T regulatory lymphocytes and endothelial function in pediatric obstructive sleep apnea. PLoS One 2013;8(7):e69710
Date
08/13/2013Pubmed ID
23936084Pubmed Central ID
PMC3728363DOI
10.1371/journal.pone.0069710Scopus ID
2-s2.0-84880816741 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
BACKGROUND: Obstructive sleep apnea (OSA) is a low-grade inflammatory disease affecting the cardiovascular and metabolic systems. Increasing OSA severity reduces T-regulatory lymphocytes (Tregs) in OSA children. Since Tregs modulate endothelial activation, and attenuate insulin resistance, we hypothesized that Tregs are associated with endothelial and metabolic dysfunction in pediatric OSA.
METHODS: 50 consecutively recruited children (ages 4.8-12 years) underwent overnight polysomnography and fasting homeostatic model (HOMA) of insulin resistance was assessed. Percentage of Tregs using flow cytometry, and endothelial function, expressed as the time to peak occlusive hyperemia (Tmax), were examined. In a subgroup of children (n = 21), in vitro Treg suppression tests were performed.
RESULTS: Circulating Tregs were not significantly associated with either BMI z score or HOMA. However, a significant inverse correlation between percentage of Tregs and Tmax emerged (p<0.0001, r = -0.56). A significant negative correlation between Tregs suppression and the sleep pressure score (SPS), a surrogate measure of sleep fragmentation emerged (p = 0.02, r = -0.51) emerged, but was not present with AHI.
CONCLUSIONS: Endothelial function, but not insulin resistance, in OSA children is strongly associated with circulating Tregs and their suppressive function, and appears to correlate with sleep fragmentation. Thus, alterations in T cell lymphocytes may contribute to cardiovascular morbidity in pediatric OSA.
Author List
Tan HL, Gozal D, Samiei A, Bhattacharjee R, Wang Y, Ramirez HM, Bandla HP, Kulkarni R, Kheirandish-Gozal LAuthor
Hari Bandla MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Body Mass IndexCase-Control Studies
Child
Child, Preschool
Endothelium, Vascular
Female
Humans
Insulin Resistance
Lymphocyte Count
Male
Polysomnography
Sleep Apnea, Obstructive
T-Lymphocytes, Regulatory
