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Lin J, Kuang H, Jiang J, Zhou H, Peng L, Yan X, Kuang J. Circadian Rhythms in Cardiovascular Function: Implications for Cardiac Diseases and Therapeutic Opportunities. Med Sci Monit 2023; 29:e942215. [PMID: 37986555 PMCID: PMC10675984 DOI: 10.12659/msm.942215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/21/2023] [Indexed: 11/22/2023] Open
Abstract
Circadian rhythms are internal 24-h intrinsic oscillations that are present in essentially all mammalian cells and can influence numerous biological processes. Cardiac function is known to exhibit a circadian rhythm and is strongly affected by the day/night cycle. Many cardiovascular variables, including heart rate, heart rate variability (HRV), electrocardiogram (ECG) waveforms, endothelial cell function, and blood pressure, demonstrate robust circadian rhythms. Many experiential and clinical studies have highlighted that disruptions in circadian rhythms can ultimately lead to maladaptive cardiac function. Factors that disrupt the circadian rhythm, including shift work, global travel, and sleep disorders, may consequently enhance the risk of cardiovascular diseases. Some cardiac diseases appear to occur at particular times of the day or night; therefore, targeting the disease at particular times of day may improve the clinical outcome. The objective of this review is to unravel the relationship between circadian rhythms and cardiovascular health. By understanding this intricate interplay, we aim to reveal the potential risks of circadian disruption and discuss the emerging therapeutic strategies, specifically those targeting circadian rhythms. In this review, we explore the important role of circadian rhythms in cardiovascular physiology and highlight the role they play in cardiac dysfunction such as ventricular hypertrophy, arrhythmia, diabetes, and myocardial infarction. Finally, we review potential translational treatments aimed at circadian rhythms. These treatments offer an innovative approach to enhancing the existing approaches for managing and treating heart-related conditions, while also opening new avenues for therapeutic development.
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Affiliation(s)
- Jiayue Lin
- Postgraduate School, Hunan University of Chinese Medicine, Changsha, Hunan, PR China
- Department of Cardiovascular, The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, Changsha, Hunan, PR China
| | - Haoming Kuang
- Postgraduate School, Hunan University of Chinese Medicine, Changsha, Hunan, PR China
| | - Jiahao Jiang
- Department of Chinese Medicine, The First People’s Hospital of Kunshan, Suzhou, Jiangsu, PR China
| | - Hui Zhou
- Department of Cardiovascular, Beibei Hospital of Chinese Medicine, Chongqing, PR China
| | - Li Peng
- Department of Cardiovascular, The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, Changsha, Hunan, PR China
| | - Xu Yan
- Department of Cardiovascular, The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, Changsha, Hunan, PR China
| | - Jianjun Kuang
- Department of Orthopedics and Traumatology, The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, Changsha, Hunan, PR China
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Takahashi M, Fukazawa M, Tahara Y, Kim HK, Tanisawa K, Ito T, Nakaoka T, Higuchi M, Shibata S. Association between circadian clock gene expressions and meal timing in young and older adults. Chronobiol Int 2023; 40:1235-1243. [PMID: 37722714 DOI: 10.1080/07420528.2023.2256855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/03/2023] [Indexed: 09/20/2023]
Abstract
Ageing is associated with a decline in circadian clock systems, which correlates with the development of ageing-associated diseases. Chrononutrition is a field of chronobiology that examines the relationship between the timing of meal/nutrition and circadian clock systems. Although there is growing evidence regarding the role of chrononutrition in the prevention of lifestyle and ageing-related diseases, the optimal timing of meal intake to regulate the circadian clock in humans remains unknown. In this study, we investigated the relationship between clock gene expression and meal timing in young and older adults. In this cross-sectional study, we enrolled 51 healthy young men and 35 healthy older men (age, mean±standard deviation: 24 ± 4 and 70 ± 4 y, respectively). Under daily living conditions, beard follicle cells were collected at 4-h intervals over a 24-h period to evaluate clock gene expression. Participants were asked to record the timing of habitual sleep and wake-up, breakfast, lunch, and dinner. From these data, we calculated "From bedtime to breakfast time," "From wake up to first meal time," and "From dinner to bed time." NR1D1 and PER3 expressions in older adults at 06:00 h were significantly higher than those in young adults (P = 0.001). There were significant differences in the peak time for NR1D2 (P = 0.003) and PER3 (P = 0.049) expression between young and older adults. "From bedtime to breakfast time" was significantly longer in older adults than in young adults. In contrast, "From dinner to bed time" was significantly shorter in older adults than in young adults. Moreover, higher rhythmicity of NR1D1 correlated with longer "From bedtime to breakfast time" (r = -0.470, P = 0.002) and shorter "From wake up to first meal time" in young adults (r = 0.302, P = 0.032). Higher rhythmicity of PER3 correlated with longer "From bedtime to breakfast time" in older adults (r = -0.342, P = 0.045). These results suggest that the peak time of clock gene expression in older adults may be phase-advanced compared to that in young adults. In addition, a longer fasting duration from bedtime to breakfast in both young and older adults and earlier intake of meals after waking up in young adults may correlate with robust clock gene expression rhythms.
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Affiliation(s)
- Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Mayuko Fukazawa
- Faculty of Science and Engineering, Waseda University, Shinjuku, Japan
| | - Yu Tahara
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hyeon-Ki Kim
- Department of Physical Activity Research, National Institute of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Kumpei Tanisawa
- Faculty of Sports Sciences, Waseda University, Tokorozawa, Japan
| | - Tomoko Ito
- Department of Food and Nutrition, Tokyo Kasei University, Tokyo, Japan
| | - Takashi Nakaoka
- Japan Organization of Occupational Health and Safety, Kawasaki, Japan
| | - Mitsuru Higuchi
- Faculty of Sports Sciences, Waseda University, Tokorozawa, Japan
| | - Shigenobu Shibata
- Faculty of Science and Engineering, Waseda University, Shinjuku, Japan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Vesnina A, Prosekov A, Atuchin V, Minina V, Ponasenko A. Tackling Atherosclerosis via Selected Nutrition. Int J Mol Sci 2022; 23:8233. [PMID: 35897799 PMCID: PMC9368664 DOI: 10.3390/ijms23158233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 12/02/2022] Open
Abstract
The development and pathogenesis of atherosclerosis are significantly influenced by lifestyle, particularly nutrition. The modern level of science and technology development promote personalized nutrition as an efficient preventive measure against atherosclerosis. In this survey, the factors were revealed that contribute to the formation of an individual approach to nutrition: genetic characteristics, the state of the microbiota of the gastrointestinal tract (GIT) and environmental factors (diets, bioactive components, cardioprotectors, etc.). In the course of the work, it was found that in order to analyze the predisposition to atherosclerosis associated with nutrition, genetic features affecting the metabolism of nutrients are significant. The genetic features include the presence of single nucleotide polymorphisms (SNP) of genes and epigenetic factors. The influence of telomere length on the pathogenesis of atherosclerosis and circadian rhythms was also considered. Relatively new is the study of the relationship between chrono-nutrition and the development of metabolic diseases. That is, to obtain the relationship between nutrition and atherosclerosis, a large number of genetic markers should be considered. In this relation, the question arises: "How many genetic features need to be analyzed in order to form a personalized diet for the consumer?" Basically, companies engaged in nutrigenetic research and choosing a diet for the prevention of a number of metabolic diseases use SNP analysis of genes that accounts for lipid metabolism, vitamins, the body's antioxidant defense system, taste characteristics, etc. There is no set number of genetic markers. The main diets effective against the development of atherosclerosis were considered, and the most popular were the ketogenic, Mediterranean, and DASH-diets. The advantage of these diets is the content of foods with a low amount of carbohydrates, a high amount of vegetables, fruits and berries, as well as foods rich in antioxidants. However, due to the restrictions associated with climatic, geographical, material features, these diets are not available for a number of consumers. The way out is the use of functional products, dietary supplements. In this approach, the promising biologically active substances (BAS) that exhibit anti-atherosclerotic potential are: baicalin, resveratrol, curcumin, quercetin and other plant metabolites. Among the substances, those of animal origin are popular: squalene, coenzyme Q10, omega-3. For the prevention of atherosclerosis through personalized nutrition, it is necessary to analyze the genetic characteristics (SNP) associated with the metabolism of nutrients, to assess the state of the microbiota of the GIT. Based on the data obtained and food preferences, as well as the individual capabilities of the consumer, the optimal diet can be selected. It is topical to exclude nutrients of which their excess consumption stimulates the occurrence and pathogenesis of atherosclerosis and to enrich the diet with functional foods (FF), BAS containing the necessary anti-atherosclerotic, and stimulating microbiota of the GIT nutrients. Personalized nutrition is a topical preventive measure and there are a number of problems hindering the active use of this approach among consumers. The key factors include weak evidence of the influence of a number of genetic features, the high cost of the approach, and difficulties in the interpretation of the results. Eliminating these deficiencies will contribute to the maintenance of a healthy state of the population through nutrition.
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Affiliation(s)
- Anna Vesnina
- Laboratory of Natural Nutraceuticals Biotesting, Research Department, Kemerovo State University, 650043 Kemerovo, Russia;
| | - Alexander Prosekov
- Laboratory of Biocatalysis, Kemerovo State University, 650043 Kemerovo, Russia;
| | - Victor Atuchin
- Laboratory of Optical Materials and Structures, Institute of Semiconductor Physics, 630090 Novosibirsk, Russia
- Research and Development Department, Kemerovo State University, 650000 Kemerovo, Russia
- Laboratory of Applied Physics, Novosibirsk State University, 630090 Novosibirsk, Russia
- Department of Industrial Machinery Design, Novosibirsk State Technical University, 630073 Novosibirsk, Russia
- R&D Center “Advanced Electronic Technologies”, Tomsk State University, 634034 Tomsk, Russia
| | - Varvara Minina
- Department of Genetic and Fundamental Medicine, Kemerovo State University, 650000 Kemerovo, Russia;
| | - Anastasia Ponasenko
- Laboratory of Genome Medicine, Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia;
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Ragnoli B, Pochetti P, Pignatti P, Barbieri M, Mondini L, Ruggero L, Trotta L, Montuschi P, Malerba M. Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:904. [PMID: 35055726 PMCID: PMC8775678 DOI: 10.3390/ijerph19020904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/18/2022]
Abstract
Sleep health and its adaptation to individual and environmental factors are crucial to promote physical and mental well-being across animal species. In recent years, increasing evidence has been reported regarding the relationship between sleep and the immune system and how sleep disturbances may perturb the delicate balance with severe repercussions on health outcomes. For instance, experimental sleep deprivation studies in vivo have reported several major detrimental effects on immune health, including induced failure of host defense in rats and increased risk for metabolic syndrome (MetS) and immune suppression in humans. In addition, two novel risk factors for dysregulated metabolic physiology have recently been identified: sleep disruption and circadian misalignment. In light of these recent findings about the interplay between sleep and the immune system, in this review, we focus on the relationship between sleep deprivation and immunity against viruses, with a special interest in SARS-CoV-2 infection.
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Affiliation(s)
- Beatrice Ragnoli
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
| | - Patrizia Pochetti
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
| | - Patrizia Pignatti
- Allergy and Immunology Unit, Istituti Clinici Scientifici Maugeri IRCCS Pavia, 27100 Pavia, Italy;
| | - Mariangela Barbieri
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
| | - Lucrezia Mondini
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
| | - Luca Ruggero
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
| | - Liliana Trotta
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
| | - Paolo Montuschi
- Pharmacology Department, Faculty of Medicine, Catholic University of the Sacred Heart, 20123 Milan, Italy;
- Faculty of Medicine, National Hearth and Lung Institute, Imperial College of Science Technology and Medicine, Airways Disease Section, London SW7 2BX, UK
| | - Mario Malerba
- Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy; (B.R.); (P.P.); (M.B.); (L.M.); (L.R.); (L.T.)
- Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
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Kim MY, Jung S, Kim J, Lee HJ, Jeong S, Sim SJ, Kim SK. Highly sensitive and multiplexed one-step RT-qPCR for profiling genes involved in the circadian rhythm using microparticles. Sci Rep 2021; 11:6463. [PMID: 33742035 PMCID: PMC7979730 DOI: 10.1038/s41598-021-85728-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 11/09/2020] [Indexed: 11/09/2022] Open
Abstract
Given the growing interest in molecular diagnosis, highly extensive and selective detection of genetic targets from a very limited amount of samples is in high demand. We demonstrated the highly sensitive and multiplexed one-step RT-qPCR platform for RNA analysis using microparticles as individual reactors. Those particles are equipped with a controlled release system of thermo-responsive materials, and are able to capture RNA targets inside. The particle-based assay can successfully quantify multiple target RNAs from only 200 pg of total RNA. The assay can also quantify target RNAs from a single cell with the aid of a pre-concentration process. We carried out 8-plex one-step RT-qPCR using tens of microparticles, which allowed extensive mRNA profiling. The circadian cycles were shown by the multiplex one-step RT-qPCR in human cell and human hair follicles. Reliable 24-plex one-step RT-qPCR was developed using a single operation in a PCR chip without any loss of performance (i.e., selectivity and sensitivity), even from a single hair. Many other disease-related transcripts can be monitored using this versatile platform. It can also be used non–invasively for samples obtained in clinics.
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Affiliation(s)
- Mi Yeon Kim
- Center for Molecular Recognition Research, Materials and Life Science Research Division, Korea Institute of Science and Technology(KIST), Seoul, KS013, Korea.,Department of Chemical Biological Engineering, Korea University, Seoul, KS013, Korea
| | - Seungwon Jung
- Center for Molecular Recognition Research, Materials and Life Science Research Division, Korea Institute of Science and Technology(KIST), Seoul, KS013, Korea
| | - Junsun Kim
- Center for Molecular Recognition Research, Materials and Life Science Research Division, Korea Institute of Science and Technology(KIST), Seoul, KS013, Korea.,Department of Chemical Biological Engineering, Korea University, Seoul, KS013, Korea
| | - Heon Jeong Lee
- Department of Psychiatry and Chronobiology Institute, Korea University College of Medicine, Seoul, KS013, Korea
| | - Seunghwa Jeong
- Department of Psychiatry and Chronobiology Institute, Korea University College of Medicine, Seoul, KS013, Korea
| | - Sang Jun Sim
- Department of Chemical Biological Engineering, Korea University, Seoul, KS013, Korea
| | - Sang Kyung Kim
- Center for Molecular Recognition Research, Materials and Life Science Research Division, Korea Institute of Science and Technology(KIST), Seoul, KS013, Korea.
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Chaulin AM, Duplyakov DV. High-sensitivity cardiac troponins: circadian rhythms. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2639] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
High-sensitivity cardiac troponins (hs-cTnI and hs-cTnT) contribute to a progression in the diagnosis and treatment of cardiovascular diseases: acceleration of diagnosis of acute myocardial infarction (early diagnostic algorithms: 0-1 h, 0-3 h), and earlier initiation of optimal treatment, expansion of diagnostic and prognostic potential (earlier detection of myocardial damage during chemotherapy, endocarditis, myocarditis and other diseases). However, increased sensitivity slightly reduced the specificity and created the need for a more thorough interpretation of elevated levels of hs-cTnI and hs-cTnT in a number of pathologies that damage cardiomyocytes. In addition, there was a need to introduce reference levels of hs-cTnI and hs-cTnT (99 percentile), taking into account sex. Recently, there has also been information about circadian (diurnal) variations in hs-cTnT and hs-cTnI levels. We analyze in detail the results of clinical studies that found circadian changes in hs-cTnI and hs-cTnT. Possible mechanisms underlying these changes in hs-cTnT and hs-cTnI concentrations are discussed.
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Affiliation(s)
| | - D. V. Duplyakov
- Samara Regional Clinical Cardiology Dispensary; Samara State Medical University
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Effects of sleep deprivation on endothelial function in adult humans: a systematic review. GeroScience 2021; 43:137-158. [PMID: 33558966 DOI: 10.1007/s11357-020-00312-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/06/2020] [Indexed: 01/01/2023] Open
Abstract
Sleep deprivation is highly prevalent and is associated with increased cardiovascular disease (CVD) morbidity and mortality. Age-related alterations in sleep and chronobiology may exaggerate CVD susceptibility in older individuals. The mechanisms responsible for the association between sleep deprivation and CVD are not fully understood, but endothelial dysfunction may play a central role. Our objective was to conduct a systematic literature review to evaluate the evidence on the effects of sleep deprivation on endothelial function (EF). This review adhered to the PRISMA guidelines and was pre-registered with PROSPERO (#CRD42020192485, 07/24/2020). We searched PubMed, Web of Science, Embase, and Cochrane Library for articles published through May 1, 2020. Eligibility criteria included publication in English and use of well-established EF methodologies in adult humans. Two investigators independently performed the literature search, study selection, data extraction, risk-of-bias assessment, and qualitative data synthesis. Out of 3571 articles identified, 24 articles were included in the systematic review. Main findings include the following: (1) shorter sleep duration is associated with lower macrovascular EF; (2) not sleeping 7-9 h/night is linked with impaired microvascular EF; (3) sleep restriction impairs micro- and macrovascular EF; (4) acute total sleep deprivation impairs micro- and macrovascular EF but data on macrovascular EF are less consistent; and (5) shift work impairs macrovascular EF. In conclusion, sleep deprivation impairs EF, which may explain the link between insufficient sleep and CVD. Future investigations should fully elucidate the underlying mechanisms and develop strategies to combat the adverse endothelial effects of sleep deprivation across the lifespan.
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Chronotype and social jetlag influence human circadian clock gene expression. Sci Rep 2018; 8:10152. [PMID: 29976939 PMCID: PMC6033857 DOI: 10.1038/s41598-018-28616-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/27/2018] [Indexed: 12/31/2022] Open
Abstract
We examined the relationships between chronotype or social jetlag and clock gene expression. Twenty-four young men [Chronotype: morningness, n = 8; intermediate, n = 8, eveningness, n = 8], aged 27 ± 2 years old (mean ± SE), completed two trials in a randomized order: (1) a Friday trial and (2) a Monday trial. In both trials, hair follicle cells were collected to evaluate the expression of clock genes over a 24-hour period at 4-hour intervals. There was a significant main effect of time on the expression of NR1D1, NR1D2, and PER3 (P < 0.001) in the morningness group, but not in the eveningness group. Changes in the peak time of expression of NR1D1 (r = 0.434, P = 0.034), NR1D2 (r = 0.481, P = 0.017), and PER3 (r = 0.457, P = 0.025) from the Friday to Monday trials were positively correlated with social jetlag (SJL) time. Our findings indicate that there was no change in the patterns of clock gene expression between workdays and the day after the holiday in the morningness group, and that SJL time influences the peak time of clock gene expression, moving it from the early to late workday, after a holiday.
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Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction. Int J Cardiol 2018; 270:14-20. [PMID: 29891238 DOI: 10.1016/j.ijcard.2018.05.136] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/15/2018] [Accepted: 05/31/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND High-sensitivity cardiac troponin T (hs-cTnT) blood concentrations were shown to exhibit a diurnal rhythm, characterized by gradually decreasing concentrations throughout daytime, rising concentrations during nighttime and peak concentrations in the morning. We aimed to investigate whether this also applies to (h)s-cTnI assays and whether it would affect diagnostic accuracy for acute myocardial infarction (AMI). METHODS Blood concentrations of cTnI were measured at presentation and after 1 h using four different cTnI assays: three commonly used sensitive (s-cTnI Architect, Ultra and Accu) and one experimental high-sensitivity assay (hs-cTnI Accu) in a prospective multicenter diagnostic study of patients presenting to the emergency department with suspected AMI. These concentrations and their diagnostic accuracy for AMI (quantified by the area under the curve (AUC)) were compared between morning (11 p.m. to 2 p.m.) and evening (2 p.m. to 11 p.m.) presenters. RESULTS Among 2601 patients, AMI was the final diagnosis in 17.6% of patients. Concentrations of (h)s-cTnI as measured using all four assays were comparable in patients presenting in the morning versus patients presenting in the evening. Diagnostic accuracy for AMI of all four (h)s-cTnI assays were high and comparable between patients presenting in the morning versus presenting in the evening (AUC at presentation: 0.90 vs 0.93 for s-cTnI Architect; 0.91 vs 0.94 for s-cTnI Ultra; 0.89 vs 0.94 for s-cTnI Accu; 0.91 vs 0.94 for hs-cTnI Accu). CONCLUSIONS Cardiac TnI does not seem to express a diurnal rhythm. Diagnostic accuracy for AMI is very high and does not differ with time of presentation. CLINICAL TRIAL REGISTRATION NCT00470587, http://clinicaltrials.gov/show/NCT00470587.
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10
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Roos A, Holzmann MJ. Diurnal variation in admission troponin concentrations in patients with chest pain in the emergency department. Clin Biochem 2018; 54:18-24. [DOI: 10.1016/j.clinbiochem.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/05/2018] [Accepted: 02/07/2018] [Indexed: 12/15/2022]
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Chellappa SL, Lasauskaite R, Cajochen C. In a Heartbeat: Light and Cardiovascular Physiology. Front Neurol 2017; 8:541. [PMID: 29104560 PMCID: PMC5654948 DOI: 10.3389/fneur.2017.00541] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/27/2017] [Indexed: 12/22/2022] Open
Abstract
Light impinging on the retina fulfils a dual function: it serves for vision and it is required for proper entrainment of the endogenous circadian timing system to the 24-h day, thus influencing behaviors that promote health and optimal quality of life but are independent of image formation. The circadian pacemaker located in the suprachiasmatic nuclei modulates the cardiovascular system with an intrinsic ability to anticipate morning solar time and with a circadian nature of adverse cardiovascular events. Here, we infer that light exposure might affect cardiovascular function and provide evidence from existing research. Findings show a time-of-day dependent increase in relative sympathetic tone associated with bright light in the morning but not in the evening hours. Furthermore, dynamic light in the early morning hours can reduce the deleterious sleep-to-wake evoked transition on cardiac modulation. On the contrary, effects of numerous light parameters, such as illuminance level and wavelength of monochromatic light, on cardiac function are mixed. Therefore, in future research studies, light modalities, such as timing, duration, and its wavelength composition, should be taken in to account when testing the potential of light as a non-invasive countermeasure for adverse cardiovascular events.
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Affiliation(s)
- Sarah L Chellappa
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Ruta Lasauskaite
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
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12
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Circadian Clock Model Supports Molecular Link Between PER3 and Human Anxiety. Sci Rep 2017; 7:9893. [PMID: 28860482 PMCID: PMC5579000 DOI: 10.1038/s41598-017-07957-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 07/06/2017] [Indexed: 01/17/2023] Open
Abstract
Generalized anxiety and major depression have become increasingly common in the United States, affecting 18.6 percent of the adult population. Mood disorders can be debilitating, and are often correlated with poor general health, life dissatisfaction, and the need for disability benefits due to inability to work. Recent evidence suggests that some mood disorders have a circadian component, and disruptions in circadian rhythms may even trigger the development of these disorders. However, the molecular mechanisms of this interaction are not well understood. Polymorphisms in a circadian clock-related gene, PER3, are associated with behavioral phenotypes (extreme diurnal preference in arousal and activity) and sleep/mood disorders, including seasonal affective disorder (SAD). Here we show that two PER3 mutations, a variable number tandem repeat (VNTR) allele and a single-nucleotide polymorphism (SNP), are associated with diurnal preference and higher Trait-Anxiety scores, supporting a role for PER3 in mood modulation. In addition, we explore a potential mechanism for how PER3 influences mood by utilizing a comprehensive circadian clock model that accurately predicts the changes in circadian period evident in knock-out phenotypes and individuals with PER3-related clock disorders.
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Satou R, Sato M, Kimura M, Ishizuka Y, Tazaki M, Sugihara N, Shibukawa Y. Temporal Expression Patterns of Clock Genes and Aquaporin 5/Anoctamin 1 in Rat Submandibular Gland Cells. Front Physiol 2017; 8:320. [PMID: 28588500 PMCID: PMC5440558 DOI: 10.3389/fphys.2017.00320] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/03/2017] [Indexed: 01/20/2023] Open
Abstract
Circadian rhythms are essential for health and regulate various physiological functions. These rhythms are regulated by a negative-feedback loop involving clock genes in the suprachiasmatic nucleus (SCN) and peripheral tissues. The rate of secretion of salivary substances, ions, and water follows a circadian rhythm, however, the relationship between the molecular mechanism of salivary secretion and peripheral circadian rhythm is not yet clear. Anoctamin 1 (ANO1, also known as TMEM16A) and Aquaporin 5 (AQP5) play an important role in the transport of ions and water in the submandibular glands (SGs). We examined the interaction between the rhythmic expression pattern of the clock genes, Ano1 and Aqp5, in rat whole SGs as well as isolated acinar and ductal cells. Circadian rhythmic expression for Bmal1, Per1, Per2, Clock, Cry1, Cry2, Rorα, and Rev-erbα mRNAs, also called the clock genes, was observed in rat SGs by semi-quantitative RT-PCR analysis. We also observed rhythmic patterns in Ano1 and Aqp5 mRNA expression. The expression of ANO1 protein also showed circadian rhythm, as confirmed by western blot analysis. We could not observe any time delay between the peak expression of ANO1 protein and its mRNA. Expression levels of the clock gene mRNAs in the ductal cells was higher than that in acinar cells, however, rhythmic oscillations were observed in both. Our results suggest that SGs have peripheral clocks, and rhythmic expressions of Ano1 and Aqp5 along with the clock genes, may play an important role in the circadian regulation of salivary secretion.
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Affiliation(s)
- Ryouichi Satou
- Department of Epidemiology and Public Health, Tokyo Dental CollegeTokyo, Japan
| | - Masaki Sato
- Department of Physiology, Tokyo Dental CollegeTokyo, Japan
| | - Maki Kimura
- Department of Physiology, Tokyo Dental CollegeTokyo, Japan
| | - Yoichi Ishizuka
- Department of Epidemiology and Public Health, Tokyo Dental CollegeTokyo, Japan
| | | | - Naoki Sugihara
- Department of Epidemiology and Public Health, Tokyo Dental CollegeTokyo, Japan
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14
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Positive association between physical activity and PER3 expression in older adults. Sci Rep 2017; 7:39771. [PMID: 28045078 PMCID: PMC5206642 DOI: 10.1038/srep39771] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/25/2016] [Indexed: 01/13/2023] Open
Abstract
The circadian clock regulates many physiological functions including physical activity and feeding patterns. In addition, scheduled exercise and feeding themselves can affect the circadian clock. The purpose of the present study was to investigate the relationship between physical/feeding activity and expression of clock genes in hair follicle cells in older adults. Twenty adult men (age, 68 ± 7 years, mean ± SE) were examined in this cross-sectional study. Prior to hair follicle cell collection, the participants were asked to wear a uniaxial accelerometer for one week. The timings of breakfast, lunch, and dinner were also recorded. Hair follicle cells were then collected over a 24 h period at 4 h intervals. The amplitude of PER3 expression was positively correlated with moderate and vigorous physical activity (r = 0.582, p = 0.007) and peak oxygen uptake (r = 0.481, p = 0.032), but these correlations were not observed for NR1D1 or NR1D2. No association was noted between meal times and the amplitude or the acrophase for any of these three clock genes. These findings suggest that rhythmic expression of the circadian clock gene PER3 is associated with the amount of daily physical activity and physical fitness in older adults.
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15
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Klinkenberg LJJ, Wildi K, van der Linden N, Kouw IWK, Niens M, Twerenbold R, Rubini Gimenez M, Puelacher C, Daniel Neuhaus J, Hillinger P, Nestelberger T, Boeddinghaus J, Grimm K, Sabti Z, Bons JAP, van Suijlen JDE, Tan FES, ten Kate J, Bekers O, van Loon LJC, van Dieijen-Visser MP, Mueller C, Meex SJR. Diurnal Rhythm of Cardiac Troponin: Consequences for the Diagnosis of Acute Myocardial Infarction. Clin Chem 2016; 62:1602-1611. [DOI: 10.1373/clinchem.2016.257485] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/06/2016] [Indexed: 11/06/2022]
Abstract
Abstract
BACKGROUND
Interpretation of serial high-sensitivity cardiac troponin (hs-cTn) measurements for the diagnosis of acute myocardial infarction (AMI) assumes random fluctuation of hs-cTn around an individual's homeostatic set point. The aim of this study was to challenge this diagnostic concept.
METHODS
Study 1 examined the presence of a diurnal hs-cTn rhythm by hourly blood sampling, day and night, in 24 individuals without a recent history of AMI. Study 2 assessed morning vs evening diagnostic accuracy of hs-cTnT and hs-cTnI in a prospective multicenter diagnostic study of 2782 unselected patients, presenting to the emergency department with acute chest pain.
RESULTS
In study 1, hs-cTnT, but not hs-cTnI, exhibited a diurnal rhythm, characterized by gradually decreasing concentrations throughout daytime, rising concentrations during nighttime, to peak concentrations in the morning (mean 16.2 ng/L at 8:30 AM and 12.1 ng/L at 7:30 PM). In study 2, the hs-cTnT rhythm was confirmed by higher hs-cTnT concentrations in early-morning presenters compared to evening presenters with an adjudicated diagnosis of noncardiac disease. The diagnostic accuracy [area under the receiver-operation characteristics curve (AUC)] of hs-cTnT at presentation, 1 h, and for the combination of absolute changes with presenting concentration, were very high and comparable among patients presenting early morning as compared to evening (all AUC >0.93). hs-cTnI exhibited no diurnal rhythm with no differences in AUC among early-morning and evening presenters.
CONCLUSIONS
Rhythmic diurnal variation of hs-cTnT is a general phenomenon that is not seen with hs-cTnI. While the diurnal hs-cTnT rhythm does not seem to affect the diagnostic accuracy of hs-cTnT for AMI, it should be considered when using hs-cTnT for screening purposes.
Clinical Trial Registration
1. Circadian Variation of Cardiac Troponin, NCT02091427, www.clinicaltrials.gov/ct2/show/NCT02091427. 2. Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) Study, NCT00470587, www.clinicaltrials.gov/ct2/show/NCT00470587.
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Affiliation(s)
- Lieke J J Klinkenberg
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), the Netherlands
| | - Karin Wildi
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Noreen van der Linden
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), the Netherlands
| | - Imre W K Kouw
- Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
| | - Marijke Niens
- Department of Clinical Chemistry and Laboratory Hematology, Gelre ziekenhuizen, Apeldoorn/Zutphen, the Netherlands
| | - Raphael Twerenbold
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Maria Rubini Gimenez
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Christian Puelacher
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Jean Daniel Neuhaus
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Petra Hillinger
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Thomas Nestelberger
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Jasper Boeddinghaus
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Karin Grimm
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Zaid Sabti
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Judith A P Bons
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
| | - Jeroen D E van Suijlen
- Department of Clinical Chemistry and Laboratory Hematology, Gelre ziekenhuizen, Apeldoorn/Zutphen, the Netherlands
| | - Frans E S Tan
- Department of Methodology and Statistics, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - Joop ten Kate
- Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, the Netherlands
| | - Otto Bekers
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), the Netherlands
| | - Luc J C van Loon
- Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
| | - Marja P van Dieijen-Visser
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), the Netherlands
| | - Christian Mueller
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
| | - Steven J R Meex
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), the Netherlands
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Copin N, Gusto G, Vol S, Rollier S, Lantieri O, Lasfargues G, Tichet J. Perturbation du métabolisme lipidique chez des travailleurs postés consultants de centres d’examens de santé. Presse Med 2016; 45:e145-56. [DOI: 10.1016/j.lpm.2015.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 10/19/2015] [Accepted: 12/17/2015] [Indexed: 12/29/2022] Open
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17
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Nernpermpisooth N, Qiu S, Mintz JD, Suvitayavat W, Thirawarapan S, Rudic DR, Fulton DJ, Stepp DW. Obesity alters the peripheral circadian clock in the aorta and microcirculation. Microcirculation 2016; 22:257-66. [PMID: 25660131 DOI: 10.1111/micc.12192] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 02/03/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Perturbation of daily rhythm increases cardiovascular risk. The aim of this study was to determine whether obesity alters circadian gene expression and microvascular function in lean mice and obese (db/db) mice. METHODS Mice were subjected to normal LD or DD to alter circadian rhythm. Metabolic parameters and microvascular vasoreactivity were evaluated. Array studies were conducted in the am and pm cycles to assess the rhythmicity of the entire genomics. Rhythmic expression of specific clock genes (Bmal1, Clock, Npas2, Per1, Per2, and Cry1), clock output genes (dbp), and vascular relaxation-related genes (eNOS, GTPCH1) were assessed. RESULTS Obesity was associated with metabolic dysfunction and impaired endothelial dilation in the microvasculature. Circadian rhythm of gene expression was suppressed 80% in both macro- and microcirculations of obese mice. Circadian disruption with DD increased fasting serum glucose and HbA1c in obese but not lean mice. Endothelium-dependent dilation was attenuated in obese mice and in lean mice subjected to DD. Rhythmic expression of per1 and dbp was depressed in obesity. Expression of eNOS expression was suppressed and GTPCH1 lost rhythmic expression both in obesity and by constant darkness. CONCLUSION These results suggest that obesity reduces circadian gene expression in concert with impaired endothelial function. The causal relationship remains to be determined.
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18
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Viola AU, Gabel V, Chellappa SL, Schmidt C, Hommes V, Tobaldini E, Montano N, Cajochen C. Dawn simulation light: a potential cardiac events protector. Sleep Med 2015; 16:457-61. [DOI: 10.1016/j.sleep.2014.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 11/27/2014] [Accepted: 12/05/2014] [Indexed: 12/20/2022]
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19
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Hardman JA, Tobin DJ, Haslam IS, Farjo N, Farjo B, Al-Nuaimi Y, Grimaldi B, Paus R. The peripheral clock regulates human pigmentation. J Invest Dermatol 2015; 135:1053-1064. [PMID: 25310406 DOI: 10.1038/jid.2014.442] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/15/2014] [Accepted: 09/24/2014] [Indexed: 12/20/2022]
Abstract
Although the regulation of pigmentation is well characterized, it remains unclear whether cell-autonomous controls regulate the cyclic on-off switching of pigmentation in the hair follicle (HF). As human HFs and epidermal melanocytes express clock genes and proteins, and given that core clock genes (PER1, BMAL1) modulate human HF cycling, we investigated whether peripheral clock activity influences human HF pigmentation. We found that silencing BMAL1 or PER1 in human HFs increased HF melanin content. Furthermore, tyrosinase expression and activity, as well as TYRP1 and TYRP2 mRNA levels, gp100 protein expression, melanocyte dendricity, and the number gp100+ HF melanocytes, were all significantly increased in BMAL1 and/or PER1-silenced HFs. BMAL1 or PER1 silencing also increased epidermal melanin content, gp100 protein expression, and tyrosinase activity in human skin. These effects reflect direct modulation of melanocytes, as BMAL1 and/or PER1 silencing in isolated melanocytes increased tyrosinase activity and TYRP1/2 expression. Mechanistically, BMAL1 knockdown reduces PER1 transcription, and PER1 silencing induces phosphorylation of the master regulator of melanogenesis, microphthalmia-associated transcription factor, thus stimulating human melanogenesis and melanocyte activity in situ and in vitro. Therefore, the molecular clock operates as a cell-autonomous modulator of human pigmentation and may be targeted for future therapeutic strategies.
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Affiliation(s)
- Jonathan A Hardman
- The Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; Doctoral Training Centre in Integrative Systems Biology, Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Desmond J Tobin
- Centre for Skin Sciences, School of Life Sciences, University of Bradford, Bradford, UK
| | - Iain S Haslam
- The Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | | | | | - Yusur Al-Nuaimi
- The Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Benedetto Grimaldi
- Department of Drug Discovery and Development, Instituto Italiano di Tecnologia (IIT), Genoa, Italy
| | - Ralf Paus
- The Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; Department of Dermatology, University of Muenster, Muenster, Germany.
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20
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Qin T, Sun YY, Bai WW, Wang B, Xing YF, Liu Y, Yang RX, Zhao YX, Li JM. Period2 deficiency blunts hypoxia-induced mobilization and function of endothelial progenitor cells. PLoS One 2014; 9:e108806. [PMID: 25268972 PMCID: PMC4182576 DOI: 10.1371/journal.pone.0108806] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/25/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In the clinic, variations in circadian rhythm are evident in patients with cardiovascular disease, and the risk of cardiovascular events increases when rhythms are disrupted. In this study, we focused on the role of the circadian gene period2 (per2) in mobilization and function of endothelial progenitor cells (EPCs) in vitro and in vivo after myocardial infarction (MI) in mice. METHODS AND RESULTS MI was produced by surgical ligation of the left anterior descending coronary artery in mice with and without per2 deficiency. Trans-thoracic echocardiography was used to evaluate cardiac function in mice. Per2-/- mice with MI showed decreased cardiac function and increased infarct size. The number of CD34+ cells and capillary density were decreased in the myocardium of per2-/- mice on immunohistochemistry. Flow cytometry revealed decreased number of circulating EPCs in per2-/- mice after MI. In vitro, per2-/- EPCs showed decreased migration and tube formation capacity under hypoxia. Western blot analysis revealed inhibited activation of extracellular signal-regulated kinase and Akt signaling in the bone marrow of per2-/- mice and inhibited PI3K/Akt expression in per2-/- EPCs under hypoxia. CONCLUSIONS Per2 modulates EPC mobilization and function after MI, which is important to recovery after MI in mice.
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Affiliation(s)
- Tao Qin
- Department of Emergency Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yuan-Yuan Sun
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University, Jinan, Shandong, China
- Department of Traditional Chinese Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Wen-Wu Bai
- Department of Traditional Chinese Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Bo Wang
- Department of Traditional Chinese Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yi-Fan Xing
- Department of Traditional Chinese Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yan Liu
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University, Jinan, Shandong, China
| | - Rui-Xue Yang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University, Jinan, Shandong, China
| | - Yu-Xia Zhao
- Department of Traditional Chinese Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
- * E-mail: (YXZ); (JML)
| | - Jian-Min Li
- Department of Orthopedics, Qilu Hospital, Shandong University, Jinan, Shandong, China
- * E-mail: (YXZ); (JML)
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