{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:22:20Z","timestamp":1792844540340,"version":"4.5.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is prevalent among patients with Parkinson\u2019s disease (PD), yet its contribution to neuroinflammation and disease progression remains poorly understood. This study investigated the association between OSA severity, sleep parameters, and systemic cytokine\/chemokine profiles in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, 48 patients underwent clinical evaluation, polysomnography (PSG), and multiplex cytokine profiling. Participants were classified as PD+OSA\n                      <jats:sup>+<\/jats:sup>\n                      or PD+OSA\n                      <jats:sup>-<\/jats:sup>\n                      based on PSG, with additional stratification by OSA severity. Multivariate and network analyzes were applied to identify inflammatory signatures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      OSA was diagnosed in 54.2% of PD patients and was associated with older age, poorer quality of life, and higher UPDRS-II\/III scores (p\u00a0&amp;lt; 0.05). The PD+OSA\n                      <jats:sup>+<\/jats:sup>\n                      group exhibited reduced REM sleep, increased arousals, and higher oxygen desaturation indices. Cytokine analysis revealed that moderate-to-severe OSA was associated with a mixed Th1\/Th2 inflammatory axis involving IL-6, TNF-\u03b1, IFN-\u03b3, IL-13, CCL2, CXCL1, and IL-4, while mild OSA was associated with innate activation and chemotaxis (IL-1\u03b2, IL-18, CXCL10, GM-CSF). Network modeling demonstrated dense cytokine connectivity in PD+OSA\n                      <jats:sup>+<\/jats:sup>\n                      , suggesting systemic immune reorganization driven by intermittent hypoxia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>OSA is a prevalent disorder in PD, affecting over half of the patients, and is linked to sleep fragmentation and a proinflammatory environment driven by Th1\/Th2 and chemokine signaling, which may contribute to worsening motor and non-motor symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1808550","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:42:31Z","timestamp":1779082951000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Obstructive sleep apnea is linked to inflammatory changes and motor impairment in Parkinson\u2019s disease"],"prefix":"10.3389","volume":"17","author":[{"given":"Carlos Mauricio Oliveira","family":"de Almeida","sequence":"first","affiliation":[{"name":"State University of Amazonas (UEA), School of Health Sciences","place":["Manaus, Brazil"]},{"name":"State University of Amazonas, School of Health Sciences, Researcher in the Sleep Disorders Sector at Hospital Adriano Jorge","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello Facundo do","family":"Valle-Filho","sequence":"additional","affiliation":[{"name":"Federal University of Amazonas (UFAM)","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raissa","family":"Costa Said","sequence":"additional","affiliation":[{"name":"State University of Amazonas, School of Health Sciences, Researcher in the Sleep Disorders Sector at Hospital Adriano Jorge","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jefferson Macedo","family":"Dantas","sequence":"additional","affiliation":[{"name":"State University of Amazonas, School of Health Sciences, Researcher in the Sleep Disorders Sector at Hospital Adriano Jorge","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agatha Lopes","family":"Azedo","sequence":"additional","affiliation":[{"name":"State University of Amazonas (UEA), School of Health Sciences","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Carvalho","family":"Ferreira","sequence":"additional","affiliation":[{"name":"State University of Amazonas (UEA), School of Health Sciences","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emillaine","family":"Noronha","sequence":"additional","affiliation":[{"name":"State University of Amazonas (UEA), School of Health Sciences","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenly Gonzalez","family":"Perez","sequence":"additional","affiliation":[{"name":"State University of Amazonas, School of Health Sciences, Researcher in the Sleep Disorders Sector at Hospital Adriano Jorge","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoel Alves","family":"Sobreira-Neto","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1 (UFC)","place":["Fortaleza, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f4nio Luiz Ribeiro Boechat","family":"Lopes","sequence":"additional","affiliation":[{"name":"Federal University of Amazonas (UFAM)","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Vinicius Della","family":"Coletta","sequence":"additional","affiliation":[{"name":"State University of Amazonas (UEA), School of Health Sciences","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nani Oliveira","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Instituto Ren\u00e9 Rachou \u2013 Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ)-Minas","place":["Belo Horizonte, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9a","family":"Teixeira-Carvalho","sequence":"additional","affiliation":[{"name":"Instituto Ren\u00e9 Rachou \u2013 Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ)-Minas","place":["Belo Horizonte, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Monteiro","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Federal University of Amazonas (UFAM)","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemilson Soares","family":"Pontes","sequence":"additional","affiliation":[{"name":"Laboratory of Virology and Immunology, National Institute of Amazonian Research (INPA)","place":["Manaus, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S1474-4422(05)70285-4","article-title":"The diagnosis of Parkinson\u2019s disease","volume":"5","author":"Tolosa","year":"2006","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/S10654-011","article-title":"Epidemiology and etiology of Parkinson\u2019s disease: a review of the evidence","author":"Wirdefeldt","year":"2011","journal-title":"Eur J Epidemiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/SJ.BJP.0707167","article-title":"Inflammation as a causative factor in the aetiology of Parkinson\u2019s disease","volume":"150","author":"Whitton","year":"2007","journal-title":"Br J Pharmacol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12974-022-02481-3","article-title":"Parkinson\u2019s disease peripheral immune biomarker profile: a multicentre, cross-sectional and longitudinal study","volume":"19","author":"Li","year":"2022","journal-title":"J\u00a0Neuroinflamm"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2021.11.018","article-title":"Inflammatory markers and BDNF in obstructive sleep apnea (OSA) in Parkinson\u2019s disease (PD)","volume":"90","author":"Kaminska","year":"2022","journal-title":"Sleep Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.10.009","article-title":"Delayed emergence of a parkinsonian disorder or dementia in 81% of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: A 16-year update on a previously reported series","volume":"14","author":"Schenck","year":"2013","journal-title":"Sleep Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70476\u20138","article-title":"Rapid-eye-movement sleep behaviour disorder as an early marker for a neurodegenerative disorder: a descriptive study","volume":"5","author":"Iranzo","year":"2006","journal-title":"Lancet Neurol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1159\/000481939","article-title":"High frequency of sleep disorders in parkinson\u2019s disease and its relationship with quality of life","volume":"78","author":"Sobreira-Neto","year":"2017","journal-title":"Eur Neurol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282X20190098","article-title":"Obstructive sleep apnea and parkinson\u2019s disease: characteristics and associated factors","volume":"77","author":"Sobreira-Neto","year":"2019","journal-title":"Arq Neuropsiquiatr"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/ENE.16109","article-title":"Prevalence and clinical aspects of obstructive sleep apnea in Parkinson disease: A meta-analysis","volume":"31","author":"Maggi","year":"2024","journal-title":"Eur J Neurol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/J.SMRV.2016.07.002","article-title":"Prevalence of obstructive sleep apnea in the general population: A systematic review","volume":"34","author":"Senaratna","year":"2017","journal-title":"Sleep Med Rev"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.5664\/JCSM.10596","article-title":"Bidirectional association between Parkinson\u2019s disease and obstructive sleep apnea: a cohort study","volume":"19","author":"Jeon","year":"2023","journal-title":"J\u00a0Clin Sleep Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/S10072-019-04211-9","article-title":"The relationship between obstructive sleep apnea and Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"41","author":"Sun","year":"2020","journal-title":"Neurological Sci"},{"key":"B14","doi-asserted-by":"publisher","first-page":"116","DOI":"10.3390\/ijms26083762","article-title":"Obstructive sleep apnea and parkinson\u2019s disease: bidirectional clinical and pathophysiologic links","volume":"26","author":"Wang","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/CNS.70384","article-title":"Chronic\u00a0intermittent hypoxia-induced neural injury: pathophysiology, neurodegenerative implications, and therapeutic insights","volume":"31","author":"Jia","year":"2025","journal-title":"CNS Neurosci Ther"},{"key":"B16","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40478-022-01498-2","article-title":"Sleep fragmentation affects glymphatic system through the different expression of AQP4 in wild type and 5xFAD mouse models","volume":"11","author":"Vasciaveo","year":"2023","journal-title":"Acta Neuropathol Commun"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/MDS.28412","article-title":"Impact of obstructive sleep apnea on cognitive and motor functions in parkinson\u2019s disease","volume":"36","author":"Elfil","year":"2021","journal-title":"Movement Disord"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANEUROL.2025.4691","article-title":"Obstructive sleep apnea, positive airway pressure, and implications of early treatment in parkinson disease","volume":"83","author":"Neilson","year":"2025","journal-title":"JAMA Neurol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0047387","article-title":"Non-motor symptoms in patients with Parkinson\u2019s disease - correlations with inflammatory cytokines in serum","volume":"7","author":"Lindqvist","year":"2012","journal-title":"PloS One"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-018-1729-0","article-title":"Laryngopharyngeal motor dysfunction and obstructive sleep apnea in Parkinson\u2019s disease","volume":"23","author":"Bahia","year":"2019","journal-title":"Sleep Breath"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.3.181","article-title":"Accuracy of clinical diagnosis of idiopathic Parkinson\u2019s disease: A clinico-pathological study of 100 cases","volume":"55","author":"Hughes","year":"1992","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20213","article-title":"Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations","volume":"19","author":"Goetz","year":"2004","journal-title":"Movement Disord"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.04.020","article-title":"Validation of the Brazilian portuguese version of the pittsburgh sleep quality index","volume":"12","author":"Bertolazi","year":"2011","journal-title":"Sleep Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/17.8.703","article-title":"Sleepiness in different situations measured by the Epworth Sleepiness Scale","volume":"17","author":"Johns","year":"1994","journal-title":"Sleep"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282x20200125","article-title":"Validation of the Brazilian portuguese version of the rapid eye movement sleep behavior disorder screening questionnaire (RBDSQ-BR)","volume":"78","author":"Pena-Pereira","year":"2020","journal-title":"Arq Neuropsiquiatr"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21740","article-title":"The REM sleep behavior disorder screening questionnaire - A new diagnostic instrument","volume":"22","author":"Stiasny-Kolster","year":"2007","journal-title":"Movement Disord"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2008.12.008","article-title":"Psychometric properties of the Parkinson\u2019s Disease Sleep Scale - Brazilian version","volume":"15","author":"Margis","year":"2009","journal-title":"Parkinsonism Relat Disord"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-sponsored revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov Disord"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1590\/s0004-282x2003000500014","article-title":"Sugest\u00f5es para o uso do mini-exame do estado mental no Brasil","volume":"61","author":"Brucki","year":"2003","journal-title":"Arq Neuropsiquiatr"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.03.025","article-title":"Restless legs syndrome\/Willis-Ekbom disease diagnostic criteria: Updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria - history, rationale, description, and significance","volume":"15","author":"Allen","year":"2014","journal-title":"Sleep Med"},{"key":"B32","article-title":"No title","volume-title":"International Classification of Sleep Disorders 3rd ed revised","year":"2023"},{"key":"B33","article-title":"The AASM manual for scoring the scoring of sleep and associated events: rules, terminology and technical specifications","volume-title":"AASM","author":"Berry","year":"2016"},{"key":"B34","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.smrv.2014.07.003","article-title":"Oxidative stress in obstructive sleep apnea and intermittent hypoxia - Revisited - The bad ugly and good: Implications to the heart and brain","volume":"20","author":"Lavie","year":"2015","journal-title":"Sleep Med Rev"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1113\/JP271502","article-title":"Mechanisms of microglial activation in models of inflammation and hypoxia: Implications for chronic intermittent hypoxia","volume":"594","author":"Kiernan","year":"2016","journal-title":"J Physiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1002\/MDS.28229","article-title":"Signs of chronic hypoxia suggest a novel pathophysiological event in \u03b1-synucleinopathies","volume":"35","author":"Heras-Garvin","year":"2020","journal-title":"Movement Disord"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.887094","article-title":"Worse sleep quality aggravates the motor and non-motor symptoms in parkinson\u2019s disease","volume":"14","author":"Yi","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"B38","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1038\/s41531-025-01018-8","article-title":"Glymphatic dysfunction evidenced by DTI-ALPS is related to obstructive sleep apnea intensity in newly diagnosed Parkinson\u2019s disease","volume":"11","author":"Nepozitek","year":"2025","journal-title":"NPJ Parkinsons Dis"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.2119\/MOLMED.2014.00034","article-title":"Interleukin-18 as a therapeutic target in acute myocardial infarction and heart failure","volume":"20","author":"O\u2019Brien","year":"2014","journal-title":"Mol Med"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/FIMMU.2023.1240597","article-title":"Sustained and intermittent hypoxia differentially modulate primary monocyte immunothrombotic responses to IL-1\u03b2 stimulation","volume":"14","author":"Wahlund","year":"2023","journal-title":"Front Immunol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1111\/IEJ.13814","article-title":"MicroRNA-22 suppresses NLRP3\/CASP1 inflammasome pathway-mediated proinflammatory cytokine production by targeting the HIF-1\u03b1 and NLRP3 in human dental pulp fibroblasts","volume":"55","author":"Jiang","year":"2022","journal-title":"Int Endod J"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1089\/JIR.2024.0057","article-title":"Evaluation of serum\/plasma levels of interleukins (IL-6, IL-12, IL-17, IL-18, and IL-23) in adults and children with obstructive sleep apnea: A systematic review, meta-analysis, and trial sequential analysis","volume":"44","author":"Golshah","year":"2024","journal-title":"J Interferon Cytokine Res"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.5664\/JCSM.3070","article-title":"Serum inflammatory markers in obstructive sleep apnea: a meta-analysis","volume":"9","author":"Nadeem","year":"2013","journal-title":"J Clin Sleep Med"},{"key":"B44","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3390\/BIOM15010016","article-title":"IL-18 blockage reduces neuroinflammation and promotes functional recovery in a mouse model of spinal cord injury","volume":"15","author":"Begum","year":"2024","journal-title":"Biomolecules"},{"key":"B45","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/s11325-025-03348-6","article-title":"Effects of continuous positive airway pressure therapy on inflammatory markers in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials","volume":"29","author":"Zhu","year":"2025","journal-title":"Sleep Breath"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1808550\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:42:32Z","timestamp":1779082952000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1808550\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":45,"alternative-id":["10.3389\/fimmu.2026.1808550"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1808550","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"article-number":"1808550"}}