Brain preconditioning and obstructive sleep apnea syndrome.
Intermittent hypoxia stimulates the development of adaptive responses, called preconditioning. This process is partially mediated by genetic remodeling, via hypoxia inducible factor (HIF), which induces long-term adaptation processes and is responsible for the increase of levels of vascular endothelial growth factor (VEGF), erythropoietin (Epo), atrial natriuretic peptide (ANP), and nitric oxide (NO). The synthesis of brain-derived neurotrophic factor (BDNF) participates in the control of neural plasticity after hypoxia. The mechanisms of neuroprotection against hypoxia may be related to vascular adjustments and to central neurogenic neuroprotection. Some of the factors known to be involved in the development of the mechanism of neuroprotection are also present in the responses to repetitive apneas that occur during sleep in patients with obstructive sleep apnea (OSA) syndrome, who are frequently exposed to severe sleep hypoxemia. It appears that OSA syndrome represents a clinical example of preconditioning and the development of adaptive responses to intermittent hypoxia.
Brzecka
Anna
A
Department of Lung Diseases, University of Medicine in Wrocław, 105 Grabiszyńska St., 53-439 Wrocław, Poland. aniabrz@box43.pl.
D000220:Adaptation, Biological; D000818:Animals; D009320:Atrial Natriuretic Factor / Q000235:genetics / Q000378:metabolism*; D019208:Brain-Derived Neurotrophic Factor / Q000502:physiology; D004921:Erythropoietin / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D009569:Nitric Oxide / Q000235:genetics / Q000378:metabolism*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism*
D019208:Brain-Derived Neurotrophic Factor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D004921:Erythropoietin; D009569:Nitric Oxide; D009320:Atrial Natriuretic Factor