Design of a study to investigate the mechanisms of obstructive sleep apnoea by means of drug-induced sleep endoscopy.
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.
['Bisogni|Valeria|V|', 'Maiolino|Giuseppe|G|', 'Ceolotto|Giulio|G|', 'Pengo|Martino F|MF|', 'Marchese Ragona|Rosario|R|', 'Artusi|Carlo|C|', 'Brugnolo|Laura|L|', 'Lerco|Silvia|S|', 'Borsetto|Daniele|D|', 'Gaudioso|Piergiorgio|P|', 'Martini|Alessandro|A|', 'Plebani|Mario|M|', 'Rossi|Gian Paolo|GP|']
D000328:Adult D000450:Aldosterone D002394:Catechol O-Methyltransferase D002395:Catecholamines D004724:Endoscopy D019332:Endothelin-1 D006801:Humans D008297:Male D010865:Pilot Projects D011446:Prospective Studies D011498:Protein Precursors D012083:Renin D012107:Research Design D012890:Sleep D020181:Sleep Apnea, Obstructive
obstructive sleep apnoea drug-induced sleep endoscopy sympathetic nervous system renin-angiotensin-aldosterone system catechol-O-methyltransferase endothelin-1