Role of endothelial dysfunction in sleep-disordered breathing in egyptian children with sickle cell disease.

Autor: Youssry I; Department of Pediatric Hematology, Faculty ofMedicine, Cairo University, Giza, Egypt., Mostafa AS; Department of Pediatric Pulmonology, Faculty of Medicine, Cairo University, Giza, Egypt., Hamed DH; Department of Pediatric Pulmonology, Faculty of Medicine, Cairo University, Giza, Egypt., Hafez YFA; Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt., Bishai IE; Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt., Selim YMM; Department of Pediatric Hematology, Faculty ofMedicine, Cairo University, Giza, Egypt. yasmeenselim87@gmail.com.
Jazyk: angličtina
Zdroj: BMC pediatrics [BMC Pediatr] 2024 Oct 01; Vol. 24 (1), pp. 626. Date of Electronic Publication: 2024 Oct 01.
DOI: 10.1186/s12887-024-05066-6
Abstrakt: Background: Endothelial dysfunction is an integral pathophysiologic mechanism in sickle cell disease (SCD), and can lead to many complications. Sleep-disordered breathing (SDB) is a SCD complication with diverse incidence and pathophysiology. This study aimed to determine the prevalence of SDB in children with SCD and to assess its relation to endothelial dysfunction.
Methods: Sixty children with SCD and 60 healthy controls were enrolled. The levels of TNF-α, IL-6, and IL-17A were evaluated in the entire cohort using enzyme-linked immunosorbent assay (ELISA) kits. Polysomnography (PSG) was performed for all SCD patients after completion of the Pediatric Sleep Questionnaire (PSQ).
Results: TNF-α, IL-6, and IL-17A levels were significantly greater in children with SCD than in controls (p-values < 0.001, < 0.001, and 0.006, respectively). The PSQ revealed symptoms suggestive of SDB in 50 children with SCD (83.3%), and PSG revealed obstructive sleep apnea (OSA) in 44 children with SCD (73.3%); 22 patients had mild OSA, and 22 had moderate-to-severe OSA according to the apnea-hypopnea index (AHI). TNF-α was significantly greater in SCD children who reported heavy or loud breathing, trouble breathing or struggle to breathe, and difficulty waking up in the morning (p-values = 0.002, 0.002, and 0.031, respectively). The IL-6 levels were significantly greater in SCD children who stopped growing normally (p-value = 0.002). The levels of IL-6 and IL-17A were significantly greater in SCD children with morning headaches (p-values = 0.007 and 0.004, respectively).
Conclusion: Children with SCD showed a high prevalence of SDB with significantly elevated levels of markers of endothelial function, highlighting the interplay of SDB and endothelial dysfunction in SCD.
(© 2024. The Author(s).)
Databáze: MEDLINE
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