Effect of continuous positive airway pressure therapy on serum IL-23 and CRP levels in patients with obstructive sleep apnea hypopnea syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHOU Xiaolei , ZHANG Juan , ZHAO Zhiguo , KUANG Hongping , TANG Bingxiang ,  ZHANG Manlin

Department of Respiratory and Critical Care Medicine, Henan Chest Hospital, Zhengzhou, Henan 450000, P. R. China;

Corresponding?author：

ZHANG Manlin, Email: f6222050@126.com

Keywords：

Obstructive sleep apnea hypopnea syndrome; Interleukin-23; C-reactive protein; Continuous positive airway pressure

DOI：

10.7507/1671-6205.201812006

Video：

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Objective To investigate the pathogenesis and treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) by detecting the changes of serum interleukin-23 (IL-23) and C-reactive protein (CRP) levels of the OSAHS patients before and after treatment with continuous positive airway pressure (CPAP).Methods Fifty-eight patients with moderate to severe OSAHS diagnosed by polysomnography were recruited as an experimental group, 57 out-patient healthy subjects with matched age, sex and body mass index of the experimental group were enrolled as a control group. The serum concentrations of IL-23 and CRP in the experimental group were detected and compared before and after CPAP application for 3 months. The serum concentrations of IL-23 and CRP in the control group were also measured.Results The serum levels of IL-23 and CRP in the OSAHS patients were significantly higher than those in the normal control subjects (P<0.05). The serum levels of IL-23 and CRP in the OSAHS patients after CPAP treatment were significantly lower than those before CPAP treatment (P<0.05). The serum concentrations of IL-23 and CRP were positively correlated with apnea hypopnea index (r=0.756, r=0.345, P<0.05, respectively), and negatively correlated with mean oxygen saturation (r=–0.715, r=–0.334, P<0.05, respectively).Conclusions The serum levels of IL-23 and CRP are positively correlated with the severity of OSAHS. After CPAP treatment, the levels of IL-23 and CRP decrease, which indicates that CPAP treatment may reduce the inflammatory reaction and correct anoxia of OSAHS patients.

Citation： ZHOU Xiaolei, ZHANG Juan, ZHAO Zhiguo, KUANG Hongping, TANG Bingxiang, ZHANG Manlin. Effect of continuous positive airway pressure therapy on serum IL-23 and CRP levels in patients with obstructive sleep apnea hypopnea syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(1): 36-40. doi: 10.7507/1671-6205.201812006 Copy

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1. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(基層版)寫作組. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(基層版). 中華全科醫師雜志, 2015, 14(7): 509-515.
2. 李文鵬. 阻塞性睡眠呼吸暫停綜合征與代謝綜合征. 中國循環雜志, 2015, 30(5): 511-512.
3. 王蓓. 阻塞性睡眠呼吸暫停與心律失常. 臨床內科雜志, 2017, 34(1): 13-15.
4. 郭鳳霞, 儲德節. 持續正壓通氣對 OSAHS 合并 2 型糖尿病患者睡眠、糖代謝及氧化應激的影響. 臨床肺科雜志, 2017, 22(11): 1962-1965.
5. 黎嬌, 況九龍. 阻塞性睡眠呼吸暫停低通氣綜合征氧化應激與心血管疾病相關性的研究進展. 實用醫學雜志, 2014, 30(12): 2002-2004.
6. Christou K, Markoulis N, Moulas AN, et al. Reactive oxygen metabolites (ROMs) as an index of oxidative stress in obstructive sleep apnea patients. Sleep Breath, 2003, 7(3): 105-110.
7. 陳實, 李承紅, 孟慶華. OSAHS 患者胰島素抵抗指數變化及其與血清炎癥因子水平的相關性. 山東醫藥, 2017, 57(7): 66-68.
8. Kang JH, Lin HC. Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study. Sleep Med, 2012, 13(6): 583-588.
9. Tang C, Chen S, Qian H, et al. Interleukin-23: as a drug target for autoimmune inflammatory diseases. Immunology, 2011, 135(2): 112-124.
10. Ngiow SF, Teng MW, Smyth MJ. A balance of interleukin-12 and -23 in cancer. Trends Immunol, 2013, 34(11): 548-555.
11. Croxford AL, Mair F, Becher B. IL-23: one cytokine in control of autoimmunity. Eur J Immunol, 2012, 42(9): 2263-2273.
12. Can M, Uygur F, Tanr?verdi H, et al. Effect of continuous positive airway pressure (CPAP) therapy on IL-23 in patients with obstructive sleep apnea. Immunol Res, 2016, 64(5-6): 1179-1184.
13. Lin QC, Chen LD, Yu YH, et al. Obstructive sleep apnea syndrome is associated with metabolic syndrome and inflammation. Eur Arch Otorhinolaryngol, 2014, 271(4): 825-831.
14. Chami HA, Fontes JD, Vasan RS, et al. Vascular inflammation and sleep disordered breathing in a community-based cohort. Sleep, 2013, 36(5): 763-768.
15. Guven SF, Turkkani MH, Ciftci B, et al. The relationship between high-sensitivity C-reactive protein levels and the severity of obstructive sleep apnea. Sleep Breath, 2012, 16(1): 217-221.
16. Floss DM, Schr?der J, Franke M, et al. Insights into IL-23 biology: from structure to function. Cytokine Growth Factor Rev, 2015, 26(5): 569-578.
17. Ciprandi G, Cuppari C, Salpietro A, et al. Serum IL-23 strongly and inversely correlates with FEV1 in asthmatic children. Int Arch Allergy Immunol, 2012, 159(2): 183-186.
18. Ciprandi G, Cuppari C, Salpietro A, et al. Serum IL-23 in asthmatic children. J Biol Regul Homeost Agents, 2012, 26(1 Suppl): S53-S61.
19. 劉燕, 顧永春, 湯穎, 等. Th17/Treg 平衡在阻塞性睡眠呼吸暫停低通氣綜合征中的作用及其機制. 中華醫學雜志, 2016, 96(44): 3577-3581.
20. Dong L, Xia JW, Gong Y, et al. Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease. Evid Based Complement Alternat Med, 2014, 2014: 637969.
21. Ye J, Liu H, Zhang GH, et al. The Treg/Th17 imbalance in patients with obstructive sleep apnoea syndrome. Mediators Inflamm, 2012, 2012: 815308.
22. Yokoe T, Minoguchi K, Matsuo H, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation, 2003, 107(8): 1129-1134.
23. Jin F, Liu J, Zhang X, et al. Effect of continuous positive airway pressure therapy on inflammatory cytokines and atherosclerosis in patients with obstructive sleep apnea syndrome. Mol Med Rep, 2017, 16(5): 6334-6339.
24. Tie YX, Fu YY, Xu Z, et al. Relationship between C-reactive protein levels and obstructive sleep apnea syndrome. Genet Mol Res, 2015, 15(2): gmr7808.
25. 尹春麗. 成年男性 OSAHS 患者日間嗜睡相關因素分析[D]. 吉林大學, 2011.
26. 韓鋒鋒, 楊玲, 林建海. OSAHS 與單純鼾癥兒童睡眠效率及睡眠結構分析. 中國醫師雜志, 2005, 7(5): 646-647.

Chinese Journal of Respiratory and Critical Care Medicine

Effect of continuous positive airway pressure therapy on serum IL-23 and CRP levels in patients with obstructive sleep apnea hypopnea syndrome

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