Effect of Simulated Sleep on the Expression of Circadian Clock Genes Bmal1, Per2, Immune Function, and Short-term Clinical Outcomes in Patients with Sepsis
LI Zheng, JU Peihong, HUA Wei, et al
Yangpu Central Hospital (Affiliated to Tongji University), Shanghai 200090
Abstract：【Objective】To explore the effect of simulated sleep on the expression of circadian clock genes Brain and Muscle ARNT-Like 1 (Bmal1) and Period 2 (Per2), immune function, and short-term clinical outcomes in patients with sepsis.【Methods】Eighty sepsis patients were randomly divided into the control group (with standard symptomatic treatment) and the observation group (with standard symptomatic treatment combined with simulated sleep intervention), with 40 patients in each group. The study compared the levels of inflammatory factors [interleukin-6 (IL-6), IL-8, tumor necrosis factor-alpha (TNF-α), and C-Reactive Protein (CRP)], Bmal1 and Per2 expression, immune function, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) score, mechanical ventilation duration, ICU stay duration, and 28-day mortality rate between the two groups before treatment and 7 days after treatment.【Results】After 7 days of treatment, both groups showed reduced levels of IL-6, IL-8, TNF-α, and CRP compared to before treatment (P<0.05), with the observation group presenting even lower levels than the control group (P<0.05). Both groups exhibited increased expression of Bmal1 and Per2 mRNA (P<0.05) after 7 days of treatment compared to before treatment, with higher expression of Bmal1 and Per2 in the observation group than the control group (P<0.05). The levels of CD4+, CD4+/CD8+ increased, while CD8+ decreased in both groups compared to before treatment (P<0.05), and the observation group showed higher CD4+, CD4+/CD8+ and lower CD8+ than the control group (P<0.05). Both groups had reduced SOFA and APACHE Ⅱ scores compared to before treatment (P<0.05), with lower scores in the observation group (P<0.05). The observation group had shorter mechanical ventilation and ICU stay durations (P<0.05), but the difference in 28-day mortality rate was not statistically significant between the two groups (P>0.05).【Conclusion】Simulated sleep can improve the dysregulation of circadian clock genes Bmal1 and Per2 in sepsis patients, enhance immune function, reduce systemic inflammatory response, and improve short-term clinical outcomes.
李铮, 居培红, 华玮, 张雯艳, 黄侃, 石斌. 模拟睡眠对脓毒症患者生物钟基因Bmal1、Per2表达和免疫功能、短期临床转归的影响*[J]. 医学临床研究, 2024, 41(5): 669-673.
LI Zheng, JU Peihong, HUA Wei, et al. Effect of Simulated Sleep on the Expression of Circadian Clock Genes Bmal1, Per2, Immune Function, and Short-term Clinical Outcomes in Patients with Sepsis. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 669-673.
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2024, Vol. 41 
