Evaluation Of Im Munity Status Of Obstructive Sleep Apnea Hypopnea Syndrome In Children

Background and Object:The essential feature of Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS) is increased upper airway resistance during sleep, resulting in intermittent partial or complete airway closure, associated with increased respiratory effort, sleep fragmentation, and gas exchange abnormalities. Pediatric OSAHS has been associated with failure to thrive, ventricular dysfunction, conductive deafness, facial malformations, attention and behavior problems. OSAHS affects1%-4%of children from the newborn age to adolescence. It has a peak incidence between the age of2and6yr. This correlates with the age during which adenotonsillar hypertrophy is most marked. The purpose of this study is to investigate the effete of the immune function in children with obstructive sleep apnea hypopnea syndrome.Methods:From May2010to August2011,50OSAHS children diagnosed by overnight plysomnography in our department. The study group consisted of50patients (40boys and10girls), aged47m-148m, and52controls aged36m-143m (33boys and19 girls). Venous blood simples were taken. The samples were run on a Becton Dickinson (BD) FACSCalibur and Siemens BN II immunoassay analyzer. The levels of CD3+CD4+, CD8+, IgA. IgG IgM, IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ were mesured.Results:The cytotoxicity of the CD8+T-lymphocytes of OSA patients was significantly greater than controls [(26.47±5.52vs.23.97±4.92), P=0.017]. The percentage of CD4+/CD8+was significantly lower than controls [(1.24±0.38vs.1.45±0.41), P=0.0.006]. OSAHS children had higher serum IgA [(1.63±1.01g/L vs.1.07±0.48g/L), P=0.000], C3[(1.17±0.23g/Lvs.1.03±0.15g/L), P=0.001], IL-4[2.45(0.60,7.90) pg/mL vs.1.25(0.60,4.80)pg/mL,P=0.000], IL-6[3.75(1.50,36.50)pg/mL vs.2.50(1.20,37.90) pg/mL, P=0.009], IL-10[3.45(1.80,16.40) pg/mL vs.3.10(1.50,6.30) pg/mL, P=0.001], and IFN-y [4.40(1.00,16.60) pg/mL vs.2.65(1.00,24.50) pg/mL, P=0.003] concentrations compared to controls.Conclusion:The lymphocyte subsets of OSAHS children significantly changed, and therefore may lead to suppression in cell-mediated immunity in children. The humoral immune responses of OSAHS children were not suppressed. The OSAHS children were associated with oxidative stress and systemic inflammation.