A cause-effect relationship has been suggested between this systemic inflammatory In this context, circulating biomarkers of inflammation and oxidative stress have been described to be elevated in some OSA patients, and lowered with CPAP therapy regardless of weight changes. These intermediate mechanics may explain to some extent, the increased risk of mortality, incident hypertension, coronary artery disease and stroke described in OSA. Collapse of the upper airway during sleep leads to recurrent arousals, intermittent hypoxia, and surges in sympathetic activity. * Correspondence: Service, HospitalUniversitario MiguelServet, I-3 Avda Isabella Católica, 50006 Zaragoza, SpainĢTranslationalResearch Unit, HospitalUniversitario MiguelServet, Zaragoza, Spainįulllist of author information is available at the end of the articleĪlso important in OSA pathogenesis. Though obesity is the main risk to develop OSA, cranio-facial morphology and ventilator drive abnormalities are Obstructive sleep apnea (OSA) is the most common respiratory sleep disorder characterized by recurrent episodes of partial or complete pharyngeal obstruction. Keywords: Sleep apnea, Subclinical atherosclerosis, Systemic inflammation, Epigenetics OSA patients are treated according with national guidelines.ĭiscussion: EPIOSA will enable the prospective evaluation of inflammatory and epigenetics mechanism involved in cardiovascular complication of treated and non-treated patients with OSA compared with non OSA subjects. Bilateral carotid echography will be performed to assess subclinical atherosclerosis and atherosclerosis progression. For biobanking, aliquots of serum, plasma, urine, mRNA and DNA are also obtained. Every year, OSA status will be assessed by full sleep study and blood samples will be obtained for immediate standard biochemistry, hematology, inflammatory cytokines and cytometry analysis. Confirmatory outcomes information is requested from patient records and the regional Department of Health Services. This includes a standardized questionnaire and physical examination to determine incident comorbidities and health resources utilization, with a primary focus on cardiovascular events. At baseline and at each one year follow-up examination, patients are subjected to a core phenotyping protocol. Recruitment and study visits are performed in single University-based sleep clinic using standard operating procedures. All of them will be follow-up for at least 5 years. Methods/design: EPIOSA is a prospective cohort study aiming to recruit 350 participants of caucasian ethnicity and free of other chronic or inflammatory diseases: 300 patients with prevalent OSA and 50 non-OSA subjects. We have thus initiated the Epigenetics modification in Obstructive Sleep Apnea (EPIOSA) study ( identifier: NCT02131610). Epidemiological and animal models studies generate hypotheses for innovative strategies in OSA management by interfering intermediates mechanisms associated with cardiovascular complications. Jose M Marin1,2*, Jorge Artal3, Teresa Martin1, Santiago J Carrizo1, Marta Andres2, Inmaculada Martin-Burriel4, Rosa Bolea4, Arianne Sanz4, Luis Varona4, Javier Godino5, Begoña Gallego1, Jose A Garcia-Erce6, Isabel Villar2, Victoria Gil2, Marta Forner2, Jose P Cubero2 and Luis Ros7īackground: Obstructive sleep apnea (OSA) is associated with increased risk for cardiovascular morbidity and mortality. Epigenetics modifications and Subclinical Atherosclerosis in Obstructive Sleep Apnea: The EPIOSA study
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