Sleep-disordered breathing and immune dysregulation: from airway inflammation to systemic disease

Sleep-disordered breathing (SDB), and particularly obstructive sleep apnea (OSA), has evolved from being perceived as a purely mechanical disorder to a complex multisystem disease with significant immunological and inflammatory underpinnings. Current evidence highlights that intermittent hypoxia and sleep fragmentation induce oxidative stress and activate molecular pathways such as NF-κB and inflammasomes, leading to a persistent pro-inflammatory state. Elevated cytokines, including IL 6, TNF α, and CRP, have been consistently observed in OSA, suggesting systemic immune activation. However, the causal nature of these inflammatory mediators and their relationship with disease progression remain subjects of active debate. Advances in composite indices like the neutrophil to lymphocyte ratio and systemic immune inflammation index, alongside multi omics profiling, have revealed distinct immune endotypes, yet their clinical translation is still in its infancy. The field lacks integrative mechanistic studies capable of linking local airway inflammation to systemic immune manifestations and comorbidities, underscoring the need for a unified immunopathological model of SDB.This Research Topic aims to elucidate the complex interplay between immune dysregulation and sleep-disordered breathing, reframing OSA as a systemic immunoinflammatory disease rather than solely an upper airway condition. It seeks to bridge experimental immunology and clinical practice to better define the immune phenotypes of SDB, identify prognostic and diagnostic biomarkers, and evaluate the impact of established and novel therapies on immune restoration. Key objectives include understanding how chronic intermittent hypoxia modulates innate and adaptive responses, delineating the contribution of allergic inflammation to airway collapsibility, and investigating systemic outcomes such as cardiometabolic, neurocognitive, and autoimmune sequelae. By integrating basic, translational, and clinical approaches, this Research Topic aims to provide a multidimensional perspective on immune pathways influencing sleep-related disorders.To gather further insights into the immunological and clinical boundaries of SDB, we welcome articles addressing, but not limited to, the following themes:o Mechanistic links between intermittent hypoxia, oxidative stress, and immune activationo Identification and validation of immune-related endotypes in OSAo Biomarkers and multi-omics approaches for immune profiling and patient stratificationo Shared inflammatory mechanisms in OSA, asthma, and allergic rhinitiso Systemic implications of immune dysregulation, including cardiometabolic and neurological outcomeso Microbiome alterations and gut barrier dysfunction in sleep-related inflammationo Effects of continuous positive airway pressure, surgery, and oral appliances on immune markerso Multidisciplinary strategies integrating pulmonology, immunology, and otolaryngology in managemento Immunomodulatory and anti-inflammatory interventions for precision treatmentWe invite translational and mechanistic studies in the following article categories: Original Research Articles; Systematic Reviews and Meta-Analyses; Clinical Trials; Perspective and Hypothesis Papers. Topic editors: Jose David Abdullatif, Peter Baptista Source: https://www.frontiersin.org/research-topics/87265/sleep-disordered-breathing-and-immune-dysregulation-from-airway-inflammation-to-systemic-disease