Effect of continuous positive airway pressure on soluble CD40 ligand in patients with obstructive sleep apnea syndrome.
BACKGROUND
Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for atherosclerosis. CD40-CD40 ligand interaction promotes several proinflammatory mediators and plays a pivotal role in the various stages of atherosclerotic diseases. The present study examines whether CD40 ligation contributes to outcomes in patients with OSAS.


METHODS
The study population comprised OSAS patients with an apnea hypopnea index (AHI) > or = 30 (n = 35) and control subjects (AHI < 5; n = 16). We measured serum levels of soluble CD40 ligand (sCD40L), tumor necrosis factor (TNF)-alpha, and hypersensitive C-reactive protein (hsCRP) before and after nasal continuous positive airway pressure (nCPAP) therapy for 3 months.


RESULTS
Baseline levels of sCD40L were significantly higher in patients with OSAS (6.93 +/- 4.64 ng/mL) [mean +/- SD] than in control subjects (3.43 +/- 2.11 ng/mL, p < 0.01). Baseline levels of sCD40L positively correlated with TNF-alpha but not with hsCRP. The elevation of sCD40L was improved for 1 night after nCPAP therapy (3.83 +/- 2.78 ng/mL, p < 0.001). Even though patients with severe OSAS did not receive any other medication to control atherosclerotic risk factors for 3 months, nCPAP was continued to reduce the levels of sCD40L.


CONCLUSIONS
The present study suggested that sCD40L is a key factor that links OSAS and atherosclerotic progression.
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. nishiy@med.kobe-u.ac.jp
Kazuyuki
K
Kobayashi
Yoshihiro
Y
Nishimura
Temiko
T
Shimada
Sho
S
Yoshimura
Yasuhiro
Y
Funada
Miyako
M
Satouchi
Mitsuhiro
M
Yokoyama
D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D023201:CD40 Ligand / Q000097:blood*; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D016207:Cytokines / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D023201:CD40 Ligand; D002097:C-Reactive Protein