Université Paris Cité, VIFASOM (UPR 7330 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France.
APHP, APHP-Centre Université de Paris, Hôtel Dieu, Centre du Sommeil et de La Vigilance, Paris, France.
Front Immunol. 2022 Sep 9;13:939829. doi: 10.3389/fimmu.2022.939829. eCollection 2022.
We aimed to examine the effects of circadian and sleep rhythm disruptions on immune biomarkers among hospital healthcare professionals working night shifts and rotating day shifts.
Hospital nurses working either as permanent night shifters (n=95) or as day shifters rotating between morning and afternoon shifts (n=96) kept a daily diary on their sleep and work schedules over a full working week. Blood samples were collected at the beginning and end of the last shift during the week, and participants were categorized into three groups based on work shift: morning shift (39 day shifters sampled at 7:00 and 14:00), afternoon shift (57 day shifters sampled at 14:00 and 21:00), and night shift (95 night shifters sampled at 21:00 and 7:00). Circulating blood counts in immune cells, interleukin-6 and C-reactive protein concentrations as well as total sleep time per 24 hours during work days (TST24w) and free days (TST24f), sleep debt (TST24f - TST24w) and social jet-lag (a behavioral proxy of circadian misalignment) were assessed.
Compared with day shifters, night shifters had shorter sleep duration (TST24w=5.4 ± 1.4h), greater sleep debt (3.2 ± 1.4 h) and social jet-lag (6.7 ± 2.4 h). Variations of immune biomarkers concentrations were consistent with the expected diurnal variations among day shifters (i.e., low level in the morning, increase during the day, peak value in the evening). By contrast, in night shifters, blood concentrations of total lymphocytes, T-helper cells, cytotoxic T-cells, memory B-cells and interleukin-6 were lower at 21:00, increased during the night, and reached higher values at 7:00. Multivariate analyses ruled out significant impact of TST24w, sleep debt, and social jet-lag on immune biomarkers concentrations among day shifters. In contrast, among night shifters, multivariate analyses indicated a combined effect of total sleep time (TST24w), sleep debt and social jet-lag for total lymphocytes and T-helper cells but only a social jet-lag effect for interleukin-6 and a single total sleep time effect for neutrophil and B-Cells.
Altogether, our results point to intricate response patterns of immune rhythms to circadian misalignment and sleep debt in night shifters. Specifically, these altered pattern expressions of immune cells may increase vulnerability to infections and reduce vaccination efficiency in night workers.
我们旨在研究夜班和轮班制白班医护人员的昼夜节律紊乱对免疫生物标志物的影响。
作为永久性夜班人员（n=95）或在上午和下午班次之间轮班的白班人员（n=96）的医院护士在整个工作周内每天记录他们的睡眠和工作时间表。在一周的最后一个班次开始和结束时采集血样，并根据班次将参与者分为三组：早班（39 名白班人员在 7:00 和 14:00 采样）、下午班（57 名白班人员在 14:00 和 21:00 采样）和夜班（95 名夜班人员在 21:00 和 7:00 采样）。评估了免疫细胞的循环血细胞计数、白细胞介素-6 和 C 反应蛋白浓度以及工作日（TST24w）和休息日（TST24f）的 24 小时总睡眠时间、睡眠债务（TST24f-TST24w）和社会时差（昼夜节律失调的行为代理）。
与白班人员相比，夜班人员的睡眠时间更短（TST24w=5.4±1.4h），睡眠债务更大（3.2±1.4h），社会时差更大（6.7±2.4h）。免疫生物标志物浓度的变化与白班人员的预期昼夜变化一致（即，早上水平低，白天增加，晚上达到峰值）。相比之下，在夜班人员中，总淋巴细胞、辅助性 T 细胞、细胞毒性 T 细胞、记忆性 B 细胞和白细胞介素-6 的血液浓度在 21:00 时较低，夜间增加，并在 7:00 时达到较高值。多变量分析排除了 TST24w、睡眠债务和社会时差对白班人员免疫生物标志物浓度的显著影响。相比之下，在夜班人员中，多变量分析表明，总睡眠时间（TST24w）、睡眠债务和社会时差对总淋巴细胞和辅助性 T 细胞有综合影响，但白细胞介素-6 仅受社会时差影响，中性粒细胞和 B 细胞仅受总睡眠时间影响。
总的来说，我们的结果表明，免疫节律对夜班人员昼夜节律紊乱和睡眠债务的反应模式错综复杂。具体来说，这些免疫细胞的改变模式表达可能会增加夜班工人感染的易感性并降低疫苗接种效率。
