{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:22:32Z","timestamp":1785460952246,"version":"3.56.0"},"reference-count":23,"publisher":"Korean Society of Otorhinolaryngology-Head and Neck Surgery","issue":"2","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1F1A1074011"],"award-info":[{"award-number":["2022R1F1A1074011"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-ceo.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Otorhinolaryngol"],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:p>Objectives. Obstructive sleep apnea (OSA) is associated with chronic intermittent hypoxia and systemic inflammation, both of which contribute to vascular and metabolic complications. Monocytes, as key immune cells of innate immunity, have been implicated in this inflammatory state. However, the effect of OSA treatment on monocyte function and inflammatory phenotype remains poorly understood.Methods. In this prospective cohort study, OSA patients were evaluated before and after 3 months of continuous positive airway pressure (CPAP) therapy. Circulating monocytes were isolated, and inflammatory cytokine production (tumor necrosis factor [TNF]-\u03b1, interleukin [IL]-1\u03b2, and IL-6) was assessed at baseline and post-treatment, both at rest and after lipopolysaccharide (LPS) stimulation. Monocyte polarization (M1\/M2-like marker expression) was measured by flow cytometry. Clinical severity parameters, including the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI), were correlated with immune changes.Results. Following CPAP treatment, LPS-induced inflammatory cytokine secretion and LPS responsiveness, defined as the increase in cytokine levels upon stimulation, both declined after CPAP in proportion to baseline ODI, but not AHI. Apart from TNF-\u03b1, baseline IL-1\u03b2 and IL-6 levels were below the quantifiable range of the assay, which precluded reliable comparison after treatment. This effect may be explained by a parallel post-treatment shift in monocyte phenotype toward an anti-inflammatory M2-like (CD163+CD206+) profile, as demonstrated by our flow cytometry data, which was also significantly associated with baseline ODI.Conclusion. CPAP alleviates systemic inflammation in OSA by reducing hypoxic burden and reprogramming monocytes toward an anti-inflammatory phenotype. The magnitude of immune modulation was more closely linked to ODI than AHI, suggesting that oxygen desaturation burden serves as a meaningful adjunct to AHI in assessing monocyte-driven immune dysregulation in OSA.<\/jats:p>","DOI":"10.21053\/ceo.2025-00258","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T01:09:07Z","timestamp":1763341747000},"page":"177-184","update-policy":"https:\/\/doi.org\/10.21053\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Continuous Positive Airway Pressure Therapy Alters Monocyte Activation and Immune Phenotype in Obstructive Sleep Apnea in Relation to Hypoxic Burden"],"prefix":"10.21053","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5759-9929","authenticated-orcid":true,"given":"Seung-No","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government Seoul National University Boramae 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Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8080-4943","authenticated-orcid":true,"given":"Hee-Suk","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4178-3625","authenticated-orcid":true,"given":"Kyoung Mi","family":"Eun","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0711-855X","authenticated-orcid":true,"given":"Jivianne 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