2023-05-15 22:00:28
- Administering medications at the correct time can make them more effective and have fewer side effects for the patient.
- The UNAM developed a chronotherapy investigation that was published in the recent edition of the journal Nature Communications.
- The work can give an indication of how to improve hospital management.
The effectiveness of medications depends on many factors to achieve the best possible results. In the end, what any patient wants is a speedy recovery. Although something seemingly minimal and irrelevant such as the time of day the drugs are consumed could be quite useful.
Origin of chronopharmacology
From the above arose the chronopharmacology. It consists of the study of the effect of the opportune moment of administration of the drug on its action and the way in which it acts with respect to the circadian cycle. The purpose is to maximize efficacy and reduce adverse drug reactions.
In the case of our country, Lorena Aguilar Arnal, academic at the UNAM Biomedical Research Institute presented a study on the subject. He specified that it was reviewed how the time of day has an impact on the efficacy of a therapy aimed at treating the problems associated with obesity and diabetes.
“The time of day is important because it can enhance the effect of the drug, the dose can be lowered and there are fewer unwanted side effects. It is very clear in therapies against cancer -chemotherapy and radiotherapy- where this field has great development potential”.
This is an area little explored in the clinic, and in the field of personalized therapies it is a factor that still needs to be understood, so the work provides data that supports this vision.
The epigenetic specialist commented that although it is very intuitive to think that if a drug is taken when the target or target site for which it was designed is not there, its effect will be less than when it is present. Until now, this topic has not been studied much in the clinic and little is known about how to administer drugs in chronotherapeutic protocols.
Using a model of mice susceptible to developing diabetes, the researcher from the Department of Cell Biology and Physiology and her colleagues emulated therapies that raise nicotinamide adenine dinucleotide levels, which are currently in their first clinical trials (with human patients).
They have been found to be effective for treating insulin resistance, and other symptoms that come with diabetes, including being said to be effective for weight loss, treating dyslipidemia and fatty liver.
The work of Aguilar Arnal and his team consisted of supplying a group of laboratory rodents with a drug that raises nicotinamide adenine dinucleotide levels when they begin their periods of activity and rest.
“If the therapy is given just before you start your active period, it is much more effective than when you start your rest period.”
The data is important to support the use of a chronotherapy for this type of medication. They also provide relevant information on the molecular mechanisms why this happens in the mouse.
“The mechanism of action of therapies aimed at regulating nicotinamide adenine dinucleotide levels have specific targets, that is, molecular pathways that are more present just before the phase of the active period, and that is precisely when you should administer the drug.”
The circadian rhythm modifies the effectiveness of medications
Aguilar Arnal recalled that organisms in general, from bacteria to mammals, have an internal clock that we know as the circadian rhythm. It works like a pacemaker and whose biological function is to anticipate the moments of the day and give the body the time.
It performs different physiological, biochemical and cellular functions at different times of the day. For example, in the case of patients with dyslipidemia, the administration of rapid-release statins is more favorable before starting the rest period, because cholesterol biosynthesis occurs naturally at night.
The work can give an indication of how to improve hospital management, since these are spaces where therapies are normally adjusted to the doctors’ schedules and, in general, there are lights on even during night shifts, the university highlighted.
As an example, in the intensive care units of hospitals, the lights are constantly on and this significantly alters the physiology of the patients.
There are studies that suggest the implementation of protocols so that light is regulated at night, that is, to reduce its intensity and avoid the use of blue light. If these types of procedures were implemented, patient management would improve significantly because their circadian cycles could be more effectively preserved.
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