Altered circadian rhythms in rheumatoid arthritis patients play a role in the disease's symptoms

被引:91
作者
Cutolo, M
Villaggio, B
Otsa, K
Aakre, O
Sulli, A
Seriolo, B
机构
[1] Univ Genoa, Dept Immunol & Endocrinol, Res Lab, I-16132 Genoa, Italy
[2] Univ Genoa, Dept Immunol & Endocrinol, Div Rheumatol, I-16132 Genoa, Italy
[3] Cent Hosp, Dept Rheumatol, Tallinn, Estonia
关键词
D O I
10.1016/j.autrev.2005.04.019
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The circadian changes in the metabolism or nocturnal secretion of endogenous corticosteroids (reduction) observed in rheumatoid arthritis (RA) patients are responsible, in part, for the tirne-dependent changes that are observed in the inflammatory response and related early morning clinical symptoms of the disease. Melatonin (MLT), another circadian nocturnal hormone that is the secretory product of the pineal gland, has been implicated in the time-dependent RA inflammatory reaction with effects that are opposite to those of corticosteroids. As a consequence, altered functioning of the HPA axis (early morning reduced corticosteroid production) and of the pineal gland (night increased MLT production) found in RA patients, seem to be important factors in the appearance and perpetuation of the clinical circadian symptoms of the disease. Consistently, human proinflarnmatory Th1-type cytokine production (related to MLT stimulation) exhibits a diumal rhythmicity with peak levels during the night and early morning, at a time when plasma cortisol (inducing the Th2-type cytokine production) is lowest and MLT is highest. Reduced daily light exposure as observed in northern Europe (Estonia), at least during the winter, might explain the higher and more prolonged serum MLT concentrations that were observed in northern RA patients, as well as some epidemiological features versus southern Europe patients. (c) 2005 Elsevier B.V. All tights reserved.
引用
收藏
页码:497 / 502
页数:6
相关论文
共 32 条
[1]   Epidemiological and clinical aspects relating to the variability of rheumatoid arthritis [J].
AbdelNasser, AM ;
Rasker, JJ ;
Valkenburg, HA .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 1997, 27 (02) :123-140
[2]   CIRCADIAN-RHYTHM OF SERUM INTERLEUKIN-6 IN RHEUMATOID-ARTHRITIS [J].
ARVIDSON, NG ;
GUDBJORNSSON, B ;
ELFMAN, L ;
RYDEN, AC ;
TOTTERMAN, TH ;
HALLGREN, R .
ANNALS OF THE RHEUMATIC DISEASES, 1994, 53 (08) :521-524
[3]   Vitamin D and autoimmunity: Is vitamin D status an environmental factor affecting autoimmune disease prevalence? [J].
Cantorna, MT .
PROCEEDINGS OF THE SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE, 2000, 223 (03) :230-233
[4]   SEMINARS IN MEDICINE OF THE BETH-ISRAEL-HOSPITAL, BOSTON - THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND IMMUNE-MEDIATED INFLAMMATION [J].
CHROUSOS, GP .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (20) :1351-1362
[5]   Circadian relationships between interleukin (IL)-6 and hypothalamic-pituitary-adrenal axis hormones: Failure of IL-6 to cause sustained hypercortisolism in patients with early untreated rheumatoid arthritis [J].
Crofford, LJ ;
Kalogeras, KT ;
Mastorakos, G ;
Magiakou, MA ;
Wells, J ;
Kanik, KS ;
Gold, PW ;
Chrousos, GP ;
Wilder, RL .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (04) :1279-1283
[6]   Melatonin influences interleukin-12 and nitric oxide production by primary cultures of rheumatoid synovial macrophages and THP-1 cells [J].
Cutolo, M ;
Villaggio, B ;
Candido, F ;
Valenti, S ;
Giusti, M ;
Felli, L ;
Sulli, A ;
Accardo, S .
NEUROENDOCRINE IMMUNE BASIS OF THE RHEUMATIC DISEASES, 1999, 876 :246-254
[7]   Circadian rhythms and arthritis [J].
Cutolo, M ;
Masi, AT .
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA, 2005, 31 (01) :115-+
[8]   Circadian melatonin and cortisol levels in rheumatoid arthritis patients in winter time: a north and south Europe comparison [J].
Cutolo, M ;
Maestroni, GJM ;
Otsa, K ;
Aakre, O ;
Villaggio, B ;
Capellino, S ;
Montagna, P ;
Fazzuoli, L ;
Veldi, T ;
Peets, T ;
Hertens, E ;
Sulli, A .
ANNALS OF THE RHEUMATIC DISEASES, 2005, 64 (02) :212-216
[9]  
Cutolo M, 1999, J RHEUMATOL, V26, P282
[10]  
Cutolo M, 2003, CLIN EXP RHEUMATOL, V21, P148