Parasitology and Mycology Laboratory, CHU Grenoble Alpes, Grenoble, France.
Institute for Advanced Biosciences (IAB), Team Host-Pathogen Interactions and Immunity to Infection, INSERM U1209-CNRS UMR5309, University Grenoble Alpes, Grenoble, France.
PLoS One. 2020 Jul 1;15(7):e0235463. doi: 10.1371/journal.pone.0235463. eCollection 2020.
Sleepiness is the main clinical expression of obstructive sleep apnea (OSA) syndrome resulting from upper airway collapse. Recent studies have discussed the fact that the presence of T. gondii cysts in the brain and the resulting biochemical and immunological mechanisms could be linked to neurobehavioral disorders. The aim of the present study was to explore the potential impact of chronic toxoplasmosis on sleepiness and on obstructive sleep apnea (OSA) severity in OSA obese patients.
A case control study on obese patients screened for OSA was performed. According to the sleep disorder and matched based on gender, age and body mass index (BMI), two groups of obese patients were selected from our sample collection database. All patients were tested for toxoplasmosis serological status measuring anti-Toxoplasma IgG and IgM levels. Univariable and multivariable logistic regression models were performed to assess the impact of chronic toxoplasmosis on sleepiness and OSA severity.
107 obese patients suffering from OSA were included in the study (median age: 53.3 years Interquartile range (IQR): [41.9-59.9]; median BMI: 39.4 kg/m2 IQR: [35.5-44.1], apnea-hypopnea index = 27.5 events/h [10.7-49.9]). Chronic toxoplasmosis was present in 63.4% and 70.7% of patients with or without sleepiness (p = 0.48), respectively and was not associated either to sleepiness (OR: 0.76, 95% CI: [0.52; 2.33], p = 0.64) or OSA severity (OR = 1.75, 95% CI: [0.51; 5.98] p = 0.37).
Although chronic Toxoplasma infection in immunocompetent humans has been associated to several behavioral disorders or pathologies in recent literature, we demonstrate here that chronic toxoplasmosis is not associated to sleepiness and to sleep apnea syndrome severity in obese patients suspected of sleep apnea syndrome.
嗜睡是阻塞性睡眠呼吸暂停（OSA）综合征的主要临床表现，其原因是上呼吸道塌陷。最近的研究讨论了这样一个事实，即脑中刚地弓形虫包囊的存在以及由此产生的生化和免疫机制可能与神经行为障碍有关。本研究旨在探讨慢性弓形体感染对 OSA 肥胖患者嗜睡和阻塞性睡眠呼吸暂停（OSA）严重程度的潜在影响。
对筛查出的 OSA 肥胖患者进行病例对照研究。根据睡眠障碍，并根据性别、年龄和体重指数（BMI）进行匹配，从我们的样本采集数据库中选择了两组肥胖患者。所有患者均进行了弓形虫血清学状态检测，检测抗弓形虫 IgG 和 IgM 水平。采用单变量和多变量逻辑回归模型评估慢性弓形体感染对嗜睡和 OSA 严重程度的影响。
研究纳入了 107 名患有 OSA 的肥胖患者（中位年龄：53.3 岁，四分位距（IQR）：[41.9-59.9]；中位 BMI：39.4kg/m2，IQR：[35.5-44.1]，呼吸暂停低通气指数=27.5 次/小时[10.7-49.9]）。有嗜睡和无嗜睡的患者中，慢性弓形体感染分别占 63.4%和 70.7%（p=0.48），且与嗜睡（OR：0.76，95%CI：[0.52；2.33]，p=0.64）或 OSA 严重程度（OR=1.75，95%CI：[0.51；5.98]，p=0.37）均无关。
尽管最近的文献表明，在免疫功能正常的人类中，慢性弓形虫感染与多种行为障碍或病理有关，但我们在此证明，慢性弓形体感染与肥胖疑似 OSA 患者的嗜睡和睡眠呼吸暂停综合征严重程度无关。
