Genetic predictive links between oropharyngeal microecology and obstructive sleep apnea syndrome: expanding the perspective of etiology

Background Obstructive sleep apnea syndrome (OSAS), a global public health concern, is linked to oropharyngeal microbiota, but observational studies cannot confirm their causal association.Objective To explore the potential causal relationship between oropharyngeal microecology and OSAS.Methods The data related to the oropharyngeal microbiome and this disease were obtained from China Nucleotide Sequence Archive and genome-wide association studies. Moreover, we screened qualified single nucleotide polymorphisms as instrumental variables. Two-sample Mendelian randomization bidirectional analysis was conducted using methods such as Wald ratio and inverse-variance weighted. The horizontal pleiotropy was judged by the MR-Egger intercept, and the sensitivity analysis was conducted by the “Leave-one-out” method and Cochran's Q assessment.Results Interferences in the abundance of specific strains of oropharynx (overall, the Firmicutes/Bacteroidetes phylum ratio ↑) raised the risk of OSAS, such as increased Streptococcus mgs 2253 (OR = 4.280) and decreased Prevotella mgs 3161 (OR = 0.218). Conversely, OSAS also affected the abundance of some oropharyngeal microorganisms, such as a decrease in Neisseria lactamica mgs 343 and an increase in Pauljensenia mgs 2308.Conclusion This study emphasizes the causal relationship between oropharyngeal microecology and OSAS, expands the new etiological mechanism, and provides potential novel strategies for the prevention and treatment of OSAS.