Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for atherosclerosis. CD40-CD40 ligand interaction promotes several proinflammatory mediators and plays a pivotal role in the various stages of atherosclerotic diseases. The present study examines whether CD40 ligation contributes to outcomes in patients with OSAS.
The study population comprised OSAS patients with an apnea hypopnea index (AHI) > or = 30 (n = 35) and control subjects (AHI < 5; n = 16). We measured serum levels of soluble CD40 ligand (sCD40L), tumor necrosis factor (TNF)-alpha, and hypersensitive C-reactive protein (hsCRP) before and after nasal continuous positive airway pressure (nCPAP) therapy for 3 months.
Baseline levels of sCD40L were significantly higher in patients with OSAS (6.93 +/- 4.64 ng/mL) [mean +/- SD] than in control subjects (3.43 +/- 2.11 ng/mL, p < 0.01). Baseline levels of sCD40L positively correlated with TNF-alpha but not with hsCRP. The elevation of sCD40L was improved for 1 night after nCPAP therapy (3.83 +/- 2.78 ng/mL, p < 0.001). Even though patients with severe OSAS did not receive any other medication to control atherosclerotic risk factors for 3 months, nCPAP was continued to reduce the levels of sCD40L.
The present study suggested that sCD40L is a key factor that links OSAS and atherosclerotic progression.
[Show abstract][Hide abstract] ABSTRACT: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during
sleep. The sleep fragmentation and the accompanying hypoxemia lead to many negative consequences including cardiovascular
diseases, cognitive impairment, daytime sleepiness, fatigue, and depressive symptoms (Parish and Somers 2004; Reimer and Flemons
2003). Originally viewed as an interesting but rare malady, OSA is now recognized as a common disorder that is associated
with major morbidity and mortality (Newman et al. 2001).
[Show abstract][Hide abstract] ABSTRACT: Sleep is a necessary behavior for physiological allostasis that is common to all vertebrates. Allostasis refers to the set
of intertwined neuroendocrine-immune processes of bodily adaptation to stressful challenges during the wake cycle. The summative
effects of these challenges, the allostatic load, signifies the total cost of wear and tear to the body. A finely regulated
neuroimmunology of the sleep component of the circadian patterns is critical to the physiological repair mechanism required
in allostasis (Solomon and Moos 1964; Solomon 1987; Sterling and Eyer 1988; Chrousos and Gold 1992; Kiecolt-Glaser, McGuire,
Robles, and Glaser 2002; Irwin 2002; McEwen and Wingfield 2003; Schulkin 2003; Chiappelli and Cajulis 2004; Chiappelli et
al. in press-c).
[Show abstract][Hide abstract] ABSTRACT: Sleep is undoubtedly disturbed during pregnancy. The disturbances include an increase in nocturnal awakenings and greater
periods of time spent awake during the night, as well as complaints of fatigue during the day. Although nausea (i.e., morning
sickness) is most commonly expected in the first trimester, an increase in fatigue, which is often a consequence of disturbed
sleep, is actually the first symptom of pregnancy (Lee 2006). Various contributors have been suggested or implicated in the
magnitude of sleep disturbances in pregnancy, including hormonal, physiologic, physical (Baratte-Beebe and Lee 1999), and
behavioral changes (Buster and Carson 2003; Challis and Lye 2003). As pregnancy progress, other symptoms contribute to sleep
disturbances, some of them being fetal movements, leg cramps, shortness of breath, and an inability to get comfortable (Baratte-Beebe
et al. 1999). This review will extend beyond the description of how sleep patterns change during pregnancy to suggest that
there is an important relationship between pregnancy-associated sleep disturbances and cytokine and hormone changes that may
have relevance to maternal and fetal health. Discussion will include how disturbances experienced during pregnancy are associated
with cytokine alterations and hormonal changes, and how these relationships could add to a woman’s risk for developing pregnancy
complications or experiencing poor pregnancy outcomes.
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