Bassam Mahboub, Zelal Kharaba, Rakhee K Ramakrishnan, Narjes Saheb Sharif Askari, Laila Ibraheem Salameh, Hassan Saber Alhariri, Mayank G Vats, Wafa Taleb Erabia, Esra'a Mohammad Alshawamreh, Yassen Alfoteih, Andrea K Mogas, Rabih Halwani, Qutayba Hamid
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However, its effects on systemic inflammation and glucocorticoid responsiveness in OSA patients with asthma are largely unknown.</p><p><strong>Aims: </strong>To examine the potential role of CPAP therapy in reducing systemic inflammation and improving glucocorticoid responsiveness in asthmatic patients with OSA.</p><p><strong>Settings and design: </strong>A case-control study was conducted at the respiratory and sleep clinics involving patients with OSA and patients with asthma and OSA.</p><p><strong>Methods: </strong>The levels of inflammatory asthma biomarkers (interleukin [IL]-4, IL-17A, IL-8, IL-2, and interferon-γ [IFN-γ]), and glucocorticoid receptors (GR)-α and GR-β, were determined to compare systemic inflammation and glucocorticoid responsiveness between pre- and post-1-month CPAP treatment in both groups.</p><p><strong>Statistical analysis: </strong>The Wilcoxon signed-rank test was used to compare inflammatory biomarkers before and after CPAP therapy. <i>P</i> < 0.05 considered statistically significant. The analysis was performed using SPSS.</p><p><strong>Results: </strong>Recruited patients (<i>n</i> = 47), 51% (<i>n</i> = 24) had OSA and 49% (<i>n</i> = 23), had OSA with asthma. Interestingly, the blood levels of IL-17 and IL-8 were significantly decreased post-CPAP therapy in OSA patients, whereas IL-4, IL-17, and IFN-γ were significantly reduced post-CPAP treatment in OSA patients with asthma. Remarkably, CPAP therapy improved glucocorticoid responsiveness in asthmatic patients with OSA, but not in the OSA group and an increase in the GR-α/GR-β ratio was noted post-CPAP therapy.</p><p><strong>Conclusions: </strong>Continuous positive airway pressure therapy improved responsiveness to glucocorticoid treatment and demonstrated a suppressive effect on proinflammatory cytokines in asthmatics with OSA.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 3","pages":"166-172"},"PeriodicalIF":2.1000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/4b/ATM-17-166.PMC9374121.pdf","citationCount":"0","resultStr":"{\"title\":\"Continuous positive airway pressure therapy suppresses inflammatory cytokines and improves glucocorticoid responsiveness in patients with obstructive sleep apnea and asthma: A case-control study.\",\"authors\":\"Bassam Mahboub, Zelal Kharaba, Rakhee K Ramakrishnan, Narjes Saheb Sharif Askari, Laila Ibraheem Salameh, Hassan Saber Alhariri, Mayank G Vats, Wafa Taleb Erabia, Esra'a Mohammad Alshawamreh, Yassen Alfoteih, Andrea K Mogas, Rabih Halwani, Qutayba Hamid\",\"doi\":\"10.4103/atm.atm_37_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>Asthma and obstructive sleep apnea (OSA) are prevalent respiratory disorders that frequently coexist. 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引用次数: 0
摘要
背景：哮喘和阻塞性睡眠呼吸暂停（OSA）是经常并存的呼吸系统疾病。持续气道正压疗法（CPAP）是治疗 OSA 的标准疗法。目的：研究 CPAP 治疗在减少伴有 OSA 的哮喘患者全身炎症和改善糖皮质激素反应性方面的潜在作用：在呼吸和睡眠诊所进行了一项病例对照研究，研究对象包括 OSA 患者和哮喘合并 OSA 患者：方法：测定哮喘炎症生物标志物（白细胞介素[IL]-4、IL-17A、IL-8、IL-2和干扰素-γ[IFN-γ]）以及糖皮质激素受体（GR）-α和GR-β的水平，比较两组患者CPAP治疗前后1个月的全身炎症和糖皮质激素反应性：采用Wilcoxon符号秩检验比较CPAP治疗前后的炎症生物标志物。P<0.05为差异有统计学意义。使用 SPSS 进行分析：招募的患者（n = 47）中，51%（n = 24）患有 OSA，49%（n = 23）患有 OSA 合并哮喘。有趣的是，OSA 患者的血液中 IL-17 和 IL-8 水平在 CPAP 治疗后显著降低，而 OSA 合并哮喘患者的 IL-4、IL-17 和 IFN-γ 水平在 CPAP 治疗后显著降低。值得注意的是，CPAP疗法改善了伴有OSA的哮喘患者对糖皮质激素的反应性，但OSA组患者的反应性却没有得到改善，而且GR-α/GR-β比值在CPAP疗法后有所增加：结论：持续气道正压疗法改善了 OSA 哮喘患者对糖皮质激素治疗的反应性，并显示出对促炎细胞因子的抑制作用。
Continuous positive airway pressure therapy suppresses inflammatory cytokines and improves glucocorticoid responsiveness in patients with obstructive sleep apnea and asthma: A case-control study.
Context: Asthma and obstructive sleep apnea (OSA) are prevalent respiratory disorders that frequently coexist. Continuous positive airway pressure (CPAP) therapy is the standard treatment for OSA. However, its effects on systemic inflammation and glucocorticoid responsiveness in OSA patients with asthma are largely unknown.
Aims: To examine the potential role of CPAP therapy in reducing systemic inflammation and improving glucocorticoid responsiveness in asthmatic patients with OSA.
Settings and design: A case-control study was conducted at the respiratory and sleep clinics involving patients with OSA and patients with asthma and OSA.
Methods: The levels of inflammatory asthma biomarkers (interleukin [IL]-4, IL-17A, IL-8, IL-2, and interferon-γ [IFN-γ]), and glucocorticoid receptors (GR)-α and GR-β, were determined to compare systemic inflammation and glucocorticoid responsiveness between pre- and post-1-month CPAP treatment in both groups.
Statistical analysis: The Wilcoxon signed-rank test was used to compare inflammatory biomarkers before and after CPAP therapy. P < 0.05 considered statistically significant. The analysis was performed using SPSS.
Results: Recruited patients (n = 47), 51% (n = 24) had OSA and 49% (n = 23), had OSA with asthma. Interestingly, the blood levels of IL-17 and IL-8 were significantly decreased post-CPAP therapy in OSA patients, whereas IL-4, IL-17, and IFN-γ were significantly reduced post-CPAP treatment in OSA patients with asthma. Remarkably, CPAP therapy improved glucocorticoid responsiveness in asthmatic patients with OSA, but not in the OSA group and an increase in the GR-α/GR-β ratio was noted post-CPAP therapy.
Conclusions: Continuous positive airway pressure therapy improved responsiveness to glucocorticoid treatment and demonstrated a suppressive effect on proinflammatory cytokines in asthmatics with OSA.
期刊介绍：
The journal will cover studies related to multidisciplinary specialties of chest medicine, such as adult and pediatrics pulmonology, thoracic surgery, critical care medicine, respiratory care, transplantation, sleep medicine, related basic medical sciences, and more. The journal also features basic science, special reports, case reports, board review , and more. Editorials and communications to the editor that explore controversial issues and encourage further discussion by physicians dealing with chest medicine.
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