Investigation of Beclin-1 and hypoxia-induced factor-1 levels in patients with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is a syndrome that occurs with recurrent complete or partial obstructions of the upper airway during sleep and is characterized by a decrease in blood oxygen saturation (SpO2) and awakenings often accompanying this. In this study, our aim was to determine the levels of Beclin-1, HIF-1α, inflammatory and oxidative stress markers in patients with OSAS, to examine the effect of CPAP treatment on autophagic, hypoxic and oxidative stress parameters, and to reveal the correlation of these parameters with clinical. A total of 97 people, 27 controls, 42 patients diagnosed with mild-moderate OSAS, and 28 patients diagnosed with severe OSAS, between the ages of 18-69, at Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Health Research and Practice Hospital Chest Diseases Outpatient Clinic were included in the study. Results were recorded before CPAP treatment and at the third month of CPAP treatment in severe OSAS patients. Beclin-1, HIF-1α, TNF-α and IL-6 levels in blood samples were studied by ELISA method, and TAS (Total Antioxidant Status) and TOS (Total Oxidant Status) parameters were studied by colorimetric method. Oxidative Stress Index (OSI) was calculated as TOS/TAS*100. Analyzes for data were performed with IBM SPSS version 22.0. While the statistical significance level was considered as p<0.05 in general, the significance level was considered as p<0.02 for the Bonferroni corrected Mann Whitney U Test. A significant difference was found between the values of TNF-α, IL-6, Beclin-1, HIF-1α, CRP, TOS and OSI parameters of the control group and mild-moderate and severe OSAS groups. TNF-α, IL-6, Beclin-1, HIF 1α, CRP, TOS and OSI values of patients with mild-moderate OSAS and severe OSAS were found to be significantly higher than the values of the control group. There was no significant difference between the OSAS groups in terms of serum TAS levels. In severe OSAS patients, TNF-α, IL-6, HIF-1α, CRP, TOS and OSI values 3 months after treatment were found to be statistically significantly lower than before treatment. In severe OSAS patients, Beclin-1 values 3 months after treatment were not found to be significant compared to before treatment. The effect of CPAP treatment on Beclin-1 levels in patients with obstructive sleep apnea syndrome and the relationship between Beclin-1 and HIF-1α and oxidative stress were studied for the first time. HIF-1α levels are associated with intermittent hypoxia (IH), proinflammatory markers and oxidative stress; it is thought to play a role in the pathogenesis of the disease and may be a diagnostic marker. In addition, it can be said that autophagic pathways are affected in OSAS and may be related to the pathogenesis of the disease. Keywords: OSAS, Oxidative Stress, Inflammation, Beclin-1, HIF-1