In a recent study published in the Journal of Neuroimaging, a team of researchers from the UCLA have reported the first evidence that obstructive sleep apnea contributes to a breakdown of the blood–brain barrier, which plays an important role in protecting brain tissue. The findings are significant for diseases such as Multiple Sclerosis, where compromised blood-brain barrier function is associated with subsequent brain damage caused by the disease. These new insights may contribute to novel strategies for the treatment of obstructive sleep apnea, a condition that affects about 22 million adults in the United States, as well as open up new therapeutic strategies for protecting against the breakdown of the BBB.
Obstructive sleep apnea (OSA) subjects show significant brain damage, particularly in sites that control autonomic, cognitive, emotional, and breathing functions, which are deficient in the condition. Symptoms associated with injury to these brain areas are linked to higher morbidity, mortality, and decreased quality of life in the syndrome.
However, the underlying pathological processes contributing to damage in these regions are unclear.
The blood-brain barrier (BBB) is a highly selective permeability barrier that separates the circulating blood from the brain extracellular fluid (BECF) in the central nervous system (CNS).
The blood–brain barrier allows the passage of water, some gases, and lipid-soluble molecules by passive diffusion, as well as the selective transport of molecules such as glucose and amino acids that are crucial to neural function. On the other hand, the blood–brain barrier may prevent the entry of lipophilic, potential neurotoxins by way of an active transport mechanism mediated by P-glycoprotein.
Compromised blood-brain barrier function is a potential mechanism of brain injury, together with the substantial blood pressure, intermittent hypoxia and hypercarbic changes encountered in the syndrome; the altered BBB function may induce or exacerbate injury over time in OSA subjects as well as for other diseases such as MS where compromised BBB is a factor.
“We found that the blood–brain barrier becomes more permeable in obstructive sleep apnea, a breakdown that could contribute to brain injury, as well as potentially enhancing or accelerating the damage,” said Rajesh Kumar, the study’s principal investigator and an associate professor in the departments of anesthesiology and radiological sciences at the UCLA Geffen School of Medicine.
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