期刊
AUTOIMMUNITY REVIEWS
卷 7, 期 3, 页码 223-228出版社
ELSEVIER
DOI: 10.1016/j.autrev.2007.11.019
关键词
rheumatoid arthritis; circadian rhythms; circannual rhythms; hormones; immune response; cortisol
类别
Biological signaling and rhythms occur in a complex network with participation and interaction of the central nervous system, the autonomic nervous system, the endocrine glands, peripheral endocrine tissues and the immune system. It is a clinical observation that patients affected by chronic immune/inflammatory conditions (i.e. rheumatoid arthritis/RA) exhibit circadian, circamensual (females) and circannual rhythms of disease-related symptoms. Proinflammatory cytokines exhibit a peculiar rhythmicity, in particular serum TNF and serum IL-6, and together,with other relevant immunological parameters display an elevation in the early morning hours in patients with RA. As a matter of fact, RA patients particularly experience joint pain, morning stiffness, and functional disability in the early morning hours. Since circadian rhythmicity of neuroendocrine pathways is closely coupled to. inumme/inflammatory reactions, new aspects at least concerning RA management are suggested. In particular, further investigations will indicate whether timed release of immunosuppressive/antiinflammatory drugs will have increased efficacy and whether dosages can be reduced below critical levels above which adverse events appear. (C) 2007 Elsevier B.V. All rights reserved.
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