Exosomes Implication in PD1-PD-L1 Activation in OSAS

Study Overview
=================
Brief Summary
-----------------
An increased occurrence of cancer associated mortality has been described in patients with Obstructive Sleep Apnea Syndrome (OSAS). This association might be partially explained by an impaired cellular immune response that has been described in OSAS. Is has been suggested that OSAS impact immune cells by upregulation of the PD-1/PD-L1 pathway. Exosomes are small membrane vesicles released by numerous cells in the bloodstream. Exosomes have been shown to be implicated in cancer cells proliferation via a PD-1/PD-L1 pathway activation. This study will evaluate exosomal PD-1/PD-L1 expression in patients with OSAS as compared to controls and will further investigate their impact on immune cells function and proliferation capacities.

Official Title
-----------------
Exosomes Implication in PD1-PD-L1 Pathway Activation in Obstructive Sleep Apnea Syndrome

Conditions
-----------------
Sleep Apnea Syndromes, Obstructive, Cancer

Intervention / Treatment
-----------------
* Diagnostic Test: PD1/PD-L1 exosomal expression


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients requiring a sleep recording for suspected OSAS Exclusion Criteria: Préviously treated OSAS Cancer past history Pregnant women Cognitif impairment

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| OSAS patients<br>45 patients investigated for suspected OSAS with an apnea hypopnea index ≥15 per hour | Diagnostic Test: PD1/PD-L1 exosomal expression<br>* exosomal PD1/PD-L1 expression<br>|
| Non OSAS patients<br>45 patients investigated for suspected OSAS with an apnea hypopnea index <15 per hour | Diagnostic Test: PD1/PD-L1 exosomal expression<br>* exosomal PD1/PD-L1 expression<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| exosomal PD1 expression | Peripheral blood (≈20 ml) will be collected from non-OSAS or OSAS subjects on EDTA-coated tubes. Exosomes will be isolated by centrifugation. For detecting exosome-associated surface proteins by flow cytometry, exosomes will be first captured on magnetic beads. The bead/exosome complexes will be then co-incubated with the labeled detection antibodies, either anti-PD1. Next, the complexes will be washed 3x resuspended in 300uL of PBS for antigen detection by flow cytometry. | at baseline | 
| exosomal PD-L1 expression | Peripheral blood (≈20 ml) will be collected from non-OSAS or OSAS subjects on EDTA-coated tubes. Exosomes will be isolated by centrifugation. For detecting exosome-associated surface proteins by flow cytometry, exosomes will be first captured on magnetic beads. The bead/exosome complexes will be then co-incubated with the labeled detection antibodies, either anti-PD-L1. Next, the complexes will be washed 3x resuspended in 300uL of PBS for antigen detection by flow cytometry. | at baseline |