Sleep Medicine
Volume 10, Issue 1 , Pages 95-103 , January 2009

Exhaled breath condensate cytokine level as a diagnostic tool for obstructive sleep apnea syndrome

  • Yongxia Li

      Affiliations

    • Department of Respiratory Medicine, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
    • Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
    • Corresponding Author InformationCorresponding author. Address: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Tel.: +66 74 429754; fax: +66 74 212900.
  • ,
  • Virasakdi Chongsuvivatwong

      Affiliations

    • Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
  • ,
  • Alan Geater

      Affiliations

    • Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
  • ,
  • Ao Liu

      Affiliations

    • Department of Respiratory Medicine, Kunming General Hospital of People’s Liberation Army, Kunming, Yunnan, China

Received 1 June 2007 ,Revised 13 November 2007 ,Accepted 13 November 2007.

References 

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–1235
  2. Brooks D, Horner RL, Kozar LF, Render-Teixeira CL, Phillipson EA. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest. 1997;99:106–109
  3. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342:1378–1384
  4. Bounhoure JP, Galinier M, Didier A, Leophonte P. Sleep apnea syndromes and cardiovascular disease. Bull Acad Natl Med. 2005;189:445–464
  5. Dursunoglu D, Dursunoglu N. Cardiovascular diseases in obstructive sleep apnea. Tuberk Toraks. 2006;54:382–396
  6. Stoohs R, Guilleminault C. Cardiovascular changes associated with obstructive sleep apnea syndrome. J Appl Physiol. 1992;72:583–589
  7. Lattimore JD, Celermajer DS, Wilcox I. Obstructive sleep apnea and cardiovascular disease. J Am Coll Cardiol. 2003;41:1429–1437
  8. Harbison J, O’Reilly P, McNicholas WT. Cardiac rhythm disturbances in the obstructive sleep apnea syndrome: effects of nasal continuous positive airway pressure therapy. Chest. 2000;118:591–595
  9. Garpestad E, Katayama H, Parker JA, et al. Stroke volume and cardiac output decrease at termination of obstructive apneas. J Appl Physiol. 1992;73:1743–1748
  10. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005;353:2034–2041
  11. Arzt M, Young T, Finn L, Skatrud JB, Bradley TD. Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med. 2005;172:1447–1451
  12. Bloch KE, Schoch OD, Zhang JN, Russi EW. German version of the Epworth Sleepiness Scale. Respiration. 1999;66:440–447
  13. Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax. 1992;47:101–105
  14. Williams AJ, Yu G, Santiago S, Stein M. Screening for sleep apnea using pulse oximetry and a clinical score. Chest. 1991;100:631–635
  15. Carpagnano GE, Kharitonov SA, Resta O, Foschino-Barbaro MP, Gramiccioni E, Barnes PJ. Increased 8-isoprostane and interleukin-6 in breath condensate of obstructive sleep apnea patients. Chest. 2002;122:1162–1167
  16. Yamauchi M, Nakano H, Maekawa J, et al. Oxidative stress in obstructive sleep apnea. Chest. 2005;127:1674–1679
  17. Suratt PM, Turner BL, Wilhoit SC. Effect of intranasal obstruction on breathing during sleep. Chest. 1986;90:324–329
  18. McNicholas WT, Tarlo S, Cole P, et al. Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis. 1982;126:625–628
  19. Leznoff A, Haight JS, Hoffstein V. Reversible obstructive sleep apnea caused by occupational exposure to guar gum dust. Am Rev Respir Dis. 1986;133:935–936
  20. Zwillich CW, Pickett C, Hanson FN, Weil JV. Disturbed sleep and prolonged apnea during nasal obstruction in normal men. Am Rev Respir Dis. 1981;124:158–160
  21. Wynne JW. Obstruction of the nose and breathing during sleep. Chest. 1982;82:657–658
  22. Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation. 2005;112:2660–2667
  23. Vgontzas AN, Papanicolaou DA, Bixler EO, Kales A, Tyson K, Chrousos GP. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. Clin Endocrinol Metab. 1997;82:1313–1316
  24. Schulz R, Mahmoudi S, Hattar K, et al. Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med. 2000;162:566–570
  25. Romero PV, Rodriguez B, Martinez S, Canizares R, Sepulveda D, Manresa F. Analysis of oxidative stress in exhaled breath condensate from patients with severe pulmonary infections. Arch Bronconeumol. 2006;42:113–119
  26. Shahid SK, Kharitonov SA, Wilson NM, Bush A, Barnes PJ. Exhaled 8-isoprostane in childhood asthma. Respir Res. 2005;6:79
  27. Montuschi P, Kharitonov SA, Ciabattoni G, Barnes PJ. Exhaled leukotrienes and prostaglandins in COPD. Thorax. 2003;58:585–588
  28. Carpagnano GE, Barnes PJ, Geddes DM, Hodson ME, Kharitonov SA. Increased leukotriene B4 and interleukin-6 in exhaled breath condensate in cystic fibrosis. Am J Respir Crit Care Med. 2003;167:1109–1112
  29. Biernacki WA, Kharitonov SA, Barnes PJ. Increased leukotriene B4 and 8-isoprostane in exhaled breath condensate of patients with exacerbations of COPD. Thorax. 2003;58:294–298
  30. Carpenter CT, Price PV, Christman BW. Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS. Chest. 1998;114:1653–1659
  31. Montuschi P, Kharitonov SA, Ciabattoni G, et al. Exhaled 8-isoprostane as a new non-invasive biomarker of oxidative stress in cystic fibrosis. Thorax. 2000;55:205–209
  32. Janssen LJ. Isoprostanes: an overview and putative roles in pulmonary pathophysiology. Am J Physiol Lung Cell Mol Physiol. 2001;280:L1067–L1082
  33. Spath-Schwalbe E, Hansen K, Schmidt F, et al. Acute effects of recombinant human interleukin-6 on endocrine and central nervous sleep functions in healthy men. J Clin Endocrinol Metab. 1998;83:1573–1579
  34. Shoham S, Davenne D, Cady AB, Dinarello CA, Krueger JM. Recombinant tumor necrosis factor and interleukin 1 enhance slow-wave sleep. Am J Physiol. 1987;253:R142–R149
  35. de Vries JE. Immunosuppressive and anti-inflammatory properties of interleukin-10. Ann Med. 1995;27:537–541
  36. Groux H, Cottrez F. The complex role of interleukin-10 in autoimmunity. J Autoimmunity. 2003;20:281–285
  37. Rechtshaffen A, Kales A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. US Government Printing Office. Washington, DC: NIH Publication No. 204, 1986.
  38. Diagnosis and Treatment of Obstructive Sleep Apnea. National Guideline Clearinghouse. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2005, 54p. Available from: www.guideline.gov.
  39. Study Group of Sleep Respiratory Disease, Branch of Respiratory Diseases, Chinese Medical Association. Guideline for diagnosis and treatment of obstructive sleep hypopnea syndrome. Chin J Tuberc Respir Dis (Chin) 2002; 25: 195–198.
  40. Flemons WW, Buysse D, Redline S, et al. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research – the report of an American Academy of Sleep Medicine task force. Sleep. 1999;22:667–689
  41. Montuschi P, Corradi M, Ciabattoni G, Nightingale J, Kharitonov SA, Barnes PJ. Increased 8-isoprostane, a marker of oxidative stress, in exhaled condensate of asthma patients. Am J Respir Crit Care Med. 1999;160:216–220
  42. Carpagnano GE, Resta O, Foschino-Barbaro MP, et al. Exhaled Interleukine-6 and 8-isoprostane in chronic obstructive pulmonary disease: effect of carbocysteine lysine salt monohydrate (SCMC-Lys). Eur J Pharmacol. 2004;505:169–175
  43. Alberti A, Sarchielli P, Gallinella E, et al. Plasma cytokine levels in patients with obstructive sleep apnea syndrome: a preliminary study. J Sleep Res. 2003;12:305–311
  44. R Development Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org, 2007.
  45. Chongsuvivatwong V. Epicalc: Epidemiological Calculator. R package version 2.5.1.4. http://www.cran.r-project.org, 2007.
  46. Akaike Hirotsugu. A new look at the statistical model identification. IEEE Trans Automat Control. 1974;19(6):716–723
  47. Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab. 2000;85:1151–1158
  48. Liu H, Liu J, Xiong S, Shen G, Zhang Z, Xu Y. The change of interleukin-6 and tumor necrosis factor in patients with obstructive sleep apnea syndrome. J Tongji Med Univ. 2000;3:200–202
  49. Minoguchi K, Tazaki T, Yokoe T, et al. Elevated production of tumor necrosis factor-alpha by monocytes in patients with obstructive sleep apnea syndrome. Chest. 2004;126:1473–1479
  50. Yokoe T, Minoguchi K, Matsuo H, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107:1129–1134
  51. Carpagnano GE, Kharitonov SA, Resta O, Foschino-Barbaro MP, Gramiccioni E, Barnes PJ. 8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy. Chest. 2003;124:1386–1392
  52. Garey KW, Neuhauser MM, Robbins RA, Danziger LH, Rubinstein I. Markers of inflammation in exhaled breath condensate of young healthy smokers. Chest. 2004;125:22–26
  53. Roth MD, Arora A, Barsky SH, Kleerup EC, Simmons M, Tashkin DP. Airway inflammation in young marijuana and tobacco smokers. Am J Respir Crit Care Med. 1998;157:928–937
  54. Baraldi E, Carraro S, Alinovi R, et al. Cysteinyl leukotrienes and 8-isoprostane in exhaled breath condensate of children with asthma exacerbations. Thorax. 2003;58:505–509
  55. Bucchioni E, Kharitonov SA, Allegra L, Barnes PJ. High levels of interleukin-6 in the exhaled breath condensate of patients with COPD. Respir Med. 2003;97:1299–1302

PII: S1389-9457(07)00422-4

doi: 10.1016/j.sleep.2007.11.013

Sleep Medicine
Volume 10, Issue 1 , Pages 95-103 , January 2009