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Circadian Rhythms, Disease and Chronotherapy.
J Biol Rhythms
December 2021
Howard Hughes Medical Institute, Chronobiology and Sleep Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Circadian clocks are biological timing mechanisms that generate 24-h rhythms of physiology and behavior, exemplified by cycles of sleep/wake, hormone release, and metabolism. The adaptive value of clocks is evident when internal body clocks and daily environmental cycles are mismatched, such as in the case of shift work and jet lag or even mistimed eating, all of which are associated with physiological disruption and disease. Studies with animal and human models have also unraveled an important role of functional circadian clocks in modulating cellular and organismal responses to physiological cues (ex.
View Article and Find Full Text PDFChronotherapy of cardiac and vascular disease: timing medications to circadian rhythms to optimize treatment effects and outcomes.
Curr Opin Pharmacol
April 2021
Department of Internal Medicine, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
Circadian rhythms impact cardiac and vascular pathophysiology, resulting in 24-hour patterning of symptoms and life-threatening/ending events (chronopathology), plus kinetics and dynamics of medications (chronopharmacology), resulting in administration-time differences in efficacy and safety. Scheduling medications according to circadian rhythm determinants (chronotherapy) can improve treatment effects, for example, before dinner/bedtime ingestion of cholesterol-lowering medications and acetylsalicylic acid, respectively, exerts enhanced control of hypercholesterolemia and after-awakening peak of platelet aggregation; bedtime ingestion of conventional hypertension medications optimizes normalization of sleep-time blood pressure (BP)-strongest independent BP marker of cardiovascular disease (CVD) risk-and most effectively prevents (chronoprevention) CVD morbidity and mortality. Exploration of chronotherapeutic strategies to improve management of cardiac arrhythmias and vascular pathophysiology is still awaited.
View Article and Find Full Text PDFClinical chronobiology: a timely consideration in critical care medicine.
Crit Care
May 2018
University College London Centre for Altitude Space and Extreme Environment Medicine, University College London Hospitals NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, First Floor, 170 Tottenham Court Road, London, W1T 7HA, UK.
A fundamental aspect of human physiology is its cyclical nature over a 24-h period, a feature conserved across most life on Earth. Organisms compartmentalise processes with respect to time in order to promote survival, in a manner that mirrors the rotation of the planet and accompanying diurnal cycles of light and darkness. The influence of circadian rhythms can no longer be overlooked in clinical settings; this review provides intensivists with an up-to-date understanding of the burgeoning field of chronobiology, and suggests ways to incorporate these concepts into daily practice to improve patient outcomes.
View Article and Find Full Text PDF[Chronopathology and chronotherapy of chronic pancreatitis].
Vopr Kurortol Fizioter Lech Fiz Kult
March 2008
Circadian rhythms of cardiovascular system vegetative provision, indices of rheohepatography and pancreas exocrine function of 417 patients with chronic pancreatitis were studied. Signs of desynchronosis were registered in more than one third of the cases. Presence of vibration disease leads to escalation of negative processes of desynchronosis.
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