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Published on: December 6, 2016
Inflammatory measures in children with obstructive sleep apnoea
Charmaine S Tam1, Melanie Wong, Rachel McBain
1SIDS and Sleep Apnoea Research Group, The Children's Hospital at Westmead, New South Wales, Australia.
Insights
Children with obstructive sleep apnoea (OSA) show elevated inflammatory markers, including Interferon-gamma (IFN-gamma) and Interleukin-8 (IL-8). These findings suggest a pro-inflammatory state even in mild OSA, highlighting the importance of early intervention.
Area of Science:
- Pediatric Sleep Medicine
- Immunology
- Respiratory Medicine
Background:
- Obstructive sleep apnoea (OSA) is a common condition in children.
- Inflammation is increasingly recognized as a contributing factor in OSA.
- Understanding inflammatory profiles in pediatric OSA is crucial for early diagnosis and management.
Purpose of the Study:
- To investigate a spectrum of inflammatory markers in children diagnosed with OSA.
- To compare inflammatory profiles between children with OSA and healthy controls.
Main Methods:
- Polysomnography was used to diagnose OSA in 44 children.
- Blood samples were analyzed for C-reactive protein and a panel of cytokines (IL-1beta to TNF-alpha).
- 69 children without OSA symptoms served as controls.
Main Results:
- Children with OSA exhibited significantly higher levels of Interferon-gamma (IFN-gamma) and Interleukin-8 (IL-8) compared to controls.
- These differences remained significant after adjusting for age, sex, and body mass index.
- No correlations were found between inflammatory markers and OSA severity or other sleep parameters.
Conclusions:
- Mild pediatric OSA is associated with elevated IFN-gamma and a trend towards elevated IL-8, indicating a pro-inflammatory state.
- These early inflammatory changes may precede those observed in adults with more severe OSA.
- Early identification and intervention for OSA in children may be beneficial.
Aim:
To evaluate a range of inflammatory measures in children with obstructive sleep apnoea (OSA).
Methods:
In total, 44 children with polysomnographically defined OSA (30 boys; mean age: 7.3 +/- 3.7 years) and 69 control subjects (44 boys; mean age: 7.6 +/- 4 years) were recruited. Controls were screened for symptoms of OSA by questionnaire at the time of elective surgery that was unrelated to the upper airway. Blood samples were analysed for C-reactive protein, and cytokines IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, GM-CSF, IFN-gamma and TNF-alpha.
Results:
The majority of the children had mild OSA (32/44). Children with OSA (respiratory disturbance index 5.3 +/- 6.5 events/h) had significantly higher IFN-gamma and IL-8 levels than controls (P < 0.001 and 0.003, respectively), although correction for age, sex and body mass index reduced these differences (IFN-gammaP = 0.002, and IL-8 P = 0.051). There were no significant correlations between inflammatory measures and body mass index, respiratory disturbance index, or other sleep, desaturation, or arousal parameters including respiratory or spontaneous arousal indices, desaturation index or severity, sleep efficiency, or apnoea/hypopnoea duration in the OSA group.
Conclusion:
Children with OSA, even of mild severity, have significantly elevated IFN-gamma levels and a trend towards elevated IL-8 levels compared with asymptomatic controls, consistent with a pro-inflammatory effect of OSA. These changes seen in mild OSA may precede changes in other pro-inflammatory cytokines found in studies of adults with more severe and long-standing disease, implying a potential benefit from early disease identification and intervention.
