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Effect of oral appliance on circulating leukocyte telomere length and SIRT1 in obstructive sleep apnea

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Abstract

Objectives

The increased cardiovascular risk seen in patients with obstructive sleep apnea (OSA) may be due to combination of oxidative stress, systemic inflammation and damage to leukocyte telomere length (LTL) seen with aging. Another molecule, Sirtuin 1 (SIRT1), a histone/protein deacetylase, regulates endothelial nitric oxide synthase and is involved in different aspects of cardiovascular disease, aging and stress resistance. The aim of this study was to evaluate the effects of mandibular advancement device (MAD) on the circulating LTL and SIRT1 protein level in peripheral blood mononuclear cells (PBMCs) in patients with OSA.

Materials and methods

Forty patients with moderately severe to severe OSA who desired MAD and 20 healthy controls were prospectively enrolled. The LTL was measured by quantitative polymerase chain reaction while SIRT1 protein levels in PBMC was assessed using a Sirtuin 1 ELISA Kit. All study subjects underwent baseline sleep study, with OSA patients having repeat testing at 3 months after MAD.

Results

Compared to healthy subjects, patients with OSA at baseline had lower LTL and SIRT1 protein levels in PBMC. After 3 months of MAD, 24 OSA patients, designated as MAD responders, median (range) LTL increased from (0.556 [0.393–0.748]) to (0.708 [0.533–0.893]) and SIRT1 protein levels in PBMC increased from 0.58 ± 0.23 pg/μg of total protein to 0.95 ± 0.26 pg/μg of total protein. For the 16 MAD unresponsive patients, LTL and SIRT1 protein levels remained low.

Conclusions

Successful treatment of OSA with MAD can restore LTL and SIRT1 protein levels in PBMC.

Clinical relevance

LTL and SIRT1 protein levels in PBMC can be improved following effective treatment of OSA using MAD.

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Acknowledgments

We would like to acknowledge the help with statistics from Ms. Fang-Ju Sun of Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.

Funding

This work was supported by a grant from the Ministry of Science and Technology (Grant MOST 103-2314-B-303-014-MY2).

Author information

Authors and Affiliations

  1. Division of Pulmonary Medicine, Department of Internal Medicine, Buddhist Tzu Chi Medical Foundation, Taipei Tzu Chi Hospital, No.289, Jianguo Rd., Xindian Dist, New Taipei City, 23142, Taiwan

    Ching-Chi Lin & Mei-Wei Lin

  2. Department of Dentistry, Mackay Memorial Hospital, Taipei, Taiwan

    Huey-Yuan Wang

  3. Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan

    Shwu-Fang Liaw

  4. Chest Division, Department of Internal Medicine, Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan

    Chung-Hsin Chiu

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  1. Ching-Chi Lin
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  4. Chung-Hsin Chiu
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  5. Mei-Wei Lin
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Correspondence to Ching-Chi Lin.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consents

Informed consent was obtained from all individual study participants.

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Lin, CC., Wang, HY., Liaw, SF. et al. Effect of oral appliance on circulating leukocyte telomere length and SIRT1 in obstructive sleep apnea. Clin Oral Invest 23, 1397–1405 (2019). https://doi.org/10.1007/s00784-018-2560-5

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  • DOI: https://doi.org/10.1007/s00784-018-2560-5

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