Immunological Response of Obstructive Sleep Apnea (OSA) in Adult Comorbid Patients
Introduction: 15% of adults exhibit OSA in general population, majority of which remain undiagnosed. OSA has been associated with chronic inflammation and heart disease; however, no direct pathway is explained. The purpose of this study is to investigate different immunological pathways partaking in this syndrome to explain the underlying mechanism of diseases.
Four hundred patients examined at Ayass Lung Clinic& Sleep Center in 2013 were included in the study. We analyzed immunoglobulin levels and their association with other biomarkers and comorbid diseases. OSA was diagnosed with the polysomnography. Demographic, clinical, laboratory and sleep study information were obtained from medical records. Logistic regression models were employed to determine association between immunological factors and the OSA.
Results: One third (31%) of patient population suffered from OSA, half (51%) were aged (age>65), 56% female and three-fourth were White. The prevalence of higher levels of IgA>453 and B2IgA >12 in our study population were, 82%, 39% while in OSA patients the levels were 89%, and 30% respectively.
Univariate analysis showed that those with a higher level of IgA>453 have twice odds of having an OSA and B2IgA >12 were 40% less likely to be associated with OSA (p=0.02) compared to control groups. Multivariate logistic regression analysis, after controlling for age, gender, ethnicity, obesity, asthma, hypertension and lupus were as follow; IgA>453 (OR 2.13; 95% CI, 1.06-4.26; P<0.05), B2IgA >12 (OR 0.57; 95% CI, 0.34-0.96; P<0.04). Higher IgA levels were twice more likely to be associated with OSA and B2IgA levels were less likely to be associated with OSA.
Conclusion: Understanding the immunological response of OSA will shed light on the possibility of different ways to help these patients. We hope that these cellular findings can be utilized for development of diagnostic/therapeutic biomarkers for early detection, prevention, and even treatments. Prospective studies are vital to exclude the role of comorbidity in modulating the immune response in OSA patients with comorbid conditions.