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Oliveira MAB, de Abreu ACOV, Constantino DB, Tonon AC, Díez-Noguera A, Amaral FG, Hidalgo MP. Taking biological rhythms into account: From study design to results reporting. Physiol Behav 2024; 273:114387. [PMID: 37884108 DOI: 10.1016/j.physbeh.2023.114387] [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: 07/03/2023] [Revised: 09/22/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Numerous physiological and behavioral processes in living organisms exhibit strong rhythmicity and are regulated within a 24-hour cycle. These include locomotor activity and sleep patterns, feeding-fasting cycles, hormone synthesis, body temperature, and even mood and cognitive abilities, all of which are segregated into different phases throughout the day. These processes are governed by the internal timing system, a hierarchical multi-oscillator structure conserved across all organisms, from bacteria to humans. Circadian rhythms have been seen across multiple taxonomic kingdoms. In mammals, a hierarchical internal timing system is comprised of so-called central and periphereal clocks. Although these rhythms are intrinsic, they are under environmental influences, such as seasonal temperature changes, photoperiod variations, and day-night cycles. Recognizing the existence of biological rhythms and their primary external influences is crucial when designing and reporting experiments. Neglecting these physiological variations may result in inconsistent findings and misinterpretations. Thus, here we propose to incorporate biological rhythms into all stages of human and animal research, including experiment design, analysis, and reporting of findings. We also provide a flowchart to support decision-making during the design process, considering biological rhythmicity, along with a checklist outlining key factors that should be considered and documented throughout the study. This comprehensive approach not only benefits the field of chronobiology but also holds value for various other research disciplines. The insights gained from this study have the potential to enhance the validity, reproducibility, and overall quality of scientific investigations, providing valuable guidance for planning, developing, and communicating scientific studies.
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Affiliation(s)
- Melissa Alves Braga Oliveira
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Carolina Odebrecht Vergne de Abreu
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - André C Tonon
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Antoni Díez-Noguera
- Department de Bioquimica i Fisiologia, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
| | | | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
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Suarez-Trujillo A, Hoang N, Robinson L, McCabe CJ, Conklin D, Minor RC, Townsend J, Plaut K, George UZ, Boerman J, Casey TM. Effect of circadian system disruption on the concentration and daily oscillations of cortisol, progesterone, melatonin, serotonin, growth hormone, and core body temperature in periparturient dairy cattle. J Dairy Sci 2022; 105:2651-2668. [PMID: 35033342 DOI: 10.3168/jds.2021-20691] [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: 05/02/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022]
Abstract
Metabolic, circadian, sleep, and reproductive systems are integrated and reciprocally regulated, but the understanding of the mechanism is limited. To study this integrated regulation, the circadian timing system was disrupted by exposing late pregnant nonlactating (dry) cows to chronic shifts in the light-dark phase, and rhythms of body temperature and circulating cortisol (CORT), progesterone (P4), serotonin (5HT), melatonin (MEL), and growth hormone (GH) concentrations were measured. Specifically, across 2 identical studies (1 and 2), at 35 d before expected calving (BEC) multiparous cows were assigned to control (CON; n = 24) and exposed to 16 h light and 8 h dark or phase shift (PS; n = 24) treatments and exposed to 6-h light-dark phase shifts every 3 d until parturition. All cows were exposed to control lighting after calving. Blood samples were collected in the first study at 0600 h on d 35 BEC, d 21 BEC, and 2 d before calving, and d 0, 2, 9, 15, and 22 postpartum (PP). A subset of cows (n = 6/group) in study 1 was blood sampled every 4 h over 48 h beginning on d 23 BEC, 9 BEC, and 5 PP. Body temperature was measured every 30 min (n = 8-16/treatment) for 48 h at 23 BEC and 9 BEC in both studies; and at 14 PP and 60 PP only in study 2. Treatment did not affect levels of CORT, GH, or P4 at 0600 h, but overall level of 5HT was lower and MEL higher in PS cows across days sampled. A 2-component versus single-component cosinor model better described [>coefficient of determination (R2); <Akaike information criterion and <Bayesian information criterion] daily oscillations of all hormones and temperature for both treatments. Circadian rhythm fit (R2) of body temperature and MEL increased from 23 BEC to 9 BEC in CON and was marked by loss of feeding time influence on oscillations in both treatments. Both treatments exhibited circadian rhythms of CORT at 9 BEC, CON cows also exhibited circadian rhythms in P4 at 23 BEC, and 5HT at 9 BEC. Daily oscillations in temperature and hormones, except CORT, were affected by PS treatment in the prepartum and were associated with longer gestation. In the PP, circadian rhythmicity was lost or diminished for all hormones and body temperature in both treatments. Stronger rhythms of body temperature and multiple hormones at 1 wk prepartum may indicate a synchronizing cue to time parturition. Therefore, dairy systems may need to consider management factors that affect circadian clocks in late-gestation cows.
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Affiliation(s)
| | - Nguyen Hoang
- Department of Mathematics and Statistics, San Diego State University, San Diego, CA 92182
| | - Leela Robinson
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
| | - Conor J McCabe
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
| | - Dawn Conklin
- Department of Animal Sciences, North Carolina Agricultural and Technical State University, Greensboro 27401
| | - Radiah C Minor
- Department of Animal Sciences, North Carolina Agricultural and Technical State University, Greensboro 27401
| | - Jonathan Townsend
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907
| | - Karen Plaut
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
| | - Uduak Z George
- Department of Mathematics and Statistics, San Diego State University, San Diego, CA 92182
| | - Jacquelyn Boerman
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
| | - Theresa M Casey
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907.
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Casey T, Suarez-Trujillo A, Cummings S, Huff K, Crodian J, Bhide K, Aduwari C, Teeple K, Shamay A, Mabjeesh SJ, San Miguel P, Thimmapuram J, Plaut K. Core circadian clock transcription factor BMAL1 regulates mammary epithelial cell growth, differentiation, and milk component synthesis. PLoS One 2021; 16:e0248199. [PMID: 34415905 PMCID: PMC8378744 DOI: 10.1371/journal.pone.0248199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022] Open
Abstract
The role the mammary epithelial circadian clock plays in gland development and lactation is unknown. We hypothesized that mammary epithelial clocks function to regulate mammogenesis and lactogenesis, and propose the core clock transcription factor BMAL1:CLOCK regulates genes that control mammary epithelial development and milk synthesis. Our objective was to identify transcriptional targets of BMAL1 in undifferentiated (UNDIFF) and lactogen differentiated (DIFF) mammary epithelial cells (HC11) using ChIP-seq. Ensembl gene IDs with the nearest transcriptional start site to ChIP-seq peaks were explored as potential targets, and represented 846 protein coding genes common to UNDIFF and DIFF cells and 2773 unique to DIFF samples. Genes with overlapping peaks between samples (1343) enriched cell-cell adhesion, membrane transporters and lipid metabolism categories. To functionally verify targets, an HC11 line with Bmal1 gene knocked out (BMAL1-KO) using CRISPR-CAS was created. BMAL1-KO cultures had lower cell densities over an eight-day growth curve, which was associated with increased (p<0.05) levels of reactive oxygen species and lower expression of superoxide dismutase 3 (Sod3). RT-qPCR analysis also found lower expression of the putative targets, prolactin receptor (Prlr), Ppara, and beta-casein (Csn2). Findings support our hypothesis and highlight potential importance of clock in mammary development and substrate transport.
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Affiliation(s)
- Theresa Casey
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Aridany Suarez-Trujillo
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Shelby Cummings
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Katelyn Huff
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Jennifer Crodian
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Ketaki Bhide
- Bioinformatics Core, Purdue University, West Lafayette, IN, United States of America
| | - Clare Aduwari
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Kelsey Teeple
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
| | - Avi Shamay
- Animal Science Institute, Agriculture Research Origination, The Volcani Center, Rishon Letsiyon, Israel
| | - Sameer J. Mabjeesh
- Department of Animal Sciences, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Phillip San Miguel
- Genomics Core, Purdue University, West Lafayette, IN, United States of America
| | - Jyothi Thimmapuram
- Bioinformatics Core, Purdue University, West Lafayette, IN, United States of America
| | - Karen Plaut
- Department of Animal Science, Purdue University, West Lafayette, IN, United States of America
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Bergman NJ. Birth practices: Maternal-neonate separation as a source of toxic stress. Birth Defects Res 2019; 111:1087-1109. [PMID: 31157520 DOI: 10.1002/bdr2.1530] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/26/2022]
Abstract
Maternal-neonate separation for human newborns has been the standard of care since the last century; low birth weight and preterm infants are still routinely separated from their mothers. With advanced technology, survival is good, but long-term developmental outcomes are very poor for these especially vulnerable newborns. The poor outcomes are similar to those described for adversity in childhood, ascribed to toxic stress. Toxic stress is defined as the absence of the buffering protection of adult support. Parental absence has been strictly enforced in neonatal care units for many reasons and could lead to toxic stress. The understanding of toxic stress comes from discoveries about our genome and epigenetics, the microbiome, developmental neuroscience and the brain connectome, and life history theory. The common factor is the early environment that gives (a) signals to epigenes, (b) sensory inputs to neural circuits, and (c) experiences for reproductive fitness. For human newborns that environment is direct skin-to-skin contact from birth. Highly conserved neuroendocrine behaviors determined by environment are described in this review. The scientific rationale underlying skin-to-skin contact is presented: autonomic development and regulation of the physiology leads to emotional connection and achieving resilience. Maternal-neonate separation prevents these critical neural processes from taking place, but also channel development into an alternative developmental strategy. This enables better coping in a stressful environment in the short term, but with permanently elevated stress systems that negatively impact mental and physical health in the long term. This may explain the increasing incidence of developmental problems in childhood, and also Developmental Origins of Health and Disease. Arguments are presented that maternal-neonate separation is indeed a source of toxic stress, and some suggestions are offered toward a "zero separation" paradigm.
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Affiliation(s)
- Nils J Bergman
- Department of Neonatology, Karolinska Institute, Stockholm, Sweden
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Banskota S, Ghia JE, Khan WI. Serotonin in the gut: Blessing or a curse. Biochimie 2018; 161:56-64. [PMID: 29909048 DOI: 10.1016/j.biochi.2018.06.008] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/12/2018] [Indexed: 12/25/2022]
Abstract
Serotonin (5-hydroxytryptamine or 5-HT) once most extensively studied as a neurotransmitter of the central nervous system, is seen to be predominantly secreted in the gut. About 95% of 5-HT is estimated to be found in gut mainly within the enterochromaffin cells whereas about 5% is found in the brain. 5-HT is an important enteric signaling molecule and is well known for playing a key role in sensory-motor and secretory functions in the gut. In recent times, studies uncovering various new functions of gut-derived 5-HT indicate that many more are yet to be discovered in coming days. Recent studies revealed that 5-HT plays a pivotal role in immune cell activation and generation/perpetuation of inflammation in the gut. In addition to its various roles in the gut, there are now emerging evidences that suggest an important role of gut-derived 5-HT in other biological processes beyond the gut, such as bone remodeling and metabolic homeostasis. This review focuses to briefly summarize the accumulated and newly updated role of 5-HT in the maintenance of normal gut physiology and in the pathogenesis of inflammation in the gut. The collected information about this multifaceted signaling molecule may aid in distinguishing its good and bad effects which may lead to the development of novel strategies to overcome the unwanted effect, such as in inflammatory bowel disease.
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Affiliation(s)
- Suhrid Banskota
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Jean-Eric Ghia
- Department of Immunology and Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Waliul I Khan
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
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Characterization of mammary-specific disruptions for Tph1 and Lrp5 during murine lactation. Sci Rep 2017; 7:15155. [PMID: 29123193 PMCID: PMC5680223 DOI: 10.1038/s41598-017-15508-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/27/2017] [Indexed: 12/22/2022] Open
Abstract
Serotonin is a homeostatic regulator of the mammary gland during lactation. The contribution of mammary-derived serotonin to circulating serum serotonin concentrations was previously unknown. We have developed mice with mammary-specific disruptions of tryptophan hydroxylase 1 (Tph1) or low-density lipoprotein receptor-related protein 5 (Lrp5) that are induced during late pregnancy and lactation via use of the whey acidic protein (WAP)-Cre cre-lox system. Our objective was to characterize dams with a lactation- and mammary-specific disruption of Lrp5 (WAP-Cre × Lrp5FL/FL) or Tph1 (WAP-Cre × Tph1FL/FL). Milk yield and pup weights were recorded throughout lactation. Dams were euthanized on d10 postpartum and mammary glands and duodenal tissue were harvested. WAP-Cre × Lrp5FL/FL dams had elevated serotonin concentrations in both the mammary gland and circulation compared to controls. In contrast, WAP-Cre × Tph1FL/FL dams had decreased mammary gland and serum serotonin concentrations compared to controls. Alveolar morphology, milk yield, and pup weights were similar. Mammary-derived serotonin makes a significant contribution to circulating serotonin concentrations during lactation, with no effect on milk yield or alveolar morphology. These transgenic models can and should be confidently used in future lactation studies to further elucidate the contribution of serotonin to the maintenance of lactation.
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Nagy P, Fábri ZN, Varga L, Reiczigel J, Juhász J. Effect of genetic and nongenetic factors on chemical composition of individual milk samples from dromedary camels (Camelus dromedarius) under intensive management. J Dairy Sci 2017; 100:8680-8693. [PMID: 28843681 DOI: 10.3168/jds.2017-12814] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/16/2017] [Indexed: 12/16/2022]
Abstract
The aims of the present study were to monitor the changes in gross chemical composition of individual dromedary camel milk over a 5-yr period, to provide reference values, and to determine the effect of genetic and nongenetic factors influencing camel milk composition under intensive management. A total of 1,528 lactating dromedary camels were included in the study. Animals were fed a constant diet and were milked twice a day in a herringbone parlor. Milk samples were collected at monthly intervals using a sampling device and then fat, protein, lactose, total solids (TS), and solids-nonfat (SNF) concentrations of raw camel milk were determined with an automatic milk analyzer. For each milk sample, production parameters were recorded and quantities (grams) of milk constituents were calculated. The overall mean quantity and fat, protein, lactose, SNF, and TS concentrations of the morning milk were 4.0 kg, 2.58%, 2.95%, 4.19%, 8.08%, and 10.46%, respectively. Milk quantity showed a positive correlation with lactose and a negative correlation with all other components. Parity exerted a strong effect on all milk parameters. Primiparous dromedaries (n = 60) produced less milk with higher concentrations of components than did multiparous animals (n = 1,468). Milk composition varied among the 7 breeds tested, but none of the genotypes was found to be superior to the others in this respect. We detected a significant, yet small calf sex-biased difference in milk yield and composition. Stage of lactation and season strongly influenced milk yield and all milk components. We also found a significant interaction between month postpartum (mPP) and month of the year. The concentration of all milk components decreased from 1 to 5 mPP. Later, lactose concentration and quantity continued to decrease parallel with decreasing milk production. The concentration of other components showed a temporary increase in mid lactation, from 6 to 11 mPP, and in late lactation, from 18 to 23 mPP. Mean fat, protein, SNF, and TS concentrations showed a high seasonal variation (9.5 to 28.7%), with the lowest and highest values being measured during summer and winter, respectively. This seasonal variation was independent of nutrition and may reflect an endogenous circannual rhythm. We observed a noticeable variation among years. Dromedary camels could provide a useful in vivo model to study the homeorhetic regulation of mammary cell function by endogenous and environmental factors.
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Affiliation(s)
- P Nagy
- Emirates Industry for Camel Milk and Products, Farm and Veterinary Department, PO Box 294236, Dubai, United Arab Emirates.
| | - Zs N Fábri
- Department of Food Science, Faculty of Agricultural and Food Sciences, Széchenyi István University, 9200 Mosonmagyaróvár, Hungary
| | - L Varga
- Department of Food Science, Faculty of Agricultural and Food Sciences, Széchenyi István University, 9200 Mosonmagyaróvár, Hungary
| | - J Reiczigel
- Department of Biomathematics and Informatics, University of Veterinary Medicine, 1078 Budapest, Hungary
| | - J Juhász
- Emirates Industry for Camel Milk and Products, Farm and Veterinary Department, PO Box 294236, Dubai, United Arab Emirates
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Abstract
Serotonin was first discovered in the gut, and its conventional actions as an intercellular signalling molecule in the intrinsic and extrinsic enteric reflexes are well recognized, as are a number of serotonin signalling pharmacotherapeutic targets for treatment of nausea, diarrhoea or constipation. The latest discoveries have greatly broadened our understanding of non-conventional actions of peripheral serotonin within the gastrointestinal tract and in a number of other tissues. For example, it is now clear that bacteria within the lumen of the bowel influence serotonin synthesis and release by enterochromaffin cells. Also, serotonin can act both as a pro-inflammatory and anti-inflammatory signalling molecule in the intestinal mucosa via activation of serotonin receptors (5-HT7 or 5-HT4 receptors, respectively). For decades, serotonin receptors have been known to exist in a variety of tissues other than the gut, but studies have now provided strong evidence for physiological roles of serotonin in several important processes, including haematopoiesis, metabolic homeostasis and bone metabolism. Furthermore, evidence for serotonin synthesis in peripheral tissues outside of the gut is emerging. In this Review, we expand the discussion beyond gastrointestinal functions to highlight the roles of peripheral serotonin in colitis, haematopoiesis, energy and bone metabolism, and how serotonin is influenced by the gut microbiota.
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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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