Inflammatory cytokines in pediatric obstructive sleep apnea.
Inflammatory cytokines in pediatric obstructive sleep apnea.
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DOI：
10.1097/md.0000000000004944
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发表时间：
2016-10
期刊：
影响因子：
1.6
通讯作者：
Lee LA
中科院分区：
文献类型：
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作者：
Huang YS;Guilleminault C;Hwang FM;Cheng C;Lin CH;Li HY;Lee LA
小儿阻塞性睡眠呼吸暂停（OSA）与慢性全身性炎症和认知障碍有关。本研究旨在探讨促炎细胞因子，特别是白细胞介素17 （IL-17）和白细胞介素23 （IL-23）在儿童OSA中的地位和认知。对照组和阻塞性睡眠呼吸暂停儿童参与了这项研究。排除标准为腺扁桃体切除术、心脏、神经和严重精神疾病、颅面综合征和肥胖。多导睡眠图后进行血清炎症标志物检测、神经认知测试（如连续工作任务（CPT）和威斯康星卡片分类测试）、问卷调查、血浆高敏c反应蛋白（HS-CRP）、肿瘤坏死因子α (TNF-α)、白细胞介素1 （IL-1）、白细胞介素6 （IL-6）、IL-17和IL-23分析。七十九年4至12岁两组结束了研究中的研究对象:47 nonobese阻塞性睡眠呼吸暂停综合症儿童(平均年龄7.84±0.56年,身体质量指数(BMI) = 16.95±0.47 kg / m2, BMI z分数= 0.15±0.21,和平均低通气指数(AHI) = 9.13±1.67事件/ h)和32个健康控制儿童(平均年龄7.02±0.65年,与体重指数= 16.55±0.58 kg / m2, BMI z分数=−0.12±0.27,意味着AHI = 0.41±0.07事件/ h)登记。血清细胞因子分析显示，OSA患儿HS-CRP、IL-17和IL-23水平显著升高（P = 0.002、P = 0.024和P = 0.047）。回归检验显示HS-CRP、TNF-α、IL-6、IL-17，特别是IL-23对连续性能测试和威斯康星卡片分类测试有显著影响。OSA患儿IL-17水平异常，IL-17是一种与辅助性T细胞相关的白细胞介素，辅助性T细胞参与自身免疫和炎症的发展。这种高表达水平可能导致儿童OSA的并发症；我们还发现炎症细胞因子，特别是IL-23，对异常神经认知测试有显著影响。
Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation and with cognitive impairments. This study aimed to investigate the status of proinflammatory cytokines, particularly interleukin 17 (IL-17) and interleukin 23 (IL-23) and cognition in pediatric OSA. Controls and OSA children participated in the study. Exclusion criteria were adenotonsillectomy, heart, neurological and severe psychiatric diseases, craniofacial syndromes, and obesity. Polysomnogram was followed by serum testing for inflammatory markers and neurocognitive tests such as continuous performance task (CPT) and Wisconsin card sorting test, questionnaires, analyses of plasma high-sensitivity C-reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), IL-17, and IL-23. Seventy-nine, 4 to 12-year-old subjects in 2 groups ended the study: 47 nonobese OSA children (mean age = 7.84 ± 0.56 years, body mass index [BMI] = 16.95 ± 0.47 kg/m2, BMI z-score = 0.15 ± 0.21, and mean apnea–hypopnea index [AHI] = 9.13 ± 1.67 events/h) and 32 healthy control children (mean age = 7.02 ± 0.65 years, with BMI = 16.55 ± 0.58 kg/m2, BMI z-score = −0.12 ± 0.27, and mean AHI = 0.41 ± 0.07 event/h) were enrolled. Serum cytokine analyses showed significantly higher levels of HS-CRP, IL-17, and IL-23 in OSA children (P = 0.002, P = 0.024, and P = 0.047). Regression test showed significant influence of HS-CRP, TNF-α, IL-6, IL-17, and specifically IL-23, with the continuous performance test and Wisconsin card sorting test. OSA children have abnormal levels of IL-17, an interleukin related to T helper 17 cells, a T helper cell involved in development of autoimmunity and inflammation. This high expression level may contribute to the complications of pediatric OSA; we also found a significant influence of inflammatory cytokines, particularly IL-23, on abnormal neurocognitive testing.