Biochemical and clinical effects of continuous positive airway pressure combined with sildenafil on inflammatory and hemodynamic profiles in obese asthma patients with pulmonary arterial hypertension.

Wenmei Bai, Nana Wang, Zixuan Wang, Zhimin Wu, Xueying Luo, Fengsen Li

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Article in Journal of medical biochemistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Wenmei BaiXinjiang Medical University Affiliated Traditional Chinese Medicine Hospital, Department of Respiratory, Urumqi, China.

Nana WangXinjiang Medical University Affiliated Traditional Chinese Medicine Hospital, Department of Respiratory, Urumqi, China.

Zixuan WangXinjiang Medical University, Urumqi, China.

Zhimin WuXinjiang Medical University, Urumqi, China.

Xueying LuoXinjiang Medical University, Urumqi, China.

Fengsen LiXinjiang Medical University Affiliated Traditional Chinese Medicine Hospital, Department of Respiratory, Urumqi, China.

Funding

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6 · The paper itself

Abstract

Background: Obesity-associated asthma complicated by pulmonary arterial hypertension (PAH) involves multifactorial biochemical dysregulation, including endothelial dysfunction, oxidative stress, and chronic inflammation. This study aimed to evaluate the combined biochemical and clinical effects of continuous positive airway pressure (CPAP) and sildenafil on pulmonary function, inflammatory biomarkers, and hemodynamic parameters in obese asthma patients with PAH. Methods: A total of 134 patients (BMI >30 kg/m2, FEV1 < 70% pred, PASP > 30 mmHg) were enrolled and divided into a treatment group (n = 63, CPAP + sildenafil) and a control group (n = 71, sildenafil alone). Pulmonary and hemodynamic indices (PaÜ2, FiÜ2, PASP, OI, and PaO2/FiO2), lung function parameters (FEV1 , PEF), and asthma control test (ACT) scores were assessed at baseline and follow-up (6 and 12 months). Serum interleukin-6 (IL-6), tumor necrosis factor-a (TNF-α), and fractional exhaled nitric oxide (FeNO) were quantified to evaluate biochemical inflammation. Correlation analysis was performed between biomarker changes and ACT improvements. Results: The CPAP + sildenafil group showed significantly higher post-treatment PaÜ2 levels, lower PASP and FiÜ2 values, improved OI, and greater increases in PaO2/FiO2 and FEV1 percentages compared with the control group (P < 0.001). Biochemical assays revealed substantial reductions in serum IL-6 and TNF-α levels, as well as FeNO concentrations, in the combination group. Post-treatment changes in IL-6 (r= 0.68, P < 0.0001), TNF-α (r= 0.59, P < 0.0001), and FeNO (r= 0.72, P < 0.0001) were strongly correlated with improved ACT scores, suggesting a close biochemical-clinical relationship between airway inflammation and therapeutic response. Conclusions: CPAP combined with sildenafil exerts dual biochemical and clinical benefits in obese asthma patients with PAH by enhancing oxygenation, lowering pulmonary artery pressure, and suppressing inflammatory cytokine activity. The observed reductions in IL-6, TNF-α, and FeNO highlight the biochemical basis of treatment efficacy and the potential of these markers as laboratory indicators for monitoring therapeutic outcomes.

Indexed as

biochemical markerscontinuous positive airway pressureFeNOIL-6obese asthmapulmonary arterial hypertensionsildenafilTNF-α

Identifiers

PMID42775035

DOI10.5937/jomb0-62326

PMCPMC13596864

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.