Figure 3
From: Insights into endocrine-immunological disturbances in autoimmunity and their impact on treatment
Altered balance between nocturnal hormones in rheumatoid arthritis. The altered balance between nocturnal hormone production in chronic diseases such as rheumatoid arthritis (RA) is characterized by increased levels and steady-state duration of melatonin (enhancer of the immune/inflammatory reaction) and by decreased adrenal cortisol availability (downregulator of the immune/inflammatory reaction).