Dados do Trabalho

Título

Effect of Continuous Positive Airway Pressure on Telomere Length and its Associated Mechanisms

Introdução

Growing cross-sectional evidence suggests the contribution of obstructive sleep apnea (OSA) in the molecular pathways of aging related to the maintenance of telomere length, through the accumulation of damage by greater levels of inflammation and reactive oxygen species. However, to date, only a couple of studies investigated the role of OSA or its treatment on telomere in a longitudinal approach.

Objetivo

In this sense, the present study aimed to investigate the effect of OSA and its treatment with continuous positive airway pressure (CPAP) on the variation of telomere length and its associated mechanisms.

Métodos

A 6-month randomized, double-blind and sham-controlled clinical trial was conducted. Participants were randomized to use CPAP or sham-CPAP and attended 7 visits, in which they underwent clinical assessment and had their blood collected to determine mean leukocyte telomere length (LTL) and the dosage of metabolic and inflammatory markers.

Resultados

Among 127 individuals that we contacted, 46 met the inclusion criteria. At baseline, individuals in both groups were homogeneous. After 3 months of treatment, we observed an effect of the treatment on LTL, in which the SHAM group (1.0117±0.1552 vs 0.9457 ± 0.0747) showed a more expressive reduction than the CPAP group (1.0960±0.1122 vs 1.0521±0.1094). After 6 months of treatment, we observed a reduction of depressive and anxiety symptoms and sleepiness, as well as an improvement in sleep quality. We found a time-related stability on LTL in individuals undergoing CPAP treatment (1.0960±0.1122, 1.0521±0.1094, 1.0675±0.1225). We also analyzed the correlation between deltas LTL with TNF-a and IL-6. We observed a significant correlation between LTL and TNF-a (rho=-0.354, p<0.001). Interestingly, when we stratified by intervention, we no longer observed the correlation in CPAP group (rho=-0.150, p=0.195), but a stronger negative correlation between SHAM and TNF-a (rho=-0,475, p=0.08).

Conclusões

We could conclude that CPAP, when compared with the sham-CPAP, was effective in normalizing the polysomnographic parameters and the subjective complaints normally reported by individuals with OSA. Regarding the main outcome of the study, we observed an effect of the treatment on the stability of the LTL. This work was supported by grants from Associação Fundo de Incentivo à Pesquisa (AFIP) and Fundação de Amparo à Pesquisa de São Paulo (FAPESP).

Palavras -chave

Sleep apnea, Sleep, CPAP, Telomeres.