Obstructive sleep apnea, immuno-inflammation, and atherosclerosis

被引:131
作者
Arnaud, Claire [2 ,3 ]
Dematteis, Maurice [2 ,3 ,4 ]
Pepin, Jean-Louis [2 ,3 ,4 ]
Baguet, Jean-Philippe [3 ,5 ,6 ]
Levy, Patrick [1 ,2 ,3 ,4 ]
机构
[1] CHU Grenoble, EFCR, Lab HP2, F-38043 Grenoble, France
[2] INSERM, ERI17, F-38043 Grenoble, France
[3] Univ Grenoble 1, Fac Med, F-38403 Grenoble, France
[4] CHU Grenoble, Lab Sommeil, F-38043 Grenoble, France
[5] CHU Grenoble, Hop A Michallon, Dept Cardiol & Hypertens, F-38043 Grenoble, France
[6] INSERM, U877, F-38042 Grenoble, France
关键词
Atherosclerosis; Obstructive sleep apnea; Intermittent hypoxia; Inflammation; Chemokines; Adipose tissue; POSITIVE AIRWAY PRESSURE; CHRONIC INTERMITTENT HYPOXIA; C-REACTIVE PROTEIN; PROFESSIONAL-EDUCATION COMMITTEE; FOUNDATION SCIENTIFIC STATEMENT; HEART-ASSOCIATION COUNCIL; CIRCULATING NITRIC-OXIDE; SERUM ADIPONECTIN LEVEL; NECROSIS-FACTOR-ALPHA; INSULIN-RESISTANCE;
D O I
10.1007/s00281-009-0148-5
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
071005 [微生物学]; 100108 [医学免疫学];
摘要
Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder leading to cardiovascular and metabolic complications. OSA is also a multicomponent disorder, with intermittent hypoxia (IH) as the main trigger for the associated cardiovascular and metabolic alterations. Indeed, recurrent pharyngeal collapses during sleep lead to repetitive sequences of hypoxia-reoxygenation. This IH induces several consequences such as hemodynamic, hormonometabolic, oxidative, and immuno-inflammatory alterations that may interact and aggravate each other, resulting in artery changes, from adaptive to degenerative atherosclerotic remodeling. Atherosclerosis has been found in OSA patients free of other cardiovascular risk factors and is related to the severity of nocturnal hypoxia. Early stages of artery alteration, including functional and structural changes, have been evidenced in both OSA patients and rodents experimentally exposed to IH. Impaired vasoreactivity with endothelial dysfunction and/or increased vasoconstrictive responses due to sympathetic, endothelin, and renin-angiotensin systems have been reported and also contribute to vascular remodeling and inflammation. Oxidative stress, inflammation, and vascular remodeling can be directly triggered by IH, further aggravated by the OSA-associated hormonometabolic alterations, such as insulin resistance, dyslipidemia, and adipokine imbalance. As shown in OSA patients and in the animal model, genetic susceptibility, comorbidities (obesity), and life habits (high fat diet) may aggravate atherosclerosis development or progression. The intimate molecular mechanisms are still largely unknown, and their understanding may contribute to delineate new targets for prevention strategies and/or development of new treatment of OSA-related atherosclerosis, especially in patients at risk for cardiovascular disease.
引用
收藏
页码:113 / 125
页数:13
相关论文
共 160 条
[1]
Augmented endothelin vasoconstriction in intermittent hypoxia-induced hypertension [J].
Allahdadi, KJ ;
Walker, BR ;
Kanagy, NL .
HYPERTENSION, 2005, 45 (04) :705-709
[2]
Arnaud C, 2009, AM J RESP CRIT CARE, V179
[3]
ARNAUD C, 2008, EUR RESP J S52, V32
[4]
The severity of oxygen desaturation is predictive of carotid wall thickening and plaque occurrence [J].
Baguet, JP ;
Hammer, L ;
Lévy, P ;
Pierre, H ;
Launois, S ;
Mallion, JM ;
Pépin, JL .
CHEST, 2005, 128 (05) :3407-3412
[5]
Insulin resistance and daytime sleepiness in patients with sleep apnoea [J].
Barcelo, A. ;
Barbe, F. ;
de la Pena, M. ;
Martinez, P. ;
Soriano, J. B. ;
Pierola, J. ;
Agusti, A. G. N. .
THORAX, 2008, 63 (11) :946-950
[6]
Neuropeptide Y and leptin in patients with obstructive sleep apnea syndrome -: Role of obesity [J].
Barceló, A ;
Barbé, F ;
Llompart, E ;
la Peña, MC ;
Durán-Cantolla, J ;
Ladaria, A ;
Bosch, M ;
Guerra, L ;
Agustí, AGN .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2005, 171 (02) :183-187
[7]
[8]
BELAIDI E, 2008, EUR RESP J S52, V32
[9]
Major Role for Hypoxia Inducible Factor-1 and the Endothelin System in Promoting Myocardial Infarction and Hypertension in an Animal Model of Obstructive Sleep Apnea [J].
Belaidi, Elise ;
Joyeux-Faure, Marie ;
Ribuot, Christophe ;
Launois, Sandrine H. ;
Levy, Patrick ;
Godin-Ribuot, Diane .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 53 (15) :1309-1317
[10]
Leptin and atherosclerosis [J].
Beltowski, Jerzy .
ATHEROSCLEROSIS, 2006, 189 (01) :47-60