Potential Role of TNF-α, IL-6 and CRP in Obstructive Sleep Apnea Hypopnea Syndrome Associated Pulmonary Hypertension_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WangShaojin , ZhangPeng , XiaCenfeng , GuiZhenzhen , TanHai , ZhengXiwei ,  ZhangJin

Department of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China;

Corresponding author：

ZhangJin, Email: jinzhangnew@hotmail.com

Keywords：

Obstructive sleep apnea hypopnea syndrome; Pulmonary hypertension; Tumor necrosis factor α; Interleukin 6; C-reactive protein

DOI：

10.7507/1671-6205.2016057

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Abstract Full text Figures/Tables Video References Cited by

Objective To observe the relationship of serum tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and C-reactive protein (CRP) with obstructive sleep apnea hypopnea syndrome (OSAHS) associated pulmonary hypertension (OSAHS-PH). Methods From September 2013 to October 2014, 38 OSAHS patients, 32 OSAHS-PH patients and 35 healthy subjects were enrolled from the General Hospital of Ningxia Medical University. OSAHS was diagnosed by polysomnography. The pulmonary artery systolic pressure (PASP) was measured by echocardiograph, and the diagnose criteria for pulmonary hypertension was PASP≥40 mm Hg. Serum TNF-α, IL-6, CRP and endothelin 1 (ET-1) were detected by enzyme-linked immunosorbent assay. The correlation between TNF-α, IL-6, CRP, ET-1 and PASP was analyzed. Results The serum levels of TNF-α, IL-6, CRP and ET-1 were remarkably different among three groups (F=55.34, 25.05, 23.85, 34.06 respectively; all P < 0.05). The levels of TNF-α, IL-6, CRP and ET-1 in the OSAHS group were higher than those in the healthy group, and lower than those in the OSAHS-PH group (all P < 0.05). The PASP was positively correlated with the levels of the four factors (r=0.755, 0.762, 0.747, 0.759 respectively; all P < 0.01). Conclusion The levels of serum TNF-α, IL-6 and CRP are correlated with pulmonary hypertension and they may be involved in the process of OSAHS-PH.

Citation： Wang Shaojin, Zhang Peng, Xia Cenfeng, Gui Zhenzhen, Tan Hai, Zheng Xiwei, Zhang Jin. Potential Role of TNF-α, IL-6 and CRP in Obstructive Sleep Apnea Hypopnea Syndrome Associated Pulmonary Hypertension. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(3): 241-244. doi: 10.7507/1671-6205.2016057 Copy

1.	Qaseem A, Holty JEC, Owens DK, et al. Management of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med, 2013, 159:471-483.
2.	Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc, 2008, 5:136-143.
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4.	Atwood CW, McCrory D, Garcia JGN, et al. Pulmonary artery hypertension and sleep-disordered breathing: ACCP evidence-based clinical practice guidelines. Chest, 2004, 126(1_Suppl):72S-77S.
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7.	Karkoulias K, Lykouras D, Sampsonas F, et al. The role of endothelin-1 in obstructive sleep apnea syndrome and pulmonary arterial hypertension: pathogenesis and endothelin-1 antagonists. Curr Med Chem, 2010, 17:1059-1066.
8.	Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation, 2005, 112:2660-2667.
9.	Greenberg H, Ye X, Wilson D, et al. Chronic intermittent hypoxia activates nuclear factor-κB in cardiovascular tissues in vivo. Biochem Biophy Res Commun, 2006, 343:591-596.
10.	Garvey JF, Taylor CT, McNicholas WT. Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation. Eur Respir J, 2009, 33:1195-1205.
11.	Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol, 2010, 7:677-685.
12.	Zhang H, Park Y, Wu J, et al. Role of TNF-alpha in vascular dysfunction. Clin Sci, 2009, 116:219-230.
13.	Sutendra G, Dromparis P, Bonnet S, et al. Pyruvate dehydrogenase inhibition by the inflammatory cytokine TNFα contributes to the pathogenesis of pulmonary arterial hypertension. J Mol Med (Berl), 2011, 89:771-783.
14.	Baessler A, Nadeem R, Harvey M, et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers--a meta-analysis. J Inflamm-Lond, 2013, 10:13.
15.	范嘉铨, 陈飞鹏, 黄华兴.阻塞性呼吸暂停低通气综合征患者血清sCD40L, IL-18, IL-6及MMP-9的水平及意义.实验与检验医学, 2013, 31:115-117.
16.	Chaouat A, Savale L, Chouaid C, et al. Role for interleukin-6 in COPD-related pulmonary hypertension. Chest, 2009, 136:678-687.
17.	王关嵩, 钱桂生, 毛宝龄, 等.缺氧肺动脉高压大鼠肺组织中白细胞介素6和Janus激酶表达的变化.中华结核和呼吸杂志, 2005, 26:664-667.

1. Qaseem A, Holty JEC, Owens DK, et al. Management of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med, 2013, 159:471-483.
2. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc, 2008, 5:136-143.
3. Hoeper MM, Bogaard HJ, Condliffe R, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol, 2013, 62(25 Suppl):D42-D50.
4. Atwood CW, McCrory D, Garcia JGN, et al. Pulmonary artery hypertension and sleep-disordered breathing: ACCP evidence-based clinical practice guidelines. Chest, 2004, 126(1_Suppl):72S-77S.
5. Price LC, Wort SJ, Perros F, et al. Inflammation in pulmonary arterial hypertension. Chest, 2012, 141:210-221.
6. 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版).中华结核和呼吸杂志, 2012, 35:9-12.
7. Karkoulias K, Lykouras D, Sampsonas F, et al. The role of endothelin-1 in obstructive sleep apnea syndrome and pulmonary arterial hypertension: pathogenesis and endothelin-1 antagonists. Curr Med Chem, 2010, 17:1059-1066.
8. Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation, 2005, 112:2660-2667.
9. Greenberg H, Ye X, Wilson D, et al. Chronic intermittent hypoxia activates nuclear factor-κB in cardiovascular tissues in vivo. Biochem Biophy Res Commun, 2006, 343:591-596.
10. Garvey JF, Taylor CT, McNicholas WT. Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation. Eur Respir J, 2009, 33:1195-1205.
11. Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol, 2010, 7:677-685.
12. Zhang H, Park Y, Wu J, et al. Role of TNF-alpha in vascular dysfunction. Clin Sci, 2009, 116:219-230.
13. Sutendra G, Dromparis P, Bonnet S, et al. Pyruvate dehydrogenase inhibition by the inflammatory cytokine TNFα contributes to the pathogenesis of pulmonary arterial hypertension. J Mol Med (Berl), 2011, 89:771-783.
14. Baessler A, Nadeem R, Harvey M, et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers--a meta-analysis. J Inflamm-Lond, 2013, 10:13.
15. 范嘉铨, 陈飞鹏, 黄华兴.阻塞性呼吸暂停低通气综合征患者血清sCD40L, IL-18, IL-6及MMP-9的水平及意义.实验与检验医学, 2013, 31:115-117.
16. Chaouat A, Savale L, Chouaid C, et al. Role for interleukin-6 in COPD-related pulmonary hypertension. Chest, 2009, 136:678-687.
17. 王关嵩, 钱桂生, 毛宝龄, 等.缺氧肺动脉高压大鼠肺组织中白细胞介素6和Janus激酶表达的变化.中华结核和呼吸杂志, 2005, 26:664-667.

Chinese Journal of Respiratory and Critical Care Medicine

Potential Role of TNF-α, IL-6 and CRP in Obstructive Sleep Apnea Hypopnea Syndrome Associated Pulmonary Hypertension

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