<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD 2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="editorial">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">EXCLI J</journal-id>
      <journal-title>EXCLI Journal</journal-title>
      <issn pub-type="epub">1611-2156</issn>
      <publisher>
        <publisher-name>Leibniz Research Centre for Working Environment and Human Factors</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">2015-269</article-id>
	  <article-id pub-id-type="doi">10.17179/excli2015-269</article-id>
      <article-id pub-id-type="pii">Doc540</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Editorial material</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Highlight report: Role of the circadian clock system in breast cancer</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Ghallab</surname>
            <given-names>Ahmed</given-names>
          </name>
          <xref ref-type="corresp" rid="COR1">&#x0002a;</xref>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>Forensic Medicine and Toxicology Department, Faculty of Veterinary Medicine,  South Valley University, Qena, Egypt</aff>
      <author-notes>
        <corresp id="COR1">*To whom correspondence should be addressed: Ahmed Ghallab, Forensic Medicine and Toxicology Department, Faculty of Veterinary Medicine,  South Valley University, Qena, Egypt, E-mail: <email>ghallab@vet.svu.edu.eg</email></corresp>
      </author-notes>
      <pub-date pub-type="epub">
        <day>14</day>
        <month>04</month>
        <year>2015</year>
      </pub-date>
      <pub-date pub-type="collection">
        <year>2015</year>
      </pub-date>
      <volume>14</volume>
      <fpage>540</fpage>
	  <lpage>541</lpage>
      <history>
        <date date-type="received">
          <day>12</day>
          <month>04</month>
          <year>2015</year>
        </date>
        <date date-type="accepted">
          <day>14</day>
          <month>04</month>
          <year>2015</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright &#xA9; 2015 Ghallab</copyright-statement>
        <copyright-year>2015</copyright-year>
        <license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
          <p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0/) You are free to copy, distribute and transmit the work, provided the original author and source are credited.</p>
        </license>
      </permissions>
      <self-uri xlink:href="http://www.excli.de/vol14/Ghallab_14042015_proof.pdf">This article is available from http://www.excli.de/vol14/Ghallab_14042015_proof.pdf</self-uri>
    </article-meta>
  </front>
  <body>
    <sec>
      <title>‬‬‬</title><p>It is well known that the circadian clock system coordinates physiological functions throughout the day (Dibner et al., 2010[<xref ref-type="bibr" rid="R5">5</xref>]; Mohawk et al., 2012[<xref ref-type="bibr" rid="R12">12</xref>]; Fu and Lee, 2003[<xref ref-type="bibr" rid="R6">6</xref>]; Hammad et al., 2013[<xref ref-type="bibr" rid="R9">9</xref>]). Circadian rhythms are generated by molecular feedback loops; transcriptional activators induce the expression of genes that repress their own transcription (Lowrey and Takahashi, 2011[<xref ref-type="bibr" rid="R11">11</xref>]). Disruption of circadian rhythms has been discussed as a possible risk factor of cancer. For example, epidemiological studies have suggested that working at night increases the risk of breast cancer (Kamdar et al., 2013[<xref ref-type="bibr" rid="R10">10</xref>]). However, recently a comprehensive study including 766 breast cancer patients has been published that broadens our understanding of the role of the circadian clock system in breast cancer (Cadenas et al., 2014[<xref ref-type="bibr" rid="R3">3</xref>]). The authors studied all known clock genes in relation to prognosis. Interestingly, loss of expression of circadian clock genes in tumour tissue was associated with a clearly higher risk to develop metastasis (Cadenas et al., 2014[<xref ref-type="bibr" rid="R3">3</xref>]). Recently, numerous studies have been performed to identify prognostic genes in breast cancer (e.g. Sicking et al., 2014[<xref ref-type="bibr" rid="R18">18</xref>][<xref ref-type="bibr" rid="R17">17</xref>]; Siggelkow et al., 2012[<xref ref-type="bibr" rid="R19">19</xref>]; Godoy et al., 2014[<xref ref-type="bibr" rid="R8">8</xref>]; Schmidt et al., 2008[<xref ref-type="bibr" rid="R13">13</xref>][<xref ref-type="bibr" rid="R14">14</xref>]; Cadenas, 2012;[<xref ref-type="bibr" rid="R1">1</xref>] Cadenas et al., 2010[<xref ref-type="bibr" rid="R2">2</xref>]; Ghallab, 2014[<xref ref-type="bibr" rid="R7">7</xref>]). However, loss of circadian clock genes seems to be of independent prognostic influence. The association of decreased circadian clock gene expression was also observed in different molecular subtypes of breast cancer (Desmedt et al., 2007[<xref ref-type="bibr" rid="R4">4</xref>]; Schmidt et al., 2008[<xref ref-type="bibr" rid="R13">13</xref>][<xref ref-type="bibr" rid="R14">14</xref>], 2009[<xref ref-type="bibr" rid="R16">16</xref>]) and was independent of established clinical factors. But the perhaps most interesting result of Cadenas et al. (2014[<xref ref-type="bibr" rid="R3">3</xref>]) was obtained by pairwise analysis of functionally related clock genes. PER3 and CRY2 are proteins that form dimers acting as negative feedback regulators and are known to show similar oscillation patterns. Therefore, a strong correlation between both genes can be anticipated. Indeed the authors observed strong correlations between CRY2 and PER3 in well-differentiated tumours that did not grow aggressively (Cadenas et al., 2014[<xref ref-type="bibr" rid="R3">3</xref>]). In contrast, the correlation between both clock genes was lost in more aggressive carcinomas. This breakdown of correlation between clock genes was also observed with loss of expression of the estrogen receptor, amplification of the oncogene HER2 and increasing histological grade (Cadenas et al., 2014[<xref ref-type="bibr" rid="R3">3</xref>]). In conclusion, Cadenas and colleagues have clearly shown that loss of clock gene expression and particularly the breakdown of coordinated co-expression of clock genes is associated with worse prognosis and dedifferentiation, a feature so far unknown in breast cancer.</p></sec>
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</article>