Obstructive Sleep Apnea Syndrome Clinical Trial
Official title:
Inflammatory Mediators in Obstructive Sleep Apnoea Syndrome; Mechanisms of Production and the Effect of Long Term Antioxidants Administration
Obstructive Sleep Apnea Syndrome (OSAS) is associated with elevated plasma levels of IL-6
and TNF-α, which cannot be accounted for by obesity (Vgontzas et al Sleep Med Rev
2005;9:211-24, Ciftci et al Cytokine 2004;28:87-91].
Obstructive apneas-hypopneas are accompanied by strenuous diaphragmatic contractions before
the ensuing arousals and re-establishment of airway patency. We have shown that strenuous
diaphragmatic contractions induced by resistive loading lead to elevated plasma levels of
IL-6, TNF-α, and IL-1β (Vassi-lakopoulos et al AJRCCM 2002;166:1572-8) with concomitant
up-regulation of the cytokines within the diaphragmatic myofibers (Vassilakopoulos et al
AJRCCM 2004;170:154-61).
OSAS patients exhibit frequent episodes of hypoxemia during the night. Loaded breathing is a
form exercise for the respiratory muscles, and both acute and chronic hypoxia lead to an
augmented plasma IL-6 response to exercise compared to normoxia (Lundby et al Eur J Appl
Physiol 2004;91:88-93).
In OSAS, monocytes have oxidative stress (Dyugovskaya et al AJRCCM 2002;165:934-9) and
produce more cytokines (TNF-α) in vitro (Minoguchi et al Chest 204;126:1473-9).
Hypothesis #1: plasma levels of IL-6 and TNF-α are increased during the night in OSAS
patients secondary to the intermittent strenuous diaphragmatic contractions and the episodes
of hypoxia-reoxygenation associated with the obstructive apneas-hypopneas.
Hypothesis #2: monocytes from sleep apnea patients, exhibit augmented intracellular
expression of IL-6 and TNF-α during the night.
Hypothesis #3: Oxidative stress is a stimulus for cytokine upregulation in OSAS.
n/a
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Basic Science
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