CHEST Guidelines-Axon-and-Schwann-Cell-Degeneration-in-Nerves-of-Up

Axon-and-Schwann-Cell-Degeneration-in-Nerves-of-Up

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The study investigates the link between nerve injuries in the upper airways and pharyngeal dysfunction in snorers and patients with sleep apnea (OSA). Conducted by researchers from Umeå University, it involved 22 patients undergoing palatal surgery and 12 healthy controls. Tissue samples from the soft palate were analyzed using immunohistochemical and morphological methods to study axons, Schwann cells, and muscle integrity. Patients exhibited significantly fewer axons, a smaller area occupied by Schwann cells, and more circular-shaped Schwann cells lacking central axons compared to controls. These changes are linked to pharyngeal dysfunction and the severity of sleep apnea, reiterating that nerve injuries, potentially caused by snoring-induced vibrations and tissue stretching, lead to swallowing dysfunction and increased upper airway obstruction risk during sleep.<br /><br />The research highlighted a significant decrease in axon density within nerve fascicles and more connective tissue in patients. Regenerating axons were more prevalent in patients, with higher expression of GAP-43, a marker for nerve growth, indicating an attempted response to nerve injury. Muscle samples from patients showed signs of fiber size variability indicating denervation, with implications for muscle weakness contributing to dysfunction.<br /><br />Contributing to the understanding of OSA mechanisms, the study suggests that repeated vibratory trauma from snoring causes nerve and muscle injuries in the soft palate, disturbing the reflexes and neuromuscular responses needed to maintain airway patency during sleep. Addressing snoring-related trauma could improve nerve regeneration and overall pharyngeal function.<br /><br />The research, funded by various Swedish organizations, aligns with findings that disruptive neuromuscular function in OSA may have significant pathogenic relevance, highlighting the importance of further study and intervention strategies against snoring-induced trauma to the soft palate.

Keywords

nerve injuries

pharyngeal dysfunction

sleep apnea

snoring

Umeå University

soft palate

axon density

GAP-43

vibratory trauma

neuromuscular function