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Published in: Immunologic Research 5-6/2016

01-12-2016 | Original Article

Effect of continuous positive airway pressure (CPAP) therapy on IL-23 in patients with obstructive sleep apnea

Authors: Murat Can, Fırat Uygur, Hakan Tanrıverdi, Bilgehan Acıkgoz, Barıs Alper, Berrak Guven

Published in: Immunologic Research | Issue 5-6/2016

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Abstract

Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder characterized by repeated episodes of apnea and hypopnea during sleep. Continuous positive airway pressure (CPAP) is the most effective method for treating OSAS and alleviating the patients’ symptoms. The aim of this study was to assess the effect of 3-month CPAP therapy on serum levels of IL-23 in patients with OSAS. Twenty-three patients with newly diagnosed moderate-to-severe OSAS who had not yet started nasal CPAP treatment were prospectively enrolled. All of the subjects underwent simple spirometry and an overnight sleep study. Twenty-seven healthy individuals without OSAS were also recruited as the control group. Serum IL-23 and C-reactive protein (CRP) levels were measured before and after 3 months of CPAP therapy. There was no significant difference between moderate and severe OSAS patients in IL-23 and CRP, but both parameters were significantly higher than control group. The CPAP treatment produced a significant decrease in the levels of the inflammatory mediators CRP and IL-23 in patients. Changes in IL-23 were positively correlated with changes in AHI and in CRP. In conclusion, based on these results, serum IL-23 levels reflect OSAS-related systemic inflammation and are a useful marker for improvement in OSAS following CPAP therapy.
Literature
1.
go back to reference Lindberg E, Gislason T. Epidemiology of sleep related obstructive breathing. Sleep Med Rev. 2000;4:411–33.CrossRefPubMed Lindberg E, Gislason T. Epidemiology of sleep related obstructive breathing. Sleep Med Rev. 2000;4:411–33.CrossRefPubMed
2.
go back to reference Coughlin SR, Mawdsley L, Mugarza JA, Calverley PMA, Wilding JPH. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25:735–41.CrossRefPubMed Coughlin SR, Mawdsley L, Mugarza JA, Calverley PMA, Wilding JPH. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25:735–41.CrossRefPubMed
3.
go back to reference Marin JM, Carrizo SJ, Vicente E, Agusti AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53.CrossRefPubMed Marin JM, Carrizo SJ, Vicente E, Agusti AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53.CrossRefPubMed
4.
go back to reference Botros N, Concato J, Mohsenin V, Selim B, Doctor K, Yaggi HK. Obstructive sleep apnea as a risk factor for type 2 diabetes. Am J Med. 2009;122:1122–7.CrossRefPubMedPubMedCentral Botros N, Concato J, Mohsenin V, Selim B, Doctor K, Yaggi HK. Obstructive sleep apnea as a risk factor for type 2 diabetes. Am J Med. 2009;122:1122–7.CrossRefPubMedPubMedCentral
5.
go back to reference Can M, Acıkgoz S, Mungan G, Bayraktaroglu T, Kocak E, Guven B, Demirtas S. Serum cardiovascular risk factors in obstructive sleep apnea. Chest. 2006;129:233–7.CrossRefPubMed Can M, Acıkgoz S, Mungan G, Bayraktaroglu T, Kocak E, Guven B, Demirtas S. Serum cardiovascular risk factors in obstructive sleep apnea. Chest. 2006;129:233–7.CrossRefPubMed
6.
go back to reference Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation. 2005;112:2660–7.CrossRefPubMed Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation. 2005;112:2660–7.CrossRefPubMed
7.
go back to reference Christou K, Markoulis N, Moulas AN, Pastaka C, Gourgoulianis KI. Reactive oxygen metabolites (ROMs) as an index of oxidative stress in obstructive sleep apnea patients. Sleep Breath. 2003;7(3):105–10.CrossRefPubMed Christou K, Markoulis N, Moulas AN, Pastaka C, Gourgoulianis KI. Reactive oxygen metabolites (ROMs) as an index of oxidative stress in obstructive sleep apnea patients. Sleep Breath. 2003;7(3):105–10.CrossRefPubMed
8.
go back to reference Chen WS, Chang YS, Chang CC, Chang DM, Chen YH, Tsai CY, Chen JH. Management and risk reduction of rheumatoid arthritis in individuals with obstructive sleep apnea: a nationwide population-based study in Taiwan. Sleep. 2016;1:515–523. Chen WS, Chang YS, Chang CC, Chang DM, Chen YH, Tsai CY, Chen JH. Management and risk reduction of rheumatoid arthritis in individuals with obstructive sleep apnea: a nationwide population-based study in Taiwan. Sleep. 2016;1:515–523.
9.
go back to reference Kang JH, Lin HC. Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study. Sleep Med. 2012;13:583–8.CrossRefPubMed Kang JH, Lin HC. Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study. Sleep Med. 2012;13:583–8.CrossRefPubMed
10.
go back to reference Tang C, Chen S, Qian H, Huang W. Interleukin-23: as a drug target for autoimmune inflammatory diseases. Immunology. 2011;135:112–24.CrossRef Tang C, Chen S, Qian H, Huang W. Interleukin-23: as a drug target for autoimmune inflammatory diseases. Immunology. 2011;135:112–24.CrossRef
11.
go back to reference Ngiow SF, Teng MW, Smyth MJ. A balance of Interleukin-12 and -23 in cancer. Trends Immunol. 2013;34:548–55.CrossRefPubMed Ngiow SF, Teng MW, Smyth MJ. A balance of Interleukin-12 and -23 in cancer. Trends Immunol. 2013;34:548–55.CrossRefPubMed
12.
go back to reference Croxford AL, Mair F, Becher B. IL-23: one cytokine in control of autoimmunity. Eur J Immunol. 2012;42:2263–73.CrossRefPubMed Croxford AL, Mair F, Becher B. IL-23: one cytokine in control of autoimmunity. Eur J Immunol. 2012;42:2263–73.CrossRefPubMed
13.
14.
go back to reference Ye J, Liu H, Zhang G, Li P, Wang Z, Huang S, Yang Q, Li Y. The treg/th17 imbalance in patients with obstructive sleep apnoea syndrome. Mediators Inflamm. 2012;2012:815308.CrossRefPubMedPubMedCentral Ye J, Liu H, Zhang G, Li P, Wang Z, Huang S, Yang Q, Li Y. The treg/th17 imbalance in patients with obstructive sleep apnoea syndrome. Mediators Inflamm. 2012;2012:815308.CrossRefPubMedPubMedCentral
15.
go back to reference Iber C, Ancoli-Israel S, Chesson AL, Quan SF, for the American Academy of Sleep Medicine. The AASM manual 2007 for the scoring of sleep and associated events: rules, terminology, and technical specifications. Westchester: American Academy of Sleep Medicine; 2007. Iber C, Ancoli-Israel S, Chesson AL, Quan SF, for the American Academy of Sleep Medicine. The AASM manual 2007 for the scoring of sleep and associated events: rules, terminology, and technical specifications. Westchester: American Academy of Sleep Medicine; 2007.
16.
go back to reference Friedewald WT, Levy RI, Frederickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed Friedewald WT, Levy RI, Frederickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed
17.
go back to reference Lin QC, Chen LD, Yu YH, Liu KX, Gao SY. Obstructive sleep apnea syndrome is associated with metabolic syndrome and inflammation. Eur Arch Otorhinolaryngol. 2014;271:825–31.CrossRefPubMed Lin QC, Chen LD, Yu YH, Liu KX, Gao SY. Obstructive sleep apnea syndrome is associated with metabolic syndrome and inflammation. Eur Arch Otorhinolaryngol. 2014;271:825–31.CrossRefPubMed
18.
go back to reference Chami HA, Fontes JD, Vasan RS, Keaney JF, O’Connor GT, Larson MG, Benjamin EJ, Gottlieb DJ. Vascular inflammation and sleep disordered breathing in a community-based cohort. Sleep. 2013;36:763–8.PubMedPubMedCentral Chami HA, Fontes JD, Vasan RS, Keaney JF, O’Connor GT, Larson MG, Benjamin EJ, Gottlieb DJ. Vascular inflammation and sleep disordered breathing in a community-based cohort. Sleep. 2013;36:763–8.PubMedPubMedCentral
19.
go back to reference Guven SF, Turkkani MH, Ciftci B, Ciftci TU, Erdogan Y. The relationship between high-sensitivity C-reactive protein levels and the severity of obstructive sleep apnea. Sleep Breath. 2012;16:217–21.CrossRefPubMed Guven SF, Turkkani MH, Ciftci B, Ciftci TU, Erdogan Y. The relationship between high-sensitivity C-reactive protein levels and the severity of obstructive sleep apnea. Sleep Breath. 2012;16:217–21.CrossRefPubMed
20.
go back to reference Floss DM, Schröder J, Franke M, Scheller J. Insights into IL-23 biology: from structure to function. Cytokine Growth Factor Rev. 2015;26(5):569–78.CrossRefPubMed Floss DM, Schröder J, Franke M, Scheller J. Insights into IL-23 biology: from structure to function. Cytokine Growth Factor Rev. 2015;26(5):569–78.CrossRefPubMed
21.
go back to reference Ciprandi G, Cuppari C, Salpietro A, et al. Serum IL-23 strongly and inversely correlates with FEV1 in asthmatic children. Int Arch Allergy Immunol. 2012;159:183–6.PubMed Ciprandi G, Cuppari C, Salpietro A, et al. Serum IL-23 strongly and inversely correlates with FEV1 in asthmatic children. Int Arch Allergy Immunol. 2012;159:183–6.PubMed
22.
go back to reference Ciprandi G, Cuppari C, Salpietro A, et al. Serum IL-23 in asthmatic children. J Biol Regul. 2012;26:53–62. Ciprandi G, Cuppari C, Salpietro A, et al. Serum IL-23 in asthmatic children. J Biol Regul. 2012;26:53–62.
23.
go back to reference di Stefano A, Caramori G, Gnemmi I, et al. T helper type 17-related cytokine expression is increased in the bronchial mucosa of stable chronic obstructive pulmonary disease patients. Clin Exp Immunol. 2009;157:316–24.CrossRefPubMedPubMedCentral di Stefano A, Caramori G, Gnemmi I, et al. T helper type 17-related cytokine expression is increased in the bronchial mucosa of stable chronic obstructive pulmonary disease patients. Clin Exp Immunol. 2009;157:316–24.CrossRefPubMedPubMedCentral
24.
go back to reference Dong L, Xia JW, Gong Y, Chen Z, Yang HH, Zhang J, He J, Chen XD. Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation ofchronic obstructive pulmonary disease. Evid Based Complement Alternat Med. 2014;2014:637969.PubMedPubMedCentral Dong L, Xia JW, Gong Y, Chen Z, Yang HH, Zhang J, He J, Chen XD. Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation ofchronic obstructive pulmonary disease. Evid Based Complement Alternat Med. 2014;2014:637969.PubMedPubMedCentral
25.
go back to reference Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107:1129–34.CrossRefPubMed Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107:1129–34.CrossRefPubMed
26.
go back to reference Xie X, Pan L, Ren D, Du C, Guo Y. Effects of continuous positive airway pressure therapy on systemic inflammation in obstructive sleep apnea: a meta-analysis. Sleep Med. 2013;14:1139–50.CrossRefPubMed Xie X, Pan L, Ren D, Du C, Guo Y. Effects of continuous positive airway pressure therapy on systemic inflammation in obstructive sleep apnea: a meta-analysis. Sleep Med. 2013;14:1139–50.CrossRefPubMed
Metadata
Title
Effect of continuous positive airway pressure (CPAP) therapy on IL-23 in patients with obstructive sleep apnea
Authors
Murat Can
Fırat Uygur
Hakan Tanrıverdi
Bilgehan Acıkgoz
Barıs Alper
Berrak Guven
Publication date
01-12-2016
Publisher
Springer US
Published in
Immunologic Research / Issue 5-6/2016
Print ISSN: 0257-277X
Electronic ISSN: 1559-0755
DOI
https://doi.org/10.1007/s12026-016-8869-8

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