Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood Platelets.
Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood Platelets.
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DOI：
10.3389/fneur.2018.00635
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发表时间：
2018
影响因子：
3.4
通讯作者：
Białasiewicz P
中科院分区：
文献类型：
--
作者：
Gabryelska A;Łukasik ZM;Makowska JS;Białasiewicz P
阻塞性睡眠呼吸暂停是一种慢性疾病，其特征是睡眠期间反复发作的呼吸暂停或呼吸不足，导致间歇性低氧血症和觉醒。据估计，睡眠呼吸障碍的患病率约为50%的男性和24%的女性患有中度至重度的睡眠呼吸障碍。打鼾、上呼吸道塌陷和间歇性缺氧是阻塞性睡眠呼吸暂停患者全身炎症郁积的主要原因。全身性炎症被认为是导致心血管并发症的重要机制之一。血小板，以前甚至不被认为是细胞，目前正在获得关注，作为免疫连续体中的关键角色。血小板表面被赋予典型地属于免疫系统的细胞的特征性受体，这使得它们能够识别病原体、免疫复合物，并在同型和异型聚集体中相互作用。血小板通过递送特异性酶和底物分子参与生物活性脂质的跨细胞产生过程。尽管没有细胞核，血小板仍以刺激依赖的方式合成蛋白质。动脉粥样硬化和随之而来的心血管并发症是由于血小板的两种作用（血液凝固和炎症过程调节）的稳态破坏所致。血小板参数，常规评估的一部分，全血细胞计数测试，提出了作为标志物的心血管并发症的阻塞性睡眠呼吸暂停患者。在这组患者中发现血小板过度活化，特别是在肥胖受试者中。持续激活导致自发聚集性增强和细胞因子产生的变化。血小板-淋巴细胞比率被认为是阻塞性睡眠呼吸暂停综合征心血管疾病的独立标志物，持续正压通气治疗对血小板参数和表型有影响。在这篇文献综述中，我们总结了目前的知识，血小板参与阻塞性睡眠呼吸暂停综合征的主题，并考虑可能的途径，他们有助于心血管并发症。
Obstructive sleep apnea is a chronic condition characterized by recurrent episodes of apneas or hypopneas during sleep leading to intermittent hypoxemia and arousals. The prevalence of the sleep disordered breathing is estimated that almost 50% of men and 24% of women suffer from moderate to severe form of the disorder. Snoring, collapse of upper airways and intermittent hypoxia are main causes of smoldering systemic inflammation in patients suffering from obstructive sleep apnea. The systematic inflammation is considered one of the key mechanisms leading to significant cardiovascular complications. Blood platelets, formerly not even recognized as cells, are currently gaining attention as crucial players in the immune continuum. Platelet surface is endowed with receptors characteristic for cells classically belonging to the immune system, which enables them to recognize pathogens, immune complexes, and interact in a homo- and heterotypic aggregates. Platelets participate in the process of transcellular production of bioactive lipids by delivering both specific enzymes and substrate molecules. Despite their lack of nucleus, platelets synthetize proteins in a stimuli-dependent manner. Atherosclerosis and consequent cardiovascular complications result from disruption in homeostasis of both of the platelet roles: blood coagulation and inflammatory processes modulation. Platelet parameters, routinely evaluated as a part of complete blood count test, were proposed as markers of cardiovascular comorbidity in patients with obstructive sleep apnea. Platelets were found to be excessively activated in this group of patients, especially in obese subjects. Persistent activation results in enhanced spontaneous aggregability and change in cytokine production. Platelet-lymphocyte ratio was suggested as an independent marker for cardiovascular disease in obstructive sleep apnea syndrome and continuous positive air pressure therapy was found to have an impact on platelet parameters and phenotype. In this literature review we summarize the current knowledge on the subject of platelets involvement in obstructive sleep apnea syndrome and consider the possible pathways in which they contribute to cardiovascular comorbidity.
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DOI：
10.6061/clinics/2015(07)04
发表时间：
2015-07
期刊：
Clinics (Sao Paulo, Brazil)
影响因子：
--
作者：
Akyol S;Çörtük M;Baykan AO;Kiraz K;Börekçi A;Şeker T;Gür M;Çayli M
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Çayli M
影响因子：
24.3
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通讯作者：
Kohler, M.
影响因子：
2.4
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Chen, JM;López, KA
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López, KA
DOI：
10.1111/j.1751-7141.2009.00058.x
发表时间：
2010-01-01
期刊：
Preventive cardiology
影响因子：
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作者：
Bordeaux, Bryan C;Qayyum, Rehan;Becker, Diane M
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Becker, Diane M
DOI：
10.1007/978-94-007-4549-0_15
发表时间：
2013-01-01
期刊：
RESPIRATORY REGULATION - THE MOLECULAR APPROACH
影响因子：
--
作者：
Cofta, S.;Wysocka, E.;Torlinski, L.
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Torlinski, L.