基于昼夜节律研究针灸治疗类风湿关节炎的概况
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摘要
类风湿关节炎(Rheumatoid Arthritis,RA)的临床症状具有关节肿胀、僵硬、疼痛晨起加重,白天缓解到相对稳定状态的典型的昼夜节律特征。前期研究发现其临床表现的昼夜节律变化归因于RA细胞因子和激素水平的昼夜振荡,而基于RA昼夜节律性制定的药物时间疗法已经取得了突破性的临床进展。而针对RA的昼夜节律性,针灸治疗也取得了相应的研究进展;对RA病理生理的昼夜节律性以及针灸如何基于其昼夜振荡对RA进行良性调节进行检索、整理、总结,并进行综述。
The clinical syndromes of rheumatoidarthritis is characterized as the classic circadian rhythm, such as the stiffness and pain of joints are more serious at the early morning and relief in the afternoon. Several studies have verified that the diurnal oscillation of RA is attributed to the circadian variation of pro-inflammatory cytokines and hormones related to RA. In according to these results, the chronobiology and pharmacology improved the dosage form and time of taking medicine, and have made important progress. Based on circadian rhythm of RA, the research of acupuncture treating RA also have made some progress, so we summarized and recorded.
The clinical syndromes of rheumatoidarthritis is characterized as the classic circadian rhythm, such as the stiffness and pain of joints are more serious at the early morning and relief in the afternoon. Several studies have verified that the diurnal oscillation of RA is attributed to the circadian variation of pro-inflammatory cytokines and hormones related to RA. In according to these results, the chronobiology and pharmacology improved the dosage form and time of taking medicine, and have made important progress. Based on circadian rhythm of RA, the research of acupuncture treating RA also have made some progress, so we summarized and recorded.
引文
[1] Cutolo M. Rheumatoid arthritis: circadian and circannual rhythms in RA[J]. Nat Rev Rheumatol, 2011,7(9):500-502.
[2] Straub RH, Cutolo M. Circadian rhythms in rheumatoid arthritis: implications for pathophysiology and therapeutic management[J]. Arthritis Rheum, 2007,56(2):399-408.
[3] Cutolo M, Maestroni GJ, Otsa K, et al. Circadian melatonin and cortisol levels in rheumatoid arthritis patients in winter time: a north and south Europe comparison[J]. Ann Rheum Dis, 2005,64(2):212-216.
[4] Afkhamizadeh M, Sahebari M, Seyyed-Hoseini SR. Morning melatonin serum values do not correlate with disease activity in rheumatoid arthritis: a cross-sectional study[J]. Rheumatol Int, 2014,34(8):1145-1151.
[5] Cutolo M, Maestroni GJ. The melatonin-cytokine connection in rheumatoid arthritis[J]. Ann Rheum Dis, 2005,64(8):1109-1111.
[6] Rudra DS, Pal U, Maiti NC, et al. Melatonin inhibits matrix metalloproteinase-9 activity by binding to its active site[J]. J Pineal Res, 2013,54(4):398-405.
[7] Krieger DT, Allen W, Rizzo F, et al. Characterization of the normal temporal pattern of plasma corticosteroid levels[J]. J Clin Endocrinol Metab, 1971,32(2):266-284.
[8] 曾邕萍, 米存东. 类风湿关节炎患者皮质醇分泌节律与炎性细胞因子的关系[J]. 内科, 2011(2):147-150.
[9] 李晶, 吴忠, 张梅棣, 等. 类风湿关节炎患者白细胞介素-6与皮质醇节律的研究[J]. 中华风湿病学杂志, 2002(4):252-254.
[10] Boss B, Neeck G. Correlation of IL-6 with the classical humoral disease activity parameters ESR and CRP and with serum cortisol, reflecting the activity of the HPA axis in active rheumatoid arthritis[J]. Z Rheumatol, 2000,59(Suppl 2):62-64.
[11] 高骏, 刘旭光, 周海燕, 等. 从RA大鼠夜间ACTH、CS水平探讨艾灸抗炎效应的HPAA昼夜节律基础[J]. 中国中医基础医学杂志, 2010(6):515-516.
[12] 李振彬, 杨静, 王永敏. 类风湿关节炎主要炎性细胞因子的昼夜节律及其临床意义[C]. 黄山: 全国时间生物医学学术会议, 2009.
[13] 李振彬, 张英杰, 齐静, 等. 佐剂性关节炎大鼠外周血TNF-α、IL-1β、MIF与MLT的昼夜节律[J]. 解放军医药杂志, 2014(5):1-4.
[14] 马文彬, 刘旭光, 周海燕. 类风湿关节炎与昼夜节律相关性的研究进展[J]. 广东医学, 2014(7):1123-1125.
[15] 马文彬, 刘旭光, 覃勇, 等. 艾灸对类风湿关节炎大鼠肿瘤坏死因子-α昼夜节律的调控[J]. 广东医学, 2015(24):3746-3749.
[16] 马文彬, 刘旭光, 覃勇, 等. 艾灸调整实验性RA大鼠炎性因子IL-1昼夜节律的研究[J]. 上海针灸杂志, 2016(2):493-496.
[17] 马文彬, 刘旭光, 覃勇, 等. 辰时麦粒灸对RA模型大鼠炎性因子IL-6昼夜节律的影响[J]. 中国针灸, 2016(4):396-401.
[18] 马文彬, 刘旭光, 周海燕. 择时艾灸对类风湿性关节炎大鼠下丘脑-垂体-肾上腺轴昼夜节律的影响[J]. 针刺研究, 2016(2):100-107.
[19] Kirwan JR, Clarke L, Hunt LP, et al. Effect of novel therapeutic glucocorticoids on circadian rhythms of hormones and cytokines in rheumatoid arthritis[J]. Ann N Y Acad Sci, 2010,1193:127-133.
[20] Cutolo M, Straub RH, Buttgereit F. Circadian rhythms of nocturnal hormones in rheumatoid arthritis: translation from bench to bedside[J]. Ann Rheum Dis, 2008,67(7):905-908.
[21] Li S, Lu A, Li B, et al. Circadian rhythms on hypothalamic-pituitary-adrenal axis hormones and cytokines of collagen induced arthritis in rats[J]. J Autoimmun, 2004,22(4):277-285.
[22] Kanabrocki EL, Sothern RB, Messmore HL, et al. Circadian interrelationships among levels of plasma fibrinogen, blood platelets, and serum interleukin-6[J]. Clin Appl Thromb Hemost, 1999,5(1):37-42.
[23] Seres J, Herichova I, Roman O, et al. Evidence for daily rhythms of the expression of proopiomelanocortin, interleukin-1-beta and interleukin-6 in adenopituitaries of male long-evans rats: effect of adjuvant arthritis[J]. Neuroimmunomodulation, 2004,11(5):316-322.
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[26] De Cata A, D’Agruma L, Tarquini R, et al. Rheumatoid arthritis and the biological clock[J]. Expert Rev Clin Immunol, 2014,10(5):687-695.
[27] Hand LE, Hopwood TW, Dickson SH, et al. The circadian clock regulates inflammatory arthritis[J]. FASEB J, 2016,30(11):3759-3770.
[28] Hedstrom AK, Akerstedt T, Klareskog L, et al. Relationship between shift work and the onset of rheumatoid arthritis[J]. RMD Open, 2017,3(2):e475.
[29] Kouri VP, Olkkonen J, Kaivosoja E, et al. Circadian timekeeping is disturbed in rheumatoid arthritis at molecular level[J]. PLoS One, 2013,8(1):e54049.
[30] Yoshida K, Hashiramoto A, Okano T, et al. TNF-alpha modulates expression of the circadian clock gene Per2 in rheumatoid synovial cells[J]. Scand J Rheumatol, 2013,42(4):276-280.
[31] Fu L, Pelicano H, Liu J, et al. The circadian gene Period2 plays an important role in tumor suppression and DNA damage response in vivo[J]. Cell, 2002,111(1):41-50.
[32] Haas S, Straub RH. Disruption of rhythms of molecular clocks in primary synovial fibroblasts of patients with osteoarthritis and rheumatoid arthritis, role of IL-1beta/TNF[J]. Arthritis Res Ther, 2012,14(3):R122.
[33] Spies CM, Hoff P, Mazuch J, et al. Circadian rhythms of cellular immunity in rheumatoid arthritis: a hypothesis-generating study[J]. Clin Exp Rheumatol, 2015,33(1):34-43.
[34] Hashiramoto A, Yamane T, Tsumiyama K, et al. Mammalian clock gene Cryptochrome regulates arthritis via proinflammatory cytokine TNF-alpha[J]. J Immunol, 2010,184(3):1560-1565.
[35] 李振彬. 类风湿关节炎的现代治疗策略与方法[J]. 临床荟萃, 2016(5):486-489.
[36] Buttgereit F, Doering G, Schaeffler A, et al. Targeting pathophysiological rhythms: prednisone chronotherapy shows sustained efficacy in rheumatoid arthritis[J]. Ann Rheum Dis, 2010,69(7):1275-1280.
[37] To H, Yoshimatsu H, Tomonari M, et al. Methotrexate chronotherapy is effective against rheumatoid arthritis[J]. Chronobiol Int, 2011,28(3):267-274.
[38] Songa AS, Meka VS, Nali SR, et al. An in vitro and in vivo investigation into the suitability of compression coated tablets of indomethacin for the treatment of rheumatoid arthritis which follow circadian rhythms[J]. Drug Dev Ind Pharm, 2013,39(3):447-456.
[39] Spiga F, Walker JJ, Terry JR, et al. HPA axis-rhythms[J]. Compr Physiol, 2014,4(3):1273-1298.
[40] 丁沙沙, 洪寿海, 赵雪, 等. 基于下丘脑-垂体-肾上腺轴的针灸治疗对类风湿性关节炎作用机理研究现状[J]. 辽宁中医杂志, 2016,43(11):2456-2460.
[41] 周海燕, 刘旭光, 黄迪君, 等. 艾灸调整实验性RA大鼠HPAA功能的GR机制研究[J]. 中华中医药学刊, 2010,28(6):1167-1169.
[42] 周海燕, 刘旭光, 高骏. 艾灸对实验性类风湿性关节炎大鼠海马GR、MEL1B表达影响的研究[J]. 辽宁中医杂志, 2012,39(11):2313-2315.
[43] 刘旭光, 周海燕, 黄迪君, 等. 艾灸对实验性RA大鼠海马下丘脑垂体GR表达影响的研究[J]. 中华中医药学刊, 2009,27(9):1797-1799.
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[45] 薛红, 谢西梅, 姚洁. 针灸对机体痛阈的昼夜节律的影响及针灸效应的昼夜节律探讨[J]. 内蒙古中医药, 2010(15):87-89.
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[2] Straub RH, Cutolo M. Circadian rhythms in rheumatoid arthritis: implications for pathophysiology and therapeutic management[J]. Arthritis Rheum, 2007,56(2):399-408.
[3] Cutolo M, Maestroni GJ, Otsa K, et al. Circadian melatonin and cortisol levels in rheumatoid arthritis patients in winter time: a north and south Europe comparison[J]. Ann Rheum Dis, 2005,64(2):212-216.
[4] Afkhamizadeh M, Sahebari M, Seyyed-Hoseini SR. Morning melatonin serum values do not correlate with disease activity in rheumatoid arthritis: a cross-sectional study[J]. Rheumatol Int, 2014,34(8):1145-1151.
[5] Cutolo M, Maestroni GJ. The melatonin-cytokine connection in rheumatoid arthritis[J]. Ann Rheum Dis, 2005,64(8):1109-1111.
[6] Rudra DS, Pal U, Maiti NC, et al. Melatonin inhibits matrix metalloproteinase-9 activity by binding to its active site[J]. J Pineal Res, 2013,54(4):398-405.
[7] Krieger DT, Allen W, Rizzo F, et al. Characterization of the normal temporal pattern of plasma corticosteroid levels[J]. J Clin Endocrinol Metab, 1971,32(2):266-284.
[8] 曾邕萍, 米存东. 类风湿关节炎患者皮质醇分泌节律与炎性细胞因子的关系[J]. 内科, 2011(2):147-150.
[9] 李晶, 吴忠, 张梅棣, 等. 类风湿关节炎患者白细胞介素-6与皮质醇节律的研究[J]. 中华风湿病学杂志, 2002(4):252-254.
[10] Boss B, Neeck G. Correlation of IL-6 with the classical humoral disease activity parameters ESR and CRP and with serum cortisol, reflecting the activity of the HPA axis in active rheumatoid arthritis[J]. Z Rheumatol, 2000,59(Suppl 2):62-64.
[11] 高骏, 刘旭光, 周海燕, 等. 从RA大鼠夜间ACTH、CS水平探讨艾灸抗炎效应的HPAA昼夜节律基础[J]. 中国中医基础医学杂志, 2010(6):515-516.
[12] 李振彬, 杨静, 王永敏. 类风湿关节炎主要炎性细胞因子的昼夜节律及其临床意义[C]. 黄山: 全国时间生物医学学术会议, 2009.
[13] 李振彬, 张英杰, 齐静, 等. 佐剂性关节炎大鼠外周血TNF-α、IL-1β、MIF与MLT的昼夜节律[J]. 解放军医药杂志, 2014(5):1-4.
[14] 马文彬, 刘旭光, 周海燕. 类风湿关节炎与昼夜节律相关性的研究进展[J]. 广东医学, 2014(7):1123-1125.
[15] 马文彬, 刘旭光, 覃勇, 等. 艾灸对类风湿关节炎大鼠肿瘤坏死因子-α昼夜节律的调控[J]. 广东医学, 2015(24):3746-3749.
[16] 马文彬, 刘旭光, 覃勇, 等. 艾灸调整实验性RA大鼠炎性因子IL-1昼夜节律的研究[J]. 上海针灸杂志, 2016(2):493-496.
[17] 马文彬, 刘旭光, 覃勇, 等. 辰时麦粒灸对RA模型大鼠炎性因子IL-6昼夜节律的影响[J]. 中国针灸, 2016(4):396-401.
[18] 马文彬, 刘旭光, 周海燕. 择时艾灸对类风湿性关节炎大鼠下丘脑-垂体-肾上腺轴昼夜节律的影响[J]. 针刺研究, 2016(2):100-107.
[19] Kirwan JR, Clarke L, Hunt LP, et al. Effect of novel therapeutic glucocorticoids on circadian rhythms of hormones and cytokines in rheumatoid arthritis[J]. Ann N Y Acad Sci, 2010,1193:127-133.
[20] Cutolo M, Straub RH, Buttgereit F. Circadian rhythms of nocturnal hormones in rheumatoid arthritis: translation from bench to bedside[J]. Ann Rheum Dis, 2008,67(7):905-908.
[21] Li S, Lu A, Li B, et al. Circadian rhythms on hypothalamic-pituitary-adrenal axis hormones and cytokines of collagen induced arthritis in rats[J]. J Autoimmun, 2004,22(4):277-285.
[22] Kanabrocki EL, Sothern RB, Messmore HL, et al. Circadian interrelationships among levels of plasma fibrinogen, blood platelets, and serum interleukin-6[J]. Clin Appl Thromb Hemost, 1999,5(1):37-42.
[23] Seres J, Herichova I, Roman O, et al. Evidence for daily rhythms of the expression of proopiomelanocortin, interleukin-1-beta and interleukin-6 in adenopituitaries of male long-evans rats: effect of adjuvant arthritis[J]. Neuroimmunomodulation, 2004,11(5):316-322.
[24] Yoshida K, Hashimoto T, Sakai Y, et al. Involvement of the circadian rhythm and inflammatory cytokines in the pathogenesis of rheumatoid arthritis[J]. J Immunol Res, 2014,2014:282495.
[25] Gibbs JE, Ray DW. The role of the circadian clock in rheumatoid arthritis[J]. Arthritis Res Ther, 2013,15(1):205.
[26] De Cata A, D’Agruma L, Tarquini R, et al. Rheumatoid arthritis and the biological clock[J]. Expert Rev Clin Immunol, 2014,10(5):687-695.
[27] Hand LE, Hopwood TW, Dickson SH, et al. The circadian clock regulates inflammatory arthritis[J]. FASEB J, 2016,30(11):3759-3770.
[28] Hedstrom AK, Akerstedt T, Klareskog L, et al. Relationship between shift work and the onset of rheumatoid arthritis[J]. RMD Open, 2017,3(2):e475.
[29] Kouri VP, Olkkonen J, Kaivosoja E, et al. Circadian timekeeping is disturbed in rheumatoid arthritis at molecular level[J]. PLoS One, 2013,8(1):e54049.
[30] Yoshida K, Hashiramoto A, Okano T, et al. TNF-alpha modulates expression of the circadian clock gene Per2 in rheumatoid synovial cells[J]. Scand J Rheumatol, 2013,42(4):276-280.
[31] Fu L, Pelicano H, Liu J, et al. The circadian gene Period2 plays an important role in tumor suppression and DNA damage response in vivo[J]. Cell, 2002,111(1):41-50.
[32] Haas S, Straub RH. Disruption of rhythms of molecular clocks in primary synovial fibroblasts of patients with osteoarthritis and rheumatoid arthritis, role of IL-1beta/TNF[J]. Arthritis Res Ther, 2012,14(3):R122.
[33] Spies CM, Hoff P, Mazuch J, et al. Circadian rhythms of cellular immunity in rheumatoid arthritis: a hypothesis-generating study[J]. Clin Exp Rheumatol, 2015,33(1):34-43.
[34] Hashiramoto A, Yamane T, Tsumiyama K, et al. Mammalian clock gene Cryptochrome regulates arthritis via proinflammatory cytokine TNF-alpha[J]. J Immunol, 2010,184(3):1560-1565.
[35] 李振彬. 类风湿关节炎的现代治疗策略与方法[J]. 临床荟萃, 2016(5):486-489.
[36] Buttgereit F, Doering G, Schaeffler A, et al. Targeting pathophysiological rhythms: prednisone chronotherapy shows sustained efficacy in rheumatoid arthritis[J]. Ann Rheum Dis, 2010,69(7):1275-1280.
[37] To H, Yoshimatsu H, Tomonari M, et al. Methotrexate chronotherapy is effective against rheumatoid arthritis[J]. Chronobiol Int, 2011,28(3):267-274.
[38] Songa AS, Meka VS, Nali SR, et al. An in vitro and in vivo investigation into the suitability of compression coated tablets of indomethacin for the treatment of rheumatoid arthritis which follow circadian rhythms[J]. Drug Dev Ind Pharm, 2013,39(3):447-456.
[39] Spiga F, Walker JJ, Terry JR, et al. HPA axis-rhythms[J]. Compr Physiol, 2014,4(3):1273-1298.
[40] 丁沙沙, 洪寿海, 赵雪, 等. 基于下丘脑-垂体-肾上腺轴的针灸治疗对类风湿性关节炎作用机理研究现状[J]. 辽宁中医杂志, 2016,43(11):2456-2460.
[41] 周海燕, 刘旭光, 黄迪君, 等. 艾灸调整实验性RA大鼠HPAA功能的GR机制研究[J]. 中华中医药学刊, 2010,28(6):1167-1169.
[42] 周海燕, 刘旭光, 高骏. 艾灸对实验性类风湿性关节炎大鼠海马GR、MEL1B表达影响的研究[J]. 辽宁中医杂志, 2012,39(11):2313-2315.
[43] 刘旭光, 周海燕, 黄迪君, 等. 艾灸对实验性RA大鼠海马下丘脑垂体GR表达影响的研究[J]. 中华中医药学刊, 2009,27(9):1797-1799.
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