Abstract

Sleep disordered breathing (SDB) affects 3–5% of the pediatric population, including neonates who are highly susceptible due to an underdeveloped ventilatory control system, and REM-dominated sleep. Although pediatric SDB is associated with poor cognitive outcomes, very little research has focused on models of pediatric SDB, particularly in neonates. In adults and neonates, intermittent hypoxia (IH), a hallmark of SDB, recapitulates multiple physiological aspects of severe SDB, including neuronal apoptosis, sex-specific cognitive deficits, and neuroinflammation. Microglia, resident CNS immune cells, are important mediators of neurodevelopment and neuroinflammation, but to date, no studies have examined the molecular properties of microglia in the context of neonatal IH. Here, we tested the hypothesis that neonatal IH will enhance microglial inflammation and sex-specifically lead to long-term changes in working memory. To test this hypothesis, we exposed post-natal day (P1) neonates with dams to an established adult model of pathological IH consisting of 2 min cycles of 10.5% O2 followed by 21% O2, 8 h/day for 8 days. We then challenged the offspring with bacterial lipopolysaccharide (LPS) at P9 or at 6–8 weeks of age and immunomagnetically isolated microglia for gene expression analyses and RNA-sequencing. We also characterized neonatal CNS myeloid cell populations by flow cytometry analyses. Lastly, we examined working memory performance using a Y-maze in the young adults. Contrary to our hypothesis, we found that neonatal IH acutely augmented basal levels of microglial anti-inflammatory cytokines, attenuated microglial responses to LPS, and sex-specifically altered CNS myeloid populations. We identified multiple sex differences in basal neonatal microglial expression of genes related to chemotaxis, cognition, and aging. Lastly, we found that basal, but not LPS-induced, anti-inflammatory cytokines were augmented sex-specifically in the young adults, and that there was a significant interaction between sex and IH on basal working memory. Our results support the idea that neonates may be able to adapt to IH exposures that are pathological in adults. Further, they suggest that male and female microglial responses to IH are sex-specific, and that these sex differences in basal microglial gene expression may contribute to sexual dimorphisms in vulnerability to IH-induced cognitive disruption.

Highlights

  • Obstructive sleep apnea (OSA), a form of sleep disordered breathing (SDB) characterized by repetitive episodes of intermittent hypoxia (IH), is present in up to 5% of the total pediatric population including infants [1]

  • To test the effects of 8 days of neonatal IH on microglial gene expression, we used a model of IH that is used in adult rat microglial studies [11] and is similar to models used in neonate studies [14, 38]

  • We initially hypothesized that neonatal IH would sex- augment microglial inflammatory gene expression in both basal and inflammatory conditions, and that these effects would persist into adulthood

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Summary

Introduction

Obstructive sleep apnea (OSA), a form of sleep disordered breathing (SDB) characterized by repetitive episodes of intermittent hypoxia (IH), is present in up to 5% of the total pediatric population including infants [1]. Up to 80% of infants with craniofacial abnormalities, such as those associated with Down Syndrome will present with OSA [2], and some evidence suggests a higher occurrence in males [3]. Despite the common occurrence of OSA in infants, it remains poorly characterized in terms of clinical presentation, partly due to its co-morbidity with other early life complications [4, 5]. In addition to the poorly characterized clinical presentations, the long-term effects of infant OSA are unknown. OSA is associated with poor behavioral outcomes and neurocognitive dysfunction [6]. Vulnerable infant populations (i.e., preterm or low-birthweight) are at risk for OSA [7], systemic infection [8], and adverse neurodevelopment [9], little is known about how OSA contributes to these co-morbid processes

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