Spies, Cornelia M. and Straub, Rainer H. and Cutolo, Maurizio and Buttgereit, Frank (2014) Circadian rhythms in rheumatology - a glucocorticoid perspective. ARTHRITIS RESEARCH & THERAPY, 16: S3. ISSN 1478-6354, 1478-6362
Full text not available from this repository. (Request a copy)Abstract
The hypothalamic-pituitary-adrenal (HPA) axis plays an important role in regulating and controlling immune responses. Dysfunction of the HPA axis has been implicated in the pathogenesis of rheumatoid arthritis (RA) and other rheumatic diseases. The impact of glucocorticoid (GC) therapy on HPA axis function also remains a matter of concern, particularly for longer treatment duration. Knowledge of circadian rhythms and the influence of GC in rheumatology is important: on the one hand we aim for optimal treatment of the daily undulating inflammatory symptoms, for example morning stiffness and swelling; on the other, we wish to disturb the HPA axis as little as possible. This review describes circadian rhythms in RA and other chronic inflammatory diseases, dysfunction of the HPA axis in RA and other rheumatic diseases and the recent concept of the hepato-hypothalamic-pituitary-adrenal-renal axis, the problem of adrenal suppression by GC therapy and how it can be avoided, and evidence that chronotherapy with modified release prednisone effective at 02:00 a. m. can inhibit proinflammatory sequelae of nocturnal inflammation better compared with GC administration in the morning but does not increase the risk of HPA axis insufficiency in RA.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PITUITARY-ADRENAL AXIS; RANDOMIZED CONTROLLED-TRIAL; TUMOR-NECROSIS-FACTOR; LOW SERUM-LEVELS; POLYMYALGIA-RHEUMATICA; MORNING STIFFNESS; DIURNAL-VARIATION; ARTHRITIS; INTERLEUKIN-6; SUPPRESSION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Petra Gürster |
| Date Deposited: | 21 Jul 2020 07:39 |
| Last Modified: | 21 Jul 2020 07:39 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10872 |
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