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Thorax doi:10.1136/thoraxjnl-2013-203482
  • Chest clinic
  • Basic science for the chest physician

The circadian clock and asthma

  1. David W Ray1
  1. 1Faculty of Medical and Human Sciences, Institute of Human Development, Manchester, UK
  2. 2Faculty of Life Sciences, University of Manchester, Manchester, UK
  1. Correspondence to Dr Hannah J Durrington, Faculty of Medical and Human Sciences, Institute of Human Development, Manchester M13 9PT, UK; hannahd{at}doctors.org.uk
  • Received 28 March 2013
  • Revised 13 April 2013
  • Accepted 22 April 2013
  • Published Online First 23 May 2013

Abstract

It is characteristic of asthma that symptoms worsen overnight, particularly in the early hours of the morning. Nocturnal symptoms in asthma are common and are an important indicator for escalation of treatment. An extensive body of research has demonstrated that nocturnal symptoms of cough and dyspnea are accompanied by circadian variations in airway inflammation and physiologic variables, including airflow limitation and airways hyper-responsiveness. The molecular apparatus that underpins circadian variations, controlled by so called ‘clock’ genes, has recently been characterised. Clock genes control circadian rhythms both centrally, in the suprachiasmatic nucleus of the brain and peripherally, within every organ of the body. Here, we will discuss how clock genes regulate circadian rhythms. We will focus particularly on the peripheral lung clock and the peripheral immune clock and discuss how these might relate to both the pathogenesis and treatment of asthma.


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