New evidence of the relevance of the treatment of sleep apnea and its association with cardiovascular disease

Two studies, one carried out by the precision medicine group in respiratory diseases PRES of the IIS Aragón and another in which he has participated, provide new evidence of the relevance of the treatment of sleep apnea and its association with cardiovascular disease.

“Effect of positive pressure ventilation and bariatric surgery on extracellular vesicle microRNAs in patients with severe obesity and obstructive sleep apnea”

https://pubmed.ncbi.nlm.nih.gov/36284205/

This study, carried out by the Precision Medicine in Respiratory Diseases (PRES) group of the IIS Aragón, was carried out in a coordinated manner between the Royo Villanova Hospital (Recruitment and management of patients) and the Translational Research Unit of the Miguel Servet Hospital (Molecular Analysis). Obstructive sleep apnea (OSA) is a pathology characterized by a total or partial interruption of air flow during sleep, which in patients causes an increase in nocturnal micro-awakenings, poorer rest and increased drowsiness. . Furthermore, the intermittent stoppage of airflow leads to the exposure of patients to intermittent hypoxia, which, perpetuated over time, can have health consequences. OSA is associated with obesity, especially in grades 2 and 3. MicroRNAs are molecules that regulate our genes and whose alteration has been associated with diseases. MicroRNAs can be distributed throughout our body free or inside small containers, defined as extracellular vesicles, which protects them and makes them more specific about their place of action. Our objective in this study was to determine if there were differences at the level of microRNAs contained in extracellular vesicles between obese patients with and without OSA and to evaluate the changes in these markers after bariatric surgery and treatment with CPAP (continuous air pressure during sleep). ) of patients with OSA. Our work showed that patients with obesity and OSA had altered some microRNAs such as miR-126 and miR-320, which are associated with increased cardiovascular risk. Relevantly, these microRNAs returned to normal levels after treatment with CPAP, but were not corrected as a consequence of weight reduction due to bariatric surgery. These findings highlight the need for more exhaustive screening for OSA in patients with obesity due to the increased prevalence in this patient profile and the presence of markers associated with cardiovascular risk that are reversible with correct treatment of OSA. .

“Inflammasome activation mediated by oxidized LDL in patients with sleep apnea and early subclinical atherosclerosis”

https://pubmed.ncbi.nlm.nih.gov/36517180/

The PRES research group has also participated in this work led by the respiratory diseases group of the Hospital de La Paz (Madrid) and which has been published in the prestigious magazine European Respiratory Journal. This article has been carried out within the framework of the EPIOSA project, which evaluates the association of OSA with cardiovascular diseases and is funded by the Carlos III Research Institute. This research studied inflammation markers in patients with OSA with and without the presence of subclinical atherosclerosis. Subclinical atherosclerosis is an early stage of the pathology in which the patient has not yet shown any effect in the presence of atheromatous plaque. The results showed a new inflammatory pathway that could be critical for the association between OSA and cardiovascular risk. This pathway is mediated by the NLPR3 inflammasome (a set of proteins that participate in an inflammatory response), intermittent hypoxia, and the presence of oxidized low-density lipoproteins (LDL). These findings also allow us to discover a possible route for the relationship that exists between dyslipidemia and systemic inflammation in the development of atherosclerosis.