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Critical Reviews™ in Biomedical Engineering
SJR: 0.26 SNIP: 0.375 CiteScore™: 1.4

ISSN Imprimer: 0278-940X
ISSN En ligne: 1943-619X

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Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.2016018812
pages 177-191

The Potential of Circadian Realignment in Rheumatoid Arthritis

Rohit T. Rao
Chemical & Biochemical Engineering Department, Rutgers University, Piscataway, New Jersey
Kamau K. Pierre
Biomedical Engineering Department, Rutgers University, Piscataway, New Jersey
Naomi Schlesinger
Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
Ioannis P. Androulakis
Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, USA; Department of Chemical & Biochemical Engineering, Rutgers University, Piscataway, NJ, USA; Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA


In this short review, we discuss evidence supporting the modulation of peripheral circadian systems as a therapeutic strategy for rheumatoid arthritis (RA). We first review the role of proinflammatory cytokines and oxidative stress, two of the primary mediators of chronic inflammation in RA, and their regulation by circadian clock machinery. We further highlight the role of environmental and metabolic signals in regulating the central and peripheral circadian clocks, with an emphasis on seasonal variations in photoperiod and rhythmic metabolic input, respectively. Finally, we hypothesize that the entrainment and realignment of peripheral clock rhythms have the ability to modulate these mediators, improving clinical outcomes in RA patients. Our discussion emphasizes the use of light therapy and time-restricted feeding for entraining peripheral clocks either via the entrainment of the central circadian clock in suprachiasmatic nuclei (SCN) or directly by uncoupling the peripheral circadian clocks from SCN. In doing so, we highlight the use of nonpharmacologic interventions as a potential strategy for improving clinical outcomes in chronic inflammatory conditions such as RA.

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