中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (10): 750-754.doi: 10.12144/zgmfskin202610750

• 综述 • 上一篇    下一篇

昼夜节律调控在特应性皮炎中的研究进展

范恒珩1,耿芸1,熊御云1,2,李遇梅1,2   

  1. 1江苏大学附属医院皮肤科，江苏镇江，212001；2中国再生医学研究所皮肤科，江苏镇江，212001
  • 出版日期:2026-10-15 发布日期:2026-10-09

New progress in circadian rhythm regulation in atopic dermatitis

FAN Hengheng1, GENG Yun1, XIONG Yuyun1,2, LI Yumei1,2   

  1. 1 Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China; 2 Department of Dermatology, China Institute of Regenerative Medicine, Zhenjiang 212001, China
  • Online:2026-10-15 Published:2026-10-09

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摘要： 特应性皮炎（atopic dermatitis，AD）是一种慢性、复发性炎症性皮肤病，其临床症状（如瘙痒）及皮肤生理指标（如经皮水分丢失）均呈现一定的昼夜节律性波动。昼夜节律紊乱可能通过影响皮肤屏障稳态、免疫炎症反应及神经内分泌调控参与AD的发生发展。核心时钟基因CLOCK/BMAL1的转录节律异常可影响水通道蛋白-3（AQP3）、丝聚蛋白等屏障相关分子的表达，降低夜间皮肤屏障功能；生物钟与2型炎症双向影响，炎症因子经EGR1等分子干扰时钟基因表达，树突状细胞NR1D1等时钟相关基因异常则可能促进Th2型免疫偏移；褪黑素信号、皮质醇分泌节律及代谢状态改变可共同影响夜间瘙痒阈值和氧化应激水平。本文综述昼夜节律调控 AD 的相关机制，并分析择时给药、褪黑素干预及光照/睡眠管理等时间治疗学策略在AD管理中的应用价值，以期为AD精准诊疗和长期管理提供新的思路。

关键词: 特应性皮炎, 昼夜节律, 生物钟基因, 皮肤屏障, 时间治疗学

Abstract: Atopic dermatitis (AD) is a chronic and recurrent inflammatory skin disease characterized by circadian fluctuations in clinical symptoms, especially pruritus, and physiological parameters such as transepidermal water loss. Circadian disruption may contribute to the onset and progression of AD by disturbing skin barrier homeostasis, immune inflammatory responses, and neuroendocrine regulation. This review summarizes the potential mechanisms underlying circadian regulation in AD. Abnormal oscillations of the core clock genes CLOCK/BMAL1 may impair the rhythmic expression of barrier-related molecules, including aquaporin-3 (AQP3) and filaggrin, thereby weakening nocturnal skin barrier defense. The circadian clock interacts bidirectionally with type 2 inflammation; inflammatory cytokines may interfere with clock gene expression through molecules such as EGR1, whereas abnormalities of clock-related genes, including NR1D1 in dendritic cells, may promote Th2 immune polarization. Disordered melatonin signaling, disrupted cortisol rhythms, and metabolic remodeling may collectively reduce the nocturnal itch threshold and increase oxidative stress. This paper reviews the mechanisms by which circadian rhythms regulate AD, and analyzes chronotherapeutic strategies including timed medication, melatonin intervention, light exposure and sleep management.

Key words: atopic dermatitis, circadian rhythm, clock genes, skin barrier, chronotherapy