Clinical and Basic Study of Thioredoxin as a Oxidative Stress Marker in Patients with Obstructive Sleep Apnea

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Obstructive sleep apnea (OSA) is associated with increased cardiovascular mortality, and oxidative stress was suggested to play an important role. The plasma thioredoxin (TRX) level is a novel oxidative stress market Adiponectin is an adipocyte-derived molecule with anti-inflammatory property. Plasma TRX and adiponectin levels were measured in 41 patients with severe OSA before (n=41) and after (n=27) nasal continuous positive airway pressure (nCPAP) therapy for one month and 12 subjects without OSA (Non-OSA group). The TRX level was significantly higher (p=0.02) and adiponectin level was significantly lower (p=0.02) in the OSA group than in the Non-OSA group. After one month of nCPAP treatment (n=27), the TRX level significantly decreased (p=0.03) and adiponectin level significantly increased (p=0.03). Among the 53 subjects (41 OSA + 12 Non-OSA subjects), the TRX level was positively correlated with respiratory disturbance index (p=0.002) and percentage of time with SaO_2<90% (p=0.002). The adiponectin level, but not the TRX level, was correlated with BMI (p = 0.02). Plasma TRX has the potential to be a unique marker for evaluating oxidative stress in OSA patients and monitoring the effectiveness of nCPAP therapy. Thus, OSA related hypoxemia (intermittent hypoxemia) which mimics reperfusion-reoxygenation may induce tissue injury as an oxidative stress. To investigate effects of intermittent hypoxia as an oxidative stress on cells, we made an instrument which had two chambers : hypoxia and normoxia chambers. Each chamber has preconditional medium equilibrated with gases : O2, CO2 and N2. Thus, putting cells into each preconditional medium, we can make intermittent hypoxia condition to cells. Using this instrument, we will do several cell experiments under intermittent hypoxia in the future.