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• W2560755762 abstract "I have read with great interest and pleasure the excellent review by Martínez-García et al1Martínez-García M.A. Campos-Rodriguez F. Barbè F. Cancer and OSA: current evidence from human studies.Chest. 2016; 150: 451-463Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar entitled “Cancer and OSA: Current Evidence from Human Studies” published in CHEST (August 2016). The authors shed light on this important and aporetical topic. I was concerned about one issue not addressed adequately in the analysis: the role of sleep fragmentation on the innate and adaptive immune systems. In the literature, there are old and new data showing the impact of poor sleep and OSA in decreasing not only circulating monocytes but also natural killer cells, which play a key role in cancer biology and in other conditions such as autoimmune diseases.2Born J. Lance T. Hansen K. et al.Effects of sleep and circadian rhythm on human circulating immune cells.J Immunol. 1997; 58: 4454-4463Google Scholar, 3Geiger S.S. Fagundes C.T. Siegel R.M. Chrono-immunology: progress and challenges in understanding links between the circadian and immune systems.Immunology. 2015; 146: 349-358Crossref PubMed Scopus (65) Google Scholar, 4Gaotswe G. Kent B.D. Carrigan M.A. et al.Invariant natural killer T cell deficiency and functional impairment in sleep apnea: link to cancer comorbidity.Sleep. 2015; 38: 1628-1634Google Scholar Furthermore, there is evidence that poorer global sleep quality is associated with shorter telomere length in CD8+ and CD4+ lymphocytes.5Pather A.A. Gurfein B. Moran P. et al.Tired telomeres: poor global sleep quality, perceived stress, and telomere length in immune cell subset in obese men and woman.Brain Behav Immun. 2015; 47: 155-162Crossref PubMed Scopus (53) Google Scholar Cancer and OSA: Current Evidence From Human StudiesCHESTVol. 150Issue 2PreviewDespite the undeniable medical advances achieved in recent decades, cancer remains one of the main causes of mortality. It is thus extremely important to make every effort to discover new risk factors for this disease, particularly ones that can be treated or modified. Various pathophysiologic pathways have been postulated as possible causes of cancer or its increased aggressiveness, and also of greater resistance to antitumoral treatment, in the presence of both intermittent hypoxia and sleep fragmentation (both inherent to sleep apnea). Full-Text PDF ResponseCHESTVol. 150Issue 6PreviewAt the outset, we wish to thank Dr Marvisi1 for his interest in our article. As the authors of the letter have stated, in the past few years some outstanding research groups have described other pathophysiological pathways linking OSA with cancer, some orchestrated by hypoxia2-5 and some by sleep fragmentation.2-4,6,7 Some of these pathways are related to alterations to the immune system in macrophages/monocytes, natural killer cells, lymphocytes, and other immune cells.2-7 Interesting studies and reviews of the role of microvesicles/exosomes and the impact on the sympathetic/catecholaminergic system and other pathophysiological pathways have recently been published. Full-Text PDF" @default.
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• W2560755762 title "Cancer and OSA" @default.
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• W2560755762 doi "https://doi.org/10.1016/j.chest.2016.08.1472" @default.
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