Markers of inflammation: Data from the MOSAIC randomised trial of CPAP for minimally symptomatic OSA

Stradling JR, Craig SE, Kohler M, Nicoll D, Ayers L, Nunn AJ, et al. Markers of inflammation: Data from the MOSAIC randomised trial of CPAP for minimally symptomatic OSA. Thorax. 2015;70(2):181–2.

The Multi-centre Obstructive Sleep Apnoea Interventional Cardiovascular (MOSAIC) trial compared 6 months of CPAP therapy, versus no CPAP, in 391 patients with minimally symptomatic obstructive sleep apnoea (OSA). We now report some exploratory outcomes, markers of systemic inflammation (interleukin 6 (IL-6), IL-10, C reactive protein, tumour necrosis factor). We found no consistent changes (all p values >0.13). Trial registration number: ISRCTN 34164388.

Introduction
Intermittent hypoxia may generate free oxygen radicals and oxidative stress, activate expression of adhesion molecules and proinflammatory cytokines, and in turn damage the vascular endothelium with chronic low grade inflammation, ultimately leading to atheroma formation and vascular events.1 There are very few randomised controlled treatment trials in patients with OSA, and a recent meta-analysis relied exclusively on uncontrolled and non-randomised trials for its conclusion that there were small reductions in some markers of inflammation following CPAP.1 The MOSAIC randomised controlled trial looked at the effects of 6 months CPAP in 391 patients with minimally symptomatic OSA. We have now analysed stored plasma for markers of systemic inflammation, from MOSAIC patients with sufficient samples remaining, recruited at the Oxford, Reading and Taunton centres (303 patients).