Home Medicine Design of a study to investigate the mechanisms of obstructive sleep apnoea by means of drug-induced sleep endoscopy
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Design of a study to investigate the mechanisms of obstructive sleep apnoea by means of drug-induced sleep endoscopy

  • Valeria Bisogni , Giuseppe Maiolino , Giulio Ceolotto , Martino F. Pengo , Rosario Marchese Ragona , Carlo Artusi , Laura Brugnolo , Silvia Lerco , Daniele Borsetto , Piergiorgio Gaudioso , Alessandro Martini , Mario Plebani and Gian Paolo Rossi EMAIL logo
Published/Copyright: May 21, 2019
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 57 Issue 9

Abstract

Background

Obstructive sleep apnoea (OSA) is an independent risk factor of hypertension and cardiovascular diseases. Recurrent episodes of upper airways collapse during sleep causing blood oxygen desaturation, hypercapnia, and micro-arousals, are known to activate the sympathetic nervous system (SNS). However, whether changes in the renin-angiotensin-aldosterone system and endothelial activation also occur remains contentious.

Methods

Based on routine use of drug-induced sleep endoscopy (DISE) for the work-up of OSA patients in our centre, we designed a prospective study to investigate the haemodynamic and humoral changes occurring during the apnoeic episodes reproduced in vivo in the course of DISE. Specifically, plasma aldosterone concentration and renin activity, C-terminal fragment of proendothelin-1, as a marker of endothelial damage, and free plasma catecholamines, will be measured at fixed times during DISE. The activity of catechol-O-methyltransferase (COMT), a key catecholamine-inactivating enzyme that has been scantly investigated thus far owing to the lack of commercially available kits, will be also determined by a newly developed high performance liquid chromatography method, which is herein described.

Results and conclusions

The aim of this study is to provide novel information on the haemodynamic, hormonal, and SNS changes, and also on COMT activity modification concomitantly occurring during apnoea, thus contributing substantively to the understanding of the pathophysiology of OSA.

Keywords: catechol-O-methyltransferase; drug-induced sleep endoscopy; endothelin-1; obstructive sleep apnoea; renin-angiotensin-aldosterone system; sympathetic nervous system
Corresponding author: Gian Paolo Rossi, MD, FACC, FAHA, Department of Medicine, Clinica dell’Ipertensione Arteriosa, DIMED – University Hospital of Padova, Via Giustiniani, 2, 35126 Padova, Italy, Phone: +39-049-821-2279 or 7821, Fax: +39-049-821-7873

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Conflict of interest: The authors declare that they have no conflict of interest.

  3. Research funding: Grant support: FORICA (The FOundation for advanced Research In Hypertension and CArdiovascular diseases), the Società Italiana dell’Ipertensione Arteriosa and the University of Padua to GPR. Research grant by the Young Research Program of the Italy’s Health Minister to L.L. Project GR-2009 -1524351. No relationship with industry to be disclosed.

  4. Employment or leadership: None to declare.

  5. Honorarium: None to declare.

  6. Competing interests: The funding organisation played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2019-01-30
Accepted: 2019-03-23
Published Online: 2019-05-21
Published in Print: 2019-08-27

©2019 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2019-0113
Keywords for this article
catechol-O-methyltransferase; drug-induced sleep endoscopy; endothelin-1; obstructive sleep apnoea; renin-angiotensin-aldosterone system; sympathetic nervous system

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  1. Frontmatter
  2. Editorial
  3. Sepsis biomarkers: past, present and future
  4. Reviews
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  6. Faecal calprotectin in inflammatory bowel diseases: a review focused on meta-analyses and routine usage limitations
  7. Opinion Paper
  8. Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use
  9. EFLM Paper
  10. Practice in financial support of third party organised conferences and courses at a national level for health care professionals in Europe
  11. General Clinical Chemistry and Laboratory Medicine
  12. Design and implementation of quality control plans that integrate moving average and internal quality control: incorporating the best of both worlds
  13. Elecsys® and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable?
  14. Accuracy assessment of consecutive test strip lots for whole blood INR point-of-care instruments: clarifying the role of frozen plasma pools
  15. Subcutaneous adipose tissue distribution and telomere length
  16. Hematology and Coagulation
  17. Automated measurement of the erythrocyte sedimentation rate: method validation and comparison
  18. The effect of DOAC-Stop on lupus anticoagulant testing in plasma samples of venous thromboembolism patients receiving direct oral anticoagulants
  19. Reference Values and Biological Variations
  20. Narrowed reference intervals for complete blood count in a multiethnic population
  21. Elucidation of stability profiles of common chemistry analytes in serum stored at six graded temperatures
  22. Cancer Diagnostics
  23. Prognostic value of involved/uninvolved free light chain ratio determined by Freelite and N Latex FLC assays for identification of high-risk smoldering myeloma patients
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  26. Infectious Diseases
  27. Evaluation of procalcitonin immunoassay concordance near clinical decision points
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  30. Differences in procalcitonin measurements between three BRAHMS-partnered immunoassays (Liaison, Elecsys and Architect)
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  32. Analytical and diagnostic performance evaluation of five creatinine POCT devices in the identification of patients at risk for post-contrast acute kidney injury (PCAKI)
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