Effect of oral appliance on circulating leukocyte telomere length and SIRT1 in obstructive sleep apnea
The increased cardiovascular risk seen in patients with obstructive sleep apnea (OSA) may be due to combination of oxidative stress, systemic inflammation and damage to leukocyte telomere length (LTL) seen with aging. Another molecule, Sirtuin 1 (SIRT1), a histone/protein deacetylase, regulates endothelial nitric oxide synthase and is involved in different aspects of cardiovascular disease, aging and stress resistance. The aim of this study was to evaluate the effects of mandibular advancement device (MAD) on the circulating LTL and SIRT1 protein level in peripheral blood mononuclear cells (PBMCs) in patients with OSA.
Materials and methods
Forty patients with moderately severe to severe OSA who desired MAD and 20 healthy controls were prospectively enrolled. The LTL was measured by quantitative polymerase chain reaction while SIRT1 protein levels in PBMC was assessed using a Sirtuin 1 ELISA Kit. All study subjects underwent baseline sleep study, with OSA patients having repeat testing at 3 months after MAD.
Compared to healthy subjects, patients with OSA at baseline had lower LTL and SIRT1 protein levels in PBMC. After 3 months of MAD, 24 OSA patients, designated as MAD responders, median (range) LTL increased from (0.556 [0.393–0.748]) to (0.708 [0.533–0.893]) and SIRT1 protein levels in PBMC increased from 0.58 ± 0.23 pg/μg of total protein to 0.95 ± 0.26 pg/μg of total protein. For the 16 MAD unresponsive patients, LTL and SIRT1 protein levels remained low.
Successful treatment of OSA with MAD can restore LTL and SIRT1 protein levels in PBMC.
LTL and SIRT1 protein levels in PBMC can be improved following effective treatment of OSA using MAD.
KeywordsLeukocyte telomere length Sirtuin 1 (SIRT1) Mandibular advancement device (MAD) Obstructive sleep apnea Senescence
We would like to acknowledge the help with statistics from Ms. Fang-Ju Sun of Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.
This work was supported by a grant from the Ministry of Science and Technology (Grant MOST 103-2314-B-303-014-MY2).
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual study participants.
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