Appiah Cephas B, Aikins Ato O, Farmer George E, Cunningham J Thomas
Department of Physiology and Anatomy, College of Biomedical and Translational Sciences, University of North Texas Health Science Center, Fort Worth, Texas, USA.
Brain Behav Immun Health. 2025 Aug 4;48:101077. doi: 10.1016/j.bbih.2025.101077. eCollection 2025 Oct.
Chronic intermittent hypoxia (CIH) is a key feature of obstructive sleep apnea (OSA) and leads to physiological changes that can cause cardiovascular and neurological issues. This review explores the role of nitric oxide (NO) and inflammation in the development of CIH-induced health problems, specifically focusing on hypertension and cognitive dysfunction. We synthesize current evidence regarding how CIH modulates inflammatory processes and NO signaling in different brain regions, especially autonomic control centers crucial for cardiovascular regulation. We also discuss the activation of proinflammatory transcription factors, the generation of reactive oxygen species, and the involvement of pattern recognition receptors in CIH-induced neuroinflammation. Regarding cardiovascular changes associated with CIH, we focus on the effects of NO and inflammation in central autonomic regions such as the organum vasculosum of the lamina terminalis (OVLT), subfornical organ (SFO), median preoptic nucleus (MnPO), and paraventricular nucleus (PVN), shedding light on their contributions to sustained hypertension in CIH. The review delves into the latest findings on sex differences in CIH-induced neuroinflammation. In examining the current knowledge, we have pinpointed significant gaps in understanding, especially concerning the specific mechanisms of NO and inflammation interactions in different brain regions during CIH. This review provides insights into potential therapeutic targets and emphasizes the need for further research to develop more effective treatments for OSA-related cardiovascular and neurological complications.
慢性间歇性缺氧(CIH)是阻塞性睡眠呼吸暂停(OSA)的一个关键特征,并导致可引发心血管和神经问题的生理变化。本综述探讨了一氧化氮(NO)和炎症在CIH诱导的健康问题发展中的作用,特别关注高血压和认知功能障碍。我们综合了关于CIH如何调节不同脑区(尤其是对心血管调节至关重要的自主控制中心)的炎症过程和NO信号传导的现有证据。我们还讨论了促炎转录因子的激活、活性氧的产生以及模式识别受体在CIH诱导的神经炎症中的作用。关于与CIH相关的心血管变化,我们关注NO和炎症在终板血管器(OVLT)、穹窿下器(SFO)、视前正中核(MnPO)和室旁核(PVN)等中枢自主区域的作用,阐明它们对CIH持续高血压的影响。该综述深入探讨了CIH诱导的神经炎症中性别差异的最新发现。在审视当前知识时,我们指出了理解上的重大差距,特别是关于CIH期间不同脑区中NO与炎症相互作用的具体机制。本综述提供了对潜在治疗靶点的见解,并强调需要进一步研究以开发针对OSA相关心血管和神经并发症的更有效治疗方法。
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