{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:21Z","timestamp":1792787301621,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"China National Nature Science Foundation","doi-asserted-by":"crossref","award":["82073928"],"award-info":[{"award-number":["82073928"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Jiangsu Province \u201c333\u201d Project, China"},{"name":"\u201cDouble First-Class\u201d University project","award":["CPU2018GF01"],"award-info":[{"award-number":["CPU2018GF01"]}]},{"name":"Haihe Laboratory of Cell Ecosystem Innovation Fund","award":["22HHXBSS00005"],"award-info":[{"award-number":["22HHXBSS00005"]}]},{"name":"Nanjing Scientific and Technological Special Project for Life and Health","award":["202110006"],"award-info":[{"award-number":["202110006"]}]},{"DOI":"10.13039\/501100011360","name":"Key Laboratory of Natural Medicines","doi-asserted-by":"crossref","award":["SKLNMZZ202001"],"award-info":[{"award-number":["SKLNMZZ202001"]}],"id":[{"id":"10.13039\/501100011360","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Leading technology foundation research project of Jiangsu province","award":["BK20192005"],"award-info":[{"award-number":["BK20192005"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2024,3,7]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Circadian rhythm disruption (CRD) has been associated with inflammation and immune disorders, but its role in SLE progression is unclear. We aimed to investigate the impact of circadian rhythms on immune function and inflammation and their contribution to SLE progression to lupus nephritis (LN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study retrospectively analysed the clinical characteristics and transcriptional profiles of 373 samples using bioinformatics and machine-learning methods. A flare risk score (FRS) was established to predict overall disease progression for patients with lupus. Mendelian randomisation was used to analyse the causal relationship between CRD and SLE progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Abnormalities in the circadian pathway were detected in patients with SLE, and lower enrichment levels suggested a disease state (normalised enrichment score=0.6714, p=0.0062). The disruption of circadian rhythms was found to be closely linked to lupus flares, with the FRS showing a strong ability to predict disease progression (area under the curve (AUC) of 5-year prediction: 0.76). The accuracy of disease prediction was improved by using a prognostic nomogram based on FRS (AUC=0.77). Additionally, Mendelian randomisation analysis revealed an inverse causal relationship between CRD and SLE (OR 0.6284 (95% CI 0.3630 to 1.0881), p=0.0485) and a positive causal relationship with glomerular disorders (OR 0.0337 (95% CI 1.634e-3 to 6.934e-1), p=0.0280).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study reveals that genetic characteristics arising from CRD can serve as biomarkers for predicting the exacerbation of SLE. This highlights the crucial impact of CRD on the progression of lupus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2023-001109","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T23:30:25Z","timestamp":1712705425000},"page":"e001109","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Exacerbating effects of circadian rhythm disruption on the systemic lupus erythematosus"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-5245","authenticated-orcid":false,"given":"Luping","family":"Shen","sequence":"first","affiliation":[{"name":"Key Laboratory of Drug Metabolism and Pharmacokinetics, Haihe Laboratory of Cell Ecosystem, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, People's Republic of 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People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanke","family":"Xu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Drug Metabolism and Pharmacokinetics, Haihe Laboratory of Cell Ecosystem, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Jiangsu Renocell Biotech Co Ltd, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Wei","sequence":"additional","affiliation":[{"name":"Jiangsu Renocell Biotech Co Ltd, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Liu","sequence":"additional","affiliation":[{"name":"Jiangsu Renocell Biotech Co Ltd, Nanjing, 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