Lu Dongmei, Li Nanfang, Yao Xiaoguang, Zhou Ling
Postgraduate College of Xinjiang Medical University, Xinjiang Medical University, Urumqi, China; Department of Respiratory and Critical Care Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
Bosn J Basic Med Sci. 2017 Feb 21;17(1):47-53. doi: 10.17305/bjbms.2016.1579.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a complex chronic inflammatory respiratory disease with multiple pathogenic factors and high morbidity and mortality. Serum levels of nuclear factor-κB (NF-κB), hypoxia-inducible factor-1 alpha (HIF-1α), and surfactant protein D (SPD) were investigated in OSAHS patients, to determine their clinical significance and correlation with the pathogenesis. Patients were classified into a mild and moderate OSAHS group (n = 25) and severe OSAHS group (n = 33). Twenty healthy patients served as a control group. Peripheral blood levels of NF-κB, HIF-1α, and SPD were determined by Western blot, and a correlation analysis was performed. Severe OSAHS patients received nasal continuous positive airway pressure (nCPAP) therapy and were followed up after 2 months. NF-κB p65, HIF-1α, and SPD expression levels were determined after valid nCPAP therapy. NF-κB p65 and HIF-1α expression was significantly higher in severe OSAHS group than in the other two groups (p < 0.01), and was positively correlated with the apnea-hypopnea index (AHI) (r = 0.696, p < 0.001; r = 0.634, p < 0.001). SPD expression was significantly lower in severe OSAHS group than in the control group (p < 0.01) and mild and moderate OSAHS group (p < 0.01), and was negatively correlated with AHI (r = -0.569, p < 0.001). OSAHS pathogenesis was associated with changes in NF-κB, HIF-1α, and SPD protein expression levels. nCPAP therapy could improve the clinical characteristics of the patients, lower serum NF-κB and HIF-1α levels, and increase serum SPD levels. We conclude that OSAHS is related to the expression of NF-κB, HIF-1, and SPD.
阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种具有多种致病因素、高发病率和高死亡率的复杂慢性炎症性呼吸系统疾病。本研究检测了OSAHS患者血清中核因子-κB(NF-κB)、缺氧诱导因子-1α(HIF-1α)和表面活性蛋白D(SPD)水平,以确定其临床意义及与发病机制的相关性。将患者分为轻中度OSAHS组(n = 25)和重度OSAHS组(n = 33)。选取20例健康患者作为对照组。采用蛋白质印迹法检测外周血中NF-κB、HIF-1α和SPD水平,并进行相关性分析。重度OSAHS患者接受经鼻持续气道正压通气(nCPAP)治疗,2个月后进行随访。在有效nCPAP治疗后检测NF-κB p65蛋白、HIF-1α和SPD表达水平。重度OSAHS组NF-κB p65蛋白和HIF-1α表达水平显著高于其他两组(p < 0.01),且与呼吸暂停低通气指数(AHI)呈正相关(r = 0.696,p < 0.001;r = 0.634,p < 0.001)。重度OSAHS组SPD表达水平显著低于对照组(p < 0.01)及轻中度OSAHS组(p < 0.01),且与AHI呈负相关(r = -0.569,p < 0.001)。OSAHS发病机制与NF-κB、HIF-1α和SPD蛋白表达水平变化有关。nCPAP治疗可改善患者临床特征,降低血清NF-κB和HIF-1α水平,提高血清SPD水平。我们得出结论,OSAHS与NF-κB、HIF-1和SPD的表达有关。