Association of Depression with Long-Term Cardiovascular Risks in Older Patients with Obstructive Sleep Apnea.

Introduction: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Depression is a crucial factor among the various factors that are associated with OSA and CVD. Purpose: This study was conducted with an aim to assess the prognostic significance of depression on the MACE in older patients with OSA. Patients and Methods: 1106 older patients with OSA, without myocardial infarction (MI), history of hospitalization for unstable angina, or heart failure at baseline were enrolled and followed up prospectively. Incidence rates were expressed as cumulative incidence. Cox proportional hazards analysis was used to estimate the risk of all events. The primary outcomes were major adverse cardiovascular events (MACE). Each patient underwent polysomnography (PSG) and GDS-12 scale assessment. Those with an apnea-hypopnea index (AHI) greater than 5 were diagnosed with OSA, while those with a scale score greater than 3 were diagnosed with depression. Results: Among the 1106 older patients with OSA, depression was found in 133(12.0%) patients, 96(8.7%) patients experienced MACE during the follow-up. Depression was associated with a higher cumulative incidence of MACE in older patients with OSA. Multivariate analysis revealed that depression independently increased the risk of MACE (adjusted hazard ratio [aHR] = 2.29; 95% confidence interval [CI]: 1.34-3.90; P = 0.002). Subgroup analyses showed that male patients (aHR = 2.96; 95% CI: 1.52-5.77; P = 0.001), overweight-obese individuals (aHR = 2.98; 95% CI: 1.49-6.00; P = 0.002), and those with moderate-severe OSA (aHR = 2.82; 95% CI: 1.55-5.14; P = 0.001) and concurrent depression were at a higher risk for MACE. Conclusion: Depression is common in older patients with OSA in the absence of MI, hospitalization for unstable angina, or heart failure, and confers an independent, increased risk of MACE.

Multifunctional annulus fibrosus matrix prevents disc-related pain via inhibiting neuroinflammation and sensitization.

Chronic low back pain mainly attributed to intervertebral disc (IVD) degeneration. Endogenous damage-associated molecular patterns (DAMPs) in the injured IVD, particularly mitochondria-derived nucleic acid molecules (CpG DNA), play a primary role in the inflammatory responses in macrophages. M1-type macrophages form a chronic inflammatory microenvironment by releasing pro-inflammatory factors and nerve growth factor (NGF) that induce nerve growth into the inner annulus fibrosus, resulting in persistent hyperalgesia. We fabricated an amphiphilic polycarbonate that naturally forms cationic nanoparticles (cNP) in aqueous solutions, with the hydrophobic core loaded with TrkA-IN-1, an antagonist against the NGF receptor (TrkA). The drug delivery nanoparticles were denoted as TI-cNP. TrkA-IN-1 and TI-cNP were added to the decellularized annulus fibrosus matrix (DAF) hydrogel to form hybrid hydrogels, denoted as TI-DAF and TI-cNP-DAF, respectively. As a result, TrkA-IN-1 showed a delayed release profile both in TI-DAF and TI-cNP-DAF. Each mole of cNP could bind approximately 3 mol of CpG DNA to inhibit inflammation. cNP-DAF and TI-cNP-DAF significantly inhibited the M1 phenotype induced by CpG DNA. TI-DAF and TI-cNP-DAF reduced neurite branching and axon length, and inhibited the expression of neurogenic mediators (CGRP and substance P) in the presence of NGF. Besides, TI-cNP-DAF relieved mechanical hyperalgesia, reduced CGRP and substance P expression in the dorsal root ganglion, and downregulated GFAP and c-FOS signaling in the spinal cord in the rat disc herniation model. Summarily, TI-cNP-DAF, a novel composite IVD hydrogel, efficiently mediated the inflammatory environment, inhibited nerve ingrowth and sensitization, and could be clinically applied for treating discogenic pain. STATEMENT OF SIGNIFICANCE: Discogenic lower back pain, related to intervertebral disc degeneration (IDD), imposes a tremendous health and economic burden globally. M1-type macrophages release pro-inflammatory factors and nerve growth factor (NGF) that induce nerve growth into the inner annulus fibrosus, resulting in persistent hyperalgesia and discogenic pain. Reconstructing matrix integrity and modulating the inflammatory microenvironment are promising strategies for preventing the ingrowth and activation of neurites. The TI-cNP-DAF hydrogel recovers tissue integrity, alleviates inflammation, and delivers the TrkA antagonist to inhibit the activity of NGF, thus restraining hyperinnervation and nociceptive input. Due to its simple production process, injectability, and acellular strategy, the hydrogel is operable and holds great potential for treating discogenic lower back pain.

Boosting the Utilization and Electrochemical Performances of Polyaniline by Forming a Binder-Free Nanoscale Coaxially Coated Polyaniline/Carbon Nanotube/Carbon Fiber Paper Hierarchical 3D Microstructure Composite as a Supercapacitor Electrode.

Nanoscale polyaniline (PANI) is formed on a hierarchical 3D microstructure carbon nanotubes (CNTs)/carbon fiber paper (CFP) substrate via a one-step electrochemical polymerization method. The chemical and structural properties of the binder-free PANI/CNTs/CFP electrode are characterized by field emission scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy. The specific capacitance of PANI/CNTs/CFP tested in a symmetric two-electrode system reaches 731.6 mF·cm-2 (1354.7 F·g-1) at a current density of 1 mA·cm-2 (1.8 A·g-1). The symmetric supercapacitor device demonstrates excellent cycling performance up to 10,000 cycles with a capacitance retention of 81.4% at a current density of 1 mA·cm-2 (1.8 A·g-1). The results demonstrate that the binder-free CNTs/CFP composite is a strong backbone for depositing ultrathin PANI layers at a high mass loading. The hierarchical 3D microstructure PANI/CNTs/CFP provides enough space and transporting channels to form an efficient electrode-electrolyte interface for the supercapacitance reaction. The formed nanoscale PANI film coaxially coated on the sidewalls of CNTs enables efficient charge transfer and a shortened diffusion length. Hence, the utilization efficiency and electrochemical performances of PANI are significantly improved. The rational design strategy of a CNT-based binder-free hierarchical 3D microstructure can be used in preparing various advanced energy-storage electrodes for electrochemical energy-storage and conversion systems.