OSA and your gut microbiota, and how RNAs could unlock understanding in cancer and OSA

Wang et al, in today’s Nature journal, report on the relationship between intestinal microbiota composition and the severity of OSA.

So, we already know about this a little bit from previous studies outlining the relationship between gut microbiota dysbiosis and OSA (upgrade below to read more about this). The novelty here, however, is that Wang et al directly correlate the changes in gut microbiota composition with the different severities of OSA. As OSA severity increases, diversity of microbiota decreases. They also highlight the functional alterations related to a reduction in short-chain fatty acids which can provide a link to the metabolic disorders encountered in OSA. Read the full article here!

From a research and clinical applicability perspective, we ought to learn from this. This is probably out of the scope of a standard medical consultation due to time and resource restrictions, but we can keep in our minds how the traditional OSA assessment could evolve in the future based on further research and clinical validation. Given the connection between gut dysbiosis and OSA, OSA clinicians might expand their assessment to include GI symptoms such as bloating and altered bowl habits. Future research could entail baseline gut microbiota screening alongside the AHI to risk stratify patients as part of a multi-modal approach to help predict risk of metabolic co-morbidities (e.g. diabetes, hypertension). Stool sampling could present an interesting new paradigm for metabolomic profiling and helping to uncover endophenotypes that are at higher risk for developing OSA-linked chronic conditions.

Specific bacteria become depleted in severe OSA, therefore research on the targeted use of probiotics and/or prebiotics that could mitigate the chronic sequelae of OSA. Upgrade for more on the link between OSA and the gut!

How RNAs could hold the key to understanding OSA

Soccio et al report the impact of microRNA (miRNA) expression on survival outcomes in patients with OSA and metastatic colorectal cancer.

Researchers found that specific miRNAs were significantly unregulated in OSA patients, and these miRNAs were known for their roles in tumour progression, resistance to therapy, and poor survival outcomes. Read the article here!

There is a complex interaction between OSA and cancer progression. These findings create a possibility to further research miRNA-based diagnostic tools to assess prognosis and personalise treatment strategies, as well as a therapeutic target. Whilst this study pertains specifically to metastatic colorectal cancer, it is possible that it is pertinent for all cancers due to the known effect of chronic intermittent hypoxia and inflammation that OSA drives.

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