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Papers of the Week

Papers: 22 Jul 2023 - 28 Jul 2023


Human Studies, Molecular/Cellular, Neurobiology


2023 Jul 24

Nat Rev Rheumatol


Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis.


Irwin MR, Straub RH, Smith MT


Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.