Role of Cytokines in Children with Obstructive Sleep apnea

Yıl 2015, Cilt: 7 , - , 07.01.2015

Anjali Pandit , Abduhar Ablat Karmacharya Ujit Baht Bulbul Peiru Xu Mahsum Ekim

Öz

Abstract:

Aim: To explore the inflammatory and anti-inflammatory factors in children with and without obstructive sleep apnea (OSA) and observe the effects of these factors after treatment in children with OSA. Methods: A total of 142 children were enrolled in this study. Based on overnight polysomnographic evaluation and physical examination, they were divided into two groups; OSA group (47) and control group (95). OSA was diagnosed if obstructive apnea index (OAI) >1. According to apnea-hypoapnea index (AHI), OSA children were further divided into mild (AHI≥1 and≤5), moderate (AHI>5 and≤10), and severe (AHI>10) groups. A blood sample was collected for analysis of interleukin 6 (IL-6), intracellular adhesion molecule 1 (ICAM-1), and interleukin 10 (IL-10). Results: Serum levels of IL-6 and ICAM-1 were significantly higher and serum level of IL-10 was significantly lower in OSA group compared to control group. Of 47 OSA children, 43 received treatment (38 underwent adenotonsillectomy (T&A); 4 received inhaled nasal corticosteroid; and 1 received noninvasive positive pressure ventilation (NIPPV); 7 lost during follow-ups, remaining 36 were followed up after three months. There was substantial decrease in IL-6 and ICAM-1 and increase in IL-10 after treatment (P<0.01). The difference was statistically significant (P<0.05), independent of age, gender, and body mass index (BMI). Conclusion: Up-regulation of pro-inflammatory cytokines have been well established in childhood OSA, but down-regulation of anti-inflammatory cytokine IL-10 and its up-regulation following treatment is a new finding; all of which in turn could promote the onset and progression of atherogenesis in children. As this inflammatory response is reversible, early recognition and treatment of OSA children would be beneficial in decreasing the risks.

Anahtar Kelimeler

Obstructive sleep apnea, cytokines, interleukins

Kaynakça

• 1- Vitulano N, Di Marco Berardino A, Re A, et
• al. Obstructive sleep apnea and heart disease: the biomarkers point of view. Front Biosci (Schol Ed).2013; 5: 588-99.
• 2- Fusetti M, Fioretti AB, Valenti M, Masedu F et al.
• Cardiovascular and metabolic
• comorbidities in patients with obstructive sleep
• Otorhinolaryngol Ital. 2012; 32(5): 320-5.
• 3- Burioka N, Miyata M, Fukuoka Y,et al. Day
• night variations of serum interleukin-6 in patients with severe obstructive sleep apnea syndrome before and after continuous positive airway pressure (CPAP). Chronobiol Int 2008; 25(5): 827-834.
• 4- Kent BD, Ryan S, McNicholas WT.
• Obstructive sleep apnea and inflammation: relationship to cardiovascular co-morbidity. Respir Physiol Neurobiol. 2011; 178: 475-81.
• 5- Amin RS, Carroll JL, Jeffries JL ,et al.
• Twenty-four-hour ambulatory blood pressure in children with sleep disordered breathing. Am J Respir Crit Care Med 2004;169: 950-6.
• 6- Athanasios G. Kaditis, Maria G,et al.
• Cysteinyl leukotriene urine concentrations of cysteinyl leukotrienes in children with obstructive. Chest 2009; 135: 1496-1501. breathing
• 7- Tam CS, Wong M, McBain R, et al.
• Inflammatory measures in children with obstructive sleep apnea. J Pediatr Child Health 2006; 42: 277-82.
• 8- Yamauchi M Nakano H, Maekawa J, et a1.Oxidative stress in obstructive sleep apnea. Chest 2005; 127(5): 1674-1679.
• 9- Baharav A, Kotagal S, Rubin BK, Pratt J, Akselrod S. control in children with obstructive sleep apnea. Clin Auton Res 1999; 9: 345–351. Gozal dysfunction in children with sleep-disordered breathing. Sleep 2005; 28: 747–752.
• 11- Ng DK, Leung LC, Kwok KL, Chan CH. Blood pressure and OSAS in children. Am J Respir Crit Care Med. 2007; 176: 1054-5.
• 12- Bhattacharjee R, Kheirandish-Gozal L, Pillar G, Gozal D. Cardiovascular complications of obstructive sleep apnea syndrome: evidence from children. Prog Cardiovasc Dis. 2009; 51(5): 416-33.
• 13- Tatlipinar A, Duman D, Uslu C, et a1. The effects of obstructive sleep apnea syndrome due to adenotonsillar hypertrophy on the cardiovascular system in children.Turk J Pediatr. 2011; 53(4): 359-63.
• 14- Montesano M, Miano S, Paolino MC,et a1. Autonomic cardiovascular tests in children with obstructive sleep apnea syndrome.Sleep. 2010; 33 (10): 1349-55.
• 15- Tauman R, O'brien LM, Gozal D. Hypoxemia and obesity modulate plasma C- reactive protein and interleukin-6 levels in sleep-disordered breathing. Sleep Breath. 2007; 11: 77-84.
• 16- O'Brien LM, Serpero LD, Tauman R, Gozal D. Plasma adhesion molecules in children with sleep disordered breathing. Chest 2006; 129: 947–953.
• 17- Tedgui A, Mallat Z. Anti-inflammatory mechanisms in the vascular wall. Circ Res 2001; 88: 877–87.
• 18- Caligiuri G, Rudling M, Ollivier V, et a1. Interleukin-10 atherosclerosis, thrombosis, and low-density lipoproteins in apolipoprotein E knockout mice. Mol Med 2003; 9: 10–17. increases
• 19- Punjabi NM, Beamer BA.C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 2007; 30: 29- 34.
• 20- Kokturk O ,Ciftci TU, Mollarecep E, et al.Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. Int Heart J 2005; 46(5): 801-9.
• 21- Mehra R, Storfer-Isser A, Kirchner HL,et al.Soluble interleukin 6 receptor – a novel marker of moderate to severe sleep-related breathing disorder. Arch Intern Med 2006; 166: 1725-31. 22- Gozal D,
• Kheirandish-Gozal L,
• Bhattacharjee R, ,et al. C-reactive protein and obstructive
• children. Front Biosci (Elite Ed). 2012; 4: 2410-22. syndrome in
• 23- Ingram DG, Matthews CK. Effect of adenotonsillectomy on C-reactive protein levels in children with obstructive sleep apnea: a meta-analysis. Sleep Med. 2013; 14(2): 172-6.
• 24- El-Solh AA, Mador AJ, Sikka P, et al. Adhesion coronary artery disease and moderate-to- severe obstructive sleep apnea. Chest 2002; 121: 1541–1547 in patients with
• 25- Tam CS, Wong M, McBain R, Bailey S, Waters KA. Inflammatory measures in children with obstructive sleep apnea. J Pediatr Child Health 2006; 42: 277–282.
• 26- Alberti A, Sarchielli P, Gallinella E, Floridi A, Floridi A, Mazzotta G, Gallai V. Plasma cytokine levels in patients with obstructive sleep apnea syndrome: a preliminary study. J Sleep Res 2003; 12: 305–311.
• 27- David Gozal, Laura D. Serpero, Oscar Sans Capdevila, inflammation in non-obese children with obstructive sleep apnea. Sleep Med. 2008; 9(3): 254-259. Systemic
• 28- Albert M Li, Hugh S Lam, Michael HM Chan, Hung K So, Siu K Ng, Iris HS Chan, Christopher WK Lam, Yun K Wing. Inflammatory obstructive sleep apnoea. Ann Acad Med Singapore 2008; 37: 649-54. childhood
• 29- Li AM, Wing YK, Cheung A, Chan D, Ho C, Hui S, et al. Is a 2-night polysomnographic study necessary in childhood sleep-related disordered breathing? Chest 2004; 126: 1467-72.
• 30- Brouillette RT, Manoukian JJ, Ducharme FM, Oudjhane K, Earle LG, Ladan S, et al. Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 2001; 138: 838-44.