Document Detail

Nocturnal hormones and clinical rhythms in rheumatoid arthritis.
MedLine Citation:
PMID:  16126979     Owner:  NLM     Status:  MEDLINE    
It is well known that some clinical signs and symptoms of rheumatoid arthritis (RA) vary within a day and between days; the morning stiffness that is observed in patients who have RA has become one of the diagnostic criteria of the disease. The circadian changes in the metabolism or nocturnal secretion of endogenous corticosteroids is certainly responsible, in part, for the time-dependent changes that are observed in the inflammatory response and related clinical symptoms. More recently, melatonin (mLT), another circadian nocturnal hormone that is the secretory product of the pineal gland, has been implicated in time-dependent inflammatory reactions, with effects that are opposite of those of corticosteroids. Therefore, altered functioning of the hypothalamic-pituitary-adrenocortical axis (reduced corticosteroid production) and of the pineal gland (increased mLT production) found in RA patients seem to be important factors in the perpetuation and clinical circadian symptoms of the disease. Consistently, human proinflammatory Th1-type cytokine production (related to mLT stimulation) exhibits a diurnal rhythmicity, with peak levels during the night and early morning, at a time when plasma cortisol (inducing Th2-type cytokine production) is lowest and mLT is highest. Reduced daily light exposure as observed in northern Europe (Estonia), at least during the winter, might explain the higher and more prolonged mLT concentrations as well as some epidemiological features that are observed in northern European patients with RA versus southern European patients.
Maurizio Cutolo; Kati Otsa; Oivi Aakre; Alberto Sulli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1051     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-08-29     Completed Date:  2006-06-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-81     Citation Subset:  IM    
Research Laboratory and Division of Rheumatology, Department of Immunology and Endocrinology, University of Genoa, Viale Benedetto XV, 16132 Genoa-I, Italy.
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MeSH Terms
Arthritis, Rheumatoid / blood,  immunology*
Circadian Rhythm*
Cytokines / biosynthesis*
Hydrocortisone / blood,  physiology*
Hypothalamo-Hypophyseal System / physiology
Melatonin / blood,  physiology*
Pituitary-Adrenal System / physiology
Reg. No./Substance:
0/Cytokines; 50-23-7/Hydrocortisone; 73-31-4/Melatonin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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