Study Objectives: Obesity hypoventilation and obstructive sleep apnea are common complications of obesity linked to defects in respiratory pump and upper airway neural control. Leptin-deficient ob/ob mice have impaired ventilatory control and inspiratory flow limitation during sleep, which are both reversed with leptin. We aimed to localize central nervous system (CNS) site(s) of leptin action on respiratory and upper airway neuroventilatory control.

Methods: We localized the effect of leptin to medulla versus hypothalamus by administering intracerbroventricular leptin (10 μg/2 μL) versus vehicle to the lateral (n = 14) versus fourth ventricle (n = 11) of ob/ob mice followed by polysomnographic recording. Analyses were stratified for effects on respiratory (nonflow-limited breaths) and upper airway (inspiratory flow limitation) functions. CNS loci were identified by (1) leptin-induced signal transducer and activator of transcription 3 (STAT3) phosphorylation and (2) projections of respiratory and upper airway motoneurons with a retrograde transsynaptic tracer (pseudorabies virus).

Results: Both routes of leptin administration increased minute ventilation during nonflow-limited breathing in sleep. Phrenic motoneurons were synaptically coupled to the nucleus of the solitary tract, which also showed STAT3 phosphorylation, but not to the hypothalamus. Inspiratory flow limitation and obstructive hypopneas were attenuated by leptin administration to the lateral but not to the fourth cerebral ventricle. Upper airway motoneurons were synaptically coupled with the dorsomedial hypothalamus, which exhibited STAT3 phosphorylation.

Conclusions: Leptin relieves upper airway obstruction in sleep apnea by activating the forebrain, possibly in the dorsomedial hypothalamus. In contrast, leptin upregulates ventilatory control through hindbrain sites of action, possibly in the nucleus of the solitary tract.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835308PMC
http://dx.doi.org/10.5665/sleep.5762DOI Listing

Publication Analysis

Top Keywords

upper airway
28
inspiratory flow
12
flow limitation
12
leptin
9
sleep apnea
8
ob/ob mice
8
ventilatory control
8
respiratory upper
8
stat3 phosphorylation
8
airway motoneurons
8

Similar Publications

We report a case of a 39-year-old male patient who developed propofol-induced fasciculations during the induction of general anesthesia. The patient had a history of moderate obstructive sleep apnea and was intolerant to continuous positive airway pressure therapy. He subsequently underwent the insertion of a hypoglossal nerve stimulator as a viable surgical intervention.

View Article and Find Full Text PDF

Serum Periostin as a Potential Biomarker in the Evaluation of Allergic Rhinitis: A Pilot Study.

J Asthma Allergy

January 2025

Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, People's Republic of China.

Purpose: Although periostin has recently emerged as a new mediator in chronic allergic diseases, particularly in upper airway disease, its significance as a biomarker for allergic rhinitis (AR) is still unclear. Therefore, we aimed to assess the potential of periostin as a novel candidate biomarker for diagnosing and assessing the severity of AR.

Patients And Methods: A total of 40 patients with AR and 22 healthy controls, all aged over 18 years, were recruited for the study.

View Article and Find Full Text PDF

Indications for tracheostomy placement in pediatric patients with cerebral palsy.

Int J Pediatr Otorhinolaryngol

January 2025

Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Ann & Robert H Lurie Children's Hospital of Chicago, Division of Otolaryngology, Chicago, IL, USA.

Background: Cerebral palsy (CP) is the most common neuromuscular disorder in children, and children with CP are at increased risk of respiratory distress potentially requiring tracheostomy placement. Previous studies have characterized indications for tracheostomy in neurologically compromised children, however no studies focus specifically on children with CP. The purpose of this study was to identify the indications for tracheostomy placement, sites of airway obstruction, and rate of decannulation in children with CP.

View Article and Find Full Text PDF

Rationale: Patients with atrial fibrillation and a large goiter have high perioperative risks and often cannot tolerate general anesthesia, making it necessary for us to explore new safe and effective anesthesia methods.

Patient Concerns: The patient presented with atrial fibrillation accompanied by rapid ventricular rate, a thrombus attached to the left atrial appendage, and a massive thyroid goiter compressing the airway.

Diagnosis: After the left humerus fracture surgery, the patient's internal fixation loosened and fractured, accompanied by infection, formation of sinus tracts, and suppuration.

View Article and Find Full Text PDF

The aim of this study was to determine the effects of mandibular setback surgery exceeding 5 mm on upper airway and sleep quality in skeletal Class III patients, with comparisons to Class I controls. Sixteen individuals per group were selected based on their ANB angle and surgical need. 2D and 3D airway analyses were conducted.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!