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01-09-2015 | Original Article

Co-upregulation of Toll-like receptors 2 and 6 on peripheral blood cells in patients with obstructive sleep apnea

Authors: Yung-Che Chen, Mao-Chang Su, Chia-Wei Liou, Shih-Feng Liu, Chung-Jen Chen, Hsin-Ching Lin, Chang-Chun Hsiao, Ting-Ya Wang, Chin-Chou Wang, Chien-Hung Chin, Kuo-Tung Huang, An-Shen Lin, Meng-Chih Lin

Published in: Sleep and Breathing | Issue 3/2015

Abstract

Purpose

Toll-like receptor (TLR) 2 can heterodimerise with TLR6 to detect diacylated lipoproteins. Hypoxia inducible factor-1 α co-ordinates selective induction of TLR2 and TLR6 during persistent hypoxia. We hypothesized that TLR 2/6 co-expression may be upregulated by chronic intermittent hypoxia with re-oxygenation (IHR) in obstructive sleep apnea (OSA).

Methods

TLR2/6 expressions on blood immune cells were measured in 144 patients with sleep-disordered breathing (SDB), including primary snoring (PS, n = 24), moderate to severe OSA (MSO, n = 60), very severe OSA (VSO, n = 36), and very severe OSA on continuous positive airway pressure (CPAP) treatment (VSOC, n = 24). An in vitro IHR experiment was also undertaken.

Results

Patients in both the MSO and VSO groups had increased TLR2/6 co-expression on CD16⁺ neutrophil than those in the PS group. Patients in the VSOC group had reduced TLR2/6 co-expression on neutrophil than those in either the MSO or VSO group. Blood absolute neutrophil count was positively but weakly correlated with TLR2/6 co-expression on neutrophil. TLR2/6 co-expressions on both CD14⁺ monocyte and CD3⁺CD4⁺T helper cell, and TLR2 expressions on both monocyte and T helper cell in SDB patients with low Minimum SaO₂ (≦70 %) were all higher than those with high Minimum SaO₂. In vitro IHR for 1–4 days resulted in TLR2/6 co-upregulation on both neutrophil and monocyte.

Conclusions

OSA patients had increased TLR2/6 co-expressions on blood immune cells, which were related to their immune cell counts and could be reversed with CPAP treatment. In vitro IHR could induce TLR2/6 co-upregulation.

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Title: Co-upregulation of Toll-like receptors 2 and 6 on peripheral blood cells in patients with obstructive sleep apnea
Authors: Yung-Che Chen
Mao-Chang Su
Chia-Wei Liou
Shih-Feng Liu
Chung-Jen Chen
Hsin-Ching Lin
Chang-Chun Hsiao
Ting-Ya Wang
Chin-Chou Wang
Chien-Hung Chin
Kuo-Tung Huang
An-Shen Lin
Meng-Chih Lin
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Sleep and Breathing / Issue 3/2015
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-014-1116-4

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Purpose

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Conclusions

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