Abstract

Simple SummaryThe earth’s rotation produces a daily 24 h cycle of day and night. Many biological functions, such as sleep–wake cycle, feeding/fasting cycle, blood hormone levels and body temperature rhythms occur over a 24 h period. These daily fluctuations are controlled by an internal system known as the circadian clock (Latin circa—“around”—and diem—“day”). This clock coordinates the periodic changes in diverse physiological and behavioral activities and helps adapt to the periodic environment for the benefit of survival and reproduction of organisms. Nearly all organisms, from single-cell to mammals, including humans, possess a self-sustained circadian clock. Disturbances in the functioning of this internal circadian clock can alter the balance in biological functions and compromise organism fitness. In humans, clock disruption is associated with diseases such as diabetes, cardiovascular diseases and cancer. Thus, studying the interplay between the circadian clock and physiology is important in the prevention and management of fatal diseases such as cancer.To synchronize various biological processes with the day and night cycle, most organisms have developed circadian clocks. This evolutionarily conserved system is important in the temporal regulation of behavior, physiology and metabolism. Multiple pathological changes associated with circadian disruption support the importance of the clocks in mammals. Emerging links have revealed interplay between circadian clocks and signaling networks in cancer. Understanding the cross-talk between the circadian clock and tumorigenesis is imperative for its prevention, management and development of effective treatment options. In this review, we summarize the role of the circadian clock in regulation of one important metabolic pathway, insulin/IGF1/PI3K/mTOR signaling, and how dysregulation of this metabolic pathway could lead to uncontrolled cancer cell proliferation and growth. Targeting the circadian clock and rhythms either with recently discovered pharmaceutical agents or through environmental cues is a new direction in cancer chronotherapy. Combining the circadian approach with traditional methods, such as radiation, chemotherapy or the recently developed, immunotherapy, may improve tumor response, while simultaneously minimizing the adverse effects commonly associated with cancer therapies.

Highlights

  • Flight attendants that have irregular schedules are at increased risk of melanoma, prostate, and breast cancer due to disturbed circadian rhythms [39,40,41]

  • We highlight the interconnection of the circadian clock with key metabolic pathways in cancer

  • Clinical and preclinical studies demonstrate the potential and further need for investigating the importance of a chronotherapy approach for improving response and dealing with toxicity associated with existing cancer treatment

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Summary

Introduction

The circadian clock is a time-keeping mechanism that controls daily rhythms in biological processes [1,2,3]. The environmental light/dark cycle entrains the master clock in the suprachiasmatic nucleus (SCN) [4,5]. The central clock, in turn, sends neural and humoral signals to synchronize the peripheral clocks in different organs such as liver, kidney, skin, intestine, lung, pancreas, ovary, and heart to maintain the energy balance and homeostasis in our body. The feeding/fasting cycle can serve as a clue for peripheral clocks [6]. Circadian clocks consist of an intricate network of transcription–translation feedback loops formed by dozens of genes and their products, of which expressions and

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