title: TREM-1 and pentraxin-3 plasma levels and their association with obstructive sleep apnea, obesity, and endothelial function in children.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is a common health problem in children and increases the risk of cardiovascular disease (CVD). Triggering receptor expressed on myeloid cells-1 (TREM-1) plays an important role in innate immunity and amplifies inflammatory responses. Pentraxin-3 is predominantly released from macrophages and vascular endothelial cells, plays an important role in atherogenesis, and has emerged as a biomarker of CVD risk. Thus, we hypothesized that plasma TREM-1 and pentraxin-3 levels would be elevated in children with OSA.
  
  
  METHODS
  ONE HUNDRED SIX CHILDREN (MEAN AGE: 8.3 ± 1.6 y) were included after they underwent overnight polysomnographic evaluation and a fasting blood sample was drawn the morning after the sleep study. Endothelial function was assessed with a modified hyperemic test after cuff-induced occlusion of the brachial artery. Plasma TREM-1 and pentraxin-3 levels were assayed using commercial enzyme-linked immunosorbent assay kits. Circulating microparticles (MPs) were assessed using flow cytometry after staining with cell-specific antibodies.
  
  
  RESULTS
  Children with OSA had significantly higher TREM-1 and pentraxin-3 levels (versus controls: P < 0.01, P < 0.05, respectively). Plasma TREM-1 was significantly correlated with both body mass index (BMI)-z score and the obstructive apnea-hypopnea index (AHI) in univariate models. Pentraxin-3 levels were inversely correlated with BMI-z score (r = -0.245, P < 0.01), and positively associated with endothelial MPs and platelet MPs (r = 0.230, P < 0.01 and r = 0.302, P < 0.01). Both plasma TREM-1 and pentraxin-3 levels were independently associated with AHI in multivariate models after controlling for age, sex, race, and BMI-z score (P < 0.001 for TREM-1 and P < 0.001 for pentraxin-3). However, no significant associations emerged between TREM-1, pentraxin-3, and endothelial function.
  
  
  CONCLUSIONS
  Plasma TREM-1 and pentraxin-3 levels are elevated in pediatric OSA, and may play a role in modulating the degree of systemic inflammation. The short-term and long-term significance of elevated TREM-1 and pentraxin-3 in OSA-induced end-organ morbidity remains to be defined.
authors.affiliation: Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, The University of Chicago, Chicago, IL 60637, USA.
authors.forename: Jinkwan
authors.initials: J
authors.lastname: Kim
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.forename: Rakesh
authors.initials: R
authors.lastname: Bhattacharjee
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D040501:Calgranulin A / Q000097:blood; D040502:Calgranulin B / Q000097:blood; D016022:Case-Control Studies; D055252:Cell-Derived Microparticles / Q000378:metabolism; D002648:Child; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000503:physiopathology; D017286:Polysomnography; D011971:Receptors, Immunologic / Q000097:blood*; D000683:Serum Amyloid P-Component / Q000032:analysis*; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000503:physiopathology; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D040501:Calgranulin A; D040502:Calgranulin B; D008055:Lipids; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; D000683:Serum Amyloid P-Component; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D000099153:Pentraxins; C408842:TREM1 protein, human
keywords: Endothelial function; inflammation; obesity; obstructive sleep apnea; pentraxin-3; triggering receptor expressed on myeloid cells-1