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The body's internal clock is naturally aligned with the day-night cycle, but circadian rhythms can be disrupted by exposure to light at night, lack of daylight due to travel, work, electronic devices, or an underlying condition. During the day, light exposure triggers the internal clock to send signals that generate alertness and help keep us awake and active. At nightfall, the internal clock initiates the production of melatonin, which promotes sleep.

We must maintain a healthy circadian rhythm by maintaining a consistent sleep schedule, exposing ourselves to light, and exercising daily. The use of artificial light in our homes and electronic devices has led more people to report sleeping less at night, as well as irregular sleep patterns. During sleep, our cells use the rest period to repair damaged cells and regenerate new cells after apoptosis. Abnormal circadian rhythms as a potential carcinogen have increased the focus on defining the underlying mechanisms of circadian disruption-induced tumorigenesis.

The CLOCK gene (Circadian Locomotor Output Cycles Kaput) is one of the circadian clock genes and is considered a key circadian rhythm regulator, responsible for mediating several biological processes. Therefore, abnormal CLOCK expression affects its role in the circadian clock and its more general function as a direct regulator of gene expression. This dysfunction can lead to serious pathological effects, including cancer.

Circadian rhythm disruption has been shown to be associated with an increased risk of developing obesity and obesity-related diseases and is closely linked to tumorigenesis in breast cancer, prostate cancer, colorectal cancer, pancreatic adenocarcinoma, liver cancer, lung cancer, renal cancer, and others. This disorder is associated with elevated lipid levels and attenuated lipid signaling, inflammatory responses, insulin resistance, and adipokines.

Alteration of the biological clock has been detected in obesity, leading to increased expression of inflammatory cytokines, which is exacerbated by the disease itself. Furthermore, circadian rhythm disruption could contribute to metabolic dysfunction in adipose tissue, thus increasing the risk of developing cardiometabolic diseases. The interaction between circadian rhythm and cancer involves the regulation of cell division, DNA repair, immune function, hormonal balance, and the potential for chronotherapy. Disruptions in the circadian rhythm can promote abnormal cell development and tumor metastasis, possibly due to immune system imbalances and hormonal fluctuations.

Dysfunction in the 24-hour circadian rhythm is common in older adults and is more severe in people with age-related neurodegenerative diseases, including dementias related to Alzheimer's disease and Parkinson's disease. Manifestations differ depending on the type and severity of the neurodegenerative disease and, for some patients, occur before the onset of typical clinical symptoms of neurodegeneration.

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