Alberti Andrea, Sarchielli Paola, Gallinella Elisabetta, Floridi Ardesio, Floridi Alessandro, Mazzotta Giovanni, Gallai Virgilio
Department of Neuroscience, Neurologic Clinic Department of Internal Medicine, University of Perugia, Perugia, Italy.
J Sleep Res. 2003 Dec;12(4):305-11. doi: 10.1111/j.1365-2869.2003.00361.x.
The levels of some pro- and anti-inflammatory cytokines [interleukin (IL)-1beta, tumor necrosis factor (TNF)-alpha, IL-6, IL-10, and transforming growth factor (TGF)-beta], were measured by enzyme-linked immunosorbent assay (ELISA) method in the plasma of patients affected by obstructive sleep apnea syndrome (OSAS) at 22:00 hours before polysomnographic recording and immediately after the first obstructive apnea causing an SaO2 below 85%. Significantly higher levels of TNF-alpha were found in OSAS patients assessed before polysomnography compared with the control group (P < 0.01). A slight but significant increase in the plasma levels of IL-6 was also present (P < 0.05). Conversely, a significant decrease in the plasma levels of IL-10 was evident at baseline in OSAS patients (P < 0.04). No significant difference emerged between the mean values of IL-1alpha and TGF-beta between OSAS patients and controls. The present data support a prevailing activation of the Th1-type cytokine pattern in OSAS patients, which is not associated with the severity and duration of OSAS. This can have important consequences for the outcome of OSAS patients, especially with regard to the increased risk for developing atherosclerosis and cardiovascular and cerebrovascular diseases. Immediately after the first obstructive apnea causing an SaO2 <85%, a significant variation was observed in the plasma levels of TNF-alpha in OSAS patients compared with those measured before the beginning of polysomnographic recording (P < 0.001). The role played by this further increase in TNF-alpha levels after the obstructive apnea in OSAS patients remains to be established in the light of the pathogenic mechanisms of this sleep disorder.
采用酶联免疫吸附测定（ELISA）法，在多导睡眠图记录前22:00时以及首次出现导致血氧饱和度（SaO2）低于85%的阻塞性呼吸暂停后即刻，检测阻塞性睡眠呼吸暂停综合征（OSAS）患者血浆中某些促炎和抗炎细胞因子[白细胞介素（IL）-1β、肿瘤坏死因子（TNF）-α、IL-6、IL-10和转化生长因子（TGF）-β]的水平。与对照组相比，多导睡眠图检查前评估的OSAS患者中TNF-α水平显著更高（P < 0.01）。IL-6的血浆水平也有轻微但显著的升高（P < 0.05）。相反，OSAS患者基线时IL-10的血浆水平明显降低（P < 0.04）。OSAS患者和对照组之间IL-1α和TGF-β的平均值没有显著差异。目前的数据支持OSAS患者中Th1型细胞因子模式普遍激活，这与OSAS的严重程度和持续时间无关。这可能对OSAS患者的预后产生重要影响，特别是在患动脉粥样硬化以及心血管和脑血管疾病风险增加方面。在首次出现导致SaO2 < 85%的阻塞性呼吸暂停后即刻，与多导睡眠图记录开始前测量的水平相比，OSAS患者血浆中TNF-α水平出现显著变化（P < 0.001）。鉴于这种睡眠障碍的发病机制，阻塞性呼吸暂停后TNF-α水平的进一步升高在OSAS患者中所起的作用仍有待确定。
