Department and Clinic of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland.
Chair and Department of Internal Medicine, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland.
Oxid Med Cell Longev. 2021 Jul 19;2021:9681595. doi: 10.1155/2021/9681595. eCollection 2021.
Obstructive sleep apnea (OSA) is a chronic respiratory disorder, which can be present in up to 50% of the population, depending on the country. OSA is characterized by recurrent episodes of partial or complete obstruction of the upper airways with consistent movement of the respiratory musculature during sleep. Apneas and hypopneas can lead to a decrease in oxygen saturation, an increase in carbon dioxide in the blood, and subsequent arousals and sleep fragmentation caused by repetitive activation of the central nervous system. As a consequence, intermittent hypoxemia and consequent reoxygenation result in the production of reactive oxygen species, leading to systematic oxidative stress, which is postulated to be a key mechanism of endothelial dysfunction and increased risk for cardiovascular disorders in patients with OSA. In this review, various biomarkers of oxidative stress, including high-sensitivity C-reactive protein, pregnancy-associated plasma protein-A, superoxide dismutase, cell-free DNA, 8-hydroxy-2-deoxyguanosine, advanced oxidation protein products, lipid peroxidation products, receptor for advanced glycation end-products, and thioredoxin are discussed. Biomarkers of oxidative stress have the potential to be used to assess disease severity and treatment response. Continuous positive airway pressure (CPAP) is one of the most common noninvasive treatments for OSA; it keeps the upper airways open during sleep. This reduces episodes of intermittent hypoxia, reoxygenation, and arousal at night. CPAP has been shown to have anti-inflammatory properties and decrease oxidative stress. The administration of certain compounds, like vitamins A, C, and E as well as N-acetylcysteine and allopurinol, can decrease oxidative stress markers. However, their role in the treatment of OSA remains unclear.
阻塞性睡眠呼吸暂停（OSA）是一种慢性呼吸系统疾病，在不同国家，其发病率可高达人群的 50%。OSA 的特征是睡眠期间上呼吸道反复出现部分或完全阻塞，同时呼吸肌持续运动。呼吸暂停和低通气可导致血氧饱和度下降、血液中二氧化碳增加，继而中枢神经系统反复激活引起觉醒和睡眠片段化。因此，间歇性低氧血症和随后的再氧合导致活性氧的产生，导致系统性氧化应激，这被认为是 OSA 患者内皮功能障碍和心血管疾病风险增加的关键机制。在这篇综述中，讨论了各种氧化应激生物标志物，包括高敏 C 反应蛋白、妊娠相关血浆蛋白-A、超氧化物歧化酶、无细胞 DNA、8-羟基-2-脱氧鸟苷、高级氧化蛋白产物、脂质过氧化产物、晚期糖基化终产物受体和硫氧还蛋白。氧化应激生物标志物有可能用于评估疾病严重程度和治疗反应。持续气道正压通气（CPAP）是 OSA 最常见的非侵入性治疗方法之一；它可在睡眠期间保持上呼吸道通畅。这可以减少夜间间歇性低氧、再氧合和觉醒的发生。CPAP 具有抗炎作用，并能降低氧化应激。某些化合物的给药，如维生素 A、C 和 E 以及 N-乙酰半胱氨酸和别嘌呤醇，可以降低氧化应激标志物。然而，它们在 OSA 治疗中的作用仍不清楚。
