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Effect of continuous positive airway pressure treatment on Th17/Treg imbalance in patients with obstructive sleep apnea and a preliminary study on its mechanism

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

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.

Conclusion

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.

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Data availability

The datasets analyzed in this study are available upon reasonable request from the corresponding author.

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Acknowledgements

We thank each and every participant for contributing their time to this study. We would also like to thank all the doctors and nurses in our department.

Funding

This study was supported by the National Natural Science Foundation of China (81970086, 82001490) and the National Key Clinical Specialty Construction Projects of China (2012–650).

Author information

Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Chong Shen, Dandan Zong, Yating Peng, Li Zhou, Ting Liu & Ruoyun Ouyang

  2. Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China

    Chong Shen, Dandan Zong, Yating Peng, Li Zhou, Ting Liu & Ruoyun Ouyang

  3. Clinical Medical Research Center for Pulmonary and Critical Care Medicine, Changsha, 410011, Hunan Province, China

    Chong Shen, Dandan Zong, Yating Peng, Li Zhou, Ting Liu & Ruoyun Ouyang

  4. Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China

    Chong Shen, Dandan Zong, Yating Peng, Li Zhou, Ting Liu & Ruoyun Ouyang

Authors
  1. Chong Shen
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  2. Dandan Zong
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  3. Yating Peng
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  4. Li Zhou
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  5. Ting Liu
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  6. Ruoyun Ouyang
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Contributions

Chong Shen: Data Collection, Data Analysis, Writing-Original draft. Dandan Zong: Methodology, Data Curation. Yating Peng: Data Curation, Writing-review & editing. Li Zhou: Methodology, Writing-Review & Editing. Ting Liu: Methodology. Ruoyun Ouyang: Conceptualization, Writing-Review & Editing, Supervision. All authors gave final approval of the version to be published and have agreed on the journal to which the article has been submitted.

Corresponding author

Correspondence to Ruoyun Ouyang.

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Shen, C., Zong, D., Peng, Y. et al. Effect of continuous positive airway pressure treatment on Th17/Treg imbalance in patients with obstructive sleep apnea and a preliminary study on its mechanism. Sleep Breath (2024). https://doi.org/10.1007/s11325-024-02997-3

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  • DOI: https://doi.org/10.1007/s11325-024-02997-3

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