Circadian rhythms and atopic dermatitis

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Abstract

The circadian rhythm is a 24-hour periodic cycle determined by the Earth’s rotation that modulates the behavior, physiology, and metabolism of all living organisms on our planet. The system that controls the circadian rhythm is known as the circadian clock. The mechanism of the circadian clock plays a crucial role in organismal development and functioning. For a long time, circadian clocks operated normally, being dependent on the alternation of light and darkness; however, lifestyle changes (artificial lighting, electronic devices, mobile phones, television, long-distance flights, etc.) have profoundly affected circadian rhythms. The resulting disruptions have led to health problems considered significant in the development of a number of diseases (malignant tumors, cardiovascular diseases, metabolic disorders, obesity, immune dysfunction).

In the skin, circadian rhythms are reflected in daily changes in transepidermal water loss, permeability and microcirculatory function, pruritus intensity, sleep–wake cycle, and the activity of the innate and adaptive immune systems. At the cellular level, the circadian rhythm regulates the mitotic cell cycle, keratinocyte differentiation timing, and many other processes. In atopic dermatitis, a vicious cycle exists: pruritus worsens sleep quality, leading to chronic stress, thereby disrupting the sleep–wake circadian rhythm; in turn, sleep deprivation, poor sleep quality, and chronic stress aggravate pruritus. These processes trigger exacerbations of atopic dermatitis, in which both pruritus and poor sleep quality intensify, significantly impairing the rhythmic functioning of the whole body and the skin in particular.

Recognizing the importance of circadian skin functions and the consequences of their disruption allows physicians to optimize therapy and maximize efficacy of prescribed treatment. Many topical agents may provide greater benefit if circadian rhythms are taken into account, whereas lower doses or less potent formulations could be sufficient.

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About the authors

Vera I. Albanova

Moscow Regional Research and Clinical Institute

Email: albanova.v@gmail.com
ORCID iD: 0000-0001-8688-7578
SPIN-code: 5548-5359

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Stanislava Yu. Petrova

I. Mechnikov Research Institute of Vaccines and Sera; Joint-stock company Pharmaceutical enterprise "Retinoids"

Author for correspondence.
Email: petrovastanislava@yandex.ru
ORCID iD: 0000-0003-3034-0148
SPIN-code: 7268-6944

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow; Balashikha

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2. Fig. 1. Lymphocyte activity and cortisol levels in human blood according to the time of day: the circadian rhythms of the immune system are synchronized with the central clock through sympathetic, parasympathetic and glucocorticoid signals (the greatest release of cortisol occurs around 8 a.m., cortisol activity is much lower in the evening, its immunosuppressive role is decreasing); during the night period, the restoration of immune system function begins and reaches its peak recovery by the early morning hours, this is followed by an intense cortisol release in the morning, immunosuppressive mechanisms are activated that prevent hyperactivation of the immune system [41–45]. Source: Albanova VI, et al., 2025.

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