EFFECTS OF ALLERGIC AIRWAY INFLAMMATION AND CHRONIC INTERMITTENT HYPOXIA ON SYSTEMIC BLOOD PRESSURE

Background: Asthma and obstructive sleep apnea (OSA) are highly prevalent chronic conditions, and both are associated with systemic hypertension. Additionally, asthma and OSA reciprocally interact, mutually exacerbating each other. In this study, we tested the effect of allergen-induced lower airway inflammation and concurrent chronic intermittent hypoxia (CIH) on systemic blood pressure (BP), pulmonary function and pro-inflammatory cytokines, in a rat model.

Methods: Brown Norway rats were exposed to 43 days of normoxia (NORM) or CIH, concurrent with weekly House Dust Mite (HDM) challenges. BP was measured 1 day after the last HDM challenge. On Day 44, pulmonary function was tested and blood for Th-2 and Th-1 cytokine levels was collected.

Results: HDM significantly increased Mean (p= 0.002), systolic (p=0.003) and diastolic (p=0.004) BP, compared to saline-challenged controls. Higher mean BP significantly correlated to increased total respiratory system resistance (R² = 0.266, p=0.002), driven by an association with parenchymal tissue dampening (R² = 0.166, p=0.016). HDM relative to saline-challenged controls increased the expression of serum IL-6 (p=0.008), but no relationships of systemic BP with IL-6 or any other cytokines were found. CIH did not alter the allergen-induced responses on BP, although it tended to increase the expression of serum IL-6 (p=0.06) and MCP-1 (p=0.09), regardless of HDM challenge.

Conclusions: Chronic allergen-induced airway inflammation results in systemic hypertension that is correlated to the degree of distal airway obstruction induced by the allergen. These effects do not appear to be explained by the associated systemic inflammation.

Keywords: asthma; hypertension, systemic; intermittent hypoxia; lung; sleep apnea, obstructive.