Abstract:
Circadian rhythms are endogenous, self-sustained oscillations of multiple biological
processes with approximately 24-hr rhythmicity. Circadian genes and their protein products
constitute the molecular components of the circadian oscillator that form positive/negative
feedback loops and generate circadian rhythms. The circadian regulation extends beyond
clock genes to involve various clock-controlled genes (CCGs) that include various cell cycle
genes. Aberrant expression of circadian clock genes could have important consequences on
the transactivation of downstream targets that control the cell cycle and on the ability of cells
to undergo apoptosis. This may lead to genomic instability and accelerated cellular
proliferation potentially promoting carcinogenesis. The current study was carried out to gain
further insights into the roles of circadian genes and their downstream targets (cell cycle
genes) in chronic lymphocytic leukemia (CLL). We analyzed peripheral blood from 37 CLL
patients and equal number of their age- and sex-matched healthy controls for the expression
of the four circadian clock and three cell cycle genes. The expression levels of BMAL1,
PER1, PER2,MYC, CYCLIN D1 and WEE1 were significantly impaired in CLL cases
compared with those in healthy individuals (P < 0.001). BMAL1, PER1, PER2 and WEE1
were found down regulated whereas MYC and CYCLIN D1 were found upregulated. This
implies that the deregulated expression of circadian clock genes through their influence on
downstream clock-controlled cell cycle genes can play a role in the manifestation of CLL.
Moreover, when expression levels of abovementioned genes were compared between shift
workers and non-shift workers within the CLL group, the expression levels were more
aberrant in shiftworkers compared to non-shift workers. This indicates that circadian
dysregulation in terms of shift work may also be a contributing factor in the etiology of CLL.
In the current study, serum melatonin levels were also determined in 37 CLL cases and their
healthy controls. Serum melatonin levels were found significantly low (P<0.05) in CLL
subjects as compared to healthy controls. Furthermore, melatonin levels were found still
lower in shift workers as compared to non-shift workers within CLL group. Our results
suggest that down regulation of BMAL1, PER1 and PER2 is related to upregulation of
Cyclin D1, MYC and down regulation of WEE1 in CLL. Thus, aberrant expression of clock
genes can lead to abnormal expression of downstream cell-cycle genes and play a role in the
manifestation of CLL. Moreover, low melatonin levels in CLL patients may play a part in
xivderegulation of circadian clock gene expression and shiftwork serves as a further contributing
factor to an already perturbed circadian clock genes’ expression and low melatonin levels in
CLL.