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Clinical Investigations: SLEEP AND BREATHING |

Elevated Production of Tumor Necrosis Factor-α by Monocytes in Patients With Obstructive Sleep Apnea Syndrome*

Kenji Minoguchi, MD, PhD; Toshiyuki Tazaki, MD; Takuya Yokoe, MD, PhD; Hideko Minoguchi, MD, PhD; Yoshio Watanabe, MD; Mayumi Yamamoto, MD; Mitsuru Adachi, MD, PhD
Author and Funding Information

*From the First Department of Internal Medicine, Showa University, Tokyo, Japan.

Correspondence to: Kenji Minoguchi, MD, PhD, First Department of Internal Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142, Japan; e-mail: minochan@fn.catv.ne.jp



Chest. 2004;126(5):1473-1479. doi:10.1378/chest.126.5.1473
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Study objectives: Tumor necrosis factor (TNF)-α is involved in the pathogenesis of atherosclerosis. In the present study, we examined TNF-α production by monocytes, serum levels of TNF-α, and the effects of nasal continuous positive airway pressure (nCPAP) in patients with obstructive sleep apnea syndrome (OSAS).

Design: Prospective observational study.

Setting: University hospital.

Subjects: Twenty-four patients with OSAS, 15 obese control subjects, and 12 healthy subjects.

Measurements and results: After polysomnography, venous blood was collected at 5 am. Spontaneous production of TNF-α by monocytes for 24 h and serum levels of TNF-α were investigated. In addition, patients with moderate-to-severe OSAS were treated with nCPAP for 1 month, and spontaneous production of TNF-α by monocytes and serum levels of TNF-α were also measured. Spontaneous production of TNF-α by monocytes was significantly higher in patients with moderate-to-severe OSAS than in patients with mild OSAS (p < 0.0001), obese control subjects (p < 0.0001), or healthy subjects (p < 0.0001). Serum levels of TNF-α were also significantly higher in patients with moderate-to-severe OSAS than in patients with mild OSAS (p < 0.03), obese control subjects (p < 0.0005), or healthy subjects (p < 0.0001). Duration of hypoxia during total sleep time was independently associated with spontaneous production of TNF-α by monocytes in patients with OSAS and healthy and obese control subjects. nCPAP significantly decreased spontaneous production of TNF-α by monocytes (p < 0.03) and serum levels of TNF-α (p < 0.05) in patients with moderate-to-severe OSAS.

Conclusions: Spontaneous production of TNF-α by monocytes and serum levels of TNF-α are elevated in patients with moderate-to-severe OSAS but are decreased by nCPAP.

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