Endothelial repair capacity and apoptosis are inversely related in obstructive sleep apnea.
OBJECTIVE
To investigate the impact of obstructive sleep apnea (OSA) on endothelial repair capacity and apoptosis in the absence of potentially confounding factors including obesity.


METHODS
Sixteen patients with a body mass index <30 and newly diagnosed OSA and 16 controls were studied. Circulating levels of endothelial progenitor cells, a marker of endothelial repair capacity, and endothelial microparticles, a marker of endothelial apoptosis, were quantified before and after four-week therapy with continuous positive airway pressure (CPAP). Endothelial cell apoptotic rate was also quantified in freshly harvested venous endothelial cells. Vascular reactivity was measured by flow-mediated dilation.


RESULTS
Before treatment, endothelial microparticle levels were greater and endothelial progenitor cell levels were lower in patients with OSA than in controls (P < 0.001 for both). Levels of endothelial microparticles and progenitors cells were inversely related (r = -0.67, P < 0.001). Endothelial progenitor cell levels increased after effective treatment (P = 0.036).


CONCLUSIONS
In the absence of any co-morbid conditions including obesity, OSA alone impairs endothelial repair capacity and promotes endothelial apoptosis. These early endothelial alterations may underlie accelerated atherosclerosis and increased cardiovascular risk in OSA.
Jelic
Sanja
S
Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. sj366@columbia.edu
Lederer
David J
DJ
Adams
Tessa
T
Padeletti
Margherita
M
Colombo
Paolo C
PC
Factor
Phillip
P
Le Jemtel
Thierry H
TH
D000328:Adult; D017209:Apoptosis; D015992:Body Mass Index; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology; D049109:Cell Proliferation; D055252:Cell-Derived Microparticles / Q000473:pathology*; D045422:Continuous Positive Airway Pressure; D042783:Endothelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D013234:Stem Cells / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation