Inflammation in children with neuromuscular disorders and sleep disordered breathing |
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Institution: | 1. Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK;2. Department of Neuroscience, Rehabilitation, Ophthalmology Genetics and Mother and Infant Science, University of Genova, Italy;3. National Heart and Lung Institute, Imperial College, London, UK;4. Royal Brompton and Harefield NHS Foundation Trust, London, UK;5. Sleep & Ventilation Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK |
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Abstract: | IntroductionPaediatric obstructive sleep apnoea is associated with systemic inflammation and co-morbidities. We assessed whether sleep disordered breathing (SDB) due to neuromuscular weakness was associated with elevated airway and systemic pro-inflammatory cytokines.MethodsConsecutive neuromuscular children (age 5–18years) underwent overnight full polysomnography and morning collection of serum and breath condensate, analysed for cytokines (Interleukin-10, Interleukin-6, Interleukin-1β, Tumour Necrosis Factorα, high-sensitivity C-Reactive Protein, Intercellular and Vascular Adhesion Molecules ICAM-1, VCAM-1). Cytokine levels were related to Oxygen desaturation index (ODI), desaturation>4%/h, and levels of transcutaneous carbon dioxide overnight (tcCO2≥6.7 kPa > 2% sleep).ResultsA total of 23 patients were included, median age 12.6 years (IQR 8.7–14.6). ODI>3/h was associated with higher breath and serum IL-6 (p = 0.02). Children with elevated CO2 overnight had higher ICAM-1 and VCAM-1. CO2 levels correlated with serum ICAM-1 (rs0.570, p = 0.026) and VCAM-1 (rs0.76, p = 0.001).DiscussionSDB in neuromuscular children is associated with raised serum IL-6, VCAM-1, ICAM-1. This may predispose these children to future cardiovascular and other co-morbidities. |
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Keywords: | Neuromuscular disorders Hypoventilation Cytokines IL-6 ICAM-1 VCAM-1 hsCRP"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"high sensitivity C Reactive Protein TNF"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"Tumor Necrosis Factor alpha IL-6"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"Interleukin 6 IL1-β"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"Interleukin 1 beta IL-10"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"Interleukin 10 ICAM-1"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"Intercellular Adhesion Molecule 1 VCAM-1"} {"#name":"keyword" "$":{"id":"kwrd0105"} "$$":[{"#name":"text" "_":"Vascular Cellular Adhesion Molecule 1 EBC"} {"#name":"keyword" "$":{"id":"kwrd0115"} "$$":[{"#name":"text" "_":"Exhaled Breath Condensate transcutaneous carbon dioxide oxygen saturation ODI"} {"#name":"keyword" "$":{"id":"kwrd0145"} "$$":[{"#name":"text" "_":"oxygen desaturation index TST"} {"#name":"keyword" "$":{"id":"kwrd0155"} "$$":[{"#name":"text" "_":"total sleep time |
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