Circadian rhythm and joint stiffness/destruction in rheumatoid arthritis

  title={Circadian rhythm and joint stiffness/destruction in rheumatoid arthritis},
  author={Kohsuke Yoshida and Teppei Hashimoto and Yoshitada Sakai and Akira Hashiramoto},
  journal={International Journal of Clinical Rheumatology},
In patients with rheumatoid arthritis, joint stiffness and pain levels reach peak in the morning, which is a characteristic symptom with diurnal fluctuation. In human, several types of hormone secretion, cytokine and antibody production are accelerated during night time as compared with those of day time, and these immune systems are partially controlled by circadian clock genes that regulate circadian rhythm. In this review, we focus on the interaction between circadian clock genes, immune… 
2 Citations

Figures and Tables from this paper

Expressions of circadian clock genes represent disease activities of RA patients treated with biological DMARDs

The expressions of the clock genes in leukocytes could be useful as novel biomarkers predicting disease activities and therapeutic efficacies for bDMARDs in RA treatments.



Involvement of the Circadian Rhythm and Inflammatory Cytokines in the Pathogenesis of Rheumatoid Arthritis

The link between the circadian clock and inflammation is explored, focusing on the interactions of various clock genes with the immune-pathways underlying the pathology of rheumatoid arthritis.

The role of the circadian clock in rheumatoid arthritis

A full understanding of the mechanisms by which the clock couples to the immune system may provide novel therapeutic targets for the treatment of rheumatoid arthritis and improve the efficacy of current treatment strategies.

Clocking in: chronobiology in rheumatoid arthritis

The most compelling evidence for RA chronotherapy, however, is that coordinating the timing of glucocorticoid therapy to coincide with the nocturnal increase in blood IL-6 levels results in reduced morning stiffness and pain compared with the same glucoc Corticoid dose taken in the morning.

Circadian rhythms in rheumatoid arthritis: implications for pathophysiology and therapeutic management.

This review briefly summarizes present knowledge on how circadian rhythm is generated in the central nervous system (CNS) and addresses studies demonstrating connections between the central oscillator and neuroendocrine pathways and the periphery (peripheral inflammation).

Chronobiology and the treatment of rheumatoid arthritis

  • M. Cutolo
  • Medicine, Biology
    Current opinion in rheumatology
  • 2012
The most advanced approach to optimizing the risk-benefit ratio for long-term glucocorticoid treatment in RA seems to be low-dose chronotherapy with modified nighttime release prednisone (release at 3 a.m.).

Circadian Timekeeping Is Disturbed in Rheumatoid Arthritis at Molecular Level

The molecular machinery controlling the circadian rhythm is disturbed in RA patients, and ARNTL2 and NPAS2 appeared to be the most affected clock genes in human immune-inflammatory conditions.

Morning melatonin serum values do not correlate with disease activity in rheumatoid arthritis: a cross-sectional study

It is denoted that morning MLT serum values are higher in RA patients than in healthy volunteers, however, MLT and RA disease activity or other disease characteristics do not correlate.

Circadian rhythms of cellular immunity in rheumatoid arthritis: a hypothesis-generating study.

In RA some immune cell populations lose their normal circadian rhythms whereas others establish new 'inflammatory' circadian rhythms and these findings provide a good basis for further identifying pathophysiological aspects of RA chronobiology with potential therapeutic implications.

The timing of prednisolone dosage and its effect on morning stiffness in rheumatoid arthritis.

Patients with rheumatoid arthritis maintained on low dose prednisolone participated in a double-blind cross-over study to determine the effect of timing (morning or night) of prednisolate dosage on morning stiffness.