Abstract

ABSTRACTObstructive sleep apnea (OSA), characterized by intermittent hypoxia and hypercapnia (IHC), affects the composition of the gut microbiome and metabolome. The gut microbiome has diurnal oscillations that play a crucial role in regulating circadian and overall metabolic homeostasis. Thus, we hypothesized that IHC adversely alters the gut luminal dynamics of key microbial families and metabolites. The objective of this study was to determine the diurnal dynamics of the fecal microbiome and metabolome of Apoe−/− mice after a week of IHC exposure. Individually housed, 10-week-old Apoe−/− mice on an atherogenic diet were split into two groups. One group was exposed to daily IHC conditions for 10 h (Zeitgeber time 2 [ZT2] to ZT12), while the other was maintained in room air. Six days after the initiation of the IHC conditions, fecal samples were collected every 4 h for 24 h (6 time points). We performed 16S rRNA gene amplicon sequencing and untargeted liquid chromatography-mass spectrometry (LC-MS) to assess changes in the microbiome and metabolome. IHC induced global changes in the cyclical dynamics of the gut microbiome and metabolome. Ruminococcaceae, Lachnospiraceae, S24-7, and Verrucomicrobiaceae had the greatest shifts in their diurnal oscillations. In the metabolome, bile acids, glycerolipids (phosphocholines and phosphoethanolamines), and acylcarnitines were greatly affected. Multi-omic analysis of these results demonstrated that Ruminococcaceae and tauro-β-muricholic acid (TβMCA) cooccur and are associated with IHC conditions and that Coriobacteriaceae and chenodeoxycholic acid (CDCA) cooccur and are associated with control conditions. IHC significantly change the diurnal dynamics of the fecal microbiome and metabolome, increasing members and metabolites that are proinflammatory and proatherogenic while decreasing protective ones.IMPORTANCE People with obstructive sleep apnea are at a higher risk of high blood pressure, type 2 diabetes, cardiac arrhythmias, stroke, and sudden cardiac death. We wanted to understand whether the gut microbiome changes induced by obstructive sleep apnea could potentially explain some of these medical problems. By collecting stool from a mouse model of this disease at multiple time points during the day, we studied how obstructive sleep apnea changed the day-night patterns of microbes and metabolites of the gut. Since the oscillations of the gut microbiome play a crucial role in regulating metabolism, changes in these oscillations can explain why these patients can develop so many metabolic problems. We found changes in microbial families and metabolites that regulate many metabolic pathways contributing to the increased risk for heart disease seen in patients with obstructive sleep apnea.

Highlights

  • IMPORTANCE People with obstructive sleep apnea are at a higher risk of high blood pressure, type 2 diabetes, cardiac arrhythmias, stroke, and sudden cardiac death

  • intermittent hypoxia and hypercapnia (IHC) exposure alters the composition of the gut microbiome and fecal metabolome in both apolipoprotein E knockout (Apoe2/2) and low-density lipoprotein (LDL) receptor knockout (Ldlr2/2) mice on atherogenic diets [25, 26], findings that go beyond what is observed in these mice alone [27, 28]

  • To determine the early effects of Obstructive sleep apnea (OSA) on the gut microbiome, we used the atherosclerosis-prone Apoe2/2 murine model and exposed half of the cohort to IHC conditions, while control mice were exposed to room air

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Summary

Introduction

IMPORTANCE People with obstructive sleep apnea are at a higher risk of high blood pressure, type 2 diabetes, cardiac arrhythmias, stroke, and sudden cardiac death. Given that peripheral circadian rhythms regulate circulating lipids [18], hematopoietic stem cells [19], vascular smooth muscle function, sympathetic tone, and blood pressure [20, 21], OSA-induced changes to the gut microbiome could aggravate multiple physiological systems that promote atherosclerosis through their disruption. The fecal metabolomic changes observed in these mice included metabolites known to affect atherosclerosis, including trimethylamine (TMA), deconjugated and secondary bile acids, fatty acids, and phytoestrogens [25, 26, 29] Some of these luminal metabolites have diurnal fluctuations and are differentially absorbed based on the enterocyte circadian clock [30, 31]. This study tests the hypothesis that IHC disrupts the diurnal rhythms of the gut microbiome and metabolome, which may promote a proinflammatory luminal environment

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