Effect of Obstructive Sleep Apnea on Immunity in Cases of Chronic Rhinosinusitis With Nasal Polyps
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a more severe inflammatory form of CRS that often coexists with obstructive sleep apnea (OSA). However, little is known about the relationship between OSA and the immune profile in patients with CRSwNP. We aimed to investigate the immune profile of patients with CRSwNP according to OSA severity. Methods. This study included 63 patients with CRSwNP and nine control subjects. Protein levels of inflammatory mediators were determined using multiplex immunoassays. All patients underwent standard polysomnography. Results. In patients with eosinophilic CRSwNP (ECRSwNP), interleukin (IL)-6 and chemokine [C-X-C motif] ligand (CXCL)-1 (type 1 immune-related markers) were upregulated in cases of moderate-to-severe OSA. Additionally, IL-4, IL-13, C-C motif chemokine (CCL)-11, CCL-24 (type 2 immune-related markers), and IL-17A (a type 3 immune-related marker) were present at elevated levels in patients with moderate-to-severe OSA. Although there were no significant differences in type 1, 2, or 3 immune-related markers among patients with non-eosinophilic CRSwNP (NECRSwNP) according to the severity of OSA, transforming growth factor-beta expression was higher in those with moderate-to-severe OSA. Furthermore, in ECRSwNP with moderate-to-severe OSA, associations were detected between serum markers and some upregulated inflammatory markers. Conclusion. OSA may increase the heterogeneity of the immune profile (types 1, 2, and 3) in patients with ECRSwNP, but not in those with NECRSwNP.
Abstract
Objectives. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a more severe inflammatory form of CRS that often coexists with obstructive sleep apnea (OSA). However, little is known about the relationship between OSA and the immune profile in patients with CRSwNP. We aimed to investigate the immune profile of patients with CRSwNP according to OSA severity. Methods. This study included 63 patients with CRSwNP and nine control subjects. Protein levels of inflammatory mediators were determined using multiplex immunoassays. All patients underwent standard polysomnography. Results. In patients with eosinophilic CRSwNP (ECRSwNP), interleukin (IL)-6 and chemokine [C-X-C motif] ligand (CXCL)-1 (type 1 immune-related markers) were upregulated in cases of moderate-to-severe OSA. Additionally, IL-4, IL-13, C-C motif chemokine (CCL)-11, CCL-24 (type 2 immune-related markers), and IL-17A (a type 3 immune-related marker) were present at elevated levels in patients with moderate-to-severe OSA. Although there were no significant differences in type 1, 2, or 3 immune-related markers among patients with non-eosinophilic CRSwNP (NECRSwNP) according to the severity of OSA, transforming growth factor-beta expression was higher in those with moderate-to-severe OSA. Furthermore, in ECRSwNP with moderate-to-severe OSA, associations were detected between serum markers and some upregulated inflammatory markers. Conclusion. OSA may increase the heterogeneity of the immune profile (types 1, 2, and 3) in patients with ECRSwNP, but not in those with NECRSwNP.
참고문헌 (30)
- Fokkens WJ, "EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists", Rhinology, 50(1), pp.1~12 (2012)
- Ohayon MM, "Epidemiology of insomnia: what we know and what we still need to learn", Sleep Med Rev, 6(2), pp.97~111 (2002)
- Bengtsson C, "Incident chronic rhinosinusitis is associated with impaired sleep quality: results of the RHINE study", J Clin Sleep Med, 15(6), pp.899~905 (2019)
- Stanley Yung Chuan Liu, "Surgical Algorithm for Obstructive Sleep Apnea: An Update", Clinical and Experimental Otorhinolaryngology, 13(3), pp.215~224 (2020), 대한이비인후과학회[DOI]
- 유명상, "Maxillomandibular Advancement and Upper Airway Stimulation: Extrapharyngeal Surgery for Obstructive Sleep Apnea", Clinical and Experimental Otorhinolaryngology, 13(3), pp.225~233 (2020), 대한이비인후과학회[DOI]
- Nadeem R, "Serum inflammatory markers in obstructive sleep apnea: a meta-analysis", J Clin Sleep Med, 9(10), pp.1003~1012 (2013)
- Greenberg H, "Chronic intermittent hypoxia activates nuclear factor-kappaB in cardiovascular tissues in vivo", Biochem Biophys Res Commun, 343(2), pp.591~596 (2006)
- Hamada S, "Nasal nitric oxide improved by continuous positive airway pressure therapy for upper airway inflammation in obstructive sleep apnea", Sleep Breath, 21(2), pp.405~410 (2017)
- Alt JA, "Chronic rhinosinusitis and sleep: a contemporary review", Int Forum Allergy Rhinol, 3(11), pp.941~949 (2013)
- Hui JW, "Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis", Ann Allergy Asthma Immunol, 118(6), pp.685~688.e1 (2017)
- Varendh M, "Sleep quality improves with endoscopic sinus surgery in patients with chronic rhinosinusitis and nasal polyposis", Rhinology, 55(1), pp.45~52 (2017)
- Dinges DF, "Leukocytosis and natural killer cell function parallel neurobehavioral fatigue induced by 64 hours of sleep deprivation", J Clin Invest, 93(5), pp.1930~1939 (1994)
- Wu BG, "Severe obstructive sleep apnea is associated with alterations in the nasal microbiome and an increase in inflammation", Am J Respir Crit Care Med, 199(1), pp.99~109 (2019)
- Hai Wang, "Neutrophils as a Protagonist and Target in Chronic Rhinosinusitis", Clinical and Experimental Otorhinolaryngology, 12(4), pp.337~347 (2019), 대한이비인후과학회[DOI]
- 김대우, "Can Neutrophils Be a Cellular Biomarker in Asian Chronic Rhinosinusitis?", Clinical and Experimental Otorhinolaryngology, 12(4), pp.325~326 (2019), 대한이비인후과학회[DOI]
- Teodorescu M, "Obstructive sleep apnea risk, asthma burden, and lower airway inflammation in adults in the Severe Asthma Research Program (SARP) II", J Allergy Clin Immunol Pract, 3(4), pp.566~575.e1 (2015)
- Teodorescu M, "Asthma control and its relationship with obstructive sleep apnea (OSA) in older adults", Sleep Disord, 2013, pp.251567~ (2013)
- Taille C, "Obstructive sleep apnoea modulates airway inflammation and remodelling in severe asthma", PLoS One, 11(3), pp.e0150042~ (2016)
- Zhang X, "Sinomenine attenuates chronic intermittent hypoxia-induced lung injury by inhibiting inflammation and oxidative stress", Med Sci Monit, 24, pp.1574~1580 (2018)
- Nyenhuis SM, "Real-world assessment of asthma control and severity in children, adolescents, and adults with asthma: relationships to care settings and comorbidities", J Allergy Clin Immunol Pract, 8(3), pp.989~996.e1 (2020)
- Alberti A, "Plasma cytokine levels in patients with obstructive sleep apnea syndrome: a preliminary study", J Sleep Res, 12(4), pp.305~311 (2003)
- Bouloukaki I, "Abnormal cytokine profile in patients with obstructive sleep apnea-hypopnea syndrome and erectile dysfunction", Mediators Inflamm, 2014, pp.568951~ (2014)
- Carpagnano GE, "Systemic and airway inflammation in sleep apnea and obesity: the role of ICAM-1 and IL-8", Transl Res, 155(1), pp.35~43 (2010)
- Series F, "Influence of weight and sleep apnea status on immunologic and structural features of the uvula", Am J Respir Crit Care Med, 170(10), pp.1114~1119 (2004)
- Kim J, "Increased cellular proliferation and inflammatory cytokines in tonsils derived from children with obstructive sleep apnea", Pediatr Res, 66(4), pp.423~428 (2009)
- Said EA, "Altered blood cytokines, CD4 T cells, NK and neutrophils in patients with obstructive sleep apnea", Immunol Lett, 190, pp.272~278 (2017)
- Roza Khalmuratova, "Crosstalk Between Mucosal Inflammation and Bone Metabolism in Chronic Rhinosinusitis", Clinical and Experimental Otorhinolaryngology, 14(1), pp.43~49 (2021), 대한이비인후과학회[DOI]
- Ishitoya J, "Eosinophilic chronic rhinosinusitis in Japan", Allergol Int, 59(3), pp.239~245 (2010)
- Kim DK, "Non-eosinophilic nasal polyps shows increased epithelial proliferation and localized disease pattern in the early stage", PLoS One, 10(10), pp.e0139945~ (2015)
- Shi LL, "Features of airway remodeling in different types of Chinese chronic rhinosinusitis are associated with inflammation patterns", Allergy, 68(1), pp.101~109 (2013)