Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1227-1234
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1227
Causal role of immune cells in obstructive sleep apnea hypopnea syndrome: Mendelian randomization study
Huang-Hong Zhao, Zhen Ma, Dong-Sheng Guan
Huang-Hong Zhao, Department of Encephalopathy, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
Zhen Ma, Department of Personnel, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
Dong-Sheng Guan, Department of Neurology, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
Author contributions: Zhao HH assisted with planning, directing, and writing, as well as with editing and revising; Ma Z helped with the first draft of the writing, the formal analysis, and the data collection; Guan DS helped with the statistical analysis; the essay was written by all writers, who also gave their approval to the final draft.
Supported by Doctoral Research Fund Project of Henan Provincial Hospital of Traditional Chinese Medicine, No. 2022BSJJ10.
Institutional review board statement: The selected GWAS data is obtained from open-source databases, specifically the NHGRI-EBI Catalog (https://www.ebi.ac.uk/gwas/). As it originates from such sources, there is no "Institutional Review Board statement" associated with it.
Informed consent statement: Consent was not needed as the study was retrospective without exposure to the patients’ data.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen Ma, Doctor, Researcher, Department of Personnel, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, No. 19 Renmin Road, Jinshui District, Zhengzhou 450000, Henan Province, China. mz15903698623@163.com
Received: November 22, 2023
Peer-review started: November 22, 2023
First decision: December 23, 2023
Revised: February 2, 2024
Accepted: January 29, 2024
Article in press: January 29, 2024
Published online: March 6, 2024
Abstract
BACKGROUND

Despite being one of the most prevalent sleep disorders, obstructive sleep apnea hypoventilation syndrome (OSAHS) has limited information on its immunologic foundation. The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies (GWAS) and genotyping techniques using high-density genetic markers (e.g., SNP or CNVs). But this tactic hasn't yet been applied to OSAHS. Using a Mendelian randomization analysis, we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS.

AIM

To investigate the immune cells' association with OSAHS via genetic methods, guiding future clinical research.

METHODS

A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS. Summary statistics for each immune cell feature were obtained from the GWAS catalog. Information on 731 immune cell properties, such as morphologic parameters, median fluorescence intensity, absolute cellular, and relative cellular, was compiled using publicly available genetic databases. The results' robustness, heterogeneity, and horizontal pleiotropy were confirmed using extensive sensitivity examination.

RESULTS

Following false discovery rate (FDR) correction, no statistically significant effect of OSAHS on immunophenotypes was observed. However, two lymphocyte subsets were found to have a significant association with the risk of OSAHS: Basophil %CD33dim HLA DR- CD66b- (OR = 1.03, 95%CI = 1.01-1.03, P < 0.001); CD38 on IgD+ CD24- B cell (OR = 1.04, 95%CI = 1.02-1.04, P = 0.019).

CONCLUSION

This study shows a strong link between immune cells and OSAHS through a gene approach, thus offering direction for potential future medical research.

Keywords: Obstructive sleep apnea hypopnea syndrome, Immunity, Causal inference, MR analysis, Sensitivity

Core Tip: Our comprehensive bidirectional mendelian randomization analysis has revealed causal links between various immunophenotypes and obstructive sleep apnea-hypopnea syndrome (OSAHS), shedding light on the intricate web of relationships between OSAHS and the immune system.