Liu Dan, Meng Han, Wan Nansheng, Feng Jing
Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Front Neurol. 2024 Feb 21;15:1347137. doi: 10.3389/fneur.2024.1347137. eCollection 2024.
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder, and has become a serious threat to public health. Intermittent hypoxia caused by OSA results in a low-grade inflammatory response that leads to impaired mucosal barrier function. Claudin (CLDN) molecules are important for the permeability of the mucosal epithelium. This study aimed to explore whether CLDN molecules can be a potential biomarker of OSA.
A total of 37 healthy controls and 40 OSA patients underwent a physical assessment for OSA and filled out the STOP-Bang Questionnaire (SBQ) and Epworth Sleepiness Scale (ESS). Clinical specimens of plasma and urine were obtained to observe the difference between OSA patients and healthy controls and diagnostic accuracy of CLDN molecules for OSA.
CLDN1, CLDN2, and CLDN3 molecules in plasma and urine decreased in OSA patients (both < 0.05). The areas under the receiver operating characteristic curve (AUCs) of urinary CLDN1, plasma CLDN1, urinary CLDN2, plasma CLDN2, urinary CLDN3, and plasma CLDN3 were 0.887, 0.724, 0.779, 0.676, 0.828, and 0.665, respectively. The AUC of urinary CLDN1 + CLDN2 + CLDN3 was 0.906 (95% confidence interval (CI), 0.831-0.981). The AUC of plasma CLDN1 + CLDN2 + CLDN3 was 0.776 (95% CI, 0.645-0.878). The AUC of urinary CLDN3 + SBQ was 0.899 (95% CI, 0.832-0.967). The AUC of urinary CLDN3 + ESS was 0.896 (95% CI, 0.826-0.966). In addition, Urinary CLDN-3 was negative associated with the severity of OSA.
CLDN molecules are promising as useful biomarkers for OSA, which may be related to the impaired barrier function related to OSA.
阻塞性睡眠呼吸暂停（OSA）是一种常见的与睡眠相关的呼吸障碍，已成为对公众健康的严重威胁。OSA引起的间歇性缺氧会导致低度炎症反应，进而导致黏膜屏障功能受损。闭合蛋白（CLDN）分子对黏膜上皮的通透性很重要。本研究旨在探讨CLDN分子是否可能成为OSA的潜在生物标志物。
共有37名健康对照者和40名OSA患者接受了OSA的体格评估，并填写了STOP-Bang问卷（SBQ）和爱泼华嗜睡量表（ESS）。获取血浆和尿液的临床标本，以观察OSA患者与健康对照者之间的差异以及CLDN分子对OSA的诊断准确性。
OSA患者血浆和尿液中的CLDN1、CLDN2和CLDN3分子减少（均P<0.05）。尿CLDN1、血浆CLDN1、尿CLDN2、血浆CLDN2、尿CLDN3和血浆CLDN3的受试者工作特征曲线下面积（AUC）分别为0.887、0.724、0.779、0.676、0.828和0.665。尿CLDN1+CLDN2+CLDN3的AUC为0.906（95%置信区间（CI），0.831-0.981）。血浆CLDN1+CLDN2+CLDN3的AUC为0.776（95%CI，0.645-0.878）。尿CLDN3+SBQ的AUC为0.899（95%CI，0.832-0.967）。尿CLDN3+ESS的AUC为0.896（95%CI，0.826-0.966）。此外，尿CLDN-3与OSA的严重程度呈负相关。
CLDN分子有望成为OSA有用的生物标志物，这可能与OSA相关的屏障功能受损有关。
