title: Elevated production of tumor necrosis factor-alpha by monocytes in patients with obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twenty-four patients with OSAS, 15 obese control subjects, and 12 healthy subjects.
  
  
  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.
authors.affiliation: First Department of Internal Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142, Japan. minochan@fn.catv.ne.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Minoguchi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tazaki
authors.forename: Takuya
authors.initials: T
authors.lastname: Yokoe
authors.forename: Hideko
authors.initials: H
authors.lastname: Minoguchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
chemical_list: D014409:Tumor Necrosis Factor-alpha