Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Sleep Breath. 2013 May;17(2):597-604. doi: 10.1007/s11325-012-0726-y. Epub 2012 Jun 7.
The presence of both systemic and airway inflammation has been suggested in obstructive sleep apnea (OSA) by increased levels of inflammatory biomarkers in the circulation and respiratory specimens. We aimed to investigate the relationship between systemic and airway inflammation in OSA.
This study was conducted by simultaneously measuring various biomarkers both in serum and induced sputum of 43 patients. We compared the relationships of these biomarker levels with polysomnographic data and obesity measurements and also investigated their interrelationships between systemic and local compartments. We also assessed the relation of inflammatory markers with proximal airway resistance measured by impulse oscillometry.
In multiple regression analyses, each measured serum biomarker [leptin, interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF)] significantly correlated with waist circumference or fat area determined by computed tomography. In contrast, regarding airway inflammation, sputum IL-6, IL-8, TNF-α, and VEGF significantly correlated with OSA severity as indicated by the respiratory disturbance index or oxygen desaturation indices. Sputum IL-6, IL-8, TNF-α, and VEGF were significantly related to sputum neutrophil number, and sputum IL-8 and TNF-α were related to proximal airway resistance independently of body mass index. There were no significant interrelationships between the same biomarkers in serum and induced sputum.
Systemic and airway inflammation in OSA might be differently regulated by OSA itself and comorbid obesity, depending on the type of cytokine. Although we did not find apparent interrelationships between systemic and local compartments, further studies are needed to clarify this concept.
循环和呼吸道标本中炎症生物标志物水平升高提示阻塞性睡眠呼吸暂停（OSA）存在全身和气道炎症。我们旨在研究 OSA 中全身和气道炎症之间的关系。
本研究通过同时测量 43 例患者的血清和诱导痰中的各种生物标志物来进行。我们比较了这些生物标志物水平与多导睡眠图数据和肥胖测量值的关系，并研究了它们在全身和局部之间的相互关系。我们还评估了炎症标志物与脉冲振荡测量法测定的近端气道阻力之间的关系。
多元回归分析中，每种测量的血清生物标志物[瘦素、白细胞介素-6（IL-6）、IL-8、肿瘤坏死因子-α（TNF-α）和血管内皮生长因子（VEGF）]均与 CT 确定的腰围或脂肪面积显著相关。相比之下，就气道炎症而言，痰中 IL-6、IL-8、TNF-α和 VEGF 与呼吸紊乱指数或氧减饱和指数所指示的 OSA 严重程度显著相关。痰中 IL-6、IL-8、TNF-α和 VEGF 与痰中性粒细胞数显著相关，痰中 IL-8 和 TNF-α与 BMI 无关，与近端气道阻力相关。血清和诱导痰中的相同生物标志物之间没有显著的相互关系。
OSA 中的全身和气道炎症可能由 OSA 本身和并存的肥胖以不同的方式调节，这取决于细胞因子的类型。尽管我们没有发现全身和局部之间明显的相互关系，但需要进一步研究来阐明这一概念。
