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Have you heard of ‘circadian rhythms’?

Have you heard of ‘circadian rhythms’?

Circadian rhythms regulate several daily activities, embracing sleep, feeding times, energy metabolism, endocrine and immune functions with related pathological conditions, including rheumatoid arthritis (RA).1

If you suffer from a form of arthritis, you may have noticed that your symptoms are better at certain times of the day. RA is usually worse in the morning, whereas gout more frequently flares in the evening, and pain from fibromyalgia is more intense after a poor night’s sleep.2

Studies have shown links between the body clock (circadian rhythm) and arthritis symptoms.3

What do the studies show?

Research led by Dr Julie Gibbs at the University of Manchester has been exploring in more detail the link between inflammation and the body clock.

Her initial research has shown that in mice, inflammatory markers within the inflamed joint varied through the day. They observed a peak in inflammation-causing molecules during the light phase (the rest phase for nocturnal rodents).

This is in keeping with data from people with rheumatoid arthritis, where inflammation markers and joint stiffness peak during the early morning, at the end of the rest phase. It’s not yet clear however, how the immune cells responsible for these producing inflammatory markers are influenced by the body clock. 3

Researchers have also discovered:

  • Rheumatoid arthritis suppresses daily rhythms in some immune cells. Numbers of pro-inflammatory macrophage and neutrophil cells (immune cells which contribute to inflammation) were higher in inflamed joints, but the cells showed disruptions in their clockwork machinery.
  • Importantly, the research also found that anti-inflammatory immune cells known as ‘regulatory T cells’ show a daily rhythm, with their numbers peaking during the night. This could explain the “peaks” of inflammation markers and variation in symptoms throughout the day. Furthermore, this could be why some people experience relief from inflammation at night-time.
  • The regulatory T cells appear not to have their own ‘clock’, but instead their daily changes in activity are driven by rhythmic external cues generated by the body clock.

How can this help people with arthritis?

An understanding of how the full network of circadian clocks and inflammatory disorders works could help to provide new treatments that target RA and other disorders.4

By understanding when symptoms are worse, the timing of drug administration could be altered to maximise their impact and minimize long-term damage to the joints.3

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