetine + Oxybutynin, but all require further experimentation. CPAP remains the approved therapy capable of reversing most of the known molecular alterations; future drugs may be useful in treating the remaining dysfunctions.
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Advances in Molecular Pathology of Obstructive Sleep Apnea. Molecules 2022; 27:molecules27238422. [PMID: 36500515 PMCID: PMC9739159 DOI: 10.3390/molecules27238422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a common syndrome that features a complex etiology and set of mechanisms. Here we summarized the molecular pathogenesis of OSA, especially the prospective mechanism of upper? airway dilator fatigue and the current breakthroughs. Additionally, we also introduced the molecular mechanism of OSA in terms of related studies on the main signaling pathways and epigenetics alterations, such as microRNA, long non-coding RNA, and DNA methylation. We also reviewed small molecular compounds, which are potential targets for gene regulations in the future, that are involved in the regulation of OSA. This review will be beneficial to point the way for OSA research within the next decade.
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Farré R, Almendros I, Martínez-García MÁ, Gozal D. Experimental Models to Study End-Organ Morbidity in Sleep Apnea: Lessons Learned and Future Directions. Int J Mol Sci 2022; 23:ijms232214430. [PMID: 36430904 PMCID: PMC9696027 DOI: 10.3390/ijms232214430] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
Sleep apnea (SA) is a very prevalent sleep breathing disorder mainly characterized by intermittent hypoxemia and sleep fragmentation, with ensuing systemic inflammation, oxidative stress, and immune deregulation. These perturbations promote the risk of end-organ morbidity, such that SA patients are at increased risk of cardiovascular, neurocognitive, metabolic and malignant disorders. Investigating the potential mechanisms underlying SA-induced end-organ dysfunction requires the use of comprehensive experimental models at the cell, animal and human levels. This review is primarily focused on the experimental models employed to date in the study of the consequences of SA and tackles 3 different approaches. First, cell culture systems whereby controlled patterns of intermittent hypoxia cycling fast enough to mimic the rates of episodic hypoxemia experienced by patients with SA. Second, animal models consisting of implementing realistic upper airway obstruction patterns, intermittent hypoxia, or sleep fragmentation such as to reproduce the noxious events characterizing SA. Finally, human SA models, which consist either in subjecting healthy volunteers to intermittent hypoxia or sleep fragmentation, or alternatively applying oxygen supplementation or temporary nasal pressure therapy withdrawal to SA patients. The advantages, limitations, and potential improvements of these models along with some of their pertinent findings are reviewed.
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Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 1964603 Madrid, Spain
- Institut Investigacions Biomediques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence: (R.F.); (D.G.)
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 1964603 Madrid, Spain
- Institut Investigacions Biomediques August Pi Sunyer, 08036 Barcelona, Spain
| | - Miguel-Ángel Martínez-García
- CIBER de Enfermedades Respiratorias, 1964603 Madrid, Spain
- Pneumology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain
| | - David Gozal
- Department of Child Health and Child Health Research Institute, School of Medicine, The University of Missouri, Columbia, MO 65201, USA
- Correspondence: (R.F.); (D.G.)
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Harki O, Bouyon S, Sallé M, Arco-Hierves A, Lemarié E, Demory A, Chirica C, Vilgrain I, Pépin JL, Faury G, Briançon-Marjollet A. Inhibition of Vascular Endothelial Cadherin Cleavage Prevents Elastic Fiber Alterations and Atherosclerosis Induced by Intermittent Hypoxia in the Mouse Aorta. Int J Mol Sci 2022; 23:ijms23137012. [PMID: 35806017 PMCID: PMC9266969 DOI: 10.3390/ijms23137012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 01/27/2023] Open
Abstract
Intermittent hypoxia (IH), the major feature of obstructive sleep apnea syndrome (OSAS), induces atherosclerosis and elastic fiber alterations. VE-cadherin cleavage is increased in OSAS patients and in an IH-cellular model. It is mediated by HIF-1 and Src-tyr-kinases pathways and results in endothelial hyperpermeability. Our aim was to determine whether blocking VE-cadherin cleavage in vivo could be an efficient strategy to inhibit deleterious IH-induced vascular remodeling, elastic fiber defects and atherogenesis. VE-cadherin regulation, aortic remodeling and atherosclerosis were studied in IH-exposed C57Bl/6J or ApoE-/-mice treated or not with Src-tyr-kinases inhibitors (Saracatinib/Pazopanib) or a HIF-1 inhibitor (Acriflavine). Human aortic endothelial cells were exposed to IH and treated with the same inhibitors. LDL and the monocytes transendothelium passage were measured. In vitro, IH increased transendothelium LDL and monocytes passage, and the tested inhibitors prevented these effects. In mice, IH decreased VE-cadherin expression and increased plasmatic sVE level, intima-media thickness, elastic fiber alterations and atherosclerosis, while the inhibitors prevented these in vivo effects. In vivo inhibition of HIF-1 and Src tyr kinase pathways were associated with the prevention of IH-induced elastic fiber/lamella degradation and atherogenesis, which suggests that VE-cadherin could be an important target to limit atherogenesis and progression of arterial stiffness in OSAS.
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Affiliation(s)
- Olfa Harki
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Sophie Bouyon
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Marine Sallé
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Alejandro Arco-Hierves
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Emeline Lemarié
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Alexandra Demory
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Carole Chirica
- Unité Biochimie Immunoanalyse, Service de Biochimie SB2TE, CHU Grenoble Alpes, 38000 Grenoble, France;
| | - Isabelle Vilgrain
- Université Grenoble Alpes, INSERM U1292, CEA, 38042 Grenoble, France;
| | - Jean-Louis Pépin
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
| | - Gilles Faury
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
- Correspondence:
| | - Anne Briançon-Marjollet
- Université Grenoble Alpes, INSERM U1300, CHU Grenoble Alpes, Laboratoire HP2, 38042 Grenoble, France; (O.H.); (S.B.); (M.S.); (A.A.-H.); (E.L.); (A.D.); (J.-L.P.); (A.B.-M.)
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12
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Harki O, Faury G, Vilgrain I, Pépin JL, Briançon-Marjollet A. Reply: Soluble VE-cadherin: not just a marker of endothelial permeability. Eur Respir J 2021; 58:13993003.02629-2021. [PMID: 34711535 DOI: 10.1183/13993003.02629-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Olfa Harki
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, Grenoble, France
| | - Gilles Faury
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, Grenoble, France
| | | | - Jean-Louis Pépin
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, Grenoble, France
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13
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Li SQ, Lin YN, Li QY. Soluble VE-cadherin: not just a marker of endothelial permeability. Eur Respir J 2021; 58:13993003.02241-2021. [PMID: 34711537 DOI: 10.1183/13993003.02241-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Co-first author
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Co-first author
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China .,Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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14
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Farré R, Gozal D, Almendros I. Human experimental models: seeking to enhance multiscale research in sleep apnoea. Eur Respir J 2021; 58:58/4/2101169. [PMID: 34620681 DOI: 10.1183/13993003.01169-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain .,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut Investigacions Biomediques August Pi Sunyer, Barcelona, Spain
| | - David Gozal
- Dept of Child Health, The University of Missouri School of Medicine, Columbia, MO, USA
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut Investigacions Biomediques August Pi Sunyer, Barcelona, Spain
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15
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Li L, Yang Y, Zhang H, Du Y, Jiao X, Yu H, Wang Y, Lv Q, Li F, Sun Q, Qin Y. Salidroside Ameliorated Intermittent Hypoxia-Aggravated Endothelial Barrier Disruption and Atherosclerosis via the cAMP/PKA/RhoA Signaling Pathway. Front Pharmacol 2021; 12:723922. [PMID: 34504429 PMCID: PMC8421548 DOI: 10.3389/fphar.2021.723922] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Endothelial barrier dysfunction plays a key role in atherosclerosis progression. The primary pathology of obstructive sleep apnea-hypopnea syndrome is chronic intermittent hypoxia (IH), which induces reactive oxygen species (ROS) overproduction, endothelial barrier injury, and atherosclerosis. Salidroside, a typical pharmacological constituent of Rhodiola genus, has documented antioxidative, and cardiovascular protective effects. However, whether salidroside can improve IH-aggravated endothelial barrier dysfunction and atherosclerosis has not been elucidated. Methods and results: In normal chow diet-fed ApoE−/− mice, salidroside (100 mg/kg/d, p. o.) significantly ameliorated the formation of atherosclerotic lesions and barrier injury aggravated by 7-weeks IH (21%–5%–21%, 120 s/cycle). In human umbilical vein endothelial cells (HUVECs), exposure to IH (21%–5%–21%, 40 min/cycle, 72 cycles) decreased transendothelial electrical resistance and protein expression of vascular endothelial cadherin (VE-cadherin) and zonula occludens 1. In addition, IH promoted ROS production and activated ras homolog gene family member A (RhoA)/Rho-associated protein kinase (ROCK) pathway. All of these effects of IH were reversed by salidroside. Similar to salidroside, ROCK-selective inhibitors Y26732, and Fasudil protected HUVECs from IH-induced ROS overproduction and endothelial barrier disruption. Furthermore, salidroside increased intracellular cAMP levels, while the PKA-selective inhibitor H-89 attenuated the effects of salidroside on IH-induced RhoA/ROCK suppression, ROS scavenging, and barrier protection. Conclusion: Our findings demonstrate that salidroside effectively ameliorated IH-aggravated endothelial barrier injury and atherosclerosis, largely through the cAMP/PKA/RhoA signaling pathway.
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Affiliation(s)
- Linyi Li
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yunyun Yang
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Huina Zhang
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yunhui Du
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Xiaolu Jiao
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Huahui Yu
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yu Wang
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Qianwen Lv
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Fan Li
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Qiuju Sun
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yanwen Qin
- The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing, China.,The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Anzhen Hospital, Ministry of Education, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
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16
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Li X, He J. The Association Between Serum/Plasma Leptin Levels and Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression. Front Endocrinol (Lausanne) 2021; 12:696418. [PMID: 34671315 PMCID: PMC8522441 DOI: 10.3389/fendo.2021.696418] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/07/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is associated with various adipokines. Leptin, a common adipokine, has attracted considerable attention of many researchers in recent years. So far, there has been little agreement on whether blood leptin levels differ in patients with OSAS. Thus, this meta-analysis examined the relationship between serum/plasma leptin levels and the occurrence of OSAS. METHOD WanFang, Embase, CNKI, Medline, SinoMed, Web of Science, and PubMed were searched for articles before March 30, 2021, with no language limitations. STATA version 11.0 and R software version 3.6.1 were used to analyze the obtained data. The weighted mean difference and correlation coefficients were used as the main effect sizes with a random-effects model and a fixed-effects model, respectively. Trial sequential analysis was conducted using dedicated software. RESULT Screening of 34 publications identified 45 studies that met the inclusion criteria of this meta-analysis and meta-regression. Our results suggested that plasma/serum leptin levels were remarkably higher in individuals with OSAS than in healthy individuals. Subgroup analyses were performed based on OSAS severity, ethnicity, age, body mass index, assay type, and sample source. The serum and plasma leptin levels were increased in nearly all OSAS subgroups compared to those in the corresponding control groups. Meta-regression analysis indicated that age, BMI, severity, assay approaches, study design, PSG type and ethnicity did not have independent effect on leptin levels. Furthermore, a positive relationship between the serum/plasma leptin level and apnea-hypopnea index (AHI) was found in the meta-analysis. The results of the trial sequential analysis suggested that the enrolled studies surpassed the required information size, confirming that our study findings were reliable. CONCLUSION Our study results demonstrate that OSAS patients have higher leptin levels in serum/plasma compared to controls, and the serum/plasma leptin level is positively correlated with AHI, especially in adults.
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Affiliation(s)
- Xiaoyan Li
- Department of endocrinology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jie He
- Department of Pulmonary and Critical Care Medicine, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- *Correspondence: Jie He,
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