Relationship between circadian rhythm disordersand course of inflammatory bowel diseases

Abstract

Crohns disease (CD) and ulcerative colitis (UC) belong to the group ofinflammatory bowel diseases (IBD), chronic immunological diseases ofthe digestive tract (1). The pathogenesis of IBD is not fully understood;probably under the influence of various environmental and infectiousfactors as well as genetic predisposition in patients suffering from IBD,the cytokine profile changes (2). The main goal of the research currentlybeing carried out around the world is to identify risk factors for the developmentof IBD. It is suggested that disturbances of the circadian rhythmas well as quantitative and qualitative sleep disturbances may cause theimmune inbalance towards the pro-inflammatory profile and lead to thedevelopment of IBD.The aim of the study was to confirm the hypothesis about the relationshipof immune imbalance disorders with the circadian rhythm and to try toexplain its clinical significance in the course of IBD. In the longer term,the research was about to answer the question of whether the treatmentof sleep disorders, both psychological and pharmacological, should becomea new target in the treatment of IBD.Based on the literature review and own research, the following conclusionswere drawn: 1. sleep disturbances occurring 30 days before the examinationmay be a risk factor for the exacerbation of the underlying diseasein patients with IBD, regardless of the diagnosis (CD or UC). Sleepdisturbances are more common in people with moderate to severe exacerbationscompared to patients in clinical remission and compared tothe control group, 2. patients with IBD with sleep disorders have significantlyhigher levels of IL-6, IL-17 and IL-23 compared to group of patientswithout these disturbances, 3. patients with IBD with sleep disordershave increased levels of resistin and decreased levels of adiponectinand leptin compared to group of patients without these disturbances.The conducted studies will allow to consider disturbances in the circadiancycle as a risk factor for exacerbation in IBD. We also suggest thatthe treatment of sleep disorders, both pharmacological and behavioral,may become an additional treatment target among patients.