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Published on: August 7, 2017
Influence of HLA antigens and OSAS in childhood: a preliminary report
Luigia Brunetti1, Ruggiero Francavilla, Vito Leonardo Miniello
1Clinica Pediatrica 'Maggiore', Dipartimento di Biomedicina dell'Età Evolutiva, University of Bari, Bari, Italy. rfrancavilla@libero.it
Insights
Human leukocyte antigen (HLA) did not appear to be a key factor in childhood obstructive sleep apnea syndrome (OSAS). Cough and persistent wheeze were identified as significant risk factors for OSAS development in children.
Area of Science:
- Pediatric Pulmonology
- Immunogenetics
- Sleep Medicine
Background:
- Familial factors and aggregation are linked to obstructive sleep apnea syndrome (OSAS) susceptibility.
- The role of human leukocyte antigen (HLA) in pediatric sleep disordered breathing and OSAS requires further investigation.
Purpose of the Study:
- To explore the potential influence of human leukocyte antigen (HLA) on the development of sleep disordered breathing and OSAS in children.
Main Methods:
- Screened 370 children with sleep disordered breathing using a questionnaire.
- Conducted polysomnography for habitual snorers; diagnosed OSAS if apnea/hypopnea index >3.
- Performed HLA typing for class I and II in children with OSAS or primary snoring.
Main Results:
- HLA-B65 was significantly more expressed in children with sleep disordered breathing compared to controls (10.5% vs. 3.61%; Pypc < 0.04).
- No significant differences were found for other tested HLA antigens.
- Logistic regression identified cough (P < 0.02) and persistent wheeze (P < 0.008) as the sole risk factors for OSAS.
Conclusions:
- Preliminary data suggest HLA does not play a major role in the pathogenesis of pediatric OSAS.
- Further research is necessary to fully elucidate the role of HLA in OSAS development.
Abstract:
Several studies have emphasized the role of familial factors and familial aggregation in increasing susceptibility to obstructive sleep apnea syndrome (OSAS); the aim of the present study was to investigate the possible influence of human leukocyte antigen (HLA) in the development of sleep disordered breathing and OSAS of children. Between January 2000 and January 2003, all the 370 children [193 males; median age: 5.2 years (range: 1-12 years)] with sleep disordered breathing referred to our Center were screened by a 41-item multiple-choice questionnaire. All habitual snores children underwent a polisomnographic evaluation, and those with an apnea/hypopnea index >3 were diagnosed as having OSAS. All children with OSAS or primary snoring were HLA typed for class I and II. According to nocturnal polygraphic monitoring study, 41 patients were diagnosed as having OSAS and 32 as primary snoring. Patients in the two diagnostic groups were homogeneous for demographic and clinical characteristics. HLA-B65 was found to be significantly more expressed in children with sleep disordered breathing as compared with controls (10.5% versus 3.61; Pypc < 0.04) while no difference was found for the other tested antigens. A logistic regression analysis found cough (P < 0.02) and persistent wheeze (P < 0.008) the sole risk factors for OSAS development. Our preliminary data suggest that HLA does not play a key role in the pathogenesis of OSAS, however more studies are needed to clarify this issue.