Boukari Ryma, Laouafa Sofien, Ribon-Demars Alexandra, Bairam Aida, Joseph Vincent
Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada.
Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada.
Respir Physiol Neurobiol. 2017 May;239:46-54. doi: 10.1016/j.resp.2017.01.013. Epub 2017 Feb 9.
Evidence supports the importance of ovarian hormones as potential tools against sleep apneas in women. On one hand, progesterone is largely acknowledged as being a respiratory stimulant that reduces the frequency of apneas, but the underlying mechanisms remain poorly understood. Recent studies in mice showed that the respiratory effects of progesterone are mediated by at least two classes of progesterone receptors, including the nuclear (nPR) and membrane receptors (mPR). Some of these receptors (nPR) have sex-specific effects on the frequency of apneas recorded during sleep in mice, while mPRβ acts in males as well as in females. Moreover, sleep apnea is a condition that induces an "oxidative stress" response in several tissues, and this contributes to the deleterious consequences of sleep apneas, including the development of hypertension. While estradiol is recognized as an antioxidant hormone, its potential protective role has remained mostly ignored in the field. We will review recent data supporting an antioxidant role of estradiol in female rats exposed to intermittent hypoxia, a reliable animal model of sleep apnea. Since estradiol has two main receptors (ERα and ERβ) we will discuss their relative implications, and present new data showing a key role for ERα to prevent the hypertension induced by intermittent hypoxia. Overall this review highlights the fact that ovarian hormones could potentially be used as efficient tools against the causes (i.e. instabilities of the respiratory control system) and consequences (oxidative stress) of sleep apnea.
有证据支持卵巢激素作为对抗女性睡眠呼吸暂停潜在工具的重要性。一方面，孕酮在很大程度上被认为是一种呼吸刺激剂，可降低呼吸暂停的频率，但其潜在机制仍知之甚少。最近对小鼠的研究表明，孕酮的呼吸作用至少由两类孕酮受体介导，包括核受体（nPR）和膜受体（mPR）。其中一些受体（nPR）对小鼠睡眠期间记录的呼吸暂停频率有性别特异性影响，而mPRβ在雄性和雌性中均起作用。此外，睡眠呼吸暂停是一种在多个组织中引发“氧化应激”反应的病症，这会导致睡眠呼吸暂停的有害后果，包括高血压的发展。虽然雌二醇被认为是一种抗氧化激素，但其潜在的保护作用在该领域大多被忽视。我们将回顾最近的数据，这些数据支持雌二醇在暴露于间歇性低氧的雌性大鼠中的抗氧化作用，间歇性低氧是一种可靠的睡眠呼吸暂停动物模型。由于雌二醇有两种主要受体（ERα和ERβ），我们将讨论它们的相对影响，并展示新的数据，表明ERα在预防间歇性低氧诱导的高血压方面的关键作用。总体而言，这篇综述强调了卵巢激素可能潜在地用作对抗睡眠呼吸暂停的原因（即呼吸控制系统的不稳定）和后果（氧化应激）的有效工具这一事实。
