Role of Cytokines in Children with Obstructive Sleep apnea

摘要

Aim: To explore the inflammatory and anti-inflammatory factors in children with and without obstructive sleep apnea (OSA) and observe the effects of these factors after treatment in children with OSA. Methods: A total of 142 children were enrolled in this study. Based on overnight polysomnographic evaluation and physical examination, they were divided into two groups; OSA group (47) and control group (95). OSA was diagnosed if obstructive apnea index (OAI) >1. According to apnea-hypoapnea index (AHI), OSA children were further divided into mild (AHIa‰￥1 anda‰¤5), moderate (AHI>5 anda‰¤10), and severe (AHI>10) groups. A blood sample was collected for analysis of interleukin 6 (IL-6), intracellular adhesion molecule 1 (ICAM-1), and interleukin 10 (IL-10). Results: Serum levels of IL-6 and ICAM-1 were significantly higher and serum level of IL-10 was significantly lower in OSA group compared to control group. Of 47 OSA children, 43 received treatment (38 underwent adenotonsillectomy (T&A); 4 received inhaled nasal corticosteroid; and 1 received noninvasive positive pressure ventilation (NIPPV); 7 lost during follow-ups, remaining 36 were followed up after three months. There was substantial decrease in IL-6 and ICAM-1 and increase in IL-10 after treatment (P<0.01). The difference was statistically significant (P<0.05), independent of age, gender, and body mass index (BMI). Conclusion: Up-regulation of pro-inflammatory cytokines have been well established in childhood OSA, but down-regulation of anti-inflammatory cytokine IL-10 and its up-regulation following treatment is a new finding; all of which in turn could promote the onset and progression of atherogenesis in children. As this inflammatory response is reversible, early recognition and treatment of OSA children would be beneficial in decreasing the risks.