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Gubin D. Chronotherapeutic Approaches. CHRONOBIOLOGY AND CHRONOMEDICINE 2024:536-577. [DOI: 10.1039/bk9781839167553-00536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2024]
Abstract
The chapter provides a comprehensive review of current approaches to personalized chronodiagnosis and chronotherapy. We discuss circadian clock drug targets that aim to affect cellular clock machinery, circadian mechanisms of pharmacokinetics/pharmacodynamics, and chronotherapeutic approaches aimed at increasing treatment efficacy and minimizing its side effects. We explore how chronotherapy can combat acquired and compensatory drug resistance. Non-pharmacological interventions for clock preservation and enhancement are also overviewed, including light treatment, melatonin, sleep scheduling, time-restricted feeding, physical activity, and exercise.
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Affiliation(s)
- Denis Gubin
- aTyumen State Medical University, Tyumen, Russia
- bTyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
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Weinert D, Gubin D. The Impact of Physical Activity on the Circadian System: Benefits for Health, Performance and Wellbeing. APPLIED SCIENCES 2022; 12:9220. [DOI: 10.3390/app12189220] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2024]
Abstract
Circadian rhythms are an inherent property of all living systems and an essential part of the external and internal temporal order. They enable organisms to be synchronized with their periodic environment and guarantee the optimal functioning of organisms. Any disturbances, so-called circadian disruptions, may have adverse consequences for health, physical and mental performance, and wellbeing. The environmental light–dark cycle is the main zeitgeber for circadian rhythms. Moreover, regular physical activity is most useful. Not only does it have general favorable effects on the cardiovascular system, the energy metabolism and mental health, for example, but it may also stabilize the circadian system via feedback effects on the suprachiasmatic nuclei (SCN), the main circadian pacemaker. Regular physical activity helps to maintain high-amplitude circadian rhythms, particularly of clock gene expression in the SCN. It promotes their entrainment to external periodicities and improves the internal synchronization of various circadian rhythms. This in turn promotes health and wellbeing. In experiments on Djungarian hamsters, voluntary access to a running wheel not only stabilized the circadian activity rhythm, but intensive wheel running even reestablished the rhythm in arrhythmic individuals. Moreover, their cognitive abilities were restored. Djungarian hamsters of the arrhythmic phenotype in which the SCN do not generate a circadian signal not only have a diminished cognitive performance, but their social memory is also compromised. Voluntary wheel running restored these abilities simultaneously with the reestablishment of the circadian activity rhythm. Intensively exercising Syrian hamsters are less anxious, more resilient to social defeat, and show less defensive/submissive behaviors, i.e., voluntary exercise may promote self-confidence. Similar effects were described for humans. The aim of the present paper is to summarize the current knowledge concerning the effects of physical activity on the stability of the circadian system and the corresponding consequences for physical and mental performance.
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Affiliation(s)
- Dietmar Weinert
- Institute of Biology/Zoology, Martin Luther University, 06108 Halle-Wittenberg, Germany
| | - Denis Gubin
- Laboratory for Chronobiology and Chronomedicine, Research Institute of Biomedicine and Biomedical Technologies, Medical University, 625023 Tyumen, Russia
- Department of Biology, Medical University, 625023 Tyumen, Russia
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, 634009 Tomsk, Russia
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Kohn JN, Troyer E, Guay-Ross RN, Wilson K, Walker A, Spoon C, Pruitt C, Lyasch G, Pung MA, Milic M, Redwine LS, Hong S. Self-reported sleep disturbances are associated with poorer cognitive performance in older adults with hypertension: a multi-parameter risk factor investigation. Int Psychogeriatr 2020; 32:815-825. [PMID: 31647051 PMCID: PMC8011648 DOI: 10.1017/s1041610219001492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Given the evidence of multi-parameter risk factors in shaping cognitive outcomes in aging, including sleep, inflammation, cardiometabolism, and mood disorders, multidimensional investigations of their impact on cognition are warranted. We sought to determine the extent to which self-reported sleep disturbances, metabolic syndrome (MetS) factors, cellular inflammation, depressive symptomatology, and diminished physical mobility were associated with cognitive impairment and poorer cognitive performance. DESIGN This is a cross-sectional study. SETTING Participants with elevated, well-controlled blood pressure were recruited from the local community for a Tai Chi and healthy-aging intervention study. PARTICIPANTS One hundred forty-five older adults (72.7 ± 7.9 years old; 66% female), 54 (37%) with evidence of cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) score ≤24, underwent medical, psychological, and mood assessments. MEASUREMENTS CI and cognitive domain performance were assessed using the MoCA. Univariate correlations were computed to determine relationships between risk factors and cognitive outcomes. Bootstrapped logistic regression was used to determine significant predictors of CI risk and linear regression to explore cognitive domains affected by risk factors. RESULTS The CI group were slower on the mobility task, satisfied more MetS criteria, and reported poorer sleep than normocognitive individuals (all p < 0.05). Multivariate logistic regression indicated that sleep disturbances, but no other risk factors, predicted increased risk of evidence of CI (OR = 2.00, 95% CI: 1.26-4.87, 99% CI: 1.08-7.48). Further examination of MoCA cognitive subdomains revealed that sleep disturbances predicted poorer executive function (β = -0.26, 95% CI: -0.51 to -0.06, 99% CI: -0.61 to -0.02), with lesser effects on visuospatial performance (β = -0.20, 95% CI: -0.35 to -0.02, 99% CI: -0.39 to 0.03), and memory (β = -0.29, 95% CI: -0.66 to -0.01, 99% CI: -0.76 to 0.08). CONCLUSIONS Our results indicate that the deleterious impact of self-reported sleep disturbances on cognitive performance was prominent over other risk factors and illustrate the importance of clinician evaluation of sleep in patients with or at risk of diminished cognitive performance. Future, longitudinal studies implementing a comprehensive neuropsychological battery and objective sleep measurement are warranted to further explore these associations.
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Affiliation(s)
- Jordan N Kohn
- Department of Psychiatry, University of California, San Diego, USA
| | - Emily Troyer
- Department of Psychiatry, University of California, San Diego, USA
| | | | - Kathleen Wilson
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Amanda Walker
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Chad Spoon
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Christopher Pruitt
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Gary Lyasch
- Department of Psychiatry, University of California, San Diego, USA
| | - Meredith A Pung
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Milos Milic
- Department of Medicine, University of California, San Diego, USA
| | - Laura S Redwine
- College of Nursing, University of South Florida, Florida, USA
| | - Suzi Hong
- Department of Psychiatry, University of California, San Diego, USA
- Department of Family Medicine and Public Health, University of California, San Diego, USA
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Gubin DG, Malishevskaya ТN, Astakhov YS, Astakhov SY, Cornelissen G, Kuznetsov VA, Weinert D. Progressive retinal ganglion cell loss in primary open-angle glaucoma is associated with temperature circadian rhythm phase delay and compromised sleep. Chronobiol Int 2019; 36:564-577. [PMID: 30663431 DOI: 10.1080/07420528.2019.1566741] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Advanced primary open-angle glaucoma (POAG) is characterized by progressive retinal ganglion cell complex (RGCC) damage that may cause subsequent disruption of the circadian rhythms. Therefore, we evaluated circadian body temperature (BT) rhythm and sleep characteristics of 115 individuals (38 men and 77 women) diagnosed with POAG. GLV (global loss volume; %), a measure of RGCC damage, was estimated by high-definition optical coherence tomography, and RGC functional ability was assessed by pattern electroretinogram amplitude (PERGA). Depending on dynamics of POAG progression criteria, two groups were formed that were distinctively different in GLV: Stable POAG group (S-POAG; GLV = 5.95 ± 1.84, n = 65) and Progressive POAG group (P-POAG; GLV = 24.27 ± 5.09, n = 50). S-POAG and P-POAG groups were not different in mean age (67.61 ± 7.56 versus 69.98 ± 8.15) or body mass index (24.66 ± 3.03 versus 24.77 ± 2.90). All subjects performed 21 around-the-clock BT self-measurements during a 72-h period and kept activity/sleep diaries. Results showed pronounced disruption of circadian physiology in POAG and its progression with increasing severity of the disease. The daily mean of BT was unusually low, compared to age-matched controls. Moreover, our results revealed distinctive features of BT circadian rhythm alterations in POAG development and POAG progression. S-POAG is associated with lowered BT circadian rhythm robustness and inter-daily phase stability compared to controls. In the P-POAG group, the mean phase of the circadian BT rhythm was delayed by about 5 h and phases were highly scattered among individual patients, which led to reduced group mean amplitude. Circadian amplitudes of individuals were not different between the groups. Altogether, these results suggest that the body clock still works in POAG patients, but its entrainment to the 24-h environment is compromised. Probably because of the internal desynchronization, bedtime is delayed, and sleep duration is accordingly shortened by about 55 min in P-POAG compared to S-POAG patients. In the entire POAG cohort (both groups), later sleep phase and shorter mean sleep duration correlate with the delayed BT phase (r = 0.215; p = 0.021 and r = 0.322; p = 0.0004, respectively). An RGCC GLV of 15% apparently constitutes a threshold above which a delay of the circadian BT rhythm and a shortening of sleep duration occur.
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Affiliation(s)
- D G Gubin
- a Department of Biology , Medical University , Tyumen , Russia.,b Tyumen Cardiology Research Center , Tomsk National Research Medical Center, Russian Academy of Science , Tomsk , Russia
| | - Т N Malishevskaya
- c Department of Organization of Medical Care , State Autonomous Health Care Institution Tyumen Regional Ophthalmological Dispensary , Tyumen , Russia.,d Department of Ophthalmology and Optometry , West-Siberian Institute of Postgraduate Medical Education , Tyumen , Russia
| | - Y S Astakhov
- e Department of Ophthalmology , Pavlov First Saint Petersburg State Medical University , St. Petersburg , Russia
| | - S Y Astakhov
- e Department of Ophthalmology , Pavlov First Saint Petersburg State Medical University , St. Petersburg , Russia
| | - G Cornelissen
- f Halberg Chronobiology Center , University of Minnesota , Minneapolis , MN , USA
| | - V A Kuznetsov
- b Tyumen Cardiology Research Center , Tomsk National Research Medical Center, Russian Academy of Science , Tomsk , Russia
| | - D Weinert
- g Institute of Biology/Zoology , Martin Luther University , Halle-Wittenberg , Germany
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Gubin DG, Nelaeva AA, Uzhakova AE, Hasanova YV, Cornelissen G, Weinert D. Disrupted circadian rhythms of body temperature, heart rate and fasting blood glucose in prediabetes and type 2 diabetes mellitus. Chronobiol Int 2017; 34:1136-1148. [PMID: 28759269 DOI: 10.1080/07420528.2017.1347670] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We report a progressive disruption of 24-h rhythms in fasting blood glucose (FBG), body temperature (BT) and heart rate (HR) associated with metabolic dysfunction and the development of prediabetes (PD) and type 2 diabetes mellitus (T2DM) in overweight middle-aged (40-69 years old) humans. Increasing BT and HR mean values and declining 24-h BT and HR amplitudes accompany adverse changes in metabolic state. Increased nocturnal BT and a phase delay of the 24-h BT rhythm, deviant 24-h HR profile and a phase advance of the 24-h HR and FBG rhythms are early signs of the PD metabolic state. In T2DM, the 24-h FBG rhythm is no longer detectable, and the 24-h amplitudes of BT and HR are greatly diminished. In addition, lepton and creatinine values were lowered in T2DM. Moreover, positive correlations between FBG and body mass index, BMI, and negative correlations between the 24-h amplitude of FBG and BMI indicate that overweight is an additional factor causing disruption of the circadian rhythms. Further studies on circadian disruption as a consequence of metabolic dysfunction are necessary. The quantitative analysis of changing circadian BT and HR rhythms may provide prognostic markers of T2DM and therapeutic targets for its prevention and correction.
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Affiliation(s)
- D G Gubin
- a Department of Biology , Medical University , Tyumen , Russia
| | - A A Nelaeva
- b Department of Endocrinology , Medical University , Tyumen , Russia
| | - A E Uzhakova
- b Department of Endocrinology , Medical University , Tyumen , Russia
| | - Y V Hasanova
- b Department of Endocrinology , Medical University , Tyumen , Russia
| | - G Cornelissen
- c Halberg Chronobiology Center , University of Minnesota , Minneapolis , MN , USA
| | - D Weinert
- d Institute of Biology/Zoology , Martin Luther University , Halle-Wittenberg , Germany
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Gubin DG, Weinert D, Rybina SV, Danilova LA, Solovieva SV, Durov AM, Prokopiev NY, Ushakov PA. Activity, sleep and ambient light have a different impact on circadian blood pressure, heart rate and body temperature rhythms. Chronobiol Int 2017; 34:632-649. [PMID: 28276854 DOI: 10.1080/07420528.2017.1288632] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- D. G. Gubin
- Department of Biology, Tyumen Medical University, Tyumen, Russia
| | - D. Weinert
- Department of Zoology, Institute of Biology/Zoology, Martin Luther University, Halle-Wittenberg, Germany
| | - S. V. Rybina
- Department of Biology, Tyumen Medical University, Tyumen, Russia
| | - L. A. Danilova
- Department of Biology, Tyumen Medical University, Tyumen, Russia
| | - S. V. Solovieva
- Department of Biology, Tyumen Medical University, Tyumen, Russia
| | - A. M. Durov
- Department of Biology, Tyumen Medical University, Tyumen, Russia
- Department of Physical Culture and Sports, Tyumen State University, Tyumen, Russia
| | - N. Y. Prokopiev
- Department of Physical Culture and Sports, Tyumen State University, Tyumen, Russia
| | - P. A. Ushakov
- Department of Biology, Tyumen Medical University, Tyumen, Russia
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