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Cànaves-Gómez L, Fleischer A, Muncunill-Farreny J, Gimenez MP, Álvarez Ruiz De Larrinaga A, Sánchez Baron A, Codina Marcet M, De-La-Peña M, Morell-Garcia D, Peña Zarza J, Piñas Zebrian C, García Fernández S, Alonso A. Effect of Obstructive Sleep Apnea during Pregnancy on Fetal Development: Gene Expression Profile of Cord Blood. Int J Mol Sci 2024; 25:5537. [PMID: 38791576 DOI: 10.3390/ijms25105537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Obstructive sleep apnea (OSA) is quite prevalent during pregnancy and is associated with adverse perinatal outcomes, but its potential influence on fetal development remains unclear. This study investigated maternal OSA impact on the fetus by analyzing gene expression profiles in whole cord blood (WCB). Ten women in the third trimester of pregnancy were included, five OSA and five non-OSA cases. WCB RNA expression was analyzed by microarray technology to identify differentially expressed genes (DEGs) under OSA conditions. After data normalization, 3238 genes showed significant differential expression under OSA conditions, with 2690 upregulated genes and 548 downregulated genes. Functional enrichment was conducted using gene set enrichment analysis (GSEA) applied to Gene Ontology annotations. Key biological processes involved in OSA were identified, including response to oxidative stress and hypoxia, apoptosis, insulin response and secretion, and placental development. Moreover, DEGs were confirmed through qPCR analyses in additional WCB samples (7 with OSA and 13 without OSA). This highlighted differential expression of several genes in OSA (EGR1, PFN1 and PRKAR1A), with distinct gene expression profiles observed during rapid eye movement (REM)-OSA in pregnancy (PFN1, UBA52, EGR1, STX4, MYC, JUNB, and MAPKAP). These findings suggest that OSA, particularly during REM sleep, may negatively impact various biological processes during fetal development.
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Affiliation(s)
- Laura Cànaves-Gómez
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
| | - Aarne Fleischer
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Genomic & Bioinformatics Platform, IdISBa, 07120 Palma de Mallorca, Spain
| | - Josep Muncunill-Farreny
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Genomic & Bioinformatics Platform, IdISBa, 07120 Palma de Mallorca, Spain
| | - María Paloma Gimenez
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
| | - Ainhoa Álvarez Ruiz De Larrinaga
- Hospital Universitario de Araba, 01009 Vitoria-Gasteiz, Spain
- Departamento de Neurociencias, Instituto de Investigación Sanitaria Bioaraba, 01009 Vitoria-Gasteiz, Spain
| | | | - Mercedes Codina Marcet
- Servicio de Endocrinología, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - Mónica De-La-Peña
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
- Facultad de Medicina, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES), 28029 Madrid, Spain
| | - Daniel Morell-Garcia
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Servicio de Análisis Clínicos, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - José Peña Zarza
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Servicio de Pediatría, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - Concepción Piñas Zebrian
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - Susana García Fernández
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - Alberto Alonso
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
- Facultad de Medicina, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES), 28029 Madrid, Spain
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Alonso-Fernández A, Ribot Quetglas C, Herranz Mochales A, Álvarez Ruiz De Larrinaga A, Sánchez Barón A, Rodríguez Rodríguez P, Gil Gómez AV, Pía Martínez C, Cubero Marín JP, Barceló Nicolau M, Cerdà Moncadas M, Codina Marcet M, De La Peña Bravo M, Barceló Bennasar A, Iglesias Coma A, Morell-Garcia D, Peña Zarza JA, Giménez Carrero MP, Durán Cantolla J, Marín Trigo JM, Piñas Cebrian MC, Soriano JB, García-Río F. Influence of Obstructive Sleep Apnea on Systemic Inflammation in Pregnancy. Front Med (Lausanne) 2021; 8:674997. [PMID: 34796182 PMCID: PMC8593073 DOI: 10.3389/fmed.2021.674997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Obstructive sleep apnea (OSA) is prevalent in pregnancy and it is associated with adverse pregnancy-related outcomes such as gestational diabetes, pre-eclampsia, and low birth weight. Maternal systemic inflammation is proposed to be one of the main intermediate mechanisms. However, the effects of OSA on systemic inflammation are unknown in normal pregnancy. Methods: Women in the 3rd trimester underwent hospital polysomnography to evaluate whether OSA increases systemic inflammation in normal pregnancy and its potential association with adverse fetal outcomes. OSA was defined as an apnea–hypopnea index (AHI) of ≥ 5 h−1. Plasma cytokines levels (TNF-α, IL-1β, IL-6, IL-8, and IL-10) were determined by multiple immunoassays. Results: We included 11 patients with OSA and 22 women with AHI < 5 h−1, who were homogeneous in age, and body mass index (BMI). Women with OSA had significant higher levels of TNF-α, IL-1β, IL-8, and IL-10. We found significant correlations between AHI during REM and TNF-α (r = 0.40), IL-1β (r = 0.36), IL-6 (r = 0.52), IL-8 (r = 0.43), between obstructive apnea index and TNF-α (r = 0.46) and between AHI and IL-1β (r = 0.43). We also found that CT90% was related to IL-8 (r = 0.37). There were no significant differences in neonatal characteristics; however, we found inverse correlations between TNF-α and IL-8 with birth weight (both r = −0.48), while IL-8 showed a significant inverse relationship with neonatal gestational age (r = −0.48). Conclusions: OSA in our normal pregnancy population was associated with higher systemic inflammation, which was related to obstructive events, especially during REM sleep. Moreover, systemic inflammation was inversely correlated with neonatal birth weight and age.
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Affiliation(s)
- Alberto Alonso-Fernández
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.,Servicio de Neumología, Hospital Universitari Son Espases, Palma, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | | | - Ainhoa Álvarez Ruiz De Larrinaga
- Unidad del Sueño, Hospital Universitario de Araba, Vitoria-Gasteiz, Spain.,Instituto de Investigación BIOARABA, Vitoria-Gasteiz, Spain
| | | | | | - Ana Victoria Gil Gómez
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - José Pablo Cubero Marín
- Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | | | - Mónica De La Peña Bravo
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.,Servicio de Neumología, Hospital Universitari Son Espases, Palma, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Antònia Barceló Bennasar
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.,Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Palma, Spain
| | - Amanda Iglesias Coma
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.,Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Palma, Spain
| | | | | | - Joaquín Durán Cantolla
- Unidad del Sueño, Hospital Universitario de Araba, Vitoria-Gasteiz, Spain.,Instituto de Investigación BIOARABA, Vitoria-Gasteiz, Spain
| | - José María Marín Trigo
- Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - María Concepción Piñas Cebrian
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.,Servicio de Neumología, Hospital Universitari Son Espases, Palma, Spain
| | - Joan B Soriano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Servicio de Neumología, Hospital Universitario La Paz, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
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Alonso-Fernández A, Cerdá Moncadas M, Álvarez Ruiz De Larrinaga A, Sánchez Barón A, Codina Marcet M, Rodríguez Rodríguez P, Gil Gómez AV, Giménez Carrero MP, Pía Martínez C, Cubero Marín JP, de la Peña M, Barceló A, Morell-Garcia D, Pierola J, Peña Zarza JA, Durán Cantolla J, Marín Trigo JM, Soriano JB, García-Río F. Impact of Obstructive Sleep Apnea on Gestational Diabetes Mellitus. Arch Bronconeumol 2021; 58:S0300-2896(21)00160-5. [PMID: 34130878 DOI: 10.1016/j.arbres.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/30/2021] [Accepted: 05/01/2021] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) increases the risk of type 2 diabetes, and hyperinsulinemia. Pregnancy increases the risk of OSA; however, the relationship between OSA and gestational diabetes mellitus (GDM) is unclear. We aimed (1) to evaluate OSA prevalence in GDM patients; (2) to assess the association between OSA and GDM; and (3) to determine the relationships between sleep parameters with insulin resistance (IR). METHODS A total of 177 consecutive women (89 with GDM, 88 controls) in the third trimester of pregnancy underwent a hospital polysomnography. OSA was defined when the apnea-hypopnea index (AHI) was ≥5h-1. RESULTS Patients with GDM had higher pregestational body mass index (BMI) and neck circumference than controls, but no differences in snoring or OSA-symptoms, or AHI (3.2±6.0 vs. 1.9±2.7h-1, p=.069). OSA prevalence was not significantly different in both groups. We did not identify OSA as a GDM risk factor in the crude analysis 1.65 (95%CI: 0.73-3.77; p=.232). Multiple regression showed that total sleep time (TST), TST spent with oxygen saturation<90% (T90), and maximum duration of respiratory events as independent factors related with homeostasis model assessment of IR, while T90 was the only independent determinant of quantitative insulin sensitivity check index. CONCLUSION OSA prevalence during the third trimester of pregnancy was not significantly different in patients with GDM than without GDM, and no associations between OSA and GDM determinants were found. We identified T90 and obstructive respiratory events length positive-related to IR, while TST showed an inverse relationship with IR in pregnant women.
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Affiliation(s)
- Alberto Alonso-Fernández
- Department of Pneumology, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | | | | | | | - Mercedes Codina Marcet
- Department of Endocrinology and metabolism, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | | | | | | | | | - Mónica de la Peña
- Department of Pneumology, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Antonia Barceló
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Clinical Analysis, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Department of Clinical Analysis, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Javier Pierola
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - José Antonio Peña Zarza
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Department of Pediatrics, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Joaquín Durán Cantolla
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Sleep Unit, Hospital Universitario de Araba, Vitoria, Spain; Instituto de Investigación BIOARABA, Vitoria, Spain
| | - José María Marín Trigo
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Pneumology, Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Joan B Soriano
- Hospital Universitario de la Princesa-Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Pneumology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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