Inflammatory cytokines in pediatric obstructive sleep apnea

Area of Science:

• Pediatric Pulmonology
• Immunology
• Neuroscience

Background:

• Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation.
• Cognitive impairments are also frequently observed in children with OSA.
• The role of specific proinflammatory cytokines in these comorbidities requires further investigation.

Purpose of the Study:

• To investigate the levels of proinflammatory cytokines, specifically interleukin-17 (IL-17) and interleukin-23 (IL-23), in children with OSA.
• To assess the relationship between these cytokines and cognitive function in pediatric OSA.
• To explore the influence of inflammatory markers on neurocognitive test performance.

Main Methods:

• A case-control study involving 79 children aged 4-12 years, divided into nonobese OSA and healthy control groups.
• Exclusion criteria included adenotonsillectomy, obesity, and significant medical comorbidities.
• Methods included polysomnography, serum cytokine analysis (HS-CRP, TNF-α, IL-1, IL-6, IL-17, IL-23), and neurocognitive testing (CPT, WCST).

Main Results:

• Children with OSA exhibited significantly higher serum levels of high-sensitivity C-reactive protein (HS-CRP), IL-17, and IL-23 compared to controls.
• Regression analyses revealed a significant influence of HS-CRP, TNF-α, IL-6, IL-17, and particularly IL-23 on performance in the CPT and WCST.
• Elevated IL-17 levels were noted, linking T helper 17 cells to inflammation and potential OSA complications.

Conclusions:

• Pediatric OSA is characterized by elevated levels of IL-17 and IL-23, cytokines implicated in inflammation and autoimmunity.
• These inflammatory markers, especially IL-23, significantly correlate with impaired neurocognitive function in children with OSA.
• Findings suggest that targeting inflammation may be crucial for managing cognitive deficits in pediatric OSA.