Karkala Aliki, Kotoulas Serafeim-Chrysovalantis, Tzinas Asterios, Massa Eleni, Mouloudi Eleni, Gkakou Foteini, Pataka Athanasia
Respiratory Failure Unit, General Hospital of Thessaloniki "G. Papanikolaou", Exochi, 57010 Thessaloniki, Greece.
Intensive Care Unit, "Hippokration" Hospital of Thessaloniki, 54642 Thessaloniki, Greece.
Diagnostics (Basel). 2025 Jun 4;15(11):1431. doi: 10.3390/diagnostics15111431.
Obstructive sleep apnea (OSA), a prevalent disorder characterized by recurrent upper airway collapse, is increasingly recognized as a systemic inflammatory condition influenced by microbial dysregulation. Emerging evidence underscores the lung microbiome as a mediator in OSA pathophysiology, where dysbiotic shifts driven by intermittent hypoxia, oxidative stress and mechanical airway trauma amplify inflammatory cascades and perpetuate respiratory instability. This review synthesizes current knowledge on the bidirectional interplay between OSA and lung microbial communities. It aims to highlight how hypoxia-induced alterations in microbial ecology disrupt immune homeostasis, while inflammation-driven mucosal injury fosters pathogenic colonization. Clinical correlations between specific taxa like and , and disease severity, suggest microbial signatures as novel biomarkers for OSA progression and treatment response. Furthermore, oxidative stress markers and pro-inflammatory cytokines emerge as potential diagnostic tools that bridge microbial dysbiosis with sleep-related outcomes. However, challenges persist in sampling standardization of the low-biomass lower airways, as well as in causative mechanisms linking microbial dysbiosis to OSA pathophysiology. By integrating microbial ecology with precision sleep medicine, this paradigm shift promises to transform OSA management from mechanical stabilization to holistic ecosystem restoration.
阻塞性睡眠呼吸暂停（OSA）是一种以反复上气道塌陷为特征的常见疾病，越来越被认为是一种受微生物失调影响的全身性炎症状态。新出现的证据强调肺微生物群是OSA病理生理学中的一个介质，其中由间歇性缺氧、氧化应激和气道机械性创伤驱动的生态失调转变会放大炎症级联反应并使呼吸不稳定持续存在。本综述综合了关于OSA与肺微生物群落之间双向相互作用的现有知识。其目的是强调缺氧引起的微生物生态变化如何破坏免疫稳态，而炎症驱动的粘膜损伤又如何促进致病性定植。特定分类群（如 和 ）与疾病严重程度之间的临床相关性表明，微生物特征可作为OSA进展和治疗反应的新型生物标志物。此外，氧化应激标志物和促炎细胞因子成为连接微生物失调与睡眠相关结果的潜在诊断工具。然而，在低生物量下呼吸道的采样标准化以及将微生物失调与OSA病理生理学联系起来的致病机制方面，挑战依然存在。通过将微生物生态学与精准睡眠医学相结合，这种范式转变有望将OSA管理从机械稳定转变为整体生态系统恢复。
