(Philadelphia, PA) - Researchers at the University
of Pennsylvania School of Medicine discovered that a key
receptor protein is a critical component of the internal molecular
clock in mammals. What’s more, this molecule - called Rev-erb
- is sensitive to lithium and may help shed light on circadian rhythm
disorders, including bipolar disorder. The findings, which also
provide insight into clock-controlled aspects of metabolism, are
reported in this week’s issue of Science.
“We’re interested in the internal control of metabolism
because feeding behavior is on a daily cycle, and hormonal activities
that regulate this are circadian,” says senior author Mitch
Lazar, MD, PhD, Director of the Institute for Diabetes,
Obesity, and Metabolism at Penn. “Many studies, including
those here at Penn, suggest a relationship between the human circadian
clock and metabolism. Proteins are the gears of the clock, and not
much is known about what regulates protein levels within the cell.”
Rev-erb
was known to be a key component of the clock that exists in most
cells of the body. Rev-erb inhibits clock genes called bmal
and clock, but within a normal 24-hour circadian cycle
the Rev-erb protein is destroyed within the cell, allowing bmal
and other clock proteins to increase. Among other actions, these
clock genes cause Rev-erb to increase, which again inhibits bmal
and clock. “The time it takes for that to happen
determines the length of the cycle-roughly 24 hours-and keeps the
clock going,” explains Lazar.
Penn colleague and coauthor Peter Klein, MD, PhD,
Assistant Professor of Medicine, discovered a few years ago that
the drug lithium, used to treat biopolar illness, inhibits GSK3,
an enzyme known to regulate circadian rhythm in several animal species.
In the present study, the researchers showed that the destruction
of Rev-erb, a receptor shown previously by Lazar and others to play
a role in maintaining normal metabolism, is prevented by GSK3 in
mouse and human cells. “It’s like pulling a pin out
of the gears of the clock, to allow them to turn in a synchronized
manner,” says Lazar.
Lithium blocks this action of GSK3, tagging Rev-erb for destruction,
which leads to activation of clock genes such as bmal1.
“We suggest that just as our cells in the incubator need to
have their internal clocks reset, maybe this is what happens in
some people with circadian disorders,” says Lazar. “One
effect of lithium may be to reset clocks that become stuck when
Rev-erb levels build up.”
These results point to Rev-erb as a lithium-sensitive component
of the human clock and therefore a possible target for developing
new circadian-disorder drugs. Some patients taking lithium have
developed kidney toxicity and other problems. Lazar surmises that
new treatments that lead to the destruction of Rev-erb would have
the potential of providing another point of entry into the circadian
pathway.
Noting that Rev-erb is present in metabolically active tissues,
Lazar and his team at the Institute for Diabetes, Obesity, and Metabolism
are also interested in the relationship between the control of the
circadian clock and metabolic diseases such as obesity and diabetes.
“There is a dynamic interplay between circadian rhythms and
metabolism,” Lazar says. “You don't eat while you are
sleeping, and the body needs to take this into account.”
Study co-authors are Lei Yin and Jing Wang, both from Penn. The
research was funded by the National Institute of Diabetes &
Digestive & Kidney Diseases and the National Institute of Mental
Health.
###
PENN Medicine is a $2.7 billion enterprise
dedicated to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine consists
of the University of Pennsylvania School of Medicine (founded in
1765 as the nation's first medical school) and the University of
Pennsylvania Health System.
Penn’s School of Medicine is ranked #2 in the nation
for receipt of NIH research funds; and ranked #4 in the nation in
U.S. News & World Report’s most recent ranking of top
research-oriented medical schools. Supporting 1,400 fulltime faculty
and 700 students, the School of Medicine is recognized worldwide
for its superior education and training of the next generation of
physician-scientists and leaders of academic medicine.
The University of Pennsylvania Health System comprises: its
flagship hospital, the Hospital of the University of Pennsylvania,
consistently rated one of the nation’s “Honor Roll”
hospitals by U.S. News & World Report; Pennsylvania Hospital,
the nation's first hospital; Penn Presbyterian Medical Center; a
faculty practice plan; a primary-care provider network; two multispecialty
satellite facilities; and home health care and hospice.
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.
The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Home to a proud history of “firsts” in medicine, Penn Medicine teams have pioneered discoveries and innovations that have shaped modern medicine, including recent breakthroughs such as CAR T cell therapy for cancer and the mRNA technology used in COVID-19 vaccines.
The University of Pennsylvania Health System’s patient care facilities stretch from the Susquehanna River in Pennsylvania to the New Jersey shore. These include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Lancaster General Health, Penn Medicine Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.
Penn Medicine is an $11.1 billion enterprise powered by more than 49,000 talented faculty and staff.