背景:阻塞性睡眠呼吸暂停(OSA)可以被认为是一种影响所有身体系统的慢性炎症性疾病,包括免疫系统.这项研究旨在评估OSA患者的Th17/Treg模式以及持续气道正压通气(CPAP)治疗的效果。
方法:招募OSA患者和健康对照。建议接受CPAP治疗的OSA患者随访3个月。采用流式细胞术测定Th17和Treg细胞的比例。采用实时定量聚合酶链反应(PCR)和免疫印迹法检测受体相关孤儿受体γt(RORγt)和叉头/翼状螺旋转录因子(Foxp3)的mRNA和蛋白水平,分别,外周血单核细胞(PBMC)。采用酶联免疫吸附试验(ELISA)检测血清白细胞介素-17(IL-17)水平,IL-6,转化生长因子-β1(TGF-β1),缺氧诱导因子-1α(HIF-1α)。
结果:共招募了56名OSA患者和40名健康对照。Th17细胞的比例,Th17/Treg比值,RORγt的mRNA和蛋白水平,OSA患者血清IL-17、IL-6和HIF-1α水平较高。相反,Treg细胞的比例,OSA患者Foxp3的mRNA和蛋白水平以及血清TGF-β1水平均降低。OSA中Th17和Treg细胞的比例可以通过呼吸暂停低通气指数(AHI)来预测,IL-6、TGF-β1和,HIF-1α。30名中度至重度OSA患者坚持3个月的CPAP治疗,Th17/Treg失衡改善,IL-17、IL-6、TGF-β1和HIF-1α水平与治疗前值的比较。
结论:OSA患者存在Th17/Treg失衡。AHI可以促进OSA中Th17和Treg细胞比例的预测,以及血清IL-6、TGF-β1和HIF-1α水平。此外,CPAP治疗可以改善OSA患者Th17/Treg失衡并降低促炎细胞因子。
BACKGROUND: Obstructive sleep apnea (OSA) can be considered a chronic inflammatory disease that impacts all bodily systems, including the immune system. This
study aims to assess the Th17/Treg pattern in patients with OSA and the effect of continuous positive airway pressure (CPAP) treatment.
METHODS: OSA patients and healthy controls were recruited. OSA patients recommended for CPAP treatment were followed up for three months. Flow cytometry was employed to determine the proportion of Th17 and Treg cells. Real-time quantitative polymerase chain reaction (PCR) and western blotting were utilized to detect the mRNA and protein levels of receptor-related orphan receptor γt (RORγt) and forkhead/winged helix transcription factor (Foxp3), respectively, in peripheral blood mononuclear cells (PBMCs). Enzyme-linked immunosorbent assay (ELISA) was performed to measure the serum levels of interleukin-17 (IL-17), IL-6, transforming growth factor-β1 (TGF-β1), and hypoxia-induced factor-1α (HIF-1α).
RESULTS: A total of 56 OSA patients and 40 healthy controls were recruited. The proportion of Th17 cells, Th17/Treg ratio, mRNA and protein levels of RORγt, and serum IL-17, IL-6, and HIF-1α levels were higher in OSA patients. Conversely, the proportion of Treg cells, mRNA and protein levels of Foxp3, and serum TGF-β1 levels were decreased in OSA patients. The proportion of Th17 and Treg cells in OSA can be predicted by the apnea hypopnea index (AHI), IL-6, TGF-β1 and, HIF-1α. 30 moderate-to-severe OSA patients were adherent to three-month CPAP treatment, with improved Th17/Treg imbalance, IL-17, IL-6, TGF-β1, and HIF-1α levels compared to pre-treatment values.
CONCLUSIONS: There was a Th17/Treg imbalance in OSA patients. The prediction of Th17 and Treg cell proportions in OSA can be facilitated by AHI, as well as serum IL-6, TGF-β1, and HIF-1α levels. Furthermore, CPAP treatment can potentially improve the Th17/Treg imbalance and reduce proinflammatory cytokines in OSA patients.