{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:05:14Z","timestamp":1783915514242,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004700","name":"Taipei Medical University","doi-asserted-by":"publisher","award":["TMU\u2010JIRB N202405119"],"award-info":[{"award-number":["TMU\u2010JIRB N202405119"]}],"id":[{"id":"10.13039\/501100004700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Airway remodelling in obstructive sleep apnea encompasses diverse histopathological and neuromuscular alterations, yet surface\u2010level epithelial changes and ionic characteristics remain insufficiently studied. Using time\u2010of\u2010flight secondary ion mass spectrometry, this study identified disrupted epithelial ionic homeostasis in the upper airway. Inferior turbinate specimens were collected from 18 patients with obstructive sleep apnea and 22 controls undergoing upper airway surgery. Compared with controls, specimens from patients with obstructive sleep apnea demonstrated significantly elevated sodium\u2010to\u2010potassium ratios (1.66\u2009\u00b1\u20091.38 vs. 0.83\u2009\u00b1\u20090.38,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.033), with a marginal association persisting after adjustment for age and body mass index (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.057). Immunohistochemistry revealed reduced sodium\u2010potassium adenosine triphosphatase expression in the epithelium of obstructive sleep apnea specimens (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0077), while histology showed epithelial metaplasia and inflammatory changes. Among several machine learning classifiers, the random forest model achieved the highest diagnostic performance, yielding an area under the curve of 0.7928 and consistently identifying the sodium\u2010to\u2010potassium ratio as the most discriminative feature. Together, these findings demonstrate that disrupted sodium\u2010to\u2010potassium balance and diminished sodium\u2010potassium adenosine triphosphatase expression constitute epithelial signatures in obstructive sleep apnea. Such ionic dysregulation may impair membrane potential and pharyngeal muscle responsiveness, thereby promoting airway collapsibility. Given the established role of ion channels in neuromuscular regulation, the epithelial sodium\u2010to\u2010potassium ratio may represent not only a diagnostic biomarker but also a potential predictor of therapeutic response to potassium channel\u2013targeted interventions.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70323","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:41:52Z","timestamp":1772984512000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epithelial\n                    <scp>Na<\/scp>\n                    <sup>+<\/sup>\n                    \/\n                    <scp>K<\/scp>\n                    <sup>+<\/sup>\n                    Imbalance and Impaired\n                    <scp>Na<\/scp>\n                    <sup>+<\/sup>\n                    \/\n                    <scp>K<\/scp>\n                    <sup>+<\/sup>\n                    \u2010\n                    <scp>ATPase<\/scp>\n                    Activity as Surface Markers of Airway Remodelling in Obstructive Sleep Apnea"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9340-7357","authenticated-orcid":false,"given":"Yen\u2010Chun","family":"Chen","sequence":"first","affiliation":[{"name":"Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University  Taipei Taiwan"},{"name":"Department of Otolaryngology Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Department of Otolaryngology School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Hsuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Cell Biology School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Han","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Cell Biology School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010Ho","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology Taipei Medical University Hospital  Taipei Taiwan"},{"name":"School of Dentistry, College of Oral Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Han","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"},{"name":"International Master's\/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"},{"name":"Department of Otolaryngology Wan Fang Hospital, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"How","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Cell Biology School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"},{"name":"International Ph.D. Program in Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu\u2010Der","family":"Mai","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Cell Biology School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00179-2017"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-020-00981-x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200308-1100OC"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5516"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1431330"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.919501"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-2292"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201303-0448OC"},{"issue":"1","key":"e_1_2_13_10_1","first-page":"S37","article-title":"Control of the Pharyngeal Musculature During Wakefulness and Sleep: Implications in Normal Controls and Sleep Apnea","volume":"33","author":"Edwards B. 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