The concept linking inflammation and pediatric OSAS was initially invoked by Tauman et al in 2004. Since then, a large body of evidence has accumulated and confirmed such an association, particularly when concurrent obesity, another chronic low-grade inflammatory disorder, is present.,,,,, Considering the fact that plasma C-reactive protein (CRP) levels appear to be strongly associated with cardiovascular disease (CVD) risk in both adults and children,, it was reasonable to postulate that assessment and tracking of CRP levels would provide insights into the clinical course of the disease and response to treatment, as well as enable estimates of CVD risk. However, although CRP levels manifest dose dependency (ie, CRP levels increase as the severity of OSAS increases, as illustrated by PSG measures), and are responsive to treatment (ie, adenotonsillectomy [T&A]),,,, there was no evidence indicating that they are predictive of measurable CVD risk in children when using other risk assessment measures such as carotid intima-media thickness measurements., Nonetheless, assessments of circulating CRP levels may serve as an indicator of underlying neurocognitive deficits, and may also provide an accurate predictor for the presence of residual OSAS following T&A. On the basis of the interindividual variability of the responses to T&A we previously found in a large panel of inflammatory markers among a large group of obese children with OSAS, it is likely that use of CRP alone, rather than as a component of a multiarray panel, may not provide sufficiently accurate prediction of CVD risk or its resolution with treatment. The issue of multibiomarker-based signatures is discussed further below, but it is critically important to consider such an approach, so as to enable encompassing the interindividual variability in the specific biomarker response to OSAS, which is clearly prescribed, in addition to the disease itself, by both genetic and environmental factors.,,, In summary, CRP levels emerge as a robust candidate biomarker that definitely merits its inclusion in any future biomarker panel.