In asthma, it appears that the physiological diurnal variation in airway calibre is amplified, suggesting coupling between the internal body clock and pathogenic processes. The physiological diurnal variation in airway calibre is under direct circadian control, independent of external, environmental cues such as light/dark and fasting or feeding ( 18). Intriguingly, asthma displays marked time of day variations in symptoms (wheeze and whistling) ( 15), airway calibre ( 16), and in the underpinning inflammatory pathways ( 17). Analysis of the impact of shift work on chronic inflammatory diseases is lacking.Īsthma is a very common, chronic inflammatory disease of the airways affecting 339 million people worldwide ( 12) and costing the UK public sector £1.1 billion ( 13) ($80 billion in the US each year ( 14)). In mice, experimentally induced circadian disruption (by altering light/dark cycle, to simulate rotating shift work patterns) affects the innate immune system and inflammation ( 10).Īpproximately 20% of the working population in industrialized countries work permanent or rotating night shifts ( 11), exposing this large population to the risk of circadian misalignment-driven disease making this is an important area of investigation, and an emerging public health emergency. There is evidence of causal relationships between circadian misalignment and the development of diabetes, obesity, metabolic syndrome ( 8) and cardiovascular disease ( 9). Shift work is a notable example of circadian misalignment, is invariably associated with sleep disruption and with increased risk of prevalent, chronic diseases including obesity ( 2), metabolic syndrome ( 3), diabetes ( 4), cardiovascular disease ( 5), and cancers ( 6, 7). This imbalance between our internal clock and the environment results in circadian misalignment ( 1).
The development of artificial light has allowed extension of the active period of humans into the night, and through the night for night shift workers. Cyclical light/dark environmental cues, mealtimes and physical activity can serve as Zeitgebers for the circadian timing system. Most human biological processes are regulated by an internal circadian timing system to optimally prepare physiological functions for the anticipated daily environmental and behavioural cycles.
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