This Article Full Text Full Text (PDF) Online Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lavie, L. Articles by Lavie, P. Search for Related Content PubMed PubMed Citation Articles by Lavie, L. Articles by Lavie, P.

Plasma Vascular Endothelial Growth Factor in Sleep Apnea Syndrome

Effects of Nasal Continuous Positive Air Pressure Treatment

Unit of Anatomy and Cell Biology; Sleep Laboratory, Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel; and Department of Clinical Pharmacology and Sleep Laboratory, Pulmonary Medicine, Sahlgrenska Hospital, Gothenburg, Sweden

Correspondence and requests for reprints should be addressed to L. Lavie, Unit of Anatomy and Cell Biology, Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 31096, Israel. Email: lenal{at}tx.technion.ac.il

Sleep apnea syndrome is associated with recurrent episodic hypoxia during sleep, which has been implicated in the development of cardiovascular morbidity. Hypoxia is the major stimulus of vascular endothelial growth factor (VEGF), which is a potent angiogenic cytokine. In the present article we describe the results of three experiments in which plasma concentrations of VEGF were measured in patients with sleep apnea. In Experiment 1, apnea–hypopnea index was found to be a significant independent predictor of morning VEGF concentrations in 85 male subjects investigated in the sleep laboratory, of whom 47 had an apnea–hypopnea index greater than 20. In Experiment 2, VEGF concentrations measured hourly during the sleep period were found to be significantly higher in a group of five sleep apnea patients compared with six age-similar snorers and six normal young adults (129.1 ± 43.4 versus 74.6 ± 11.5 and 32.5 ± 12.8 pg/ml, respectively [p < 0.007]). In Experiment 3, VEGF concentrations were compared in patients with sleep apnea before and 1 year after nasal continuous positive airway pressure treatment. A significant decrease in VEGF concentrations was found only in patients in whom nocturnal hypoxia improved after treatment (57.1 ± 62.5 versus 39.6 ± 46.9 pg/ml, p < 0.01). There was no comparable improvement in patients who did not accept treatment (53.9 ± 23.6 versus 54.0 ± 21.5 pg/ml, ns). These results raise the possibility that VEGF may contribute to the long-term adaptation of sleep apnea syndrome to recurrent nocturnal hypoxia.

Key Words: vascular endothelial growth factor • sleep apnea • nasal continuous positive air pressure

This article has been cited by other articles:

				L. Lavie and P. Lavie Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link Eur. Respir. J., June 1, 2009; 33(6): 1467 - 1484. [Abstract] [Full Text] [PDF]

				J. F. Garvey, C. T. Taylor, and W. T. McNicholas Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation Eur. Respir. J., May 1, 2009; 33(5): 1195 - 1205. [Abstract] [Full Text] [PDF]

				F. Roche, J-M. Gaspoz, V. Pichot, M. Picard-Kossovsky, D. Maudoux, A. Garcin, S. Celle, E. Sforza, J. C. Barthelemy, and on behalf of the PROOF and SYNAPSE Study Groups Association between C-reactive protein and unrecognised sleep-disordered breathing in the elderly Eur. Respir. J., April 1, 2009; 33(4): 797 - 803. [Abstract] [Full Text] [PDF]

				R. K. Kakkar and R. B. Berry Positive Airway Pressure Treatment for Obstructive Sleep Apnea Chest, September 1, 2007; 132(3): 1057 - 1072. [Abstract] [Full Text] [PDF]

				K. Minoguchi, T. Yokoe, T. Tazaki, H. Minoguchi, N. Oda, A. Tanaka, M. Yamamoto, S. Ohta, C. P. O'Donnell, and M. Adachi Silent Brain Infarction and Platelet Activation in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., March 15, 2007; 175(6): 612 - 617. [Abstract] [Full Text] [PDF]

				W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26 Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities Eur. Respir. J., January 1, 2007; 29(1): 156 - 178. [Abstract] [Full Text] [PDF]

				G. E. Foster, M. J. Poulin, and P. J. Hanly Sleep Apnoea & Hypertension: Physiological bases for a causal relation: Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea Exp Physiol, January 1, 2007; 92(1): 51 - 65. [Abstract] [Full Text] [PDF]

				K Palombi, E Renard, P Levy, C Chiquet, C. Deschaux, J P Romanet, and J L Pepin Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea Br J Ophthalmol, July 1, 2006; 90(7): 879 - 882. [Abstract] [Full Text] [PDF]

				K. M. Oltmanns, H. Gehring, S. Rudolf, B. Schultes, C. Hackenberg, U. Schweiger, J. Born, H. L. Fehm, and A. Peters Acute hypoxia decreases plasma VEGF concentration in healthy humans Am J Physiol Endocrinol Metab, March 1, 2006; 290(3): E434 - E439. [Abstract] [Full Text] [PDF]

				S. Ryan, C. T. Taylor, and W. T. McNicholas Selective Activation of Inflammatory Pathways by Intermittent Hypoxia in Obstructive Sleep Apnea Syndrome Circulation, October 25, 2005; 112(17): 2660 - 2667. [Abstract] [Full Text] [PDF]

				K. Minoguchi, T. Yokoe, T. Tazaki, H. Minoguchi, A. Tanaka, N. Oda, S. Okada, S. Ohta, H. Naito, and M. Adachi Increased Carotid Intima-Media Thickness and Serum Inflammatory Markers in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 625 - 630. [Abstract] [Full Text] [PDF]

				L. F. Drager, L. A. Bortolotto, M. C. Lorenzi, A. C. Figueiredo, E. M. Krieger, and G. Lorenzi-Filho Early Signs of Atherosclerosis in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 613 - 618. [Abstract] [Full Text] [PDF]

				L. Anderson Candidate-based proteomics in the search for biomarkers of cardiovascular disease J. Physiol., February 15, 2005; 563(1): 23 - 60. [Abstract] [Full Text] [PDF]

				T. Tazaki, K. Minoguchi, T. Yokoe, K. T. R. Samson, H. Minoguchi, A. Tanaka, Y. Watanabe, and M. Adachi Increased Levels and Activity of Matrix Metalloproteinase-9 in Obstructive Sleep Apnea Syndrome Am. J. Respir. Crit. Care Med., December 15, 2004; 170(12): 1354 - 1359. [Abstract] [Full Text] [PDF]

				J. M. Parish and V. K. Somers Obstructive Sleep Apnea and Cardiovascular Disease Mayo Clin. Proc., August 1, 2004; 79(8): 1036 - 1046. [Abstract] [PDF]

				F. J. Nieto, D. M. Herrington, S. Redline, E. J. Benjamin, and J. A. Robbins Sleep Apnea and Markers of Vascular Endothelial Function in a Large Community Sample of Older Adults Am. J. Respir. Crit. Care Med., February 1, 2004; 169(3): 354 - 360. [Abstract] [Full Text] [PDF]

				T. D. Bradley and J. S. Floras Sleep Apnea and Heart Failure: Part I: Obstructive Sleep Apnea Circulation, April 1, 2003; 107(12): 1671 - 1678. [Full Text] [PDF]

				M. J. Tobin Sleep-Disordered Breathing, Control of Breathing, Respiratory Muscles, and Pulmonary Function Testing in AJRCCM 2002 Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 306 - 318. [Full Text] [PDF]

				C. M. Kahler, J. Wechselberger, C. Molnar, C. Prior, R. Schulz, W. Seeger, and F. Grimminger Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe night time hypoxia Am. J. Respir. Crit. Care Med., January 1, 2003; 167(1): 92 - 93. [Full Text]