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Published ahead of print on January 26, 2006, doi:10.1164/rccm.200508-1223OC

Am. J. Respir. Crit. Care Med., Volume 173, Number 8, April 2006, 897-901

A more recent version of this article appeared on April 15, 2006
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Submitted on August 8, 2005
Accepted on January 26, 2006

Antioxidant Vitamin C Improves Endothelial Function in Obstructive Sleep Apnea

Mathias Grebe1*, Hans-Joachim Eisele2, Norbert Weissmann2, Christian Schaefer1, Harald Tillmanns1, Werner Seeger2, and Richard Schulz2

1 Department of Internal Medicine, Division of Cardiology and Angiology, Justus-Liebig-University, Giessen, Germany, 2 Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Justus-Liebig-University, Giessen, Germany

* To whom correspondence should be addressed. E-mail: mathias.grebe{at}innere.med.uni-giessen.de.

Rationale : Obstructive sleep apnea (OSA) is associated with oxidative stress, endothelial dysfunction and increased cardiovascular morbidity and mortality. Objective : To test the hypothesis that endothelial dysfunction in patients with OSA is linked to oxidative stress. Methods : In the present study, we measured flow-mediated dilation (FMD) of the brachial artery by ultrasound in 10 otherwise healthy, untreated OSA patients and 10 age-and sex-matched controls without sleep-disordered breathing before and after i.v. injection of the antioxidant vitamin C. The investigator performing the FMD measurements was blinded to the status of the patients. Results : When compared to controls, baseline FMD was significantly reduced in the OSA patients. After i.v. injection of 0.5 g vitamin C vasoreactivity remained unchanged in the control subjects. In the OSA patients, ascorbate led to an increase in FMD to a level now comparable to that observed in the control group. Conclusion : The reduced endothelial-dependent vasodilation in untreated OSA patients acutely improves by the free radical scavenger vitamin C. These results are in favour of oxidative stress being responsible for the endothelial dysfunction in OSA. Antioxidant strategies should be explored for the treatment of OSA-related cardiovascular disease.
Key words: obstructive sleep apnea, cardiovascular disease, endothelial dysfunction, oxidative stress




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