Skip to main content
SpringerLink
Log in

Levels of thioredoxin are related to the severity of obstructive sleep apnea: based on oxidative stress concept

  • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Background

Oxidative stress is a typical feature of obstructive sleep apnea (OSA). Thioredoxin (TRX), as one of the oxidative stress biomarkers, is a potent protein disulfide reductase in antioxidant defense. Our study is designed to test whether thioredoxin could assess the severity of OSA.

Methods

Sixty-three adults suspected of having OSA were included in this study and were divided into four groups based on the results of polysomnography (PSG): control, mild, moderate, and severe. Subjects with chronic medical diseases (with the exception of essential hypertension) or taking any antioxidant medication were excluded. Blood samples were obtained within an hour after the overnight PSG test. Plasma TRX levels were detected by enzyme-linked immunosorbent assay.

Results

The plasma TRX level in severe group was obviously increased (8.62 ± 2.14, 13.33 ± 5.60, 14.71 ± 5.53, and 16.10 ± 7.34 ng/ml; p < 0.05). The TRX positively related to AHI (r = 0.313; p < 0.05), while negatively related to the lowest O2 saturation (r = 0.266; p < 0.037). The OSA patients associated with hypertension showed elevated TRX level (17.70 ± 6.98 vs. 13.43 ± 5.83 ng/ml; t = 2.434, p < 0.018). The cutoff value of TRX for identifying OSA was 9.39 ng/ml (sensitivity 91 %, specificity 78 %), and its cutoff value for differentiating moderate–severe OSA from mild OSA was 11.79 ng/ml (sensitivity 75 %, specificity 65 %).

Conclusion

These results suggest that plasma TRX level is associated with the severity of OSA. Therefore, TRX may be used as a severity indicator of OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Parish JM (2012) Metabolic syndrome, obstructive sleep apnea, and risk of cardiovascular disease. Sleep Breath. doi:10.1007/s11325-011-0594-x

  2. Shamsuzzaman AS, Gersh BJ, Somers VK (2003) Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA 290:1906–1914

    Article  PubMed  CAS  Google Scholar 

  3. Prabhakar NR (2002) Sleep apneas: an oxidative stress? Am J Respir Crit Care Med 165:859–860

    PubMed  Google Scholar 

  4. Kim J, Lee S, Bhattacharjee R, Khalyfa A, Kheirandish-Gozal L, Gozal D (2010) Leukocyte telomere length and plasma catestatin and myeloid-related protein 8/14 concentrations in children with obstructive sleep apnea. Chest 138:91–99

    Article  PubMed  CAS  Google Scholar 

  5. Suzuki YJ, Jain V, Park AM, Day RM (2006) Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med 40:1683–1692

    Article  PubMed  CAS  Google Scholar 

  6. Vapaatalo H (1986) Free radicals and anti-inflammatory drugs. Med Biol 64:1–7

    PubMed  CAS  Google Scholar 

  7. Harrison DG, Cai H, Landmesser U, Griendling KK (2003) Interactions of angiotensin II with NAD (P) H oxidase, oxidant stress and cardiovascular disease. J Renin Angiotensin Aldosterone Syst 4:51–61

    Article  PubMed  CAS  Google Scholar 

  8. Schulz R, Mahmoudi S, Hattar K, Sibelius U, Olschewski H, Mayer K, Seeger W, Grimminger F (2000) Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea: impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 162:566–570

    PubMed  CAS  Google Scholar 

  9. Rubartelli A, Bajetto A, Allavena G, Wollman E, Sitia R (1992) Secretion of thioredoxin by normal and neoplastic cells through a leaderless secretory pathway. J Biol Chem 267:24161–24164

    PubMed  CAS  Google Scholar 

  10. Kondo N, Ishii Y, Kwon YW, Tanito M, Horita H, Nishinaka Y, Nakamura H, Yodoi J (2004) Redox-sensing release of human thioredoxin from T lymphocytes with negative feedback loops. J Immunol 172:442–448

    PubMed  CAS  Google Scholar 

  11. Takahashi K, Chin K, Nakamura H, Morita S, Sumi K, Oga T, Matsumoto H, Niimi A, Fukuhara S, Yodoi J, Mishima M (2008) Plasma thioredoxin, a novel oxidative stress marker, in patients with obstructive sleep apnea before and after nasal continuous positive airway pressure. Antioxid Redox Signal 10:715–726

    Article  PubMed  CAS  Google Scholar 

  12. Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J (2007) Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol 39:44–84

    Article  PubMed  CAS  Google Scholar 

  13. Arne H, Jun L (2010) Thioredoxin and thioredoxin reductase: current research with special reference to human disease. Biochem Biophys Res Commun 396:120–124

    Article  Google Scholar 

  14. Arnér ES (2009) Focus on mammalian thioredoxin reductases—important selenoproteins with versatile functions. Biochim Biophys Acta 1790:495–526

    Article  PubMed  Google Scholar 

  15. Kang SW, Chae HZ, Seo MS, Kim K, Baines IC, Rhee SG (1998) Mammalian peroxiredoxin isoforms can reduce hydrogen peroxide generated in response to growth factors and tumor necrosis factor-alpha. J Biol Chem 273:6297–6302

    Article  PubMed  CAS  Google Scholar 

  16. Adachi H, Mikami A, Kumano-go T, Suganuma N, Matsumoto H, Shigedo Y, Sugita Y, Takeda M (2003) Clinical significance of pulse rate rise during sleep as a screening marker for the assessment of sleep fragmentation in sleep-disordered breathing. Sleep Med 4:537–542

    Article  PubMed  Google Scholar 

  17. Raymond B, Cayton RM, Chappell MJ (2003) Combined index of heart rate variability and oximetry in screening for the sleep apnoea/hypopnoea index syndrome. J Sleep Res 12:53–61

    Article  PubMed  Google Scholar 

  18. Riha RL (2010) Clinical assessment of the obstructive sleep apnea/hypopnoea syndrome. Ther Adv Respir Dis 4:83–91

    Article  PubMed  Google Scholar 

  19. Roche F, Celle S, Pichot V, Barthélémy JC, Sforza E (2007) Analysis of the interbeat interval increment to detect obstructive sleep apnoea/hypopnoea. Eur Respir J 29:1206–1211

    Article  PubMed  CAS  Google Scholar 

  20. Ryan S, Nolan GM, Hannigan E, Cunningham S, Taylor C, McNicholas WT (2007) Cardiovascular risk markers in obstructive sleep apnoea syndrome and correlation with obesity. Thorax 62:509–514

    Article  PubMed  Google Scholar 

  21. Hayashi M, Fujimoto K, Urushibata K, Takamizawa A, Kinoshita O, Kubo K (2006) Hypoxia-sensitive molecules may modulate the development of atherosclerosis in sleep apnoea syndrome. Respirology 11:24–31

    Article  PubMed  Google Scholar 

  22. Can M, Açikgöz S, Mungan G, Bayraktaroğlu T, Koçak E, Güven B, Demirtas S (2006) Serum cardiovascular risk factors in obstructive sleep apnea. Chest 129:233–237

    Article  PubMed  CAS  Google Scholar 

  23. Lavie L, Perelman A, Lavie P (2001) Plasma homocysteine levels in obstructive sleep apnea: association with cardiovascular morbidity. Chest 120:900–908

    Article  PubMed  CAS  Google Scholar 

  24. Svatikova A, Wolk R, Magera MJ, Shamsuzzaman AS, Phillips BG, Somers VK (2004) Plasma homocysteine in obstructive sleep apnoea. Eur Heart J 25:1325–1329

    Article  PubMed  CAS  Google Scholar 

  25. Kokturk O, Ciftci TU, Mollarecep E, Ciftci B (2006) Serum homocysteine levels and cardiovascular morbidity in obstructive sleep apnea syndrome. Respir Med 100:536–541

    Article  PubMed  Google Scholar 

  26. Miwa K, Kishimoto C, Nakamura H, Makita T, Ishii K, Okuda N, Yodoi J, Sasayama S (2005) Serum thioredoxin and alpha-tocopherol concentrations in patients with major risk factors. Circ J 69:291–294

    Article  PubMed  CAS  Google Scholar 

  27. Mansego ML, Blesa S, Gonzalez-Albert V, Tormos MC, Saez G, Redon J, Chaves FJ (2007) Discordant response of glutathione and thioredoxin systems in human hypertension? Antioxid Redox Signal 9:507–514

    Article  PubMed  CAS  Google Scholar 

  28. Ebrahimian T, Touyz RM (2008) Thioredoxin in vascular biology: role in hypertension. Antioxid Redox Signal 10:1127–1136

    Article  PubMed  CAS  Google Scholar 

  29. Lavie P, Herer P, Hoffstein V (2000) Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ 320:479–482

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

No conflict of interest is declared by the authors. This article was not commissioned, funded, or sponsored by any pharmaceutical company.

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Rui Jin Er Road, Shanghai, 200025, China

    Qian Guo, Yan Wang, Qing Yun Li, Min Li & Huan Ying Wan

Authors
  1. Qian Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qing Yun Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Min Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Huan Ying Wan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qing Yun Li.

Additional information

Qian Guo and Yan Wang have equal contribution and authorship to this paper.

None sources of support in the form of grants, equipment, or drugs, including any funding received for this work from any organizations.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guo, Q., Wang, Y., Li, Q.Y. et al. Levels of thioredoxin are related to the severity of obstructive sleep apnea: based on oxidative stress concept. Sleep Breath 17, 311–316 (2013). https://doi.org/10.1007/s11325-012-0692-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-012-0692-4

Keywords

Search

Navigation