Significance of Immunological Markers in Patients with Obstructive Sleep Apnea and Comorbid Pathology

• Published in: Neuroscience and behavioral physiology Vol. 55; no. 2; pp. 340 - 345
• Main Authors: Rubina, S. S., Chichanovskaya, L. V., Makarova, I. I., Slusar, N. N.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.02.2025; Springer Nature B.V
• Subjects: Amygdala; Anthropometry; Apnea; Asthenia; Behavioral Sciences; Biomedical and Life Sciences; Biomedicine; Brain-derived neurotrophic factor; Comorbidity; Drowsiness; Emotions; Enzyme immunoassay; Glial fibrillary acidic protein; Immunology; Ischemia; Mental depression; Neurobiology; Neurogenesis; Neuromuscular junctions; Neuroplasticity; Neurosciences; Original Research; Pathology; Prefrontal cortex; Sleep and wakefulness; Sleep apnea; Sleep disorders; obstructive sleep apnea; chronic cerebral ischemia; brain-derived neurotrophic factor; glial fibrillary acidic protein; antibodies to the NR2 subunit of NMDA; antibodies to acetylcholine receptors
• ISSN: 0097-0549; 1573-899X
• DOI: 10.1007/s11055-025-01777-0

Objective. To determine the significance of immunological markers in patients with obstructive sleep apnea (OSA) and comorbid pathology. Materials and methods. A total of 65 patients were examined. Two groups of patients were defined: the study group with moderate and severe OSA and the control group without OSA. Subjects underwent anthropometry, polysomnography, and assessment of cognitive and emotional disorders. Enzyme immunoassay was used to investigate glial fibrillary acidic protein (GFAP), antibodies to the NR2 subunit of NMDA (anti-GRIN2A Ab) and acetylcholine receptors (anti-AChR Ab), and brain-derived neurotrophic factor (BDNF). Results. Patients with OSA had higher levels of the markers GFAP ( p = 0.017), BDNF ( p = 0.006), and anti-AChR Ab ( p = 0.002) than the control group, along with more severe chronic cerebral ischemia ( p = 0.000), depression on the Hospital Depression Scale ( p = 0.004) and the Beck Depression Inventory ( p = 0.000), sleepiness on the Epworth Sleep Inventory ( p = 0.001), and asthenia on a VAS ( p = 0.000) and the MFI 20 asthenia scale ( p = 0.013). Relationships were demonstrated in the study group between impairments on the Mini-Mental State Examination (MMSE) and the BDNF level ( r = 0.302, p = 0.014) and the mean MMSE score and the BDNF level ( r = –0.266, p = 0.032). Conclusions. The results presented here demonstrated relationships between neurospecific proteins and cognitive impairment in patients with OSA. The neuromarker GFAP in patients with apnea was a predictor of decreased neurogenesis, while BDNF was a marker representative of neuroplasticity. High levels of anti-AChR Ab in patients with OSA may point to the possible presence of disorders of neuromuscular transmission. Along with drowsiness and asthenia, patients with OSA had changes in the emotional background, mainly due to depression. The severities of depression and asthenia increased with the severity of apnea and were probably associated with a low saturation level, which in turn leads to dysregulation of the prefrontal cortex, hippocampus, and amygdala.