Dynamic urinary proteomic signatures reveal key molecular pathways and biomarkers in pediatric obstructive sleep apnea
Year: 2026
Type: article
Study design: Observational Study
Abstract: This study aimed to determine whether paired pre-sleep and morning urinary proteomic profiling, expressed as the morning-to-bedtime protein ratio, can identify severity-associated molecular signatures and candidate biomarkers in pediatric obstructive sleep apnea (OSA). A total of 40 children were included, comprising 13 non-snoring controls and 27 children with PSG-defined OSA, including mild, moderate, and severe disease. Urine samples were collected before sleep and the following morning. Data-independent acquisition mass spectrometry was used to quantify proteins, and morning-to-bedtime ratios were calculated. Clustering, functional enrichment, protein-protein interaction network analysis, molecular docking, and single-cell RNA-seq validation were performed. Five distinct expression patterns were identified, among which Cluster 4 showed a progressive decline in morning-to-bedtime ratios with increasing OSA severity. IGFBP7, PRDX1, GSTP1, and IL6ST emerged as hub proteins associated with extracellular matrix remodeling, oxidative stress, and inflammatory signaling. Molecular docking demonstrated strong affinities between these proteins and commonly used OSA medications. Single-cell analyses revealed that the key proteins originate mainly from activated immune cell subsets, linking urinary alterations to systemic immune responses. Dynamic urinary proteomic profiling, particularly the morning-to-bedtime ratio, sensitively reflects nocturnal pathophysiological disturbances in pediatric OSA. IGFBP7, PRDX1, GSTP1, and IL6ST represent promising noninvasive biomarker candidates for disease stratification and provide hypothesis-generating molecular targets for future mechanistic and therapeutic studies.
Source: Respiratory Research
Authors: Kai Zhang, Yunxiao Wu, Li Zheng, Xin Ni, Zhifei Xu
Institutions: Capital Medical University, Beijing Children’s Hospital
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,490
Awards: G1001334787, G9000371073
OpenAlex ID: W7214061937
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