Department of Pulmonology, Semmelweis University, Tömő utca 25-29, Budapest, Hungary.
Department of Radiology, Semmelweis University, Budapest, Hungary.
Lung. 2020 Feb;198(1):173-179. doi: 10.1007/s00408-019-00299-0. Epub 2020 Jan 2.
Obstructive sleep apnea (OSA) is characterized by chronic intermittent hypoxia which induces inflammation in blood vessels leading to the development of cardiovascular comorbidities. Several studies implicated the role of P-selectin in vascular inflammation of OSA. P-selectin glycoprotein ligand 1 (PSGL-1) is the main activator for P-selectin and is involved in immune cell trafficking. However, PSGL-1 has not been analyzed in OSA. The aim of the study was to investigate plasma PSGL-1 and P-selectin levels to have a deeper understanding on their interaction in obstructive sleep apnea.
Fifty-one untreated patients with OSA and 42 non-OSA controls were recruited. Plasma PSGL-1 levels were determined in evening and morning samples, P-selectin levels were analyzed in morning samples using commercially available ELISA kits. Polysomnography was performed in all participants. OSA was defined by an apnea-hypopnea index ≥ 5/h.
PSGL-1 levels did not differ between controls and OSA patients either in the evening or in the morning. Although, there was no difference between controls (16.9/6.8-40.8 ng/ml) and patients with OSA (19.6/8.4-56.8, p = 0.24), patients with severe OSA had increased plasma P-selectin levels (25.6/8.4-56.8 ng/ml) compared to mild OSA patients (14.1/8.5-35.3 ng/ml, p = 0.006) and controls (p = 0.03).
P-selectin expression relates to disease severity suggesting a pathophysiological role in endothelial cell activation. PSGL-1 levels are unaltered in OSA, suggesting an alternative activation pathway for P-selectin in OSA.
阻塞性睡眠呼吸暂停（OSA）的特征是慢性间歇性缺氧，这会导致血管炎症，从而引发心血管合并症。有几项研究表明 P-选择素在 OSA 的血管炎症中起作用。P-选择素糖蛋白配体 1（PSGL-1）是 P-选择素的主要激活剂，参与免疫细胞的迁移。然而，PSGL-1 在 OSA 中尚未被分析。本研究旨在探讨血浆 PSGL-1 和 P-选择素水平，以更深入地了解它们在阻塞性睡眠呼吸暂停中的相互作用。
招募了 51 名未经治疗的 OSA 患者和 42 名非 OSA 对照组。使用商业 ELISA 试剂盒在晚上和早上样本中测定血浆 PSGL-1 水平，在早上样本中分析 P-选择素水平。所有参与者均进行了多导睡眠图检查。OSA 定义为每小时呼吸暂停-低通气指数≥5。
无论是在晚上还是在早上，PSGL-1 水平在对照组和 OSA 患者之间均无差异。尽管对照组（16.9/6.8-40.8ng/ml）和 OSA 患者（19.6/8.4-56.8ng/ml，p=0.24）之间无差异，但重度 OSA 患者的血浆 P-选择素水平升高（25.6/8.4-56.8ng/ml）与轻度 OSA 患者（14.1/8.5-35.3ng/ml，p=0.006）和对照组（p=0.03）相比。
P-选择素的表达与疾病严重程度相关，提示其在血管内皮细胞激活中的病理生理作用。OSA 中 PSGL-1 水平不变，提示 OSA 中 P-选择素的替代激活途径。
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