Litinski Mikhail, Scheer Frank Ajl, Shea Steven A
Clinical Fellow, Division of Sleep Medicine, Brigham & Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA. Tel. 617-732 5778, Fax 617-279 0683, email:
Sleep Med Clin. 2009 Jun 1;4(2):143-163. doi: 10.1016/j.jsmc.2009.02.005.
The severity of many diseases varies across the day and night. For example, adverse cardiovascular incidents peak in the morning, asthma is often worse at night and temporal lobe epileptic seizures are most prevalent in the afternoon. These patterns may be due to the day/night rhythm in environment and behavior, and/or endogenous circadian rhythms in physiology. Furthermore, chronic misalignment between the endogenous circadian timing system and the behavioral cycles could be a cause of increased risk of diabetes, obesity, cardiovascular disease and certain cancers in shift workers. Here we describe the magnitude, relevance and potential biological basis of such daily changes in disease severity and of circadian/behavioral misalignment, and present how these insights may help in the development of appropriate chronotherapy.
许多疾病的严重程度在白天和夜晚有所不同。例如，心血管不良事件在早晨达到峰值，哮喘在夜间往往更严重，而颞叶癫痫发作在下午最为普遍。这些模式可能归因于环境和行为中的昼夜节律，和/或生理上的内源性昼夜节律。此外，内源性昼夜计时系统与行为周期之间的长期失调可能是导致轮班工作者患糖尿病、肥胖症、心血管疾病和某些癌症风险增加的原因。在此，我们描述了疾病严重程度的这种每日变化以及昼夜/行为失调的程度、相关性和潜在生物学基础，并阐述了这些见解如何有助于开发适当的时间疗法。
