Bikov András, Kunos László, Pállinger Éva, Lázár Zsófia, Kis Adrián, Horváth Gábor, Losonczy György, Komlósi Zsolt István
Department of Pulmonology, Semmelweis University, Diós árok 1/C, Budapest, 1125, Hungary.
Department of Genetics, Cell- and Immunobiology, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary.
Sleep Breath. 2017 Sep;21(3):595-600. doi: 10.1007/s11325-017-1464-y. Epub 2017 Jan 27.
Microvesicles (MVs) have been implicated in the pathomechanism of obstructive sleep apnoea (OSA); however, the results are inconsistent, possibly due to an unrevealed temporal variation in circulating MV levels. We aimed to investigate the diurnal changes of MV fractions in OSA.
Peripheral blood was taken from 18 patients with OSA and 9 healthy subjects at different time points (11:00, 17:00, 21:00, 01:30 and 06:00). Samplings were repeated in nine OSA patients after 2 months of continuous positive airway pressure (CPAP) therapy. CD41+, CD62P+, glycophorin A+ and Annexin V+ MVs were determined with flow cytometry. Areas under the MV concentrations-time curves (AUC) were calculated and correlated with the severity of OSA.
A significant diurnal variability of plasma CD41+ and Annexin V+ MVs was observed only in OSA with a marked peak at 17:00. There was a direct correlation between CD41+ MV AUCs and the severity of OSA. CPAP treatment reduced diurnal variability in both CD41+ and Annexin V+ MV levels.
The relationship between the diurnal variability of CD41+ MVs and disease severity as well as the effect of CPAP treatment on MV levels support the role of MVs in the pathophysiology of OSA. More importantly, considering the significant diurnal variation in circulating MV levels, introduction of strict protocols for blood sampling is required for MV measurements.
微泡（MVs）已被认为与阻塞性睡眠呼吸暂停（OSA）的发病机制有关；然而，结果并不一致，这可能是由于循环MV水平存在未被揭示的时间变化。我们旨在研究OSA中MV组分的昼夜变化。
在不同时间点（11:00、17:00、21:00、01:30和06:00）采集18例OSA患者和9名健康受试者的外周血。9例OSA患者在持续气道正压通气（CPAP）治疗2个月后重复采样。采用流式细胞术测定CD41 +、CD62P +、血型糖蛋白A +和膜联蛋白V + MVs。计算MV浓度 - 时间曲线下面积（AUC），并将其与OSA的严重程度相关联。
仅在OSA患者中观察到血浆CD41 +和膜联蛋白V + MVs有显著的昼夜变化，在17:00有明显峰值。CD41 + MV AUC与OSA严重程度之间存在直接相关性。CPAP治疗降低了CD41 +和膜联蛋白V + MV水平的昼夜变化。
CD41 + MVs的昼夜变化与疾病严重程度之间的关系以及CPAP治疗对MV水平的影响支持了MVs在OSA病理生理学中的作用。更重要的是，考虑到循环MV水平存在显著的昼夜变化，进行MV测量时需要引入严格的血液采样方案。
