Abstract
Adult stem cells are undifferentiated cells that can be mobilized from the bone marrow or other organs, home into injured tissues, and differentiate into different cell phenotypes to serve in a repairing capacity. Furthermore, these cells can respond to inflammation and oxidative stress by exhibiting immunomodulatory properties. The protective and reparative roles of mesenchymal stem cells (MSCs), very small embryonic-like stem cells (VSELs), and endothelial progenitor cells (EPCs) have primarily been examined and characterized in auto-immune and cardiovascular diseases. Obstructive sleep apnea (OSA) is a very prevalent disease (4–5% of adult population and 2–3% of children) characterized by an abnormal increase in upper airway collapsibility. Recurrent airway obstructions elicit arterial oxygen desaturations, increased inspiratory efforts, and sleep fragmentation, which have been associated with important long-term neurocognitive, metabolic, and cardiovascular consequences. Since inflammation, oxidative stress and endothelial dysfunction are key factors in the development of the morbid consequences of OSA, bone marrow-derived stem cells could be important modulators of the morbid phenotype by affording a protective role. This mini-review is focused on the recent data available on EPCs, VSELs, and MSCs in both animal models and patients with OSA.
Highlights
ADULT BONE-MARROW DERIVED STEM CELLS AND OBSTRUCTIVE SLEEP APNEA Adult stem cells are undifferentiated cells that are present in most adult tissues and more in the bone marrow
Adult stem cells are undifferentiated cells that can be mobilized from the bone marrow or other organs, home into injured tissues, and differentiate into different cell phenotypes to serve in a repairing capacity
The cumulative evidence derived from extensive clinical and translational research carried out in this field suggests that intermittent hypoxia (IH), increased inspiratory efforts, and recurrent arousals from sleep are the main determinants underlying the inflammatory response and cardiovascular alterations observed in Obstructive sleep apnea (OSA) (Nacher et al, 2009; Kohler and Stradling, 2010; Almendros et al, 2011)
Summary
Oxidative stress and endothelial dysfunction are key factors in the development of the morbid consequences of OSA, bone marrow-derived stem cells could be important modulators of the morbid phenotype by affording a protective role. This mini-review is focused on the recent data available on EPCs, VSELs, and MSCs in both animal models and patients with OSA. Patients with no endothelial dysfunction had increased levels of EPCs and of the EPCs-recruiting and homing chemokine stromalderived factor-1α (SDF-1α) in blood when compared to controls These findings in children add support to the notion that EPCs could be an essential mechanism for endothelial repair in OSA (Kheirandish-Gozal et al, 2010). Given that EPCs can repair injured vessels by homing to the sites of ischemia and neovascularization, it has been suggested that EPCs could play a cardioprotective role in OSA patients, in cases of acute myocardial infarction (Berger and Lavie, 2011)
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