Peracaula Miriam, Torres Daniela, Poyatos Paula, Luque Neus, Rojas Eric, Obrador Anton, Orriols Ramon, Tura-Ceide Olga
Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital of Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain.
Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), 28029 Madrid, Spain.
Life (Basel). 2022 Apr 5;12(4):537. doi: 10.3390/life12040537.
Obstructive sleep apnea (OSA) is a respiratory condition during sleep caused by repeated pauses in breathing due to upper airway obstruction. It is estimated that OSA affects 30% of the population, but only 10% are well diagnosed due to the absence of a well-defined symptomatology and poor screening tools for early diagnosis. OSA is associated to an endothelial dysfunction inducing several biological responses such as hypoxia, hypercapnia and oxidative stress, among others. OSA also triggers respiratory, nervous, metabolic, humoral and immunity system activations that increase the possibility of suffering a cardiovascular (CV) disease. In this review, we expose different studies that show the relationship between OSA and endothelial dysfunction and its association with CV pathologies like hypertension, and we define the most well-known treatments and their limitations. Additionally, we describe the potential future directions in OSA research, and we report clinical features such as endothelial progenitor cell alterations that could act as biomarkers for the development of new diagnostic tools and target therapies.
阻塞性睡眠呼吸暂停(OSA)是一种睡眠期间的呼吸疾病,由上气道阻塞导致呼吸反复暂停引起。据估计,OSA影响30%的人群,但由于缺乏明确的症状学和早期诊断的筛查工具欠佳,只有10%得到了良好诊断。OSA与内皮功能障碍相关,可引发多种生物学反应,如缺氧、高碳酸血症和氧化应激等。OSA还会触发呼吸、神经、代谢、体液和免疫系统激活,增加患心血管(CV)疾病的可能性。在本综述中,我们展示了不同的研究,这些研究表明OSA与内皮功能障碍之间的关系及其与高血压等CV病理的关联,我们还定义了最知名的治疗方法及其局限性。此外,我们描述了OSA研究未来可能的方向,并报告了诸如内皮祖细胞改变等临床特征,这些特征可作为开发新诊断工具和靶向治疗的生物标志物。