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Effect of modern surgical treatment on the inflammatory/anti-inflammatory balance in patients with obstructive sleep apnoea

Published online by Cambridge University Press:  23 May 2017

M Binar ,
T M Akcam ,
O Karakoc ,
R I Sagkan ,
U Musabak  and
M Gerek
M Binar*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
T M Akcam
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Medical Park Hospital, Ankara, Turkey
O Karakoc
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
R I Sagkan
Affiliation:
Department of Immunology, Gulhane Medical School, Ankara, Turkey
U Musabak
Affiliation:
Department of Immunology, Gulhane Medical School, Ankara, Turkey
M Gerek
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
*
Address for correspondence: Dr Murat Binar, Gulhane Egitim Arastırma Hastanesi, KBB AD, Etlik, 06018, Kecioren, Ankara, Turkey Fax: +90 312 304 5700 E-mail: mbinar4@yahoo.com
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Abstract

Objective:

To investigate the inflammatory/anti-inflammatory cytokine balance – T helper 1/T helper 2 ratios – in obstructive sleep apnoea patients, before and after treatment.

Methods:

Twenty-eight patients received continuous positive airway pressure treatment and 29 patients who could not tolerate continuous positive airway pressure were scheduled for surgery. Serum levels of interleukins 2, 4 and 10, tumour necrosis factor-alpha, and interferon gamma were analysed by enzyme-linked immunosorbent assays before and three months after treatment.

Results:

The success rate of surgical treatment was 65.5 per cent. Mean compliance for the continuous positive airway pressure group was 40.9 per cent. The apnoea/hypopnoea index significantly decreased in both groups after treatment (p < 0.001). The interferon gamma/interleukin-4 ratio decreased following surgical treatment (p = 0.014), and the interleukin-2/interleukin-4 ratio decreased after treatment in 57 patients in the overall cohort (p = 0.032).

Conclusion:

After treatment for obstructive sleep apnoea, some ratios reflecting T helper 1/T helper 2 cytokine balance favoured the T helper 2 direction, suggesting a shift to an anti-inflammatory state. Successful surgery and better continuous positive airway pressure compliance can help ameliorate inflammation in obstructive sleep apnoea patients, which may reduce associated morbidities.

Keywords

Obstructive Sleep ApneaInflammationSurgical ProceduresOperativeContinuous Positive Airway PressureCytokines
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 8 , August 2017 , pp. 719 - 727
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the 26th Congress of the European Rhinologic Society, in conjunction with the 35th Congress of the International Society of Inflammation and 17th Congress of the International Rhinologic Society (‘ERS-ISIAN-IRS 2016 Congress’), 3–7 July 2016, Stockholm, Sweden.

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