# Exploring the molecular link between obstructive sleep apnea and interstitial cystitis/bladder pain syndrome: A bioinformatics and machine learning study

**Authors:** Yang Xu, Fei Jiang, Bin Zheng, Guang-Lei Zhang, Ren-Hu Li

PMC · DOI: 10.1371/journal.pone.0339824 · PLOS One · 2025-12-31

## TL;DR

This study explores the molecular connection between obstructive sleep apnea and bladder pain syndrome using bioinformatics and machine learning to find shared genes and pathways.

## Contribution

Identifies DUSP9 as a shared biomarker linking OSA and IC/BPS through integrated bioinformatics and machine learning analysis.

## Key findings

- 2,233 and 1,183 differentially expressed genes were identified in OSA and IC/BPS, respectively, with 93 overlapping genes.
- DUSP9 was identified as a key shared gene linking both disorders, forming two-gene signatures for each condition.

## Abstract

Obstructive sleep apnea (OSA) and interstitial cystitis/bladder pain syndrome (IC/BPS) are chronic conditions that significantly impact patients’ quality of life. OSA involves recurrent upper airway obstruction during sleep, causing hypoxia and fragmented sleep linked to cardiovascular and metabolic issues. IC/BPS is defined by chronic pelvic pain and urinary symptoms; its pathophysiology is complex and poorly understood. The overlap in the prevalence of OSA and IC/BPS suggests a possible shared pathophysiological link. This study aimed to identify shared molecular mechanisms and diagnostic biomarkers between OSA and IC/BPS through integrated bioinformatics approaches.

This study used bioinformatics and machine learning to analyze transcriptomic data for OSA and IC/BPS, identifying differential expressed genes (DEGs) and enriched pathways from Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) constructed gene co-expression networks and identified hub genes, while immune infiltration analysis characterized the immune microenvironment. Four machine learning algorithms developed diagnostic models and also identified key markers.

A total of 2,233 DEGs were identified in OSA and 1,183 in IC/BPS, with 93 overlapping genes. Among these, machine learning algorithms identified DUSP9 as the single common gene linking both disorders, forming two-gene signatures for each condition (DUSP9/CCDC68 for OSA and DUSP9/KPNA2 for IC/BPS). Key pathways for OSA included RIG-I-like and NOD-like receptor signaling. In contrast, IC/BPS was linked to cytokine interactions and JAK-STAT signaling. Immune infiltration analysis showed that DUSP9 expression was correlated with CD56dim natural killer cells in OSA and with activated CD4 T cells in IC/BPS, further supporting its role in the immune response associated with these disorders.

This study established DUSP9 as a pivotal shared biomarker and central regulator linking OSA and IC/BPS through integrated bioinformatics analysis.

## Linked entities

- **Genes:** DUSP9 (dual specificity phosphatase 9) [NCBI Gene 1852], CCDC68 (coiled-coil domain containing 68) [NCBI Gene 80323], KPNA2 (karyopherin subunit alpha 2) [NCBI Gene 3838]
- **Diseases:** obstructive sleep apnea (MONDO:0007147), interstitial cystitis/bladder pain syndrome (MONDO:0018301)

## Full-text entities

- **Genes:** DUSP9 (dual specificity phosphatase 9) [NCBI Gene 1852] {aka MKP-4, MKP4}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, KPNA2 (karyopherin subunit alpha 2) [NCBI Gene 3838] {aka IPOA1, PTAC58, QIP2, RCH1, SRP1-alpha, SRP1alpha}, CCDC68 (coiled-coil domain containing 68) [NCBI Gene 80323] {aka SE57-1}
- **Diseases:** bladder pain syndrome (MESH:D018856), pelvic pain (MESH:D017699), OSA (MESH:D020181), upper airway obstruction (MESH:D000402), IC (MESH:C537984), hypoxia (MESH:D000860)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

7 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12755753/full.md

## References

32 references — full list in the complete paper: https://tomesphere.com/paper/PMC12755753/full.md

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Source: https://tomesphere.com/paper/PMC12755753