EDITORIAL
Circadian rhythms of nocturnal hormones in rheumatoid arthritis: translation from bench to bedside
1 Research Laboratories and Clinical Academic Unit of Rheumatology, University of Genova Italy
2 Neuroendocrinoimmunology Laboratory, Department of Internal Medicine I, University Hospital, Regensburg, Germany
3 Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
Correspondence to:
Maurizio Cutolo, Research Laboratories and Clinical Academic Unit of Rheumatology, University of Genova Italy, Viale Benedetto XV, 6, 16132 Genova Italy; mcutolo@unige.it
Accepted 8 March 2008
| The first 150 words of the full text of this article appear below. |
Translation from basic research to clinical medicine is complex and needs to be carefully performed. In addition, translational research is needed using human subjects who meet current diagnostic criteria.
Recently, circadian rhythm science has pointed the way to rational intervention on nocturnal hormone production to modulate the immune/inflammatory reactions in patients suffering from rheumatoid arthritis (RA).1 2 These approaches have been introduced into practice with increasing degrees of interest.3
We will discuss two recent examples of therapeutically modulating melatonin (MLT) and cortisol as nocturnal hormones implicated in RA clinical circadian rhythms.
It has been known for many decades that disease symptoms in RA follow obvious circadian rhythms, with an increase of activity in the early morning hours, abatement during the day, and a smaller new increase in the early evening (fig 1A).3 4
Figure 1 Circadian rhythm of symptoms and interleukin (IL)-6. A. The graph depicts the circadian rhythm of joint stiffness, | |||||||||
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