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基于生物钟原理的变应性鼻炎治疗策略

  • 魏诗彤 ,
  • 白伟良 ,
  • 常紫雯 ,
  • 高钊 ,
  • 刘天聪
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  • 中国医科大学附属盛京医院耳鼻咽喉头颈外科,沈阳 110022
魏诗彤,硕士研究生,研究方向为鼻科学,电子信箱:wei191116@163.com

收稿日期: 2023-03-08

  修回日期: 2023-06-11

  网络出版日期: 2023-09-28

基金资助

辽宁省科技厅重点研发基金项目(2021JH2/10300087);沈阳市科学计划项目(21-172-9-08)

Exploration of a new strategy for the treatment of allergic rhinitis based on the circadian clock

  • WEI Shitong ,
  • BAI Weiliang ,
  • CHANG Ziwen ,
  • GAO Zhao ,
  • LIU Tiancong
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  • Department of Otorhinolaryngology, Shengjing Hospital of China Medical University, Shenyang 110022, China

Received date: 2023-03-08

  Revised date: 2023-06-11

  Online published: 2023-09-28

摘要

在治疗变应性鼻炎(allergic rhinitis,AR)过程中,将生物钟因素考虑在内,可以有效改善症状,提高患者生活质量。基于生物钟原理,从时间疗法、靶向生物钟分子、干预生活方式3方面探讨了AR治疗新策略,提出时间疗法可以通过优化给药时间减少副作用并增加疗效,与免疫治疗相结合有望缩短其治疗周期,提高患者接受度;而生物钟基因的破坏会增强过敏反应的严重程度,对生活方式进行干预以维持内在生物钟稳态至关重要。

本文引用格式

魏诗彤 , 白伟良 , 常紫雯 , 高钊 , 刘天聪 . 基于生物钟原理的变应性鼻炎治疗策略[J]. 科技导报, 2023 , 41(18) : 84 -91 . DOI: 10.3981/j.issn.1000-7857.2023.18.011

Abstract

Allergic rhinitis (AR) is a type I allergic reaction mediated by specific immunoglobulin E after exposure to allergens in atopic individuals. The main symptoms of AR are nasal congestion, nasal itching, sneezing and rhinorrhea, which are worse at night or early in the morning. The circadian clock is an endogenous timing system in the organism that produces an approximate 24-hour circadian rhythm. The temporal characteristics of the changes in the symptoms of AR coincide with the circadian clock, indicating a close relationship with the biological clock. Taking the biological clock into account during the treatment can be effective in improving symptoms and the quality of life. Intrinsic biological clock molecules in mast cell (MC) regulate its activation through both IgE-dependent and non-IgE-dependent pathways, leading to exacerbation of AR at night or in the early morning. Based on the understanding of the circadian clock, three treatment strategies have been proposed. Chronotherapy reduces side effects and increases efficacy by optimizing the dosing time. Combining chronotherapy with immunotherapy is expected to shorten the duration of treatment. Targeting specific biological clock molecules is expected to be a new option. Disruption of clock genes not only affects changes in the timing of the circadian clock, but can also enhances the severity of allergic reactions and even increases susceptibility to allergic diseases, therefore, lifestyle interventions to maintain intrinsic biological clock homeostasis are critical.

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