Skip to main content
Erschienen in: Current Sleep Medicine Reports 1/2017

01.03.2017 | Sleep and Cancer (D Gozal, Section Editor)

Obstructive Sleep Apnea and Cancer: Insights from Intermittent Hypoxia Experimental Models

verfasst von: Isaac Almendros, Miguel Ángel Martinez-Garcia, Ana Obeso, David Gozal

Erschienen in: Current Sleep Medicine Reports | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of the review

This review will provide an updated perspective of the relationship between obstructive sleep apnea (OSA) based on the latest experimental research carried out on animal models subjected to chronic intermittent hypoxia (IH) as a subrogate of OSA.

Recent findings

During the last years, new research linking IH and cancer has emerged. The most recent studies have (1) increased the number of types of tumor investigated in response to IH and (2) explored some of the potential mechanisms modulated by IH which could participate in the increased cancer incidence and malignancy reported under this challenge.

Summary

There are increasing evidences showing that IH mimicking OSA increases tumor incidence, malignancy, and mortality in mice. The mechanisms explored to date are related to the induction of hypoxia-inducible factors, inflammatory and oxidative stress markers, angiogenesis, and IH-induced alterations on the immune system (macrophages and lymphocytes).
Literatur
1.
Zurück zum Zitat Liu Y, Song X, Wang X, et al. Effect of chronic intermittent hypoxia on biological behavior and hypoxia-associated gene expression in lung cancer cells. J Cell Biochem. 2010;111(3):554–63. doi:10.1002/jcb.22739.CrossRefPubMed Liu Y, Song X, Wang X, et al. Effect of chronic intermittent hypoxia on biological behavior and hypoxia-associated gene expression in lung cancer cells. J Cell Biochem. 2010;111(3):554–63. doi:10.​1002/​jcb.​22739.CrossRefPubMed
5.
Zurück zum Zitat Hsieh CH, Lee CH, Liang JA, Yu CY, Shyu WC. Cycling hypoxia increases U87 glioma cell radioresistance via ROS induced higher and long-term HIF-1 signal transduction activity. Oncol Rep. 2010;24(6):1629–36. doi:10.3892/or_00001027.CrossRefPubMed Hsieh CH, Lee CH, Liang JA, Yu CY, Shyu WC. Cycling hypoxia increases U87 glioma cell radioresistance via ROS induced higher and long-term HIF-1 signal transduction activity. Oncol Rep. 2010;24(6):1629–36. doi:10.​3892/​or_​00001027.CrossRefPubMed
6.
7.
Zurück zum Zitat Kimura H, Braun RD, Ong ET, et al. Fluctuations in red cell flux in tumor microvessels can lead to transient hypoxia and reoxygenation in tumor parenchyma. Cancer Res. 1996;56(23):5522–8.PubMed Kimura H, Braun RD, Ong ET, et al. Fluctuations in red cell flux in tumor microvessels can lead to transient hypoxia and reoxygenation in tumor parenchyma. Cancer Res. 1996;56(23):5522–8.PubMed
8.
Zurück zum Zitat Dewhirst MW, Kimura H, Rehmus SW, et al. Microvascular studies on the origins of perfusion-limited hypoxia. Br J Cancer Suppl. 1996;27:S247–51.PubMedPubMedCentral Dewhirst MW, Kimura H, Rehmus SW, et al. Microvascular studies on the origins of perfusion-limited hypoxia. Br J Cancer Suppl. 1996;27:S247–51.PubMedPubMedCentral
9.•
Zurück zum Zitat Muz B, de la Puente P, Azab F, Azab AK. The role of hypoxia in cancer progression, angiogenesis, metastasis, and resistance to therapy. Hypoxia (Auckl). 2015;3:83–92. doi:10.2147/HP.S93413. Recent review about the well-known effects of hypoxia in cancer.CrossRef Muz B, de la Puente P, Azab F, Azab AK. The role of hypoxia in cancer progression, angiogenesis, metastasis, and resistance to therapy. Hypoxia (Auckl). 2015;3:83–92. doi:10.​2147/​HP.​S93413. Recent review about the well-known effects of hypoxia in cancer.CrossRef
13.
Zurück zum Zitat Cairns RA, Kalliomaki T, Hill RP. Acute (cyclic) hypoxia enhances spontaneous metastasis of KHT murine tumors. Cancer Res. 2001;61(24):8903–8.PubMed Cairns RA, Kalliomaki T, Hill RP. Acute (cyclic) hypoxia enhances spontaneous metastasis of KHT murine tumors. Cancer Res. 2001;61(24):8903–8.PubMed
14.
Zurück zum Zitat Rofstad EK, Gaustad JV, Egeland TA, Mathiesen B, Galappathi K. Tumors exposed to acute cyclic hypoxic stress show enhanced angiogenesis, perfusion and metastatic dissemination. Int J Cancer. 2010;127(7):1535–46. doi:10.1002/ijc.25176.CrossRefPubMed Rofstad EK, Gaustad JV, Egeland TA, Mathiesen B, Galappathi K. Tumors exposed to acute cyclic hypoxic stress show enhanced angiogenesis, perfusion and metastatic dissemination. Int J Cancer. 2010;127(7):1535–46. doi:10.​1002/​ijc.​25176.CrossRefPubMed
17.
Zurück zum Zitat Kondo A, Safaei R, Mishima M, Niedner H, Lin X, Howell SB. Hypoxia-induced enrichment and mutagenesis of cells that have lost DNA mismatch repair. Cancer Res. 2001;61(20):7603–7.PubMed Kondo A, Safaei R, Mishima M, Niedner H, Lin X, Howell SB. Hypoxia-induced enrichment and mutagenesis of cells that have lost DNA mismatch repair. Cancer Res. 2001;61(20):7603–7.PubMed
19.
Zurück zum Zitat Semenza GL, Wang GL. A nuclear factor induced by hypoxia via de novo protein synthesis binds to the human erythropoietin gene enhancer at a site required for transcriptional activation. Mol Cell Biol. 1992;12(12):5447–54.CrossRefPubMedPubMedCentral Semenza GL, Wang GL. A nuclear factor induced by hypoxia via de novo protein synthesis binds to the human erythropoietin gene enhancer at a site required for transcriptional activation. Mol Cell Biol. 1992;12(12):5447–54.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Minet E, Arnould T, Michel G, et al. ERK activation upon hypoxia: involvement in HIF-1 activation. FEBS Lett. 2000;468(1):53–8.CrossRefPubMed Minet E, Arnould T, Michel G, et al. ERK activation upon hypoxia: involvement in HIF-1 activation. FEBS Lett. 2000;468(1):53–8.CrossRefPubMed
22.
Zurück zum Zitat Koong AC, Chen EY, Giaccia AJ. Hypoxia causes the activation of nuclear factor kappa B through the phosphorylation of I kappa B alpha on tyrosine residues. Cancer Res. 1994;54(6):1425–30.PubMed Koong AC, Chen EY, Giaccia AJ. Hypoxia causes the activation of nuclear factor kappa B through the phosphorylation of I kappa B alpha on tyrosine residues. Cancer Res. 1994;54(6):1425–30.PubMed
24.
Zurück zum Zitat Ruehland WR, Rochford PD, O’Donoghue FJ, Pierce RJ, Singh P, Thornton AT. The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep. 2009;32(2):150–7.PubMedPubMedCentral Ruehland WR, Rochford PD, O’Donoghue FJ, Pierce RJ, Singh P, Thornton AT. The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep. 2009;32(2):150–7.PubMedPubMedCentral
27.
Zurück zum Zitat Gozal D, Kheirandish-Gozal L, Bhattacharjee R, Kim J. C-reactive protein and obstructive sleep apnea syndrome in children. Front Biosci (Elite Ed). 2012;4:2410–22.CrossRef Gozal D, Kheirandish-Gozal L, Bhattacharjee R, Kim J. C-reactive protein and obstructive sleep apnea syndrome in children. Front Biosci (Elite Ed). 2012;4:2410–22.CrossRef
28.
Zurück zum Zitat Gozal D, Lipton AJ, Jones KL. Circulating vascular endothelial growth factor levels in patients with obstructive sleep apnea. Sleep. 2002;25(1):59–65.PubMed Gozal D, Lipton AJ, Jones KL. Circulating vascular endothelial growth factor levels in patients with obstructive sleep apnea. Sleep. 2002;25(1):59–65.PubMed
31.••
Zurück zum Zitat Almendros I, Montserrat JM, Ramirez J, et al. Intermittent hypoxia enhances cancer progression in a mouse model of sleep apnoea. Eur Respir J. 2012;39(1):215–7. doi:10.1183/09031936.00185110. First published evidence linking OSA and cancer from mice models.CrossRefPubMed Almendros I, Montserrat JM, Ramirez J, et al. Intermittent hypoxia enhances cancer progression in a mouse model of sleep apnoea. Eur Respir J. 2012;39(1):215–7. doi:10.​1183/​09031936.​00185110. First published evidence linking OSA and cancer from mice models.CrossRefPubMed
32.•
Zurück zum Zitat Almendros I, Montserrat JM, Torres M, et al. Obesity and intermittent hypoxia increase tumor growth in a mouse model of sleep apnea. Sleep Med. 2012;13(10):1254–60. doi:10.1016/j.sleep.2012.08.012. There is no sinergistic effects of IH with obesity. This study have important implications in the possible lack of relationship OSA-cancer in obese patients.CrossRefPubMed Almendros I, Montserrat JM, Torres M, et al. Obesity and intermittent hypoxia increase tumor growth in a mouse model of sleep apnea. Sleep Med. 2012;13(10):1254–60. doi:10.​1016/​j.​sleep.​2012.​08.​012. There is no sinergistic effects of IH with obesity. This study have important implications in the possible lack of relationship OSA-cancer in obese patients.CrossRefPubMed
34.
Zurück zum Zitat Eubank T, Sherwani S, Peters S, Gross A, Evans R, Magalang UJ. Intermittent hypoxia augments melanoma tumor metastases in a mouse model of sleep apnea. Am J Respir Crit Care Med. 2013;187:A2302. Eubank T, Sherwani S, Peters S, Gross A, Evans R, Magalang UJ. Intermittent hypoxia augments melanoma tumor metastases in a mouse model of sleep apnea. Am J Respir Crit Care Med. 2013;187:A2302.
35.
Zurück zum Zitat Li A, Liang M, Fang Y, Cao J, Chen B. Antioxidant tempol ameliorates intermittent hypoxia-induced melanoma lung metastasis in a mouse model of OSA. Am J Respir Crit Care Med. 2016;193:A7741. Li A, Liang M, Fang Y, Cao J, Chen B. Antioxidant tempol ameliorates intermittent hypoxia-induced melanoma lung metastasis in a mouse model of OSA. Am J Respir Crit Care Med. 2016;193:A7741.
37.••
Zurück zum Zitat Almendros I, Wang Y, Becker L, et al. Intermittent hypoxia-induced changes in tumor-associated macrophages and tumor malignancy in a mouse model of sleep apnea. Am J Respir Crit Care Med. 2014;189(5):593–601. doi:10.1164/rccm.201310-1830OC. Intermittent hypoxia promotes a shift toward a pro-tumor phenotype in tumor associated macrophages increasing tumor proliferation, migration, invasion and extravasation.CrossRefPubMedPubMedCentral Almendros I, Wang Y, Becker L, et al. Intermittent hypoxia-induced changes in tumor-associated macrophages and tumor malignancy in a mouse model of sleep apnea. Am J Respir Crit Care Med. 2014;189(5):593–601. doi:10.​1164/​rccm.​201310-1830OC. Intermittent hypoxia promotes a shift toward a pro-tumor phenotype in tumor associated macrophages increasing tumor proliferation, migration, invasion and extravasation.CrossRefPubMedPubMedCentral
38.•
Zurück zum Zitat Almendros I, Gileles-Hillel A, Khalyfa A, et al. Adipose tissue macrophage polarization by intermittent hypoxia in a mouse model of OSA: effect of tumor microenvironment. Cancer Lett. 2015;361(2):233–9. doi:10.1016/j.canlet.2015.03.010. This study suggest that the inflammed adipose tissue is an important source of macrophages to the tumor under IH conditions.CrossRefPubMed Almendros I, Gileles-Hillel A, Khalyfa A, et al. Adipose tissue macrophage polarization by intermittent hypoxia in a mouse model of OSA: effect of tumor microenvironment. Cancer Lett. 2015;361(2):233–9. doi:10.​1016/​j.​canlet.​2015.​03.​010. This study suggest that the inflammed adipose tissue is an important source of macrophages to the tumor under IH conditions.CrossRefPubMed
39.
40.•
Zurück zum Zitat Akbarpour M, Khalyfa A, Qiao Z, et al. Altered CD8+ T-cell lymphocyte function and TC1 cell stemness contribute to enhanced malignant tumor properties in murine models of sleep apnea. Sleep. 2016. https://www.ncbi.nlm.nih.gov/pubmed/27748245. This work shows how IH alters CD8+ T Cell activity facilitating tumor progression. Akbarpour M, Khalyfa A, Qiao Z, et al. Altered CD8+ T-cell lymphocyte function and TC1 cell stemness contribute to enhanced malignant tumor properties in murine models of sleep apnea. Sleep. 2016. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​27748245. This work shows how IH alters CD8+ T Cell activity facilitating tumor progression.
41.•
Zurück zum Zitat Almendros I, Khalyfa A, Trzepizur W, et al. Tumor cell malignant properties are enhanced by circulating exosomes in sleep apnea. Chest. 2016;150(5):1030–41. doi:10.1016/j.chest.2016.08.1438. Intermittent hypoxia can modulate the number and content of circulating exosomes supporting cancer spreading.CrossRefPubMed Almendros I, Khalyfa A, Trzepizur W, et al. Tumor cell malignant properties are enhanced by circulating exosomes in sleep apnea. Chest. 2016;150(5):1030–41. doi:10.​1016/​j.​chest.​2016.​08.​1438. Intermittent hypoxia can modulate the number and content of circulating exosomes supporting cancer spreading.CrossRefPubMed
42.
Zurück zum Zitat Almendros I, Campillo N, Torres M, et al. Role of COX-2 in intermittent hypoxia-induced tumor growth in a murine model of obstructive sleep apnea. Am J Respir Crit Care Med. 2016;193:A7738. Almendros I, Campillo N, Torres M, et al. Role of COX-2 in intermittent hypoxia-induced tumor growth in a murine model of obstructive sleep apnea. Am J Respir Crit Care Med. 2016;193:A7738.
43.
Zurück zum Zitat Vilaseca A, Musquera M, Torres M, et al. Intermittent hypoxia increases tumor angiogenesis in a mouse model of kidney cancer. Eur Urol. 2016;15(3):E218.CrossRef Vilaseca A, Musquera M, Torres M, et al. Intermittent hypoxia increases tumor angiogenesis in a mouse model of kidney cancer. Eur Urol. 2016;15(3):E218.CrossRef
44.••
Zurück zum Zitat Gallego-Martin T, Farre R, Almendros I, Gonzalez-Obeso E, Obeso A. Chronic intermittent hypoxia mimicking sleep apnea increases spontaneous tumorigenesis in mice. Eur Respir J 2017; In press. First work showing increased cancer incidence in old mice exposed to chronic IH. Gallego-Martin T, Farre R, Almendros I, Gonzalez-Obeso E, Obeso A. Chronic intermittent hypoxia mimicking sleep apnea increases spontaneous tumorigenesis in mice. Eur Respir J 2017; In press. First work showing increased cancer incidence in old mice exposed to chronic IH.
47.••
Zurück zum Zitat Martinez-Garcia MA, Martorell-Calatayud A, Nagore E, et al. Association between sleep disordered breathing and aggressiveness markers of malignant cutaneous melanoma. Eur Respir J. 2014;43(6):1661–8. doi:10.1183/09031936.00115413. First clinical study specifically designed to investigate the relationship between melanoma agressiveness and severity of OSA.CrossRefPubMed Martinez-Garcia MA, Martorell-Calatayud A, Nagore E, et al. Association between sleep disordered breathing and aggressiveness markers of malignant cutaneous melanoma. Eur Respir J. 2014;43(6):1661–8. doi:10.​1183/​09031936.​00115413. First clinical study specifically designed to investigate the relationship between melanoma agressiveness and severity of OSA.CrossRefPubMed
48.•
Zurück zum Zitat Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farre R. Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2012;186(2):190–4. doi:10.1164/rccm.201201-0130OC. One of the first evidences showing a potential relationship between OSA and cancer mortality from human epidemiological data.CrossRefPubMedPubMedCentral Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farre R. Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2012;186(2):190–4. doi:10.​1164/​rccm.​201201-0130OC. One of the first evidences showing a potential relationship between OSA and cancer mortality from human epidemiological data.CrossRefPubMedPubMedCentral
49.•
Zurück zum Zitat Campos-Rodriguez F, Martinez-Garcia MA, Martinez M, et al. Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. Am J Respir Crit Care Med. 2013;187(1):99–105. doi:10.1164/rccm.201209-1671OC. First clinical cohort study in the field OSA-cancer. Campos-Rodriguez F, Martinez-Garcia MA, Martinez M, et al. Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. Am J Respir Crit Care Med. 2013;187(1):99–105. doi:10.​1164/​rccm.​201209-1671OC. First clinical cohort study in the field OSA-cancer.
Metadaten
Titel
Obstructive Sleep Apnea and Cancer: Insights from Intermittent Hypoxia Experimental Models
verfasst von
Isaac Almendros
Miguel Ángel Martinez-Garcia
Ana Obeso
David Gozal
Publikationsdatum
01.03.2017
Verlag
Springer International Publishing
Erschienen in
Current Sleep Medicine Reports / Ausgabe 1/2017
Elektronische ISSN: 2198-6401
DOI
https://doi.org/10.1007/s40675-017-0064-5

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.