Abstract

Objective Obstructive sleep apnea (OSA) is characterized by recurrent airway collapse that causes chronic intermittent hypoxia (CIH). OSA is associated with systemic inflammation and oxidative stress resulting in endothelial dysfunction and cardiovascular disease (CVD). Alpha lipoic acid (ALA) is a potent antioxidant with anti-inflammatory properties. We hypothesized that dietary ALA can improve endothelial function of mice exposed to CIH. Methods Mice were exposed to either CIH or intermittent air (IA) and treated with dietary ALA (0.2% w/w) or a regular chow diet for 8 weeks. Endothelial function, endothelial nitric oxide (eNOS) uncoupling, systemic oxidative stress, systemic inflammation, aortic expression of inflammatory cytokines, and antioxidant enzymes were measured after 8 weeks. Results Mice exposed to CIH exhibited endothelial dysfunction accompanied by systemic oxidative stress and inflammation as well as increased aortic expression of inflammatory cytokines. Furthermore, CIH led to eNOS uncoupling. Treatment with dietary ALA reversed endothelial dysfunction in mice exposed to CIH, lowered systemic oxidative stress and inflammation, prevented the increases of inflammatory cytokine gene expression, increased the expression of antioxidant enzymes, and preserved eNOS in a coupled state. Conclusion ALA attenuates endothelial dysfunction by preventing oxidative stress and inflammation and restoring nitric oxide bioavailability in mice exposed to CIH. Our data suggests the potential beneficial use of ALA as adjunctive therapy in OSA.

Highlights

  • Obstructive sleep apnea (OSA) is characterized by repetitive collapse of the pharyngeal airway during sleep, leading to intermittent hypoxia followed by reoxygenation

  • Alpha lipoic acid (ALA) Improved Endothelial Dysfunction in Mice Exposed to chronic intermittent hypoxia (CIH)

  • Mice subjected to CIH and fed dietary ALA showed improved endothelial function when compared to CIH alone (Emax: 80 1 ± 6 2%, P < 0 0001) (Figures 1(a) and 1(b))

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Summary

Introduction

Obstructive sleep apnea (OSA) is characterized by repetitive collapse of the pharyngeal airway during sleep, leading to intermittent hypoxia followed by reoxygenation These changes can activate several pathological pathways such as oxidative stress and inflammation that can lead to endothelial dysfunction and cardiovascular disease (CVD) [1]. Results from the recent SAVE study indicated that CPAP prescription did not prevent cardiovascular events in patients with moderate to severe OSA and established CVD when compared to those who received usual care alone [6]. This may in part be due to the relatively low adherence (less than 4 hours per night) to CPAP use

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