阻塞性睡眠呼吸暂停对机体免疫系统的重塑及其临床意义

doi:10.16352/j.issn.1001-6325.2025.06.0816

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (6): 816-821.doi: 10.16352/j.issn.1001-6325.2025.06.0816

阻塞性睡眠呼吸暂停对机体免疫系统的重塑及其临床意义

李洁琼, 肖毅^*

中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京 100730

收稿日期:2025-01-03 修回日期:2025-03-25 出版日期:2025-06-05 发布日期:2025-05-26
通讯作者: ^*xiaoyipumch@sina.com
基金资助:
国家自然科学基金(82370052);北京协和医院临床医学博士后科研孵育基金(kyfyjj202404)

The impact of obstructive sleep apnea on the remodeling of the immune system and its clinical significance

LI Jieqiong, XIAO Yi^*

Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Received:2025-01-03 Revised:2025-03-25 Online:2025-06-05 Published:2025-05-26

摘要/Abstract

摘要： 阻塞性睡眠呼吸暂停(OSA)是一种多因素的异质性呼吸系统疾病,其特征是气道塌陷反复发作,导致间歇性低氧血症、高碳酸血症和睡眠片段化。反复的间歇性低氧(IH)对机体各系统,尤其是免疫系统产生了深远的影响。此外,抑制相关炎症分子可改善IH诱导的炎性反应和组织损伤,为治疗OSA相关并发症提供新的潜在靶点。本文旨在探讨OSA对免疫系统的重塑机制及其临床意义。

关键词: 阻塞性睡眠呼吸暂停, 免疫系统, 临床意义

Abstract: Obstructive sleep apnea (OSA) is a multifactor respiratory disorder characterized by recurrent episodes of airway collapse, leading to intermittent hypoxemia, hypercapnia, and sleep fragmentation. Intermittent hypoxia (IH) has profound effects on various body systems, particularly the immune system. Additionally, the suppression of the related inflammatory molecules mitigates IH-induced inflammation and tissue injury, presenting new potential targets for treating OSA-related complications. This review aims to explore the mechanisms by which OSA reshapes the immune system and its clinical significance.

Key words: obstructive sleep apnea, immune system, clinical significance

中图分类号:

李洁琼, 肖毅. 阻塞性睡眠呼吸暂停对机体免疫系统的重塑及其临床意义[J]. 基础医学与临床, 2025, 45(6): 816-821.

LI Jieqiong, XIAO Yi. The impact of obstructive sleep apnea on the remodeling of the immune system and its clinical significance[J]. Basic & Clinical Medicine, 2025, 45(6): 816-821.

参考文献 25

[1]	Azarbarzin A, Labarca G, Kwon Y, et al. Physiological consequences of upper airway obstruction in sleep apnea[J]. Chest, 2024, 166:1209-1217. doi: 10.1016/j.chest.2024.05.028.
[2]	Cortese R, Adams TS, Cataldo KH, et al. Single-cell RNA-seq uncovers cellular heterogeneity and provides a signature for paediatric sleep apnoea[J]. Eur Respir J, 2023, 61:2201465. doi: 10.1183/13993003.01465-2022.
[3]	Zhang X, Zhang H, Li S, et al. Recent progresses in gut microbiome mediates obstructive sleep apnea-induced cardiovascular diseases[J]. FASEB Bioadv, 2024, 6: 118-130. doi: 10.1096/fba.2023-00153.
[4]	Bowers SJ, Vargas F, González A, et al. Repeated sleep disruption in mice leads to persistent shifts in the fecal microbiome and metabolome[J]. PLoS One, 2020, 15: e0229001. doi: 10.1371/journal.pone.0229001.
[5]	Li Q, Xu T, Shao C, et al. Obstructive sleep apnea is related to alterations in fecal microbiome and impaired intestinal barrier function[J]. Sci Rep, 2023, 13: 778. doi: 10.1038/s41598-023-27784-0.
[6]	Liu D, Meng H, Wan N, et al. Association of CLDN molecules with sleep apnea hypopnea syndrome: new biomarker candidates[J]. Front Neurol, 2024, 15: 1347137. doi: 10.3389/fneur.2024.1347137.
[7]	Kadier K, Dilixiati D, Ainiwaer A, et al. Analysis of the relationship between sleep-related disorder and systemic immune-inflammation index in the US population[J]. BMC Psychiatry, 2023, 23: 773. doi: 10.1186/s12888-023-05286-7.
[8]	Polasky C, Steffen A, Loyal K, et al. Redistribution of monocyte subsets in obstructive sleep apnea syndrome patients leads to an imbalanced PD-1/PD-L1 cross-talk with CD4/CD8 T cells[J]. J Immunol, 2021, 206: 51-58. doi: 10.4049/jimmunol.2001047.
[9]	Farahi L, Sinha SK, Lusis AJ. Roles of macrophages in atherogenesis[J]. Front Pharmacol, 2021, 12: 785220. doi: 10.3389/fphar.2021.785220.
[10]	Domagała-Kulawik J, Osińska I, Piechuta A, et al. T, B, and NKT cells in systemic inflammation in obstructive sleep apnoea[J]. Mediators Inflamm, 2015, 2015: 161579. doi: 10.1155/2015/161579.
[11]	Gaoatswe G, Kent BD, Corrigan MA, et al. Invariant natural killer T cell deficiency and functional impair-ment in sleep apnea: links to cancer comorbidity[J]. Sleep, 2015, 38: 1629-1634. doi: 10.5665/sleep.5062.
[12]	Galati D, Zanotta S, Canora A, et al. Severe depletion of peripheral blood dendritic cell subsets in obstructive sleep apnea patients: A new link with cancer?[J]. Cytokine, 2020, 125: 154831. doi: 10.1016/j.cyto.2019.154831.
[13]	Xu YD, Cheng M, Shang PP, et al. Role of IL-6 in dendritic cell functions[J]. J Leukoc Biol, 2022, 111: 695-709. doi: 10.1002/jlb.3mr0621-616rr.
[14]	Xie H, Yin J, Bai Y, et al. Differential expression of immune markers in the patients with obstructive sleep apnea/hypopnea syndrome[J]. Eur Arch Otorhinol-aryngol, 2019, 276: 735-744. doi: 10.1007/s00405-018-5219-6.
[15]	Cubillos-Zapata C, Avendaño-Ortiz J, Hernandez-Jimenez E, et al. Hypoxia-induced PD-L1/PD-1 crosstalk impairs T-cell function in sleep apnoea[J]. Eur Respir J, 2017, 50:1700833. doi: 10.1183/13993003.00833-2017.
[16]	Díaz-García E, García-Sánchez A, Alfaro E, et al. PSGL-1: a novel immune checkpoint driving T-cell dysfunction in obstructive sleep apnea[J]. Front Immunol, 2023, 14: 1277551. doi: 10.3389/fimmu.2023.1277551.
[17]	章哪哪, 李艳妮, 李本农,等. 外周血Th17细胞与OSA患者颈动脉内-中膜厚度的相关性[J]临床耳鼻咽喉头颈外科杂志, 2020, 34:747-751.
[18]	Borker PV, Patel SR. Monocyte activation: the link between obstructive sleep apnea and cardiovascular disease?[J]. Am J Respir Crit Care Med, 2022, 205: 1268-1270. doi: 10.1164/rccm.202201-0215ED.
[19]	Mok EM, Greenough G, Pollack CC. Untreated obstruc-tive sleep apnea is associated with increased hospitaliza-tion from influenza infection[J]. J Clin Sleep Med, 2020, 16: 2003-2007. doi: 10.5664/jcsm.8744.
[20]	Quan SF, Weaver MD, Czeisler M, et al. Associations between obstructive sleep apnea and COVID-19 infection and hospitalization among US adults[J]. J Clin Sleep Med, 2023, 19: 1303-1311. doi: 10.5664/jcsm.10588.
[21]	Cao Y, Ning P, Li Q, et al. Cancer and obstructive sleep apnea: an updated meta-analysis[J]. Medicine (Baltimore), 2022, 101: e28930. doi: 10.1097/md.0000000000028930.
[22]	Palm A, Theorell-Haglöw J, Isakson J, et al. Associa-tion between obstructive sleep apnoea and cancer: a cross-sectional, population-based study of the DISCOVERY cohort[J]. BMJ Open, 2023, 13: e064501. doi: 10.1136/bmjopen-2022-064501.
[23]	Cubillos-Zapata C, Troncoso-Acevedo F, Díaz-García E, et al. Sleep apnoea increases biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk patients and those with established lung cancer[J]. ERJ Open Res, 2024, 10:00777-2023. doi: 10.1183/23120541.00777-2023.
[24]	Díaz-García E, García-Sánchez A, Sánz-Rubio D, et al. SMAD4 expression in monocytes as a potential biomarker for atherosclerosis risk in patients with obstructive sleep apnea[J]. Int J Mol Sci, 2023, 24:7900. doi: 10.3390/ijms24097900.
[25]	Ambati A, Ju YE, Lin L, et al. Proteomic biomarkers of sleep apnea[J]. Sleep, 2020, 43:zsaa086. doi: 10.1093/sleep/zsaa086.

阻塞性睡眠呼吸暂停对机体免疫系统的重塑及其临床意义

The impact of obstructive sleep apnea on the remodeling of the immune system and its clinical significance

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