Circadian Disruption as a Risk Factor for Development of Cardiovascular and Metabolic Disorders - From Animal Models to Human Population.

The lifestyle of human society is drifting apart from the natural environmental cycles that have influenced it since its inception. These cycles were fundamental in structuring the daily lives of people in the pre-industrial era, whether they were seasonal or daily. Factors that disrupt the regularity of human behaviour and its alignment with solar cycles, such as late night activities accompanied with food intake, greatly disturb the internal temporal organization in the body. This is believed to contribute to the rise of the so-called diseases of civilization. In this review, we discuss the connection between misalignment in daily (circadian) regulation and its impact on health, with a focus on cardiovascular and metabolic disorders. Our aim is to review selected relevant research findings from laboratory and human studies to assess the extent of evidence for causality between circadian clock disruption and pathology. Keywords: Circadian clock, Chronodisruption, Metabolism, Cardiovascular disorders, Spontaneously hypertensive rat, Human, Social jetlag, Chronotype.

Stress affects expression of the clock gene Bmal1 in the suprachiasmatic nucleus of neonatal rats via glucocorticoid-dependent mechanism.

AIM: The reactivity of the circadian clock in the suprachiasmatic nuclei (SCN) to stressful stimuli has been controversial but most studies have confirmed the resilience of the SCN to stress. We tested the hypothesis that during a critical period shortly after birth, the developing SCN clock is affected by glucocorticoids. METHODS: Mothers of 2 rat strains with different sensitivities to stress, that is Wistar rats and spontaneously hypertensive rats (SHR), and their pups were exposed to stressful stimuli every day from delivery, and clock gene expression profiles were detected in the 4-day-old pups' SCN. Levels of glucocorticoids in plasma were measured by LC-MS/MS. The glucocorticoid receptors antagonist mifepristone was administered to pups to block the effect of the glucocorticoids. RESULTS: The glucocorticoid receptors were detected at the mRNA and protein levels in the SCN of 4-day-old pups. The exposure of mothers to stressful stimuli elevated their plasma glucocorticoid levels. In Wistar rat pups, combination of daily maternal stress with their manipulation increased the plasma glucocorticoid levels and shifted the Bmal1 rhythm in the SCN which was completely blocked by mifepristone. In contrast, in SHR pups, maternal stress on its own caused phase shift of the Bmal1 expression rhythm in the SCN but the effect was mediated via glucocorticoid-independent mechanism. The Per1 and Per2 expression profiles remained phase-locked to the light/dark cycle. CONCLUSION: The results demonstrate that the SCN is sensitive to stressful stimuli early after birth in pups maintained under light/dark conditions and the effect is mediated via glucocorticoid-dependent pathways.

Peripheral circadian clocks are diversely affected by adrenalectomy.

Glucocorticoids are considered to synchronize the rhythmicity of clock genes in peripheral tissues; however, the role of circadian variations of endogenous glucocorticoids is not well defined. In the present study, we examined whether peripheral circadian clocks were impaired by adrenalectomy. To achieve this, we tested the circadian rhythmicity of core clock genes (Bmal1, Per1-3, Cry1, RevErbα, Rora), clock-output genes (Dbp, E4bp4) and a glucocorticoid- and clock-controlled gene (Gilz) in liver, jejunum, kidney cortex, splenocytes and visceral adipose tissue (VAT). Adrenalectomy did not affect the phase of clock gene rhythms but distinctly modulated clock gene mRNA levels, and this effect was partially tissue-dependent. Adrenalectomy had a significant inhibitory effect on the level of Per1 mRNA in VAT, liver and jejunum, but not in kidney and splenocytes. Similarly, adrenalectomy down-regulated mRNA levels of Per2 in splenocytes and VAT, Per3 in jejunum, RevErbα in VAT and Dbp in VAT, kidney and splenocytes, whereas the mRNA amounts of Per1 and Per2 in kidney and Per3 in VAT and splenocytes were up-regulated. On the other hand, adrenalectomy had minimal effects on Rora and E4bp4 mRNAs. Adrenalectomy also resulted in decreased level of Gilz mRNA but did not alter the phase of its diurnal rhythm. Collectively, these findings suggest that adrenalectomy alters the mRNA levels of core clock genes and clock-output genes in peripheral organs and may cause tissue-specific modulations of their circadian profiles, which are reflected in changes of the amplitudes but not phases. Thus, the circulating corticosteroids are necessary for maintaining the high-amplitude rhythmicity of the peripheral clocks in a tissue-specific manner.

Circadian regulation of epithelial functions in the intestine.

Many physiological functions exhibit a diurnal rhythmicity that is influenced by biological clocks and feeding rhythms. In this review, we discuss the growing evidence showing the important role of circadian rhythms in regulating intestinal mucosa. First, we introduce the molecular timing system and the interrelationship between the master biological clock in the suprachiasmatic nuclei of the brain and the peripheral intestinal clock and provide evidence that the intestinal clock is entrained with the external environment. Second, we review the circadian rhythmicity of enterocyte proliferation and the largely unknown regulatory mechanisms behind these rhythms. Finally, we focus on the circadian clock control of food processing that functions by regulating the expression of digestive enzymes and intestinal nutrient and salt transporters. The concepts to be discussed highlight the ability of the intestinal epithelium to utilize self-sustained clock signals together with signals associated with changes in the cellular environment and to use endogenous temporal control of the gastrointestinal functions to meet varying physiological and pathophysiological demands. The fact that internal de-synchronizations within the body, such as those that occur in shift workers or with changes in food intake behaviour, are often associated with malfunctions of the gastrointestinal tract indicates that more information about the connections between the circadian clock and intestinal mucosa/transporting enterocytes could provide clues for future therapies.

Circadian regulation of electrolyte absorption in the rat colon.

The intestinal transport of nutrients exhibits distinct diurnal rhythmicity, and the enterocytes harbor a circadian clock. However, temporal regulation of the genes involved in colonic ion transport, i.e., ion transporters and channels operating in absorption and secretion, remains poorly understood. To address this issue, we assessed the 24-h profiles of expression of genes encoding the sodium pump (subunits Atp1a1 and Atp1b1), channels (α-, ß-, and γ-subunits of Enac and Cftr), transporters (Dra, Ae1, Nkcc1, Kcc1, and Nhe3), and the Na(+)/H(+) exchanger (NHE) regulatory factor (Nherf1) in rat colonic mucosa. Furthermore, we investigated temporal changes in the spatial localization of the clock genes Per1, Per2, and Bmal1 and the genes encoding ion transporters and channels along the crypt axis. In rats fed ad libitum, the expression of Atp1a1, γEnac, Dra, Ae1, Nhe3, and Nherf1 showed circadian variation with maximal expression at circadian time 12, i.e., at the beginning of the subjective night. The peak γEnac expression coincided with the rise in plasma aldosterone. Restricted feeding phase advanced the expression of Dra, Ae1, Nherf, and γEnac and decreased expression of Atp1a1. The genes Atp1b1, Cftr, αEnac, ßEnac, Nkcc1, and Kcc1 did not show any diurnal variations in mRNA levels. A low-salt diet upregulated the expression of ßEnac and γEnac during the subjective night but did not affect expression of αEnac. Similarly, colonic electrogenic Na(+) transport was much higher during the subjective night than the subjective day. These findings indicate that the transporters and channels operating in NaCl absorption undergo diurnal regulation and suggest a role of an intestinal clock in the coordination of colonic NaCl absorption.

Restricted feeding regime affects clock gene expression profiles in the suprachiasmatic nucleus of rats exposed to constant light.

The master circadian clock located in the suprachiasmatic nuclei (SCN) is dominantly entrained by external light/dark cycle to run with a period of a solar day, that is, 24 h, and synchronizes various peripheral clocks located in the body's cells and tissues accordingly. A daily restricted normocaloric feeding regime synchronizes the peripheral clocks but has no effect on SCN rhythmicity. The aim of this study was to elucidate whether feeding regime may affect the molecular mechanism generating SCN rhythmicity under conditions in which the rhythmicity is disturbed, as occurs under constant light. The rats were maintained under constant light for 30 days and were either fed ad libitum during the whole period, or their access to food was restricted to only 6 h a day during the last 2 weeks in constant light. Locomotor activity was monitored during the whole experiment. On the last day in constant light, daily expression profiles of the clock genes Per1, Per2, Bmal1, and Rev-erbα were determined in the SCN of both groups by in situ hybridization. Due to their exposure to constant light, the rats fed ad libitum became completely arrhythmic, while those exposed to the restricted feeding were active mostly during the time of food availability. In the SCN of behaviorally arrhythmic rats, no oscillations in Rev-erbα and Bmal1 gene expression were detected, but very low amplitude, borderline significant, oscillations in Per1 and Per2 persisted. Restricted feeding induced significant circadian rhythms in Rev-erbα and Bmal1 gene expression, but did not affect the low amplitude oscillations of Per1 and Per2 expression. These findings demonstrate that, under specific conditions, when the rhythmicity of the SCN is disturbed and other temporal entraining cues are lacking, the SCN molecular clockwork may likely sense temporal signals from changes in metabolic state delivered by normocaloric food.

Circadian and developmental regulation of N-methyl-d-aspartate-receptor 1 mRNA splice variants and N-methyl-d-aspartate-receptor 3 subunit expression within the rat suprachiasmatic nucleus.

The circadian rhythms of mammals are generated by the circadian clock located in the suprachiasmatic nucleus (SCN) of the hypothalamus. Its intrinsic period is entrained to a 24 h cycle by external cues, mainly by light. Light impinging on the SCN at night causes either advancing or delaying phase shifts of the circadian clock. N-methyl-d-aspartate receptors (NMDAR) are the main glutamate receptors mediating the effect of light on the molecular clockwork in the SCN. They are composed of multiple subunits, each with specific characteristics whose mutual interactions strongly determine properties of the receptor. In the brain, the distribution of NMDAR subunits depends on the region and developmental stage. Here, we report the circadian expression of the NMDAR1 subunit in the adult rat SCN and depict its splice variants that may constitute the functional receptor channel in the SCN. During ontogenesis, expression of two of the NMDAR1 subunit splice variants, as well as the NMDAR3A and 3B subunits, exhibits developmental loss around the time of eye opening. Moreover, we demonstrate the spatial and developmental characteristics of the expression of the truncated splice form of NMDAR1 subunit NR1-E in the brain. Our data suggest that specific properties of the NMDAR subunits we describe within the SCN likely influence the photic transduction pathways mediating the clock entrainment. Furthermore, the developmental changes in NMDAR composition may contribute to the gradual postnatal maturation of the entrainment pathways.

Circadian molecular clocks tick along ontogenesis.

The circadian system controls the timing of behavioral and physiological functions in most organisms studied. The review addresses the question of when and how the molecular clockwork underlying circadian oscillations within the central circadian clock in the suprachiasmatic nuclei of the hypothalamus (SCN) and the peripheral circadian clocks develops during ontogenesis. The current model of the molecular clockwork is summarized. The central SCN clock is viewed as a complex structure composed of a web of mutually synchronized individual oscillators. The importance of development of both the intracellular molecular clockwork as well as intercellular coupling for development of the formal properties of the circadian SCN clock is also highlighted. Recently, data has accumulated to demonstrate that synchronized molecular oscillations in the central and peripheral clocks develop gradually during ontogenesis and development extends into postnatal period. Synchronized molecular oscillations develop earlier in the SCN than in the peripheral clocks. A hypothesis is suggested that the immature clocks might be first driven by external entraining cues, and therefore, serve as "slave" oscillators. During ontogenesis, the clocks may gradually develop a complete set of molecular interlocked oscillations, i.e., the molecular clockwork, and become self-sustained clocks.

Photoperiodic regulation of PER1 and PER2 protein expression in rat peripheral tissues.

Circadian oscillations in biological variables in mammals are controlled by a central pacemaker in the suprachiasmatic nuclei (SCN) of the hypothalamus which coordinates circadian oscillators in peripheral tissues. The molecular clockwork responsible for this rhythmicity consists of several clock genes and their corresponding proteins that compose interactive feedback loops. In the SCN, two of the genes, Per1 and Per2, show circadian rhythmicity in their expression and protein production. This SCN rhythmicity is modified by the length of daylight, i.e. the photoperiod. The aim of the present study was to find out whether profiles of PER1 and PER2 proteins in peripheral organs are also affected by the photoperiod. Rats were maintained under a long photoperiod with 16 h of light and 8 h of darkness per day (LD 16:8) and under a short, LD 8:16, photoperiod. The PER1 and PER2 daily profiles were measured in peripheral organs by Western blotting. The photoperiod affected significantly the PER1 profile in livers and the PER2 profile in lungs and hearts. In lungs, PER2 in the cytoplasmic, but not in the nuclear fraction, was affected significantly. The effect of the photoperiod on PER1 profiles in peripheral organs appears to differ from that in the SCN.

Ontogenesis of photoperiodic entrainment of the molecular core clockwork in the rat suprachiasmatic nucleus.

The molecular mechanism underlying a generation of circadian rhythmicity within the suprachiasmatic nucleus (SCN) is based on interactive negative and positive feedback loops that drive the rhythmic transcription of clock genes and translation of their protein products. In adults, the molecular mechanism is affected by seasonal changes in day length, i.e., photoperiod. The photoperiod modulates phase, waveform, and amplitude of the rhythmic clock genes expression as well as the phase relationship between their profiles. To ascertain when and how the photoperiod affects the circadian core clock mechanism during ontogenesis, the rhythmic expression of clock genes, namely of Per1, Per2, Cry1 and Bmal1 was determined in 3-, 10- and 20-day-old rat pups maintained under either a long photoperiod with 16 h of light and 8 h of darkness per day (LD 16:8) or under a short, LD 8:16 photoperiod. The daily profiles in the level of clock genes mRNA were studied in constant darkness. The photoperiod affected the profile of Per1 and Per2 mRNA in 20- and 10- but not yet in 3-day-old pups. Expression of Cry1 was affected only in 20-day-old pups, whereas expression of Bmal1 was not yet affected even in 20-day-old rats. The results demonstrate no effect of the photoperiod on 3-day-old pups, only partial entrainment of the molecular core clockwork in 10-day-old pups and a more mature, though not yet fully complete, entrainment in 20-day-old pups as compared with adult animals. The developmental interval when the photoperiod begins to entrain the core clock mechanism completely might thus occur around the time of weaning.

Seasonal molecular timekeeping within the rat circadian clock.

In temperate zones duration of daylight, i.e. photoperiod, changes with the seasons. The changing photoperiod affects animal as well as human physiology. All mammals exhibit circadian rhythms and a circadian clock controlling the rhythms is located in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN consists of two parts differing morphologically and functionally, namely of the ventrolateral (VL) and the dorsomedial (DM). Many aspects of SCN-driven rhythmicity are affected by the photoperiod. The aim of the present overview is to summarize data about the effect of the photoperiod on the molecular timekeeping mechanism in the rat SCN, especially the effect on core clock genes, clock-controlled genes and clock-related genes expression. The summarized data indicate that the photoperiod affects i) clock-driven rhythm in photoinduction of c-fos gene and its protein product within the VL SCN, ii) clock-driven spontaneous rhythms in clock-controlled, i.e. arginine-vasopressin, and in clock-related, i.e. c-fos, gene expression within the DM SCN, and iii) the core clockwork mechanism within the rat SCN. Hence, the whole central timekeeping mechanism within the rat circadian clock measures not only the daytime but also the time of the year, i.e. the actual season.

[Metastases of perianal gland carcinoma in a dog: palliative tumor therapy]. / Perianaldrüsenkarzinom-Metastasen bei einem Hund: Palliative Tumortherapie.

Palliative radiation therapy may provide significant relief in symptoms in pets with incurable cancer. Therapy is applied over a short period of time, using larger than normal fractional doses. Palliative radiation leads to minimal or no side effects. This case report describes the situation of a miniature poodle that was presented with severe dyschezia as well as fresh blood in the feces. The dog had a large abdominal mass which was diagnosed as lymph-node metastasis of a perianal gland carcinoma. Therapy included palliative radiation as well as chemotherapy. Six months after initial presentation the dog is free of clinical symptoms.

Spontaneous c-Fos rhythm in the rat suprachiasmatic nucleus: location and effect of photoperiod.

A recently reported circadian rhythm in the spontaneous c-Fos immunoreactivity in the rat suprachiasmatic nucleus (SCN) is expressed mostly in the dorsomedial (dm) SCN, where vasopressinergic cells are located. The aim of the present study is to find out whether day length, i.e., photoperiod, affects the dm-SCN rhythm and, if so, how the rhythm adjusts to a change from a long to a short photoperiod. In addition, a question of whether the spontaneous c-Fos production is localized in vasopressin- producing cells or in other cells is also studied to characterize further the dm-SCN rhythmicity. Combined immunostaining for c-Fos and arginine vasopressin (AVP) revealed that most of c-Fos immunopositive cells were devoid of AVP; the results suggest that c-Fos-producing cells in the dm-SCN are mostly not identical with those producing AVP. In rats maintained under a long photoperiod with 16:8-h light-dark cycle (LD 16:8) daily and then released into darkness, the time of the afternoon and evening decline of the spontaneous c-Fos immunoreactivity in the dm-SCN differed just slightly from the time in rats maintained originally under a short LD 8:16 photoperiod; however, the morning c-Fos rise occurred about 4 h earlier under the long than under the short photoperiod. After a change from a long to a short photoperiod, a rough but not yet a fine adjustment of the morning c-Fos rise to the change was accomplished within 3-6 days. The results show that similar to the recently reported ventrolateral SCN rhythmicity, the intrinsic dm-SCN rhythmicity is also affected by the photoperiod and suggest that the whole SCN state is photoperiod dependent.

c-Fos rhythm in subdivisions of the rat suprachiasmatic nucleus under artificial and natural photoperiods.

Recent studies have shown that the waveform of the rhythm of c-Fos photoinduction in the ventrolateral (vl) part of the suprachiasmatic nucleus (SCN) and that of the rhythm in the spontaneous c-Fos production in the dorsomedial (dm) part of the SCN in rats released into constant darkness depend on the photoperiod under which the animals were previously maintained. The aim of the present study was to find out how the rhythms of c-Fos immunoreactivity in both SCN subdivisions are affected by actual light-dark (LD) cycles with various photoperiods, either artificial or natural ones, that animals may usually experience. Rats were maintained under artificial LD cycles, with either a long (16-h photoperiod) or a short (8-h photoperiod) or under natural daylight. In the latter case, c-Fos rhythms were followed in the summer when the photoperiod lasted about 16 h or in winter when it lasted only 8 h. The rhythms of c-Fos immunoreactivity under natural daylight did not differ significantly from those under corresponding artificial photoperiods. Under a long photoperiod, the morning c-Fos rise in the dm- as well as in the vl-SCN occurred about 4 h earlier than under a short one. In both SCN subdivisions, the interval when the nighttime c-Fos immunoreactivity was low, was shorter under a long than under a short photoperiod by roughly 6 h. The morning c-Fos rise in the dm-SCN always preceded that in the vl-SCN. Whereas in the former one the rise was due to the endogenous dm-SCN rhythmicity, in the latter one the rise was induced by the morning light onset. The results show that whereas c-Fos rhythmicity under actual LD cycles is affected by the photoperiod in both SCN subdivisions, mechanism of c-Fos induction in the dm-SCN differs from that in the vl-SCN.

Hormones, subjective night and season of the year.

Production and release of many mammalian hormones exhibit circadian rhythms controlled by a pacemaker located in the suprachiasmatic nuclei (SCN) of the hypothalamus. Under conditions when the circadian pacemaker free-runs with a period close to, but not equal to 24 h, subjective day and night may not be identical with the environmental day and night. The present study was aimed to define the phase and state of the circadian pacemaker when the circadian system is experiencing subjective night and to ascertain whether and how such a defined subjective night depends on the photoperiod. The results indicate that the subjective night may be defined as the time interval when i) light stimuli can reset the circadian system, ii) pineal melatonin production and photic induction of the c-Fos gene in the ventrolateral SCN are high, and iii) the spontaneous c-Fos protein production in the dorsomedial SCN is low. Such a defined subjective night and, logically, the whole circadian pacemaking system depend on the photoperiod and hence on the season of the year which the animals are experiencing.

Gate for photic resetting of intrinsic rhythmicity of the rat suprachiasmatic nucleus under a long photoperiod.

In rats maintained under a long photoperiod and then released into darkness, the time interval enabling photic resetting of the intrinsic rhythmicity of the suprachiasmatic nucleus (SCN), namely of the rhythm in the light-induced c-Fos production, was similar to the previously reported time interval enabling high c-fos photoinduction in the SCN (Sumová, A., Trávnícková, Z., Peters, R., Schwartz, W.J. and Illnerová, H., The rat suprachiasmatic nucleus is a clock for all seasons. Proc. Natl. Acad. Sci. USA, 92 (1995) 7754-7758). The data indicate that both intervals may represent the same window for the photic sensitivity of the SCN pacemaking program.

Daily profiles of arginine vasopressin mRNA in the suprachiasmatic, supraoptic and paraventricular nuclei of the rat hypothalamus under various photoperiods.

Daily rhythm of arginine vasopressin (AVP) mRNA levels in the suprachiasmatic nucleus (SCN) of rats maintained under a short, LD 8:16 photoperiod differed from that of rats maintained under a long, LD 16:8 photoperiod: under the short photoperiod the morning AVP rise occurred significantly later than under the long one. Daily profiles of AVP mRNA in the supraoptic and paraventricular nuclei were not rhythmic and AVP mRNA levels under LD 8:16 did not differ from those under LD 16:8. The data indicate that photoperiod affects selectively the clock driven AVP gene expression in the SCN.

Spontaneous rhythm in c-Fos immunoreactivity in the dorsomedial part of the rat suprachiasmatic nucleus.

In rats maintained for 2 days in constant darkness, the suprachiasmatic nucleus exhibited a circadian rhythm in c-Fos immunoreactivity, with the maximum in the morning and trough during the subjective night. In contrast to the night-time photic c-Fos induction occurring in the ventrolateral part of the nucleus, the spontaneous rhythmic c-Fos induction in darkness occurred in the dorsomedial part and might indicate an elevated dorsomedial neuronal activity in the early subjective day.

Photic resetting of intrinsic rhythmicity of the rat suprachiasmatic nucleus under various photoperiods.

To date, photic entrainment of the mammalian circadian system has been studied by following phase shifts of overt rhythms in the periphery governed by a circadian pacemaker located in the suprachiasmatic nucleus (SCN). The present study follows for the first time photic resetting of intrinsic rhythmicity of the SCN itself. Rats maintained under either a shorter photoperiod, with 12 h of light and 12 h of darkness per day, or under a long, 18:6-h light-dark photoperiod were exposed to a light stimulus during the dark period and then released into darkness, and the next day the SCN rhythm in the light-stimulated c-Fos protein immunoreactivity was followed as a marker of the SCN endogenous rhythmicity. After a light stimulus in the early night, the evening rise in the photic elevation of Fos protein photoinduction as well as the morning decline were phase delayed within one cycle. After a light stimulus in the late night, only the morning decline in the photic elevation of Fos was phase advanced the next night, not the evening rise; consequently, the interval enabling high photic elevation of Fos was reduced. After a light stimulus was administered around the middle of the night, the next night the evening rise in the light-stimulated Fos was eventually phase delayed, the morning decline was phase advanced, and the rhythm amplitude was reduced significantly; under 18:6-h light-dark, a mere 5-min light exposure exhibited such effects. The data indicate that resetting of the SCN rhythmicity in the light-elevated c-Fos 1 day after a resetting stimulus administration, i.e., during transient cycles, may proceed via nonparallel phase shifts of the evening rise and of the morning decline of the light-stimulated Fos, and via amplitude lowering and suggest a complex circadian pacemaking system in the rat SCN.