Sensorimotor nerve lesion of upper airway in patients with obstructive sleep apnea

https://doi.org/10.1016/j.resp.2021.103720Get rights and content
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Highlights

  • Downregulation for myelin basic protein reflects mucosal sensory nerve myelinated degeneration.

  • Upregulation for agrin reflects synaptic regeneration following denervation.

  • Sensorimotor nerve in upper airway damages, and it is closely linked to the severity of obstructive sleep apnea.

Abstract

The pathogenesis of obstructive sleep apnea (OSA) remains controversial. The role of anatomic stenosis is indisputable, and neural regulation of the upper airway remains to be elucidated. The upper airway maintains patency through the upper airway reflex. Lesions in any link of the reflex can increase the collapsibility of the upper airway. In this study, we investigated sensorimotor nerve lesions and their possible relationship with OSA. Tissue samples were obtained from the pharyngopalatine arch in 47 patients with OSA and 45 control participants to examine changes in the expression levels of myelin basic protein (MBP) and agrin through immunohistochemistry and western blotting. Downregulation of MBP in the mucosa reflects myelinated degeneration of mucosal sensory nerve axons, whereas upregulation of agrin in the neuromuscular junction reflects synaptic regeneration following denervation. The two neural factors correlate significantly with polysomnographic parameters, such as the apnea hypopnea index and lowest oxygen saturation. Our findings suggest that sensorimotor nerve damage in the upper airway of patients with OSA may be associated closely with the mechanism of OSA.

Keywords

Obstructive sleep apnea
Myelin basic protein
Agrin
Integrated optical density
Immunohistochemistry
Western blotting

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1

These authors contribute equally to this work as first author.