Changes and Significances of 8-isoprostane, Leukotriene B4, Tumor Necrosis Factor-α, Interleukin-10 and Hypersensitive C-Reactive Protein in Serumof Patients with Obstructive Sleep Apnea Hypopnea Syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

XIA Qiuping ¹ ,  CHEN Jianrong ¹ , CAI Yingyun ² , TAO Yijiang. ¹

Department of Respiratory Medicine, The Second Affiliated Hospital of Nantong University. Nantong, Jiangsu, 226001, China;

Corresponding author：

CHEN Jianrong, Email: drchenjr@163.com

Keywords：

Obstructive sleep apnea hypopnea syndrome; 8-isoprostane; Leukotriene B4; Tumor necrosis factor-α; Interleukin-10; Hypersensitive C-reactive protein

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Objective To investigate the changes of 8-isoprostane ( 8-isoPG) , leukotriene B4 ( LTB4 ) , TNF-α, IL-10 and hypersensitive C-reactive protein( Hs-CRP) in serum of patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty OSAHS patients ( 20 cases underwent therapeutic Auto-CPAP or UPPP treatment for over three months) and 30 normal controls were included in the study. Serum 8-isoPG, LTB4, TNF-α and IL-10 were measured by ELISA. Hs-CRP was detected by automatic biochemistry analyzer. Results ①The serum levels of 8-isoPG, LTB4, TNF-α, Hs-CRP were significantly higher and IL-10 was considerably lower after sleep in 40 OSAHS patients [ ( 36. 59 ±14. 89) ng/L, ( 14. 75 ±6. 25) μg/L, ( 1022. 13 ±97. 57 ) ng/L, ( 2. 46 ±1. 58 ) mg/L, ( 4. 68 ±3. 42) ng/L, respectively ] than those in the normal controls [ ( 19. 91 ±7. 76 ) ng/L, ( 1. 43 ±0. 72) μg/L, ( 540. 00 ±78. 70) ng/L, ( 0. 30 ±0. 16) mg/L, ( 7. 41 ±4. 49) ng/L, respectively] ( P lt;0. 01) . ② Serum 8-isoPG, LTB4, TNF-α, and Hs-CRP levels elevated gradually following the severity of OSAHS while serum IL-10 level was decreased( P lt; 0. 05) . ③Serum 8-isoPG, LTB4, TNF-α, and Hs-CRP levels in OSAHS patients after sleep were correlated positively with AHI ( r =0. 863, 0. 746, 0. 868, 0. 842,all P lt; 0. 01) and negatively with LSpO2 ( r = - 0. 623, - 0. 524, - 0. 618, - 0. 562, all P lt; 0. 01) and MSpO2 ( r = - 0. 654, - 0. 573, - 0. 537, - 0. 589, all P lt;0. 01) . SerumIL-10 level in OSAHS patients was correlated negatively with AHI ( r = - 0. 722, P lt; 0. 01) and positively with LSpO2 ( r = 0. 564, P lt; 0. 01) and MSpO2 ( r = 0. 505, P lt; 0.01) . ④ After three months of auto continuous positive air pressure( Auto-CPAP) or uvulopalatopharyngoplasty( UPPP) treatment, serum 8-isoPG, LTB4, TNF-α, and Hs-CRP levels of the OSAHS patients after sleep were obviously decreased [ ( 23. 10 ±9. 54) ng/L, ( 4. 02 ±2. 15) μg/L, ( 810. 25 ±135. 85) ng/L, ( 0. 79 ±0. 60) mg/L, respectively] , and serum IL-10 level was obviously increased[ ( 6. 93 ±3. 91) ng/L] ( P lt; 0. 01) . ⑤ serum 8-isoPG and IL-10 had no statistics difference and serum LTB4, TNF-α, Hs-CRP levels were higher in OSAHS underwent therapy compared with the normal controls. Conclusions The results suggest that inflammation and oxidative stress are activated and antiflammatory cytokines are decreased in the OSAHS patients. The serum levels of 8-isoPG, LTB4 , TNF-α, Hs-CRP and IL-10 may prove to be useful in severity monitoring and intervention efficacy judgement in OSAHS patients.

Citation： XIA Qiuping,CHEN Jianrong,CAI Yingyun,TAO Yijiang.. Changes and Significances of 8-isoprostane, Leukotriene B4, Tumor Necrosis Factor-α, Interleukin-10 and Hypersensitive C-Reactive Protein in Serumof Patients with Obstructive Sleep Apnea Hypopnea Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(3): 262-266. doi: Copy

1.	Carpagnano GE, Kharitonov SA, Resta O, et al.8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy. Chest, 2003,124: 1386-1392.
2.	夏秋萍, 陈建荣, 蔡映云, 等. 阻塞性睡眠呼吸暂停综合征呼出气冷凝液中炎症因子检测的研究进展. 国际呼吸杂志, 2008, 28:146-149.
3.	Kageyama N, Nomura M, Nakaya Y, et al. Relationship between adhesion molecules with hs-CRP and changes therein after ARB ( Valsartan) administration in patients with obstructive sleep apnea syndrome. J Med Invest, 2006, 53: 134-139.
4.	Riha RL, Brander P, Vennelle M, et al. Tumour necrosis factor-alpha ( -308) gene polymorphism in obstructive sleep apnoea-hypopnoea syndrome. Eur Respir J, 2005, 26: 673-678.
5.	陈金亮, 陈建荣, 陶一江, 等. 慢性阻塞性肺疾病患者呼出气冷凝液中白细胞三烯B4 和肿瘤坏死因子-α的检测及其临床意义. 中国危重病急救医学, 2008, 20: 357-360.
6.	Kheirandish L, Goldbart AD, Gozal D. Intranasal steroids and oral leukotriene modifier therapy in residual sleep-disordered breathing after tonsillectomy and adenoidectomy in children. Pediatrics, 2006 ,117: e61-e66.
7.	Ryan S, Taylor CT, McNicholas WT. Predictors of elevated nuclear factor-kappaB-dependent genes in obstructive sleep apnea syndrome.Am J Respir Crit Care Med, 2006, 174: 824-830.
8.	黄燕, 林勇. 阻塞性睡眠呼吸暂停低通气综合征患者血清脂联素水平的变化. 中国呼吸与危重监护杂志, 2006, 5: 125-128.

1. Carpagnano GE, Kharitonov SA, Resta O, et al.8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy. Chest, 2003,124: 1386-1392.
2. 夏秋萍, 陈建荣, 蔡映云, 等. 阻塞性睡眠呼吸暂停综合征呼出气冷凝液中炎症因子检测的研究进展. 国际呼吸杂志, 2008, 28:146-149.
3. Kageyama N, Nomura M, Nakaya Y, et al. Relationship between adhesion molecules with hs-CRP and changes therein after ARB ( Valsartan) administration in patients with obstructive sleep apnea syndrome. J Med Invest, 2006, 53: 134-139.
4. Riha RL, Brander P, Vennelle M, et al. Tumour necrosis factor-alpha ( -308) gene polymorphism in obstructive sleep apnoea-hypopnoea syndrome. Eur Respir J, 2005, 26: 673-678.
5. 陈金亮, 陈建荣, 陶一江, 等. 慢性阻塞性肺疾病患者呼出气冷凝液中白细胞三烯B4 和肿瘤坏死因子-α的检测及其临床意义. 中国危重病急救医学, 2008, 20: 357-360.
6. Kheirandish L, Goldbart AD, Gozal D. Intranasal steroids and oral leukotriene modifier therapy in residual sleep-disordered breathing after tonsillectomy and adenoidectomy in children. Pediatrics, 2006 ,117: e61-e66.
7. Ryan S, Taylor CT, McNicholas WT. Predictors of elevated nuclear factor-kappaB-dependent genes in obstructive sleep apnea syndrome.Am J Respir Crit Care Med, 2006, 174: 824-830.
8. 黄燕, 林勇. 阻塞性睡眠呼吸暂停低通气综合征患者血清脂联素水平的变化. 中国呼吸与危重监护杂志, 2006, 5: 125-128.

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Changes and Significances of 8-isoprostane, Leukotriene B4, Tumor Necrosis Factor-α, Interleukin-10 and Hypersensitive C-Reactive Protein in Serumof Patients with Obstructive Sleep Apnea Hypopnea Syndrome

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