Obstructive Sleep Apnea Syndrome Clinical Trial
Official title:
Inflammatory Markers in Infants With Obstructive Sleep Apnea
Obstructive sleep apnea syndrome (OSAS) is a common disorder in children (2-3%). OSAS in
turn, is associated with significant behavioral, learning, and heart problems.
Adenotonsillectomy (T&A, meaning the removal of tonsils and adenoids) is the most common
treatment for the problem .Diagnosis of OSAS in children is based on overnight
polysomnography (sleep study). Recent studies suggest that upper airway and systemic
inflammatory changes exists in school-age children and adults with OSAS, and that anti
inflammatory therapy can improve respiratory parameters during sleep and reduce adenoid
size, similar to surgery. However, there are no data in the literature on inflammatory
changes in infants with the disorder.
Healthcare resources utilization, a sensitive marker for diseases is consumed by young
children (<3y) with OSAS more then healthy children, from their first year of life We
hypothesize that infants and young children with OSAS present local inflammatory changes of
the airways as well as systemic inflammation (in the blood or urine) that contribute to the
learning, growing and heart associated medical problems. The Aims of the present study are
to characterize the local and systemic inflammatory changes of young children with OSAS, and
to evaluate their associated medical problems at diagnosis and after therapy (T&A) If indeed
inflammation is "responsible" for the development of OSAS at such a young age it should be
reduced following therapy (i.e. T&A). In such a case bio-markers may become a part of the
algorithms for diagnosis and follow up of such patients.
Specific Aims:
1. To conduct a trial evaluating the effect of Adenonsillectomy in infants (1-36 months of
age), with OSA. Outcome measures will include polysomnographic findings conducted prior
to and 12 weeks following surgery.
2. To identify the presence of inflammatory markers (such as, but not only Leukotriene B4,
Leukotriene C4/D4/E4, Isoprostane-8, IL-6, TNF-alpha, and other pro inflammatory
cytokines) in the peripheral blood (prior and after therapy), and urine (Leukotriene
E-4, and others) and correlate their local and systemic expression prior and after
therapy to the magnitude of therapy-associated response.
Study Duration: Two years (initial recruitment will be completed within the initial 12
months of the study). Assessment of the samples obtained throughout the study will be done
at the latter part of the study.
Setting: Soroka University Hospital . The Sleep Laboratory in Soroka UMC, is the only
pediatric one in the city of Beer Sheva and surroundings, evaluates over 1,000 children/year
for a variety of sleep disorders, among which >700 are referred for suspected OSAS, among
them 100 infants< 2 years/ year.
All children referred for surgery are admitted in the Dept. of Pediatrics where the PI
works. We intend to approach all the children prior to surgery and offer them to participate
in this study. Those who are interested will gain a sleep study following surgery to
validate (or to rull out) the presence of residual OSA and if there is a need, to continue
follow up in the pediatric sleep outpatient clinic in Soroka UMC.
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Observational Model: Cohort, Time Perspective: Prospective
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