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CANCER CHRONOMICS III Chronomics for cancer, aging, melatonin and experimental therapeutics researchers 1Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN 55455, USA 2VARIAN International, Zug, Switzerland 3Central Research Institute of Roentgenology & Radiology, St Petersburg, Russia 4WJB Dorn VA Medical Center, Columbia, SC, USA 5King George’s Medical University, Lucknow, India 6School of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu, P.R. China Correspondence to: Dr Franz Halberg, Halberg Chronobiology Center, University of Minnesota – MMC 8609, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Telephone: 612-624-6976. Fax: 612-624-9989. E-mail: halbe001/at/umn.edu Website: http://www.msi.umn.edu/~halberg/ See other articles in PMC that cite the published article.Abstract This position paper documents the merit of including for basic and clinical investigations the mapping of circadian and other rhythms and yet broader chronomes, time structures in and around us. Chronobiometry used herein relies on inferential statistical methods and on materials documented earlier. The circadian amplitude of melatonin is shown to relate both to cancer risk and to the presence of overt cancer, when no differences are found in the 24-hour average of melatonin. Optimization of treatment by timing, thoroughly documented along the circadian scale earlier, could be broadened to include optimization along the scale of the week, and eventually beyond. In both cases, reliance on marker rhythmometry is advocated. More generally, the limits of knowledge are expanded by considering already mapped spectral components and their characteristics that can be influenced by the dynamics of heliogeomagnetic signals heretofore unassessed. Keywords: chronome, chronotherapy, circadian, circaseptan, heliogeomagnetics, L1210 leukemia, marker rhythmometry, mitotic activity INTRODUCTION The merit of consulting and testing chronomes — time structures—as gauges of health for alterations with disease risk elevation and actual illness was discussed both in general terms (1, 2) and with respect to melatonin and cancer (3), albeit in the latter case without underlying data or citations. Herein, we provide evidence supporting the importance of considering chronomics, the mapping of time structure in and around us. More specifically, in the context of a study based on the 24-hour excretion of metabolites of melatonin (4), it was noted that the single 24-hour average of melatonin does not provide necessarily time-keeping information and that studies “which demonstrate relationships between cancer risk and melatonin excretion, find this relationship between circadian amplitude or phase (time of melatonin upswing), not the average amount of melatonin metabolite excreted in 24 hours”. We here add data on the circadian amplitude that document the point of an association between cancer on the one hand and melatonin on the other and abstractly illustrate the need to also pay attention to other dynamic characteristics, phase and period. The detail concerns separately risk assessment, Figure 1a
In none of the figures shown herein is there any evidence for any up or down “regulation”—the kind of question raised when comparing, for two groups examined, the excretion of urinary melatonin metabolites in 24-hour samples collected to integrate, and inadvertently to eliminate any alteration of 24-hour rhythms. This is a meritorious approach as compared to spotchecks that are even simpler to collect and continue to characterize much current work, dispensing even with this minimal precaution of integrating over the period of a rhythm. But there can be no increase or decrease in the chronome-adjusted average, i.e. the MESOR (midline-estimating statistic of rhythm), yet there can be nonetheless differences in variability. In each case herein, the difference lies in the dynamics and is lost if we ask, as is too often customary, exclusively about any “too much” or “too little” vs. “normal”, the latter two often handled as a constant. This approach of refraining from the study of rhythms is embraced for the sake of simplicity (read ignorance), or rather, with the accumulating evidence, as an aspect of indolence. It will be up to journal editors and referees, under such conditions when encountering negative results, to insist that it should be specified that the failure to find a difference could stem from a priori insufficient sampling and that more sampling remains to be done, if, in the face of ignoring broader chronomics, a paper is to be published at all. MATERIALS AND METHODS Chronobiometry used herein relies on inferential statistical methods and on materials illustrated, if not documented earlier (1). RESULTS OR, RATHER, POSITION Melatonin and Cancer Risk Versus Overt Cancer Figure 1a However large the number of patients is, a difference in amplitude necessarily implies that any tests at several different time-unqualified single sampling times are likely to run the risk of yielding confusing results. Thus, between certain test times, an inter-group difference can reverse sign when testing during the night (e.g., in overnight urine samples) vs. during the day (e.g., in the urine collected in the afternoon), Figure 1b The group results with fractionated samples around the clock revealing differences in circadian amplitude are compatible with the view that the increase in circadian amplitude of melatonin excretion, in the absence of an increase in MESOR, constitutes an early measure of strain, often described as “stress” (12–14). In that perspective, early stress/strain assessment requires an indispensable analysis of time structure. These lessons may serve those who focus only upon too much or too little and use a set of normal values, thereby inadvertently drawing a curtain of ignorance over the range in which all of our everyday physiology and much early pathology occur (1, 8, 9). That timing along the 24-hour and 7-day scales in the case of lentinan can make the difference between inhibiting and enhancing the growth of a subsequently implanted malignancy is also noteworthy, Figure 3 What Referees Should Assess Under “Methods” Each investigator has several choices: Most of current science still ignores rhythms and accordingly of necessity is likely to ignore differences in phase, Figure 4
We recommend not only the study of the circadian dynamics as pointed out earlier (1–3), but also to extend one’s scope to a still broader time structure in general terms with thoughts about important circadian genes (2) and with specific reference to already mapped charts of chronomes (1, 22–24). The approach by chronomics (1, 8, 9), assessing the dynamics of blood pressure as well as melatonin, has worked in the study of cardiovascular disease for risk assessment (25–27) and treatment (26, 28), and awaits more general use. Time-unspecified action, Figure 3 Beyond Circadian Optimization For at least the weekly component in a new spectrum of magnetoperiodisms, Ulmer (33; cf. 34) has mathematically modeled an effect on biochemical reactions by feedsideward coupling. He emphasizes that the geomagnetic field, driven by the solar wind (31, 32; cf. 23) which in turn may respond to the solar magnetic field, may act on charged molecules found in all cells behaving like a system of sets of pairs of electric or magnetic dipoles. Slight changes in environmental magnetism with proper frequencies will affect biochemical and biophysical processes, including the orientation of nucleic acids (35). Ulmer, who encountered circaseptan rhythms in vitro with overwhelming prominence, Figure 6
DISCUSSION Circadian problems illustrated herein were exciting by the 1950s (22), had a thorough summary by 1960 (37), and still await clinical application in the new millennium (1). Broader chronomics, focusing on time structures outside and in us, are the added challenge in our day. A protocol for chronoradiotherapy published earlier (scheme 1 in reference 1) awaits implementation in treatment with radiation. It is best combined with circadian timing that has already doubled two-year disease-free survival (1). CONCLUSION Most of a new, broad transdisciplinary periodic system and other aspects of time structure, such as trends and chaos, as yet remain to be mapped. This task calls for an international effort (23, 31). At each frequency other than circadian, an unrecognized difference in amplitude (Figure 1
Acknowledgments SUPPORT U.S. National Institutes of Health (GM-13981) (FH); Dr. h.c. mult. Earl Bakken Fund (GC, FH); University of Minnesota Supercomputing Institute (GC, FH) Footnotes DEDICATION This series of three papers on cancer chronomics is dedicated to the memory of Erna Halberg, a lady and chronobiologist (43). With an obstructed bowel, she decided to stay with us until the Erna test (44, cf. 45) was completed. May marker rhythmometry in the diagnosis and treatment of risk elevation as well as actual disease, cancer, stroke, or other, eventually replace a spotcheck single sample based health care.” REFERENCES 1. Halberg F, Cornélissen G, Wang ZR, Wan C, Ulmer W, Katinas G, Singh Ranjana, Singh RK, Singh Rajesh, Gupta BD, Singh RB, Kumar A, Kanabrocki E, Sothern RB, Rao G, Bhatt MLBD, Srivastava M, Rai G, Singh S, Pati AK, Nath P, Halberg Francine, Halberg J, Schwartzkopff O, Bakken E, Shastri VK. Chronomics: circadian and circaseptan timing of radiotherapy, drugs, calories, perhaps nutriceuticals and beyond. J Exp Therapeutics Oncol. 2003;3:223–260. 2. Hrushesky WJM. The temporal organization of life: the impact of multi-frequency non-linear biologic time structure upon the host-cancer balance. Jpn J Clin Oncol. 2000;30:529–533. [PubMed] 3. Hrushesky WJM, Blask DE. Re: melatonin and breast cancer: a prospective study [correspondence]. J Nat Cancer Inst. 2004;96:888–889. [PubMed] 4. Travis R, Allen D, Fentiman I, Key T. Melatonin and breast cancer: a prospective study. J Nat Cancer Inst. 2004;96:475–482. [PubMed] 5. Wetterberg L, Halberg F, Halberg E, Haus E, Kawasaki T, Ueno M, Uezono K, Cornélissen G, Matsuoka M, Omae T. Circadian characteristics of urinary melatonin from clinically healthy women at different civilization disease risk. Acta med scand. 1986;220:71–81. [PubMed] 6. Tarquini R, Perfetto F, Salti R, Wetterberg L, Cornélissen G, Halberg F. Changes in the circadian amplitude of melatonin with cancer and breast cancer risk. In: Cornélissen G, Kenner R, Fiser B, Siegelova J, editors. Proceedings, Symposium: Chronobiology in Medicine. Dedicated to the 85th Anniversary of Professor Franz Halberg; Brno: Masaryk University. 2004. [Omitted from finished book by typesetting error. Copy available on request from halbe001@umn.edu or corne001@umn.edu]. 7. Tarquini B, Cornélissen G, Tarquini R, Perfetto F, Halberg F. General and unspecific damping by malignancy of the circadian amplitude of circulating human melatonin? Neuroendocrinology Letters. 1999;20:25–28. [PubMed] 8. Cornélissen G, Halberg F, Perfetto F, Tarquini R, Maggioni C, Wetterberg L. Melatonin involvement in cancer: methodological considerations. In: Bartsch C, Bartsch H, Blask DE, Cardinali DP, Hrushesky WJM, Mecke W, editors. The Pineal Gland and Cancer: Neuroimmunoendocrine Mechanisms in Malignancy. Heidelberg: Springer; 2001. pp. 117–149. 9. 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Chronobiologic study design in everyday life, clinic and laboratory. Chronobiologia. 1980;7:95–120. [PubMed] 16. Wrba H, Dutter A, Sanchez de la Peña S, Cornélissen G, Halberg F. Secular or circadian effects of placebo and melatonin on murine breast cancer? Progress in Clinical and Biological Research. 1990;341A:31–40. [PubMed] 17. Wrba H, Halberg F, Dutter A. Melatonin circadian-stage-dependently delays breast cancer development in mice injected daily for several months. Neuroimmunomodulation, Proc. 1st Int. Workshop on NIM; Nov. 27–30, 1984; Bethesda, MD. Bethesda: IWGN; 1985. pp. 258–261. 18. Wrba H, Halberg F, Dutter A. Melatonin circadian-stage-dependently delays breast tumor development in mice injected daily for several months. Chronobiologia. 1986;13:123–128. [PubMed] 19. Wrba H, Dutter A, Sanchez de la Peña S, Wu J, Carandente F, Halberg F. Secular or circannual immunomodulation of placebo (Pl) and melatonin (Mt) effects on murine breast cancer? Chronobiologia. 1989;16:197. 20. Sanchez de la Pena S. The feedsideward of cephalo-adrenal immune interactions. Chronobiologia. 1993;20:1–52. [PubMed] 21. Bulbrook M, Cornélissen G, Halberg F, Kerr D, Simpson H, Wilson D, Griffiths K. Metachronanalyses of prolactin (prl) and human breast (B) cancer. Chronobiologia. 1987;14:156. 22. Halberg Franz, Cornélissen G, Katinas G, Syutkina EV, Sothern RB, Zaslavskaya R, Halberg Francine, Watanabe Y, Schwartzkopff O, Otsuka K, Tarquini R, Perfetto P, Siegelova J. Transdisciplinary unifying implications of circadian findings in the 1950s. J Circadian Rhythms. 2003. p. 2. 61 pp. www.JCircadianRhythms.com/content/pdf/1740-3391/1/2.pdf. [PubMed] 23. Halberg F, Cornélissen G, Regal P, Otsuka K, Wang ZR, Katinas GS, Siegelova J, Homolka P, Prikryl P, Chibisov SM, Holley DC, Wendt HW, Bingham C, Palm SL, Sonkowsky RP, Sothern RB, Pales E, Mikulecky M, Tarquini R, Perfetto F, Salti R, Maggioni C, Jozsa R, Konradov AA, Kharlitskaya EV, Revilla M, Wan CM, Herold M, Syutkina EV, Masalov AV, Faraone P, Singh RB, Singh RK, Kumar A, Singh R, Sundaram S, Sarabandi T, Pantaleoni GC, Watanabe Y, Kumagai Y, Gubin D, Uezono K, Olah A, Borer K, Kanabrocki EA, Bathina S, Haus E, Hillman D, Schwartzkopff O, Bakken EE, Zeman M. Chronoastrobiology: proposal, nine conferences, heliogeomagnetics, transyears, near-weeks, near-decades, phylogenetic and ontogenetic memories. Biomed Pharmacother. 2004;58 Suppl 1:S150–S187. [PubMed] 24. Halberg F, Cornélissen G, Otsuka K, Schwartzkopff O, Halberg J, Bakken EE. Chronomics. Biomedicine and Pharmacotherapy. 2001;55 Suppl 1:153–190. 25. Cornélissen G, Schwartzkopff O, Halberg F, Otsuka K, Watanabe Y. 7-day ambulatory monitoring for adults with hypertension and diabetes [letter]. Am J Kidney Diseases. 2001;37:878. [PubMed] 26. Halberg F, Cornélissen G. International Womb-to-Tomb Chronome Initiative Group: Resolution from a meeting of the International Society for Research on Civilization Diseases and the Environment (New SIRMCE Confederation); Fairy tale or reality? Medtronic Chronobiology Seminar #8, April 1995, 12 pp. text, 18 figures; March 17–18, 1995; Brussels, Belgium. http://www.msi.umn.edu/~halberg/ 27. Halberg F, Cornélissen G, Halberg J, Fink H, Chen C-H, Otsuka K, Watanabe Y, Kumagai Y, Syutkina EV, Kawasaki T, Uezono K, Zhao ZY, Schwartzkopff O. Circadian Hyper-Amplitude-Tension, CHAT: a disease risk syndrome of anti-aging medicine. J Anti-Aging Med. 1998;1:239–259. (Editor’s Note by Fossel M, p. 239.). 28. Zaslavskaya RM, Makarova LA, Shakarova AN, Komarov F, Wang ZR, Wan CM, Katinas G, Cornélissen G, Halberg F. Individualized time series-based assessment of melatonin effects on blood pressure: model for pediatricians. Neuroendocrinol Lett. 2003;24 Suppl 1:238–246. 29. Halberg F, Haus E, Cardoso SS, Scheving LE, Kuehl JFW, Shiotsuka R, Rosene G, Pauly JE, Runge W, Spalding JF, Lee JK, Good RA. Toward a chronotherapy of neoplasia: Tolerance of treatment depends upon host rhythms. Experientia (Basel). 1973;29:909–934. [PubMed] 30. Wang ZR, Chen LG, Wan CM, Qu Y, Cornélissen G, Halberg F. In vitro circadian ANP secretion by gene transferring cells encapsulated in polycaprolactone tubes: gene chronotherapy. Peptides. 2004;25:1259–1267. [PubMed] 31. Halberg F, Cornélissen G, Otsuka K, Watanabe Y, Katinas GS, Burioka N, Delyukov A, Gorgo Y, Zhao ZY, Weydahl A, Sothern RB, Siegelova J, Fiser B, Dusek J, Syutkina EV, Perfetto F, Tarquini R, Singh RB, Rhees B, Lofstrom D, Lofstrom P, Johnson PWC, Schwartzkopff O. International BIOCOS Study Group. Cross-spectrally coherent ~10.5- and 21-year biological and physical cycles, magnetic storms and myocardial infarctions. Neuroendocrinol Lett. 2000;21:233–258. [PubMed] 32. Halberg F, Cornélissen G, Schwartzkopff O, Bakken EE. Cycles in the biosphere in the service of solar-terrestrial physics? In: Schroeder W, editor. Case studies in physics and geophysics. Bremen: Wilfried Schroeder/Science Edition; 2006. pp. 39–87. 33. Ulmer W, Cornélissen G, Halberg F. Physical chemistry and the biologic week in the perspective of chrono-oncology. In vivo. 1995;9:363–374. [PubMed] 34. Ulmer W, Cornélissen G, Revilla M, Siegelova J, Dusek J, Halberg F. Circadian and circaseptan dependence of the beta-ATP peak of four different cancer cell cultures: implications for chronoradiotherapy. Scripta medica (Brno). 2001;74:87–92. 35. Maret G, v Schickfus M, Mayer A, Dransfeld K. Orientation of nucleic acids in high magnetic fields. Phys Rev Lett. 1975;35:397. 36. Halberg F, Cornélissen G, Katinas G, Tvildiani L, Gigolashvili M, Janashia K, Toba T, Revilla M, Regal P, Sothern RB, Wendt HW, Wang ZR, Zeman M, Jozsa R, Singh RB, Mitsutake G, Chibisov SM, Lee J, Holley D, Holte JE, Sonkowsky RP, Schwartzkopff O, Delmore P, Otsuka K, Bakken EE, Czaplicki J. International BIOCOS Group. Chronobiology’s progress: season’s appreciations 2004–2005. Part I, Time-, frequency-, phase-, variable-, individual-, age- and site-specific chronomics. J Applied Biomedicine. 2006;4:1–38. http://www.zsf.jcu.cz/vyzkum/jab/4_1/halberg.pdf Part II, chronomics for an immediately applicable biomedicine. 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Jpn J Clin Oncol. 2000 Dec; 30(12):529-33.
[Jpn J Clin Oncol. 2000]J Natl Cancer Inst. 2004 Jun 2; 96(11):888-9.
[J Natl Cancer Inst. 2004]J Natl Cancer Inst. 2004 Mar 17; 96(6):475-82.
[J Natl Cancer Inst. 2004]Acta Med Scand. 1986; 220(1):71-81.
[Acta Med Scand. 1986]Am J Med. 2000 Sep; 109(4):343-5.
[Am J Med. 2000]Acta Med Scand. 1986; 220(1):71-81.
[Acta Med Scand. 1986]Am J Med. 2000 Sep; 109(4):343-5.
[Am J Med. 2000]Am J Med. 1999 Nov; 107(5):432-6.
[Am J Med. 1999]Biomed Pharmacother. 2003 Oct; 57 Suppl 1():136s-163s.
[Biomed Pharmacother. 2003]Chronobiologia. 1980 Jan-Mar; 7(1):95-120.
[Chronobiologia. 1980]Prog Clin Biol Res. 1990; 341A():31-40.
[Prog Clin Biol Res. 1990]Chronobiologia. 1993 Jan-Jun; 20(1-2):1-52.
[Chronobiologia. 1993]J Natl Cancer Inst. 2004 Jun 2; 96(11):888-9.
[J Natl Cancer Inst. 2004]J Circadian Rhythms. 2003 Oct 29; 1(1):2.
[J Circadian Rhythms. 2003]J Natl Cancer Inst. 2004 Jun 2; 96(11):888-9.
[J Natl Cancer Inst. 2004]Jpn J Clin Oncol. 2000 Dec; 30(12):529-33.
[Jpn J Clin Oncol. 2000]J Circadian Rhythms. 2003 Oct 29; 1(1):2.
[J Circadian Rhythms. 2003]Am J Kidney Dis. 2001 Apr; 37(4):878.
[Am J Kidney Dis. 2001]Experientia. 1973 Aug 15; 29(8):909-34.
[Experientia. 1973]Peptides. 2004 Aug; 25(8):1259-67.
[Peptides. 2004]Biomed Pharmacother. 2004 Oct; 58 Suppl 1():S150-87.
[Biomed Pharmacother. 2004]Neuro Endocrinol Lett. 2000; 21(3):233-258.
[Neuro Endocrinol Lett. 2000]In Vivo. 1995 Jul-Aug; 9(4):363-74.
[In Vivo. 1995]Neuro Endocrinol Lett. 2000; 21(3):233-258.
[Neuro Endocrinol Lett. 2000]Biomed Pharmacother. 2004 Oct; 58 Suppl 1():S150-87.
[Biomed Pharmacother. 2004]J Circadian Rhythms. 2003 Oct 29; 1(1):2.
[J Circadian Rhythms. 2003]Biomed Pharmacother. 2004 Oct; 58 Suppl 1():S150-87.
[Biomed Pharmacother. 2004]Neuro Endocrinol Lett. 2000; 21(3):233-258.
[Neuro Endocrinol Lett. 2000]J Circadian Rhythms. 2003 Oct 29; 1(1):2.
[J Circadian Rhythms. 2003]J Natl Cancer Inst. 2004 Mar 17; 96(6):475-82.
[J Natl Cancer Inst. 2004]Acta Med Scand. 1986; 220(1):71-81.
[Acta Med Scand. 1986]Am J Med. 1999 Nov; 107(5):432-6.
[Am J Med. 1999]Am J Med. 2000 Sep; 109(4):343-5.
[Am J Med. 2000]J Circadian Rhythms. 2003 Oct 29; 1(1):2.
[J Circadian Rhythms. 2003]J Circadian Rhythms. 2003 Oct 29; 1(1):2.
[J Circadian Rhythms. 2003]In Vivo. 1995 Jul-Aug; 9(4):363-74.
[In Vivo. 1995]In Vivo. 1995 Jul-Aug; 9(4):363-74.
[In Vivo. 1995]Chronobiologia. 1993 Jul-Dec; 20(3-4):139-44.
[Chronobiologia. 1993]In Vivo. 1992 Jul-Aug; 6(4):403-27.
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