Jin Ye1, Hui Liu2, Peng Li1, Zhuang-gui Chen3, Ge-hua Zhang1, Qin-tai Yang1, Yuan Li1. 1. Sleep Disorders Centre and Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 2. Department of Internal Medicine, Division of Pulmonary and Critical Care, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 3. Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Abstract
BACKGROUND: To characterize the distribution of both tonsillar and circulating CD4(+)T-lymphocyte subsets, and to explore their clinical relevance in nonobese children with obstructive sleep apnea syndrome (OSAS). METHODS: A total of 53 children who underwent tonsillectomy for either OSAS (n = 25) or primary snoring (PS, n = 28) were prospectively enrolled. Nineteen healthy children without any symptoms were recruited as controls. We quantified the frequencies of CD4(+)T-lymphocyte subpopulations using flow cytometry, serum-related cytokines using enzyme-linked immunosorbent assay, and key transcription factors using quantitative polymerase chain reaction (qPCR). RESULTS: Tonsillar distributions of CD4(+)T-lymphocyte subsets were comparable in the OSAS and PS subjects. The peripheral Th17/Treg ratio was positively correlated to severity as measured by apnea/hypopnea index (AHI), serum C-reactive protein and hypoxia-inducible factor-1α mRNA in the OSAS children (P < 0.05). And AHI was independently associated with the peripheral Th17/Treg ratio (P < 0.05). Furthermore, the response to surgery was associated with a significant reversal of the Th17/Treg imbalance and a concomitant relief of the proinflammatory profile in the OSAS subjects. CONCLUSION: Pediatric OSAS was associated with an altered Th17:Treg balance toward Th17 predominance. The changes in lymphocytic phenotypes that correlated with recurrent intermittent hypoxia in sleep apnea may contribute to the variance in systemic inflammation and downstream morbidities of pediatric OSAS.
BACKGROUND: To characterize the distribution of both tonsillar and circulating CD4(+)T-lymphocyte subsets, and to explore their clinical relevance in nonobese children with obstructive sleep apnea syndrome (OSAS). METHODS: A total of 53 children who underwent tonsillectomy for either OSAS (n = 25) or primary snoring (PS, n = 28) were prospectively enrolled. Nineteen healthy children without any symptoms were recruited as controls. We quantified the frequencies of CD4(+)T-lymphocyte subpopulations using flow cytometry, serum-related cytokines using enzyme-linked immunosorbent assay, and key transcription factors using quantitative polymerase chain reaction (qPCR). RESULTS: Tonsillar distributions of CD4(+)T-lymphocyte subsets were comparable in the OSAS and PS subjects. The peripheral Th17/Treg ratio was positively correlated to severity as measured by apnea/hypopnea index (AHI), serum C-reactive protein and hypoxia-inducible factor-1α mRNA in the OSAS children (P < 0.05). And AHI was independently associated with the peripheral Th17/Treg ratio (P < 0.05). Furthermore, the response to surgery was associated with a significant reversal of the Th17/Treg imbalance and a concomitant relief of the proinflammatory profile in the OSAS subjects. CONCLUSION: Pediatric OSAS was associated with an altered Th17:Treg balance toward Th17 predominance. The changes in lymphocytic phenotypes that correlated with recurrent intermittent hypoxia in sleep apnea may contribute to the variance in systemic inflammation and downstream morbidities of pediatric OSAS.
Authors: Eliot S Katz; Mary G Greene; Kathryn A Carson; Patricia Galster; Gerald M Loughlin; John Carroll; Carole L Marcus Journal: J Pediatr Date: 2002-05 Impact factor: 4.406
Authors: Stijn L Verhulst; Liselotte Aerts; Sarah Jacobs; Nancy Schrauwen; Dominique Haentjens; Rita Claes; Hilde Vaerenberg; Luc F Van Gaal; Wilfried A De Backer; Kristine N Desager Journal: Chest Date: 2008-08-08 Impact factor: 9.410
Authors: Carole L Marcus; Lee Jay Brooks; Kari A Draper; David Gozal; Ann Carol Halbower; Jacqueline Jones; Michael S Schechter; Sally Davidson Ward; Stephen Howard Sheldon; Richard N Shiffman; Christopher Lehmann; Karen Spruyt Journal: Pediatrics Date: 2012-08-27 Impact factor: 7.124
Authors: Jinkwan Kim; Rakesh Bhattacharjee; Ehab Dayyat; Ayelet B Snow; Leila Kheirandish-Gozal; Julie L Goldman; Richard C Li; Laura D Serpero; Heather B Clair; David Gozal Journal: Pediatr Res Date: 2009-10 Impact factor: 3.756
Authors: Hui-Leng Tan; David Gozal; Yang Wang; Hari P R Bandla; Rakesh Bhattacharjee; Richa Kulkarni; Leila Kheirandish-Gozal Journal: Sleep Date: 2013-06-01 Impact factor: 5.849
Authors: Brian E Cade; Han Chen; Adrienne M Stilp; Kevin J Gleason; Tamar Sofer; Sonia Ancoli-Israel; Raanan Arens; Graeme I Bell; Jennifer E Below; Andrew C Bjonnes; Sung Chun; Matthew P Conomos; Daniel S Evans; W Craig Johnson; Alexis C Frazier-Wood; Jacqueline M Lane; Emma K Larkin; Jose S Loredo; Wendy S Post; Alberto R Ramos; Ken Rice; Jerome I Rotter; Neomi A Shah; Katie L Stone; Kent D Taylor; Timothy A Thornton; Gregory J Tranah; Chaolong Wang; Phyllis C Zee; Craig L Hanis; Shamil R Sunyaev; Sanjay R Patel; Cathy C Laurie; Xiaofeng Zhu; Richa Saxena; Xihong Lin; Susan Redline Journal: Am J Respir Crit Care Med Date: 2016-10-01 Impact factor: 21.405