Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review
Salvatore Lavalle,
Edoardo Masiello,
Giannicola Iannella,
Giuseppe Magliulo,
Annalisa Pace,
Jerome Rene Lechien,
Christian Calvo-Henriquez,
Salvatore Cocuzza,
Federica Maria Parisi,
Valentin Favier,
Ahmed Yassin Bahgat,
Giovanni Cammaroto,
Luigi La Via,
Caterina Gagliano,
Alberto Caranti,
Claudio Vicini,
Antonino Maniaci
Affiliations
Salvatore Lavalle
Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy
Edoardo Masiello
Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
Giannicola Iannella
Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy
Giuseppe Magliulo
Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy
Annalisa Pace
Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy
Jerome Rene Lechien
Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, 7022 Mons, Belgium
Christian Calvo-Henriquez
Service of Otolaryngology, Hospital Complex of Santiago de Compostela, 15705 Santiago de Compostela, Spain
Salvatore Cocuzza
Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy
Federica Maria Parisi
Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy
Valentin Favier
Service d’ORL et de Chirurgie Cervico-Faciale, Centre Hospitalo-Universitaire de Montpellier, 80 Avenue Augustin Fliche, 34000 Montpellier, France
Ahmed Yassin Bahgat
Department of Otorhinolaryngology, Alexandria University, Alexandria 21577, Egypt
Giovanni Cammaroto
Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy
Luigi La Via
Department of Anaesthesia and Intensive Care, University Hospital Policlinico-San Marco, 95125 Catania, Italy
Caterina Gagliano
Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy
Alberto Caranti
ENT and Audiology Department, University of Ferrara, 44121 Ferrara, Italy
Claudio Vicini
ENT and Audiology Department, University of Ferrara, 44121 Ferrara, Italy
Antonino Maniaci
Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy
Background: Obstructive sleep apnea syndrome (OSAS), affecting approximately 1 billion adults globally, is characterized by recurrent airway obstruction during sleep, leading to oxygen desaturation, elevated carbon dioxide levels, and disrupted sleep architecture. OSAS significantly impacts quality of life and is associated with increased morbidity and mortality, particularly in the cardiovascular and cognitive domains. The cyclic pattern of intermittent hypoxia in OSAS triggers oxidative stress, contributing to cellular damage. This review explores the intricate relationship between OSAS and oxidative stress, shedding light on molecular mechanisms and potential therapeutic interventions. Methods: A comprehensive review spanning from 2000 to 2023 was conducted using the PubMed, Cochrane, and EMBASE databases. Inclusion criteria encompassed English articles focusing on adults or animals and reporting values for oxidative stress and inflammation biomarkers. Results: The review delineates the imbalance between pro-inflammatory and anti-inflammatory factors in OSAS, leading to heightened oxidative stress. Reactive oxygen species biomarkers, nitric oxide, inflammatory cytokines, endothelial dysfunction, and antioxidant defense mechanisms are explored in the context of OSAS. OSAS-related complications include cardiovascular disorders, neurological impairments, metabolic dysfunction, and a potential link to cancer. This review emphasizes the potential of antioxidant therapy as a complementary treatment strategy. Conclusions: Understanding the molecular intricacies of oxidative stress in OSAS is crucial for developing targeted therapeutic interventions. The comprehensive analysis of biomarkers provides insights into the complex interplay between OSAS and systemic complications, offering avenues for future research and therapeutic advancements in this multifaceted sleep disorder.
