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Effect of modern surgical treatment on the inflammatory/anti-inflammatory balance in patients with obstructive sleep apnoea

  • M Binar (a1), T M Akcam (a2), O Karakoc (a1), R I Sagkan (a3), U Musabak (a3) and M Gerek (a1)...
Abstract Objective:

To investigate the inflammatory/anti-inflammatory cytokine balance – T helper 1/T helper 2 ratios – in obstructive sleep apnoea patients, before and after treatment.


Twenty-eight patients received continuous positive airway pressure treatment and 29 patients who could not tolerate continuous positive airway pressure were scheduled for surgery. Serum levels of interleukins 2, 4 and 10, tumour necrosis factor-alpha, and interferon gamma were analysed by enzyme-linked immunosorbent assays before and three months after treatment.


The success rate of surgical treatment was 65.5 per cent. Mean compliance for the continuous positive airway pressure group was 40.9 per cent. The apnoea/hypopnoea index significantly decreased in both groups after treatment (p < 0.001). The interferon gamma/interleukin-4 ratio decreased following surgical treatment (p = 0.014), and the interleukin-2/interleukin-4 ratio decreased after treatment in 57 patients in the overall cohort (p = 0.032).


After treatment for obstructive sleep apnoea, some ratios reflecting T helper 1/T helper 2 cytokine balance favoured the T helper 2 direction, suggesting a shift to an anti-inflammatory state. Successful surgery and better continuous positive airway pressure compliance can help ameliorate inflammation in obstructive sleep apnoea patients, which may reduce associated morbidities.

Corresponding author
Address for correspondence: Dr Murat Binar, Gulhane Egitim Arastırma Hastanesi, KBB AD, Etlik, 06018, Kecioren, Ankara, Turkey Fax: +90 312 304 5700 E-mail:
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Presented at the 26th Congress of the European Rhinologic Society, in conjunction with the 35th Congress of the International Society of Inflammation and 17th Congress of the International Rhinologic Society (‘ERS-ISIAN-IRS 2016 Congress’), 3–7 July 2016, Stockholm, Sweden.

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