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Journal of Immunology Research
Volume 2014, Article ID 282495, 6 pages
Review Article

Involvement of the Circadian Rhythm and Inflammatory Cytokines in the Pathogenesis of Rheumatoid Arthritis

1Faculty of Health Sciences, Kobe University School of Medicine, Kobe 654-0142, Japan
2Department of General Internal Medicine, Kobe University School of Medicine, Kobe 650-0017, Japan
3Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
4Clinical Immunology, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Japan

Received 5 March 2014; Accepted 24 April 2014; Published 8 May 2014

Academic Editor: Mizuko Mamura

Copyright © 2014 Kohsuke Yoshida et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Among the symptoms of patients with rheumatoid arthritis (RA), joint stiffness is influenced by diurnal rhythm and reaches peak in the morning, which is a common complaint and reflects the circadian nature of disease manifestation. In addition, inflammatory cytokines, which reach peak secretion early in the morning are major players causing the morning stiffness. In this review, we explore the link between the circadian clock and inflammation, focusing on the interactions of various clock genes with the immune-pathways underlying the pathology of rheumatoid arthritis.