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(Chest. 2004;126:1473-1479.)
© 2004 American College of Chest Physicians

Elevated Production of Tumor Necrosis Factor-{alpha} by Monocytes in Patients With Obstructive Sleep Apnea Syndrome*

Kenji Minoguchi, MD, PhD; Toshiyuki Tazaki, MD; Takuya Yokoe, MD, PhD; Hideko Minoguchi, MD, PhD; Yoshio Watanabe, MD; Mayumi Yamamoto, MD and Mitsuru Adachi, MD, PhD

* From the First Department of Internal Medicine, Showa University, Tokyo, Japan.

Correspondence to: Kenji Minoguchi, MD, PhD, First Department of Internal Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142, Japan; e-mail: minochan{at}fn.catv.ne.jp

Study objectives: Tumor necrosis factor (TNF)-{alpha} is involved in the pathogenesis of atherosclerosis. In the present study, we examined TNF-{alpha} production by monocytes, serum levels of TNF-{alpha}, and the effects of nasal continuous positive airway pressure (nCPAP) in patients with obstructive sleep apnea syndrome (OSAS).

Design: Prospective observational study.

Setting: University hospital.

Subjects: Twenty-four patients with OSAS, 15 obese control subjects, and 12 healthy subjects.

Measurements and results: After polysomnography, venous blood was collected at 5 AM. Spontaneous production of TNF-{alpha} by monocytes for 24 h and serum levels of TNF-{alpha} were investigated. In addition, patients with moderate-to-severe OSAS were treated with nCPAP for 1 month, and spontaneous production of TNF-{alpha} by monocytes and serum levels of TNF-{alpha} were also measured. Spontaneous production of TNF-{alpha} by monocytes was significantly higher in patients with moderate-to-severe OSAS than in patients with mild OSAS (p < 0.0001), obese control subjects (p < 0.0001), or healthy subjects (p < 0.0001). Serum levels of TNF-{alpha} were also significantly higher in patients with moderate-to-severe OSAS than in patients with mild OSAS (p < 0.03), obese control subjects (p < 0.0005), or healthy subjects (p < 0.0001). Duration of hypoxia during total sleep time was independently associated with spontaneous production of TNF-{alpha} by monocytes in patients with OSAS and healthy and obese control subjects. nCPAP significantly decreased spontaneous production of TNF-{alpha} by monocytes (p < 0.03) and serum levels of TNF-{alpha} (p < 0.05) in patients with moderate-to-severe OSAS.

Conclusions: Spontaneous production of TNF-{alpha} by monocytes and serum levels of TNF-{alpha} are elevated in patients with moderate-to-severe OSAS but are decreased by nCPAP.

Key Words: atherosclerosis • cardiovascular diseases • hypoxia • monocyte • sleep apnea • tumor necrosis factor-{alpha}




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