Oxidative Stress and Inflammation in COPD and Sleep Apnea and Its Comorbidities. Molecular Insights and Artificial Intelligence Approaches in Diagnosis and Prognosis

In chronic respiratory diseases (CRDs), oxidative stress and inflammation exhibit a strong pathophysiological interplay, playing essential roles in the onset and progression of these conditions and their associated comorbidities. Oxidative stress can activate inflammatory pathways, leading to sustained airway inflammation. In turn, chronic inflammation can increase the production of reactive oxygen species (ROS), thereby exacerbating oxidative stress. This vicious cycle contributes to airway remodeling, reduced lung function, and disease progression. This review emphasizes the central roles of inflammation and oxidative stress in two of the most prevalent hypoxemic conditions, chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA), as well as their involvement in the development of major comorbidities. A comprehensive understanding of these processes is crucial to developing therapeutic strategies aimed at reducing oxidative stress and inflammation for the effective management and treatment of CRDs and their comorbidities. It also underscores the crucial role of hypoxia and its transcriptional effects, mediated by hypoxia-inducible factors (HIF), as a primary driver of disease progression through the promotion of oxidative stress and inflammation. Another key element is the rapid advancement of Artificial Intelligence (AI), which presents promising strategies to mitigate the global burden of CRDs. AI holds potential for reducing healthcare costs while improving diagnostic specificity, enabling earlier detection, and optimizing disease monitoring and management. This review explores the current landscape and future prospects of AI in transforming the diagnosis, clinical management, and prognosis of these respira-tory disorders.