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Effects of Continuous Positive Airway Pressure on Cell Adhesion Molecules in Patients with Obstructive Sleep Apnea: A Meta-Analysis

  • OBSTRUCTIVE SLEEP APNEA
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Abstract

Purpose

Previous studies have confirmed that patients with obstructive sleep apnea (OSA) have higher systemic inflammatory markers, including intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1), and E-selectin compared to control subjects. However, the effects of continuous positive airway pressure (CPAP) therapy on circulating levels of ICAM-1, VCAM-1, and E-selectin in OSA patients remain inconsistent. Therefore, the primary purpose of the present meta-analysis is to estimate the effect of CPAP therapy on these cell adhesion molecules (CAMs) in patients with OSA.

Methods

The PubMed, Scopus, Embase, and Cochrane Library databases were searched. The overall effects were measured by the standardized mean difference (SMD) with a 95% confidence interval (CI). A random effects model or a fixed-effects model was used, depending on the heterogeneity of the studies.

Results

A total of 11 studies were included, comprising 650 OSA patients. The pooled results showed that CPAP therapy significantly decreased ICAM-1 (SMD =  − 0.283, 95% CI   − 0.464 to − 0.101, p = 0.002) and E-selectin levels (SMD =  − 0.349, 95% CI   − 0.566 to − 0.133, p = 0.002). In contrast, there was no significant improvement of VCAM-1 levels after CPAP treatment (SMD =  − 0.160, 95% CI   − 0.641 to 0.320, p = 0.513).

Conclusions

Our meta-analysis demonstrated that CPAP treatment significantly decreased the circulating levels of ICAM-1 and E-selectin in OSA patients. Thus, ICAM-1 and E-selectin may be effective markers to evaluate CPAP therapy for reducing OSA cardiovascular risk in clinical practice.

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Data Availability

All data generated or analyzed during this study are included in this published article.

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Funding

This work was supported by the Chinese National Natural Science Foundation (Grant Number: 81670080).

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Authors and Affiliations

  1. Department of Respiratory, The First Hospital of Jilin University, 71 Xin Min Street, Changchun, 130021, Jilin, China

    Zongsheng Tian, Jing Kang, Hongying Sun, Zhuangzhuang Mu & Mingxian Li

  2. Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China

    Jinyu Xiao

  3. Department of Radiology, The First Hospital of Jilin University, 71 Xin Min Street, Changchun, 130021, Jilin, China

    Dan Tong

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  1. Zongsheng Tian
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Contributions

DT and MXL contributed to study concept and design and provided supervision. MXL contributed to revision and submission of the manuscript. ZST, JYX, and JK contributed to literature search. HYS and ZZM contributed to data extractions. ZST and JYX contributed to data analysis and drafted the manuscript. All authors read and approved the final manuscript.

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Correspondence to Dan Tong or Mingxian Li.

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Tian, Z., Xiao, J., Kang, J. et al. Effects of Continuous Positive Airway Pressure on Cell Adhesion Molecules in Patients with Obstructive Sleep Apnea: A Meta-Analysis. Lung 199, 639–651 (2021). https://doi.org/10.1007/s00408-021-00487-x

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