Peres Alessandra, Rosa João Carlos Fraga da, Ribeiro Joane Severo, Silva Sofia de Lima, Bündchen Cristiane, Dornelles Gilson Pires, Fontanella Vania
Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Laboratory of Cellular and Molecular Immunology, Porto Alegre, RS, Brazil.
Moinhos de Vento Hospital, Porto Alegre, RS, Brazil.
Braz Oral Res. 2024 Dec 9;38:e084. doi: 10.1590/1807-3107bor-2024.vol38.0084. eCollection 2024.
Obstructive sleep apnea (OSA) causes intermittent hypoxia, increased production of reactive oxygen species, and inflammation, which may elevate morbidity and mortality from cardiovascular disease. The objective of the present study was to investigate the effect of the intraoral appliance (IOA) as a treatment for OSA when it comes to the modulation of inflammatory markers and oxidative damage in elderly individuals. This "before and after" clinical trial included 9 patients diagnosed with OSA recruited from a multicenter randomized clinical trial study that evaluated the treatment with IOA for 60 days. Demographic and anthropometric variables, apnea and hypopnea index (AHI), and oxygen desaturation index (ODI) were collected by type III polysomnography, Epworth Sleepiness Scale, and inflammatory and oxidative damage markers (interleukin 6 (1L-6); tumor necrosis factor α (TNF-α); interleukin 10 (IL-10); thiobarbituric acid reactive substances (TBARS); total thiols; advanced oxidation protein products (AOPP), and nitric oxide (NO)). Shapiro-Wilk test, paired t-test and Pearson's correlation tests were used to analyze the results, respectively (α=0.05). The sample had a mean age of 71.86 ± 4.63 years, the majority were women (55.55%), and had a significant reduction in AHI (p=0.003), ODI (p=0.038), IL-10 (p=0.0001), AOPP (p=0.038) and TBARS levels (p=0.0001). There was a significant correlation between IL-10 and NO (r=0.855) and between TBARS and IL-6 (r=0.669), both after treatment. This study demonstrated that treating elderly patients with OSA using an IOA for 60 days reduces oxidative damage through the modulation of AOPP and TBARS.
阻塞性睡眠呼吸暂停（OSA）会导致间歇性缺氧、活性氧生成增加以及炎症，这可能会提高心血管疾病的发病率和死亡率。本研究的目的是探讨口腔矫治器（IOA）作为一种治疗OSA的方法，对老年个体炎症标志物和氧化损伤的调节作用。这项“前后对照”临床试验纳入了9名从一项多中心随机临床试验研究中招募的被诊断为OSA的患者，该研究评估了IOA治疗60天的效果。通过III型多导睡眠图、爱泼华嗜睡量表以及炎症和氧化损伤标志物（白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、白细胞介素10（IL-10）、硫代巴比妥酸反应物质（TBARS）、总硫醇、晚期氧化蛋白产物（AOPP）和一氧化氮（NO））收集人口统计学和人体测量学变量、呼吸暂停低通气指数（AHI）以及氧饱和度下降指数（ODI）。分别使用夏皮罗-威尔克检验、配对t检验和皮尔逊相关检验来分析结果（α=0.05）。样本的平均年龄为71.86±4.63岁，大多数为女性（55.55%），AHI（p=0.003）、ODI（p=0.038）、IL-10（p=0.0001）、AOPP（p=0.038）和TBARS水平（p=0.0001）均有显著降低。治疗后，IL-10与NO之间（r=0.855）以及TBARS与IL-6之间（r=0.669）存在显著相关性。本研究表明，使用IOA对老年OSA患者进行60天治疗可通过调节AOPP和TBARS来减少氧化损伤。
