• Marta Marin-Oto, Javier Godino, Marta Andres, and Jose Marin.
• Chest. 2014 Mar 1;145(3 Suppl):609C.

Session TitlePulmonary and Sleep MedicineSESSION TYPE: Slide PresentationPRESENTED ON: Saturday, March 22, 2014 at 09:00 AM - 10:00 AMPURPOSE: Intermittent hypoxia and increase sympathetic activity during apnea episodes may cause systemic inflammation via down-regulation of regulatory T-cell (Treg cells). This may contribute to premature atherosclerosis leading to an increase in the size of arterial intima-media thickness (IMT). To evaluate the relationship between Treg plasma cells and intima-media thickness (IMT) in non-OSA and OSA patients without comorbiditiesMethodsDuring a 10 months period, we enrolled 100 adults (age range: 20 to 55) among those referred for sleep study due to suspected OSA. Exclusion criteria were: history of tobacco or alcohol consumption, hypertension, dyslipidemia, diabetes, cardiovascular, cerebrovascular, renal, neuromuscular, inflammatory or autoimmune chronic diseases. OSA diagnosis was made on the basis of an apnea/hypopnea index (AHI) > 5. IMT was assessed in common carotid arteries by high-resolution B-mode ultrasonography. By flow-cytometry analysis, CD+CD25+Foxp3+ cells as were acquired (BD Pharmigen) and identified as Treg cells.ResultsNon-OSA subjects (n = 30) were younger (41 ± 8 vs 45 ± 8 years, p = 0.02) and had a lower body mass index (26.4 ± 3.8 vs 30.1 ± 5.5 kg/m2, p < 0.001) than OSA patients (n = 70). IMT was 0.53 ± 0.08 (95 percentile: 0.65 mm) and 0.66 ± 0.12 mm respectively (p<0.001). Abnormal IMT (> 0.65 mm) was identified in 41% of OSA group. In multivariate linear regression analyses, age, BMI and baseline systolic blood pressure but not AHI, were related with IMT. Treg cells represent 7.5 ± 1.6% of all CD3 (lymphocytes) in non-OSA subjects and 6.7 ± 1.4 % in OSA patients. IMT and Treg cells were significantly related (r = -0.29, p =0.007).ConclusionsDown regulation of Treg cells but not AHI is associated with subclinical atherosclerosis suggesting different epigenetic adaptations to apnea episodes in OSA.Clinical ImplicationsThe effect of nocturnal intermittent hypoxia and increase sympathetic activity is not homogeneous among all patients with OSA. It seems that a subset of patients exhibit an increased risk of subclinical atherosclerosis associated with a down-regulation of regulatory T-cells. This subgroup of patients probably represents a particular phenotypic presentation of OSA that merits a specific treatment. Supported by ISCIII grant PI12/02175 and SEPAR-2014DISCLOSURE: The following authors have nothing to disclose: Marta Marin-Oto, Teresa Martin, Javier Godino, Marta Andres, Victoria Gil, Jose MarinNo Product/Research Disclosure Information.

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