阻塞性睡眠呼吸暂停时血液中反应性氧物种和肝的增加,排除了预期的红细胞形成
Jihyun Song1, Krishna M Sundar2, Monika Horvathova3,4
1Division of Hematology, University of Utah, Salt Lake City, Utah, USA.
American journal of hematology
|June 23, 2023
概括
患有阻塞性睡眠呼吸暂停 (OSA) 的患者不会产生高血红蛋白水平. 这是由于通过新细胞分解和炎症抑制红细胞生产的血液溶解.
科学领域:
- 生理学 生理学 生理学
- 血液学 血液学 血液学
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 导致间歇性缺氧.
- 缺氧通常会增加血红蛋白 (Hb) 度.
- 大多数OSA患者 (>98%) 没有表现出升高的Hb水平.
研究的目的:
- 研究在OSA患者中预防二次红细胞瘤的机制.
- 确定为什么OSA尽管间歇性缺氧,但不会导致红细胞质量增加.
主要方法:
- 在527名OSA患者中分析了Hb水平.
- 使用放射性核素标记和CO吸入测量红细胞质量.
- 研究了45名OSA患者在持续正气道压力 (CPAP) 治疗前后.
- 评估了红色素形成标志物 (红色素素,网球细胞分裂) 和新细胞分解指标 (活性氧物种,microRNA-21,hepcidin).
主要成果:
- 在OSA患者中,红细胞质量是正常的,不包括作为掩盖因素的血体积膨胀.
- 在OSA患者中观察到加速的红细胞形成和新细胞分解.
- 新细胞分解涉及增加的活性氧物种和下调的催化酶.
- 炎症诱导的肝素限制了红色素形成的铁的可用性.
- CPAP治疗减少了一些新细胞分解标记物,但Hb保持不变.
结论:
- 在OSA中没有增加的红细胞质量是其致病的关键方面.
- 新细胞溶解 (新红细胞的血液溶解) 和抑制炎症的红细胞形成可以预防OSA中的红细胞溶解.
- 这些机制解释了大多数阻塞性睡眠呼吸暂停患者缺乏升高的血红蛋白.
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