'Chronomics' in ICU: circadian aspects of immune response and therapeutic perspectives in the critically ill

摘要: Complex interrelations exist between the master central clock, located in suprachiasmatic nuclei of hypothalamus, and several peripheral clocks, such as those found different immune cells body. Moreover, external factors that are called ‘timekeepers’, light/dark sleep/wake cycles, interact with internal clocks by synchronizing their oscillation phases. Chronobiology is science studies biologic rhythms exhibiting recurrent cyclic behavior. Circadian have a duration approximately 24 h can be assessed through chronobiologic analysis time series melatonin, cortisol, temperature. Critically ill patients experience severe circadian deregulation due to not only lack effective timekeepers intensive care unit (ICU) environment but also systemic inflammation. The latter has been both animal human disrupt rhythmicity all measured biomarkers. aims this article describe physiology during acute stress discuss effects ICU milieu upon rhythms, order emphasize value considering circadian-immune disturbance potential tool for personalized treatment. Thus, besides neoplastic processes, critical illness could linked what referred ‘chronomics’: timing rhythm. In addition, therapeutic perspectives will presented association environmental approaches restore connection hasten physical recovery.