The Extracellular Matrix of the Lateral Pharyngeal Wall in Obstructive Sleep Apnea

Autor(es)

da Silva Dantas, Danielle Andrade ^[1] ; Mauad, Thais ^[2] ; Silva, Luiz F. F. ^[2] ; Lorenzi-Filho, Geraldo ^[3] ; Formigoni, Gilberto G. S. ^[1] ; Cahali, Michel B. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Dept Otolaryngol, Inst Heart, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Lab Med Invest 5, Dept Pathol, Inst Heart, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Sleep Lab, Div Pulm, Inst Heart, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Sleep; v. 35, n. 4, p. 483-490, APR 1 2012.
• Citações Web of Science: 16

Resumo

Study Objectives: To compare the components of the extracellular matrix in the lateral pharyngeal muscular wall in patients with and without obstructive sleep apnea (OSA). This may help to explain the origin of the increased collapsibility of the pharynx in patients with OSA. Design: Specimens from the superior pharyngeal constrictor muscle, obtained during pharyngeal surgeries, were evaluated using histochemical and immunohistochemical analyses to determine the fractional area of collagen types I and II, elastic fibers, versican, fibronectin, and matrix metalloproteinases 1 and 2 in the endomysium. Setting: Academic tertiary center. Patiens: A total of 51 nonobese adult patients, divided into 38 patients with OSA and 13 nonsnoring control subjects without OSA. Interventions: Postintervention study performed on tissues from patients after elective surgery. Measurements and Results: Pharyngeal muscles of patients with OSA had significantly more collagen type I than pharyngeal muscles in control subjects. Collagen type I was correlated positively and independently with age. The other tested components of the extracellular matrix did not differ significantly between groups. In a logistic regression, an additive effect of both the increase of collagen type I and the increase in age with the presence of OSA was observed (odds ratio (OR), 2.06; 95% confidence interval (CI), 1.17-3.63), when compared with the effect of increased age alone (OR, 1.11; 95% CI, 1.03-1.20). Conclusion: Collagen type I in the superior pharyngeal constrictor muscle was more prevalent in patients with OSA and also increased with age. It was hypothesized that this increase could delay contractile-relaxant responses in the superior pharyngeal constrictor muscle at the expiratory-inspiratory phase transition, thus increasing pharyngeal collapsibility. (AU)

• Processo FAPESP: 06/50630-7 - Estudo da matriz extracelular da musculatura da parede lateral da faringe em pacientes com sindrome da apneia obstrutiva do sono.
• Beneficiário: Michel Burihan Cahali
• Modalidade de apoio: Auxílio à Pesquisa - Regular