1
|
Krakowiak K, Maidstone RJ, Chakraborty A, Kendall AC, Nicolaou A, Downton P, Cristian AD, Singh D, Loudon AS, Ray DW, Durrington HJ. Identification of diurnal rhythmic blood markers in bronchial asthma. ERJ Open Res 2023; 9:00161-2023. [PMID: 37404842 PMCID: PMC10316035 DOI: 10.1183/23120541.00161-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/01/2023] [Indexed: 07/06/2023] Open
Abstract
Rationale Asthma is a rhythmic inflammatory disease of the airway, regulated by the circadian clock. "Spill-over" of airway inflammation into the systemic circulation occurs in asthma and is reflected in circulating immune cell repertoire. The objective of the present study was to determine how asthma impacts peripheral blood diurnal rhythmicity. Methods 10 healthy and 10 mild/moderate asthma participants were recruited to an overnight study. Blood was drawn every 6 h for 24 h. Main results The molecular clock in blood cells in asthma is altered; PER3 is significantly more rhythmic in asthma compared to healthy controls. Blood immune cell numbers oscillate throughout the day, in health and asthma. Peripheral blood mononucleocytes from asthma patients show significantly enhanced responses to immune stimulation and steroid suppression at 16:00 h, compared to at 04:00 h. Serum ceramides show complex changes in asthma: some losing and others gaining rhythmicity. Conclusions This is the first report showing that asthma is associated with a gain in peripheral blood molecular clock rhythmicity. Whether the blood clock is responding to rhythmic signals received from the lung or driving rhythmic pathology within the lung itself is not clear. Dynamic changes occur in serum ceramides in asthma, probably reflecting systemic inflammatory action. The enhanced responses of asthma blood immune cells to glucocorticoid at 16:00 h may explain why steroid administration is more effective at this time.
Collapse
Affiliation(s)
- Karolina Krakowiak
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Robert J. Maidstone
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Amlan Chakraborty
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Alexandra C. Kendall
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Anna Nicolaou
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Polly Downton
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | | | - Dave Singh
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Andrew S.I. Loudon
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - David W. Ray
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Hannah J. Durrington
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Medicines Evaluation Unit, University of Manchester, Manchester, UK
| |
Collapse
|
2
|
Mokros Ł, Witusik A, Szydłowska D, Jankowski KS, Kuna P, Pietras T. Mental health indices may fully mediate the relationship between morningness-eveningness and disease control among adult asthma patients. J Asthma 2021; 59:1923-1932. [PMID: 34606405 DOI: 10.1080/02770903.2021.1989463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: The aim of this study was to assess the association between morningness-eveningness and disease control with consideration of mental state as a mediator and the control of confounding factors among adult asthma patients.Methods: This is a cross-sectional study, which included a nonrandom sample of N = 66 patients from an outpatient unit with a confirmed asthma diagnosis, who gave an informed consent and completed a set of questionnaires: a survey comprising questions about sociodemographic and clinical characteristics, the Asthma Control Test (ACT), the Composite Scale of Morningness (CSM), and the General Health Questionnaire (GHQ-28). Mediation models were created separately for each GHQ-28 dimension (somatic symptoms, anxiety/insomnia, social dysfunction and depressive symptoms), for a total score and for four GHQ-28 dimensions together, considered as mediators.Results: Low morning affect was related to poor disease symptom control among patients with asthma. The effect was fully mediated by non-psychotic mental health indices. Evening-time preference was associated with a rise in asthma control, and mediated by somatic symptoms and anxiety/insomnia, when controlled for morning affect.Conclusions: The current study underlines the significance of assessment of both individual morningness-eveningness preference and mental health in the management of asthma symptoms.
Collapse
Affiliation(s)
- Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Andrzej Witusik
- Faculty of Composition, Theory of Music, Conducting, Eurhythmics and Music Education, Music Therapy Course, Grazyna and Kiejstut Bacewicz Memorial Academy of Music in Lodz, Lodz, Poland
| | - Dorota Szydłowska
- Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | | | - Piotr Kuna
- Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Tadeusz Pietras
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| |
Collapse
|