Circadian rhythms and rheumatoid arthritis

Publication date: Available online 15 September 2018Source: Joint Bone SpineAuthor(s): Cutolo MaurizioAbstractCircadian rhythms (Nobel prize for Medicine 2017) regulate, under action of biological clocks located both at the level of central nervous system and inside peripheral cells, several daily activities, embracing sleep, feeding times, energy metabolism, endocrine and immune functions with related pathological conditions, including rheumatoid arthritis (RA).In RA the circadian rhythms impact on cellular functions, involving night synthesis and release of proinflammatory cytokines and chemokines, cell migration to inflamed tissues, phagocytosis, proliferative cell response and all are peaking at late night. In chronic inflammatory conditions such as RA, the amplitude of the circadian rhythm of the anti-inflammatory endogenous cortisol availability is not increased as expected and requested, which indicate a reduced night cortisol secretion under the adrenal chronic stress induced by the disease. Therefore, the prevention/treatment of the Immune cell night hyperactivity, with related flare of cytokine synthesis and morning RA clinical symptoms, has been shown more effective when the availability of the exogenous glucocorticoids is obtained in the middle of the night (night release). The impressive positive results observed in RA patients treated with modified night release prednisone with a low-dose chronotherapy, seem applicable even for other agents such as conventional ...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research