Obstructive sleep apnea syndrome and circadian rhythms of hormones and cytokines
Obstructive sleep apnea syndrome and circadian rhythms of hormones and cytokines
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DOI：
10.1164/ajrccm.153.3.8630548
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发表时间：
1996-03-01
影响因子：
24.7
通讯作者：
Zabel, P
中科院分区：
文献类型：
--
作者：
Entzian, P;Linnemann, K;Zabel, P
一些细胞因子表现出高度的时间调节和促睡眠效能（例如，白细胞介素-1 [IL-1]，肿瘤坏死因子- α [tnf - α]）。为了寻找阻塞性睡眠呼吸暂停综合征（OSAS）的根本原因，我们研究了10例OSAS患者细胞因子释放的昼夜节律是否发生改变。10名健康志愿者作为对照人群。10例OSAS患者中有7例在鼻持续气道正压通气（nCPAP）面罩通气治疗3个月后复查。通过血液样本的短期培养，研究生物节律细胞因子（IL-1、IL-6、γ -干扰素[γ - ifn]、tnf - α）的体外释放。在OSAS患者中，tnf - α释放的昼夜节律明显受到干扰：该细胞因子的夜间生理峰值几乎消失，并且出现了一个额外的日间峰值。与对照组相比，IL-1、IL-6和γ - ifn以及免疫调节激素褪黑激素和皮质醇的昼夜变化没有差异。由于TNF- α是一种已知的睡眠调节剂，而nCPAP治疗并没有使TNF节律正常化，我们假设TNF- α可能在OSAS中发挥病理生理作用。进一步的研究应针对tnf - α和OSAS之间是否存在生理病理和/或致病联系。
Several cytokines exhibit a high degree of temporal regulation as well as somnogenic potency (e.g., interleukin-1 [IL-1], tumor necrosis factor-alpha [TNF-alpha]). Seeking the underlying cause of obstructive sleep apnea syndrome (OSAS), we investigated whether circadian rhythms of cytokine release were altered in 10 patients with OSAS. Ten healthy volunteers served as the control population. Seven of the 10 OSAS patients were reexamined after 3 mo of therapy with nasal continuous positive airway pressure (nCPAP) mask ventilation. Circadian cytokine release (IL-1, IL-6, gamma-interferon [gamma-IFN], TNF-alpha) was investigated ex vivo by short-term culture of blood samples. The circadian rhythm of TNF-alpha release was significantly disturbed in OSAS patients: nocturnal physiologic peaks in this cytokine had almost disappeared and an additional daytime peak had developed. Circadian variations in IL-1, IL-6, and gamma-IFN, and in the immunoregulatory hormones melatonin and cortisol, did not differ from those in the controls. Because TNF-alpha is a known modulator of sleep, and nCPAP therapy did not normalize TNF rhythms, we assume that TNF-alpha could well play a pathophysiologic role in OSAS. Further studies should be directed at whether a physiopathologic and/or pathogenic link exists between TNF-alpha and OSAS.