2 to 1 5 mg/dl) range in apparently healthy men and women is a st

2 to 1.5 mg/dl) range in apparently healthy men and women is a strong predictor of cardiovascular risk [41-43]. In patients with acute coronary artery disease, stable angina pectoris, and a history of myocardial infarction, higher levels of CRP are also associated with future cardiovascular inhibitor Brefeldin A events [44,45]. IL-6 is a circulating cytokine known to be secreted from a number of different cells, including activated macrophages and lymphocytes [46]. Inflammation is the main stimulus for IL-6 production, but other stimuli also exist, such as cigarette smoke [46] and adiposity [47]. TNF-�� is a pro-inflammatory cytokine that has a significant role in host defense and also mediates the pathogenesis of a number of disease processes, including atherosclerosis, septic shock, and auto-immune disorders [48].

TNF-�� has two transmembrane-bound receptors and soluble forms that are released by proteolysis of the cell-bound receptor under the control of other inflammatory cytokines (e.g., IL-6, IL-2, IFN-��), T cell activation, and by TNF-�� itself [48,49]. Hypoxemia results in increases in IL-6 and CRP in normal humans [50]. Sleep fragmentation and deprivation also induces an increase in cytokines that may underlie inflammatory responses, which lead to cardiovascular morbidity [20,30]. OSA results in repetitive and severe nocturnal hypoxemia and sleep disturbances [1,3,51]. Continuous positive airway pressure (CPAP) is the primary treatment for OSA [52], since it eliminates upper airway collapse during sleep and improves sleep fragmentation, daytime symptoms [53], and quality of life [54].

Evidence shows that CPAP therapy reduces cardiovascular morbidity and risk [11,55], There are many studies with small sample sizes and few with larger sample sizes which address the effect of CPAP therapy on cardiovascular profiles and serum inflammatory markers. Therefore, we performed a meta-analysis to study the effects of CPAP on the serum inflammatory markers CRP, IL-6, and TNF-��. Objectives We aim to assess the effect of CPAP treatment on inflammatory Dacomitinib markers in human subjects with sleep apnea by comparing levels of inflammatory markers before and after specified treatment in all available published studies. Methods Studies and endpoint definitions PRISMA guidelines were followed to perform this meta-analysis. PICOS format was followed; P: inflammatory markers (CRP, TNF-��, and IL-6), I: CPAP treatment, C; levels of markers before and after treatment period, O: decrease in marker levels. Inflammatory markers were chosen based on a review of the literature. The following inflammatory markers were chosen: CRP, TNF-��, and IL-6.

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