文献类型：期刊文献

中文题名：炎症性肠病中的昼夜节律:从生理基础到时间医学应用

英文题名：Circadian rhythms in inflammatory bowel disease:from physiological basis to chronotherapy applications

作者：张永宣[1];岳诗棋[1];王妍[1];神珂[1];张培豪[2];和建政[3,4];修明慧[1,4]

第一作者：张永宣

通信作者：Xiu, MH[1];He, JZ[2];He, JZ[3];Xiu, MH[3]

机构：[1]甘肃中医药大学公共卫生学院,兰州730000;[2]甘肃中医药大学基础医学院,兰州730000;[3]甘肃中医药大学科研实验中心,兰州730000;[4]敦煌医学与转化教育部重点实验室,兰州730000

第一机构：甘肃中医药大学公共卫生学院

通信机构：[1]corresponding author), Gansu Univ Tradit Chinese Med, Sch Publ Hlth, Lanzhou 730000, Peoples R China;[2]corresponding author), Gansu Univ Tradit Chinese Med, Res & Expt Ctr, Lanzhou 730000, Peoples R China;[3]corresponding author), Minist Educ, Key Lab Dunhuang Med & Translat, Lanzhou 730000, Peoples R China.|[10735]甘肃中医药大学;[10735e9d5e7087247e71b]甘肃中医药大学公共卫生学院;

年份：2026

卷号：71

期号：2

起止页码：464

中文期刊名：科学通报

外文期刊名：Chinese Science Bulletin

收录：;EI(收录号：20260219876803);WOS:【ESCI(收录号:WOS:001665191100003)】；北大核心:【北大核心2023】；

基金：国家自然科学基金(82360896);甘肃省杰出青年基金(23JRRA1202);甘肃中医药大学研究生“创新创业基金”项目(2025CXCY-063);敦煌医学与转化教育部重点实验室开放课题(DHYX24-15)资助。

语种：中文

中文关键词：炎症性肠病;昼夜节律;肠道菌群;肠道免疫;时间医学;择时治疗

外文关键词：inflammatory bowel disease;circadian rhythm;gut microbiota;gut immunity;chronomedicine;timing treatment

摘要：炎症性肠病(inflammatory bowel disease,IBD)是一种以胃肠道慢性炎症为特征的易复发性疾病,其临床病理特征主要表现为肠道黏膜的持续性炎症损伤和修复异常,主要分为克罗恩病(Crohn’s disease,CD)和溃疡性结肠炎(ulcerative colitis,UC)两种临床亚型.最新研究表明,昼夜节律紊乱(circadian rhythm disorder,CRD)与IBD的发病机制、疾病进展以及治疗效果密切相关.本文系统阐述了肠道生理学中的昼夜节律、IBD患者的昼夜节律表达模式,以及昼夜节律对IBD肠道中微生物菌群、肠道黏膜屏障及免疫系统的调控机制.此外,基于IBD症状、炎症活动度及药物疗效均呈现昼夜依赖性,本文还进一步展望了基于节律调节的时间医学(chrono medicine)策略(包括昼夜节律调节药物、时间药理学、择时给药、限时禁食等)在IBD治疗中的潜在应用前景,为优化临床实践提供理论支持和治疗思路.
Inflammatory bowel disease(IBD),encompassing Crohn’s disease(CD)and ulcerative colitis(UC),is a chronic and recurrent gastrointestinal inflammatory disorder.It is characterized by persistent mucosal inflammation,damage to the intestinal epithelium,and impaired tissue repair.The primary clinical symptoms of IBD include abdominal pain,diarrhea,and bloody stools,with the frequency and severity of episodes often exhibiting a distinct circadian rhythm pattern.Various studies have proven that circadian rhythm disorders(CRD)are implicated in the pathogenesis,exacerbation,and treatment outcomes of IBD.This connection arises from the crucial role that circadian and biological clock molecules play an important role in regulating the diversity and colonization of gut microbiota,modulating mucosal barrier function through the expression of tight junction proteins,and exerting immunoregulatory effects via regulating immune cell activation,proliferation,and migration.However,disruptions to these rhythms often stem from modern lifestyle factors such as shift work,sleep deprivation,or irregular eating patterns.This leads to dysbiosis of the gut microbiota,increased intestinal permeability,and abnormal activation of the immune system,thereby inducing the onset of IBD or exacerbating its progression.IBD symptoms exhibit significant circadian rhythmic fluctuations.For example,disease activity,gut microbiota composition,intestinal mucosal barrier function,and inflammatory cytokine expression levels often exhibit diurnal patterns.Furthermore,drug metabolism and efficacy are also regulated by circadian rhythms,influencing the pharmacokinetic characteristics and pharmacodynamic performance of common IBD treatment regimens,such as glucocorticoids and immunomodulators.For instance,administering certain medications at specific times can enhance bioavailability and reduce toxicity.It suggests the potential feasibility of chronotherapy strategies.Accordingly,this review explores the application prospects of chronotherapy in the management of IBD,including multiple potential pathways that restores circadian synchrony and improve the intestinal microenvironment.These include:timed medication administration that is based on chronopharmacology and disease activity fluctuations,time-restricted eating that means consuming meals within a prescribed window during active phases,and behavioral interventions like adequate light exposure and sleep.These approaches aim not only to enhance therapeutic efficacy,but also to mitigate drug side effects and improve the quality of life for patients,particularly IBD patients with sleep disturbances.In summary,integrating circadian biology into IBD research offers new insights into disease mechanisms and paves the way for personalized timebased therapeutic interventions.Future efforts should further advance clinical translational studies to identify optimal time windows and individualized treatment strategies for different IBD subtypes.This review synthesizes existing evidence to establish a foundational framework for future clinical research,emphasizing the critical importance of considering circadian rhythms in IBD management and treatment.