Title:Disruption of Circadian Rhythms and Sleep in Critical Illness and its Impact on Innate Immunity
Volume: 21
Issue: 24
Author(s): Viola Dengler, Kristin Westphalen and Michael Koeppen
Affiliation:
Keywords:
Circardian rhythym, critical care, innate immunity, sepsis.
Abstract: The earth rotates on its axis around the sun, creating a day and night cycle, that caused the development
of circadian rhythms. The circadian rhythm is primarily entrained by light, which is detected by the retina. Retinal
ganglion cells project to a part of the hypothalamus termed suprachiasmatic nucleus. Here, we find the master molecular
clock, composed of a transcription-translation-loop at its core. The master clock indirectly influences the
innate immune system via different biological systems. Also, the master clock controls the peripheral clocks, which
are present in innate immune cells. Here, circadian rhythm proteins influence the response of immune cells to
pathogens. Furthermore, the master clock influences our sleep-pattern, the most important restorative physiological
function. In critically ill patients the circadian rhythm is substantially altered, supporting a dysfunctional innate
immune response. This review discusses recent basic science findings on the interaction of the circadian rhythm
and the innate immune system. Furthermore we give an outlook on potential future therapeutic strategies.
