Chronobiology and Chronotherapy in Inflammatory Joint Diseases

Circadian rhythm perturbations can impact the evolution of different conditions, including autoimmune diseases. This narrative review summarizes the current understanding of circadian biology in inflammatory joint diseases and discusses the potential application of chronotherapy. Proinflammatory cyt...

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Autores principales:	Francesco Ursini, Alfredo De Giorgi, Martina D’Onghia, Roberto De Giorgio, Fabio Fabbian, Roberto Manfredini
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronobiology inflammatory joint diseases chronotherapy Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/8bb8504ea5824e9ba064831f16ea02dc
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spelling	oai:doaj.org-article:8bb8504ea5824e9ba064831f16ea02dc2021-11-25T18:40:59ZChronobiology and Chronotherapy in Inflammatory Joint Diseases10.3390/pharmaceutics131118321999-4923https://doaj.org/article/8bb8504ea5824e9ba064831f16ea02dc2021-11-01T00:00:00Zhttps://www.mdpi.com/1999-4923/13/11/1832https://doaj.org/toc/1999-4923Circadian rhythm perturbations can impact the evolution of different conditions, including autoimmune diseases. This narrative review summarizes the current understanding of circadian biology in inflammatory joint diseases and discusses the potential application of chronotherapy. Proinflammatory cytokines are key players in the development and progression of rheumatoid arthritis (RA), regulating cell survival/apoptosis, differentiation, and proliferation. The production and secretion of inflammatory cytokines show a dependence on the human day–night cycle, resulting in changing cytokine plasma levels over 24 h. Moreover, beyond the circadian rhythm of cytokine secretion, disturbances in timekeeping mechanisms have been proposed in RA. Taking into consideration chronotherapy concepts, modified-release (MR) prednisone tablets have been introduced to counteract the negative effects of night-time peaks of proinflammatory cytokines. Low-dose MR prednisone seems to be able to improve the course of RA, reduce morning stiffness and morning serum levels of IL-6, and induce significant clinical benefits. Additionally, methotrexate (MTX) chronotherapy has been reported to be associated with a significant improvement in RA activity score. Similar effects have been described for polymyalgia rheumatica and gout, although the available literature is still limited. Growing knowledge of chronobiology applied to inflammatory joint diseases could stimulate the development of new drug strategies to treat patients in accordance with biological rhythms and minimize side effects.Francesco UrsiniAlfredo De GiorgiMartina D’OnghiaRoberto De GiorgioFabio FabbianRoberto ManfrediniMDPI AGarticlechronobiologyinflammatory joint diseaseschronotherapyPharmacy and materia medicaRS1-441ENPharmaceutics, Vol 13, Iss 1832, p 1832 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronobiology inflammatory joint diseases chronotherapy Pharmacy and materia medica RS1-441
spellingShingle	chronobiology inflammatory joint diseases chronotherapy Pharmacy and materia medica RS1-441 Francesco Ursini Alfredo De Giorgi Martina D’Onghia Roberto De Giorgio Fabio Fabbian Roberto Manfredini Chronobiology and Chronotherapy in Inflammatory Joint Diseases
description	Circadian rhythm perturbations can impact the evolution of different conditions, including autoimmune diseases. This narrative review summarizes the current understanding of circadian biology in inflammatory joint diseases and discusses the potential application of chronotherapy. Proinflammatory cytokines are key players in the development and progression of rheumatoid arthritis (RA), regulating cell survival/apoptosis, differentiation, and proliferation. The production and secretion of inflammatory cytokines show a dependence on the human day–night cycle, resulting in changing cytokine plasma levels over 24 h. Moreover, beyond the circadian rhythm of cytokine secretion, disturbances in timekeeping mechanisms have been proposed in RA. Taking into consideration chronotherapy concepts, modified-release (MR) prednisone tablets have been introduced to counteract the negative effects of night-time peaks of proinflammatory cytokines. Low-dose MR prednisone seems to be able to improve the course of RA, reduce morning stiffness and morning serum levels of IL-6, and induce significant clinical benefits. Additionally, methotrexate (MTX) chronotherapy has been reported to be associated with a significant improvement in RA activity score. Similar effects have been described for polymyalgia rheumatica and gout, although the available literature is still limited. Growing knowledge of chronobiology applied to inflammatory joint diseases could stimulate the development of new drug strategies to treat patients in accordance with biological rhythms and minimize side effects.
format	article
author	Francesco Ursini Alfredo De Giorgi Martina D’Onghia Roberto De Giorgio Fabio Fabbian Roberto Manfredini
author_facet	Francesco Ursini Alfredo De Giorgi Martina D’Onghia Roberto De Giorgio Fabio Fabbian Roberto Manfredini
author_sort	Francesco Ursini
title	Chronobiology and Chronotherapy in Inflammatory Joint Diseases
title_short	Chronobiology and Chronotherapy in Inflammatory Joint Diseases
title_full	Chronobiology and Chronotherapy in Inflammatory Joint Diseases
title_fullStr	Chronobiology and Chronotherapy in Inflammatory Joint Diseases
title_full_unstemmed	Chronobiology and Chronotherapy in Inflammatory Joint Diseases
title_sort	chronobiology and chronotherapy in inflammatory joint diseases
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8bb8504ea5824e9ba064831f16ea02dc
work_keys_str_mv	AT francescoursini chronobiologyandchronotherapyininflammatoryjointdiseases AT alfredodegiorgi chronobiologyandchronotherapyininflammatoryjointdiseases AT martinadonghia chronobiologyandchronotherapyininflammatoryjointdiseases AT robertodegiorgio chronobiologyandchronotherapyininflammatoryjointdiseases AT fabiofabbian chronobiologyandchronotherapyininflammatoryjointdiseases AT robertomanfredini chronobiologyandchronotherapyininflammatoryjointdiseases
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Chronobiology and Chronotherapy in Inflammatory Joint Diseases

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