Faculty of Medicine, Sumy State University, Sumy, Ukraine.
Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
Medicine (Baltimore). 2023 Aug 11;102(32):e34614. doi: 10.1097/MD.0000000000034614.
The circadian rhythm (CR) is a fundamental biological process regulated by the Earth's rotation and solar cycles. It plays a critical role in various bodily functions, and its dysregulation can have systemic effects. These effects impact metabolism, redox homeostasis, cell cycle regulation, gut microbiota, cognition, and immune response. Immune mediators, cycle proteins, and hormones exhibit circadian oscillations, supporting optimal immune function and defence against pathogens. Sleep deprivation and disruptions challenge the regulatory mechanisms, making immune responses vulnerable. Altered CR pathways have been implicated in diseases such as diabetes, neurological conditions, and systemic autoimmune diseases (SADs). SADs involve abnormal immune responses to self-antigens, with genetic and environmental factors disrupting self-tolerance and contributing to conditions like Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Inflammatory Myositis. Dysregulated CR may lead to increased production of pro-inflammatory cytokines, contributing to the systemic responses observed in SADs. Sleep disturbances significantly impact the quality of life of patients with SADs; however, they are often overlooked. The relationship between sleep and autoimmune conditions, whether causal or consequential to CR dysregulation, remains unclear. Chrono-immunology investigates the role of CR in immunity, offering potential for targeted therapies in autoimmune conditions. This paper provides an overview of the connections between sleep and autoimmune conditions, highlighting the importance of recognizing sleep disturbances in SADs and the need for further research into the complex relationship between the CR and autoimmune diseases.
昼夜节律（CR）是受地球自转和太阳周期调节的基本生物过程。它在各种身体功能中起着关键作用，其失调会产生全身影响。这些影响会影响代谢、氧化还原稳态、细胞周期调节、肠道微生物群、认知和免疫反应。免疫介质、周期蛋白和激素表现出昼夜波动，支持最佳的免疫功能和抵御病原体。睡眠剥夺和紊乱会挑战调节机制，使免疫反应变得脆弱。改变的 CR 途径与糖尿病、神经疾病和系统性自身免疫疾病（SAD）等疾病有关。SAD 涉及对自身抗原的异常免疫反应，遗传和环境因素破坏自身耐受，并导致系统性红斑狼疮、类风湿关节炎和炎性肌病等疾病。CR 的失调可能导致促炎细胞因子的产生增加，导致 SAD 中观察到的全身反应。睡眠障碍会显著影响 SAD 患者的生活质量；然而，它们往往被忽视。睡眠与自身免疫性疾病之间的关系，无论是因果关系还是 CR 失调的后果，仍然不清楚。时间免疫学研究 CR 在免疫中的作用，为自身免疫性疾病的靶向治疗提供了潜力。本文概述了睡眠与自身免疫性疾病之间的联系，强调了认识到 SAD 中的睡眠障碍的重要性，以及需要进一步研究 CR 与自身免疫性疾病之间的复杂关系。
