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Gene & Protein in Disease                                            Circadian biology in Alzheimer’s disease



              Chronotherapy – the alignment of medical treatment   The phrase “time is brain,” often cited in stroke care, is
            with biological rhythms – is a promising avenue for   equally profound in the context of Alzheimer’s disease. It
            Alzheimer’s  disease  care.  Drug  metabolism  follows   is time for temporal regulation to emerge as a therapeutic
            circadian  patterns,  influencing  efficacy  and  toxicity.   target.
            Melatonin, traditionally used to regulate sleep, also
            influences autophagy, oxidative stress, and synaptic   Conflict of interest
            signaling – making it a promising chronotherapeutic   The author declares no conflict of interest.
            agent. In addition, dual orexin receptor antagonists have
            shown early success in regulating sleep-wake cycles  and   References
            promoting tau clearance. 9                         1.   Hippius H, Neundorfer G. The discovery of Alzheimer’s
              Restoring circadian synchrony through lifestyle     disease. Dialogues Clin Neurosci. 2003;5(1):101-108.
            interventions – such as time-restricted feeding, structured      doi: 10.31887/DCNS.2003.5.1/hhippius
            light exposure, and regular physical activity – has shown   2.   Korczyn AD, Grinberg LT. Is Alzheimer disease a disease?
            benefits in sleep quality, systemic inflammation, and   Nat Rev Neurol. 2024;20(4):245-251.
            cognitive  resilience,  particularly  in  the  early  stages  of
            Alzheimer’s disease. 10                               doi: 10.1038/s41582-024-00940-4
              A growing field of interest is chronoepigenetics, where   3.   Hoyt KR, Obrietan K. Circadian clocks, cognition, and
            epigenetic regulators – such as sirtuin-1, an NAD -   Alzheimer’s disease: Synaptic mechanisms, signaling
                                                         +
                                                                  effectors, and chronotherapeutics.  Mol Neurodegener.
            dependent deacetylase, and poly(ADP-ribose) polymerase   2022;17(1):35.
            1 – intersect with circadian clock gene expression,
            modulating neuroprotective and synaptic pathways. 11,12       doi: 10.1186/s13024-022-00537-9
            Targeting these molecular intersections may lead to   4.   Gibson M. A systematic review of the relationship between
            precision therapies that simultaneously stabilize circadian   night  shift  work  and  oxidative  stress.  Chronobiol Int.
            rhythms and mitigate neurodegeneration.               2022;39(2):285-298.
              These insights also transform our approach to       doi: 10.1080/07420528.2021.1989446
            biomarkers. Circadian-informed markers – such as   5.   Gonzales PNG, Villaraza SG, Rosa JCD. The association
            rhythmic fluctuations in melatonin, cortisol, body    between sleep and Alzheimer’s disease: A systematic review.
            temperature, retinal responses, and microglial activation –   Dement Neuropsychol. 2024;18:e20230049.
            may offer early diagnostic signals and optimize therapeutic      doi: 10.1590/1980-5764-DN-2023-0049
            timing.  Technologies  such  as  actigraphy,  metabolomic
            profiling, and neuroimaging of circadian structures are   6.   Morrone CD, Raghuraman R, Hussaini SA, Yu WH.
                                                                  Proteostasis failure exacerbates neuronal circuit dysfunction
            advancing  the  field  of  time-based  phenotyping  and  risk   and sleep impairments in Alzheimer’s disease.  Mol
            stratification.                                       Neurodegener. 2023;18(1):27.

              Despite these advances, challenges remain. Clinical      doi: 10.1186/s13024-023-00617-4
            adoption of chronotherapy is hindered by the absence of   7.   Son G, Neylan TC, Grinberg LT. Neuronal and glial
            standardized chronotyping protocols, limited longitudinal   vulnerability of the suprachiasmatic nucleus in tauopathies:
            data, and the lack of circadian integration into trial design.   Evidence  from  human  studies  and  animal  models.  Mol
            Regulatory frameworks must evolve to incorporate time-  Neurodegener. 2024;19(1):4.
            of-day considerations in drug labeling and approval. Public
            health initiatives should also promote circadian hygiene      doi: 10.1186/s13024-023-00695-4
            – including consistent sleep schedules, timed meals, and   8.   Mueed Z, Rai PK, Kamal MA, Poddar NK. Decoding the
            light exposure – as a core component of brain health.  inter-relationship between sleep disorders and Alzheimer’s
                                                                  disease pathogenesis.  CNS Neurol Disord Drug Targets.
              As Alzheimer’s disease cases continue to rise globally,   2021;20(8):723-735.
            particularly among aging and urbanized populations,
            there is an urgent need to expand our clinical and research   doi: 10.2174/1871527319666200903161249
            frameworks. The circadian system, once considered   9.   Carpi M, Mercuri NB, Liguori C. Orexin receptor antagonists
            peripheral, now emerges as a central regulatory axis linking   for the prevention and treatment of Alzheimer’s disease and
            genes, proteins, metabolism, and behavior within a unified   associated sleep disorders. Drugs. 2024;84(11):1365-1378.
            pathophysiological model.                             doi: 10.1007/s40265-024-02096-3



            Volume 4 Issue 3 (2025)                         2                           doi: 10.36922/GPD025160031
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