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Sleep and Breathing
Published in: Sleep and Breathing 2/2015

01-05-2015 | Review

Obstructive sleep apnea promotes cancer development and progression: a concise review

Authors: Jie Cao, Jing Feng, Lian Li, Baoyuan Chen

Published in: Sleep and Breathing | Issue 2/2015

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Abstract

Background

Obstructive sleep apnoea-hypopnoea (OSA) is an increasingly common sleep disorder which is widely accepted to be associated with high rates of morbidity and mortality. OSA is an independent risk factor for cardiovascular diseases, cerebrovascular disease, and metabolic disease. Recently, several studies have demonstrated that patients with OSA have a higher prevalence of cancer and cancer-related mortality. The epidemiological surveys suggest that patients with OSA had a higher incidence of cancer and cancer-related mortality than patients without OSA. Animal studies indicate that the activation of HIF-1 and VEGF pathways in response to intermittent hypoxia may promote the blood supply which supports tumor growth. In addition, tumor-associated macrophages may be altered by intermittent hypoxia (or sleep fragmentation) to a tumor-promoting phenotype yielding more aggressive cancer behavior.

Conclusions

The relationship between OSA and cancer has been confirmed, in which patients with OSA have a relative high prevalence of cancer and cancer-related mortality. The mechanism of OSA promoting cancer development and progression may be related with intermittent hypoxia and possibly sleep fragmentation. The activation of several cancer-related pathways may play an important role in tumor growth and metastasis. More clinical data and basic studies are needed to explain and confirm the relationship between OSA and cancer.
Literature
1.
Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young T, American Heart Association Council for High Blood Pressure Research Professional Education Committee CoCC, American Heart Association Stroke C, American Heart Association Council on Cardiovascular N, American College of Cardiology F (2008) Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 118(10):1080–1111CrossRefPubMed
2.
Drummond M, Winck JC, Pereira S, Almeida J, Marques JA (2003) Obstructive sleep apnoea and cardiovascular disease—a retrospective study. Rev Port Pneumol 9(4):327–335PubMed
3.
Javaheri S, Parker TJ, Liming JD, Corbett WS, Nishiyama H, Wexler L, Roselle GA (1998) Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations. Circulation 97(21):2154–2159CrossRefPubMed
4.
Kokturk O, Ciftci TU, Mollarecep E, Ciftci B (2005) Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. Int Heart J 46(5):801–809CrossRefPubMed
5.
Bassetti C, Aldrich MS (1999) Sleep apnea in acute cerebrovascular diseases: final report on 128 patients. Sleep 22(2):217–223PubMed
6.
Saletu M, Nosiska D, Kapfhammer G, Lalouschek W, Saletu B, Benesch T, Zeitlhofer J (2006) Structural and serum surrogate markers of cerebrovascular disease in obstructive sleep apnea (OSA): association of mild OSA with early atherosclerosis. J Neurol 253(6):746–752CrossRefPubMed
7.
Lurie A (2011) Metabolic disorders associated with obstructive sleep apnea in adults. Adv Cardiol 46:67–138CrossRefPubMed
8.
Parish JM, Adam T, Facchiano L (2007) Relationship of metabolic syndrome and obstructive sleep apnea. J Clin Sleep Med 3(5):467–472PubMedCentralPubMed
9.
Felmet KA, Petersen M (2006) Obstructive sleep apnea and cognitive dysfunction. JAAPA 19(11):16–20PubMed
10.
Ferini-Strambi L, Baietto C, Di Gioia MR, Castaldi P, Castronovo C, Zucconi M, Cappa SF (2003) Cognitive dysfunction in patients with obstructive sleep apnea (OSA): partial reversibility after continuous positive airway pressure (CPAP). Brain Res Bull 61(1):87–92CrossRefPubMed
11.
Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farre R (2012) Sleep-disordered breathing and cancer mortality: Results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 186(2):190–194CrossRefPubMedCentralPubMed
12.
Campos-Rodriguez F, Martinez-Garcia MA, Martinez M, Duran-Cantolla J, Pena Mde L, Masdeu MJ, Gonzalez M, Campo F, Gallego I, Marin JM, Barbe F, Montserrat JM, Farre R (2013) Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. Am J Respir Crit Care Med 187(1):99–105CrossRefPubMed
13.
Christensen AS, Clark A, Salo P, Nymann P, Lange P, Prescott E, Rod NH (2013) Symptoms of sleep disordered breathing and risk of cancer: a prospective cohort study. Sleep 36(10):1429–1435PubMedCentralPubMed
14.
Zhang X, Giovannucci EL, Wu K, Gao X, Hu F, Ogino S, Schernhammer ES, Fuchs CS, Redline S, Willett WC, Ma J (2013) Associations of self-reported sleep duration and snoring with colorectal cancer risk in men and women. Sleep 36(5):681–688PubMedCentralPubMed
15.
Martinez-Garcia MA, Campos-Rodriguez F, Duran-Cantolla J, de la Pena M, Masdeu MJ, Gonzalez M, Del Campo F, Serra PC, Valero-Sanchez I, Ferrer MJ, Marin JM, Barbe F, Martinez M, Farre R, Montserrat JM (2014) Obstructive sleep apnea is associated with cancer mortality in younger patients. Sleep Med 15(7):742–748CrossRefPubMed
16.
Olbryt M, Habryka A, Student S, Jarzab M, Tyszkiewicz T, Lisowska KM (2014) Global gene expression profiling in three tumor cell lines subjected to experimental cycling and chronic hypoxia. PLoS One 9(8):e105104CrossRefPubMedCentralPubMed
17.
18.
Lavie L, Lavie P (2009) Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link. Eur Respir J 33(6):1467–1484CrossRefPubMed
19.
Almendros I, Montserrat JM, Ramirez J, Torres M, Duran-Cantolla J, Navajas D, Farre R (2012) Intermittent hypoxia enhances cancer progression in a mouse model of sleep apnoea. Eur Respir J 39(1):215–217CrossRefPubMed
20.
Almendros I, Montserrat JM, Torres M, Bonsignore MR, Chimenti L, Navajas D, Farre R (2012) Obesity and intermittent hypoxia increase tumor growth in a mouse model of sleep apnea. Sleep Med 13(10):1254–1260CrossRefPubMed
21.
Almendros I, Montserrat JM, Torres M, Dalmases M, Cabanas ML, Campos-Rodriguez F, Navajas D, Farre R (2013) Intermittent hypoxia increases melanoma metastasis to the lung in a mouse model of sleep apnea. Respir Physiol Neurobiol 186(3):303–307CrossRefPubMed
22.
Almendros I, Wang Y, Becker L, Lennon FE, Zheng J, Coats BR, Schoenfelt KS, Carreras A, Hakim F, Zhang SX, Farre R, Gozal D (2014) Intermittent hypoxia-induced changes in tumor-associated macrophages and tumor malignancy in a mouse model of sleep apnea. Am J Respir Crit Care Med 189(5):593–601CrossRefPubMedCentralPubMed
23.
24.
25.
Louie E, Nik S, Chen JS, Schmidt M, Song B, Pacson C, Chen XF, Park S, Ju J, Chen EI (2010) Identification of a stem-like cell population by exposing metastatic breast cancer cell lines to repetitive cycles of hypoxia and reoxygenation. Breast Cancer Res 12(6):R94CrossRefPubMedCentralPubMed
26.
Liu Y, Song X, Wang X, Wei L, Liu X, Yuan S, Lv L (2010) Effect of chronic intermittent hypoxia on biological behavior and hypoxia-associated gene expression in lung cancer cells. J Cell Biochem 111(3):554–563CrossRefPubMed
27.
Ahluwalia A, Tarnawski AS (2012) Critical role of hypoxia sensor–HIF-1alpha in VEGF gene activation. Implications for angiogenesis and tissue injury healing. Curr Med Chem 19(1):90–97CrossRefPubMed
28.
Wright C, Milne S, Leeson H (2014) Sperm DNA damage caused by oxidative stress: Modifiable clinical, lifestyle and nutritional factors in male infertility. Reprod BioMed Online 28(6):684–703CrossRefPubMed
29.
Klaunig JE, Kamendulis LM, Hocevar BA (2010) Oxidative stress and oxidative damage in carcinogenesis. Toxicol Pathol 38(1):96–109CrossRefPubMed
30.
Klaunig JE, Wang Z, Pu X, Zhou S (2011) Oxidative stress and oxidative damage in chemical carcinogenesis. Toxicol Appl Pharmacol 254(2):86–99CrossRefPubMed
31.
Hwang AB, Lee SJ (2011) Regulation of life span by mitochondrial respiration: the HIF-1 and ROS connection. Aging (Albany NY) 3(3):304–310
32.
Galanis A, Pappa A, Giannakakis A, Lanitis E, Dangaj D, Sandaltzopoulos R (2008) Reactive oxygen species and HIF-1 signalling in cancer. Cancer Lett 266(1):12–20CrossRefPubMed
33.
Hakim F, Wang Y, Zhang SX, Zheng J, Yolcu ES, Carreras A, Khalyfa A, Shirwan H, Almendros I, Gozal D (2014) Fragmented sleep accelerates tumor growth and progression through recruitment of tumor-associated macrophages and TLR4 signaling. Cancer Res 74(5):1329–1337CrossRefPubMedCentralPubMed
34.
Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371(9612):569–578CrossRefPubMed
35.
Wiseman M (2008) The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 67(3):253–256CrossRefPubMed
36.
Gharib SA, Seiger AN, Hayes AL, Mehra R, Patel SR (2014) Treatment of obstructive sleep apnea alters cancer-associated transcriptional signatures in circulating leukocytes. Sleep 37(4):709–714, 714A-714 TPubMedCentralPubMed
37.
Lee SL, Rouhi P, Dahl Jensen L, Zhang D, Ji H, Hauptmann G, Ingham P, Cao Y (2009) Hypoxia-induced pathological angiogenesis mediates tumor cell dissemination, invasion, and metastasis in a zebrafish tumor model. Proc Natl Acad Sci U S A 106(46):19485–19490CrossRefPubMedCentralPubMed
Metadata
Title
Obstructive sleep apnea promotes cancer development and progression: a concise review
Authors
Jie Cao
Jing Feng
Lian Li
Baoyuan Chen
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 2/2015
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-015-1126-x

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