Activation of Inflammatory Circulating Factors by Intermittent Hypoxia in Sleep Apnea Syndrome

  • Larissa DyugovskayaEmail author
  • Andrey Polyakov


Obstructive sleep apnea syndrome (OSAS), characterized by intermittent and recurrent pauses in respiration during sleep, constitutes an independent risk factor for cardiovascular morbidity. Intermittent hypoxia (IH) is the hallmark of OSAS. A large number of clinical studies, cell culture, and animal models utilizing IH delineate the central role of oxidative stress in OSAS. These facilitate increased interactions of blood leukocytes with endothelial cells, resulting in endothelial injury and dysfunction. Such events can promote the development of cardiovascular morbidities in OSAS. IH can activate several global signaling pathways and various transcription factors such as nuclear factor κB and hypoxia-inducible factor 1α, which play a key role in mediating the inflammatory and cardiovascular consequences in OSAS. This chapter summarized the current literature and our own data on phenotype, functional changes, and inflammatory responses of various blood cells exposed to IH in vivo and in vitro. We focus on the causal relationships between IH and atherogenic transformation of monocytes, lymphocytes, and neutrophils in OSAS patients and on the molecular mechanisms of the cell dysfunctions developed under IH conditions.


Reactive Oxygen Species Production Obstructive Sleep Apnea Syndrome Intermittent Hypoxia Obstructive Sleep Apnea Syndrome Patient Neutrophil Apoptosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Obstructive sleep apnea syndrome


Intermittent hypoxia


Nasal continuous positive air pressure


Hypoxia-inducible factor


Apnea-hypopnea index


Reactive oxygen species


Endothelial cells




Vascular endothelial growth factor


Mitogen-activated protein kinase


Extracellular signal-regulated kinase


Dendritic cells


Oxidized low-density lipoprotein


Phorbol myristate acetate


Human umbilical vein endothelial cells


Human coronary artery endothelial cells


Neutrophil apoptosis


Ischemic heart disease


Tumor necrotic factor



We thank Prof. Peretz Lavie for his helpful comments and suggestions. We are also indebted to Prof. Lena Lavie for her constructive comments and criticism.


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Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  1. 1.The Lloyd Rigler Sleep Apnea Research Laboratory, Unit of Anatomy and Cell Biology, The Bruce Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael

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