[人类昼夜节律系统:生理学、病理生理学以及与睡眠和压力反应的相互作用]。

Q3 Medicine
Psychiatrike = Psychiatriki Pub Date : 2024-06-28 Epub Date: 2023-07-17 DOI:10.22365/jpsych.2023.016
Agorastos Agorastos, Miltiadis Vasiliadis, George P Chrousos
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引用次数: 0

摘要

在我们的星球上,昼夜交替的节律使生物体对能量的需求发生剧烈波动,这促使地球物理进化需要一种必要的生物时间组织来维持平衡和适应整个系统发育过程中的环境变化。固有的昼夜节律系统(CS)代表了一种高度保守和复杂的内部生物 "时钟",根据地球自转的 24 小时进行调整。该系统创造并维持了细胞和生物体的节律性,并实现了从基因表达到行为等多层次生理过程的短暂协调。下丘脑上核(SCN)是生物体昼夜节律系统的主要起搏器,而无处不在的外周细胞分子钟振荡网络则参与了复杂的昼夜节律层次结构。昼夜节律紊乱 "的定义是,在不同组织层次上这种和谐定时的昼夜节律秩序的严重丧失,可能会改变分子、细胞和机体层次的基本平衡系统的基本特性,并导致生物行为适应机制的崩溃,从而导致适应性压力调节失调,并增加对压力的敏感性和脆弱性。昼夜节律紊乱与神经内分泌、免疫、心脏代谢和自律神经失调有关,与昼夜节律减弱、特定睡眠模式病变和认知障碍有关,还与昼夜节律基因表达改变有关。因此,这种情况可能在精神和躯体疾病的发展中起着核心作用。然而,在临床上,昼夜节律紊乱和睡眠障碍往往被认为是大多数疾病的 "继发性 "表现,而忽视了 CS 潜在的重要病理生理作用。了解昼夜节律失调的病理生理机制及其在与压力相关的全身性疾病中的作用,可以为疾病机制提供新的见解,并有助于推进针对高危人群的时间生物学治疗可能性和预防策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The human circadian system: physiology, pathophysiology and interactions with sleep and stress reactivity].

The dramatic fluctuations in the energy demands of living organisms by the rhythmic succession of night and day on our planet has prompted a geophysical evolutionary need for a biological temporal organization necessary for maintenance of homeostasis and adaptation to environmental changes across phylogeny. The intrinsic circadian system (CS) represents a highly conserved and complex internal biological "clock", adjusted to the 24-hour rotation of the earth about itself. This system creates and maintains cellular and organismal rhythmicity and enables a nyctohemeral coordination of multi-level physiologic processes, ranging from gene expression to behaviour. The suprachiasmatic nucleus (SCN) of the hypothalamus is the primary pacemaker of the circadian system of the organism, while a ubiquitous peripheral oscillating network of cellular molecular clocks participates in a complex circadian hierarchy. A critical loss of this harmoniously timed circadian order at different organizational levels is defined as "chronodisruption", a condition that may alter the fundamental properties of basic homeostatic systems at molecular, cellular and organismal levels, and lead to a breakdown of biobehavioral adaptive mechanisms, resulting in maladaptive stress regulation and increased sensitivity and vulnerability to stress. Chronodisruption has been linked to neuroendocrine, immune, cardiometabolic and autonomic dysregulation, with blunted diurnal rhythms, specific sleep pattern pathologies and cognitive deficits, as well as with altered circadian gene expression. This condition may, thus, play a central role in the development of mental and somatic disease. Nevertheless, circadian and sleep disturbances are often clinically considered as "secondary" manifestations in most disorders, neglecting the potentially important pathophysiological role of CS. Understanding the pathophysiologic mechanisms of circadian dysregulation and their role in stress-related, systemic disease could provide new insights into disease mechanisms and could help advance chronobiological treatment possibilities and preventive strategies in populations at risk.

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来源期刊
Psychiatrike = Psychiatriki
Psychiatrike = Psychiatriki Medicine-Medicine (all)
CiteScore
2.60
自引率
0.00%
发文量
37
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