Chronotype in patients with immune-mediated inflammatory disease: a systematic review

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Abstract

Immune-mediated inflammatory diseases (IMID) such as rheumatoid arthritis, inflammatory bowel disease and asthma share common pathophysiological pathways characterised by chronic inflammation and subsequent tissue damage involving multiple body sites. Circadian rhythms are 24-hour body cycles that regulate immune activity and control magnitude of immune response based on time of day. Chronotype is a person’s individual circadian phase preference, ranging from morningness to eveningness, which is known to influence risk of cardiometabolic and mental health disease. We systematically reviewed the literature to assess the association of questionnaire-based chronotype and patients with IMID. A comprehensive search of Medline and Embase identified twelve studies meeting the inclusion criteria, conducted in seven countries and covering four IMIDs to include 15,625 IMID patients and 410,783 healthy controls. Results showed that later chronotype may be a risk factor for worse quality of life and increased symptom burden in patients with IMIDs. In addition, chronotype may be a risk factor for IMID incidence, but the direction and magnitude of this effect was not consistent across individual IMIDs. Chronotype assessment could contribute to risk stratification in patients with IMIDs. Cross-disciplinary collaboration to understand the role of circadian rhythms and chronotype in driving common inflammatory pathways could help to improve outcomes for patients with IMIDs.
Original languageEnglish
JournalJournal of Biological Rhythms
Early online date14 Nov 2022
DOIs
Publication statusE-pub ahead of print - 14 Nov 2022

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