<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN" "http://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="review-article" dtd-version="1.2" xml:lang="en">
    <front>
        <journal-meta>
            <journal-id journal-id-type="pmc">F1000Research</journal-id>
            <journal-title-group>
                <journal-title>F1000Research</journal-title>
            </journal-title-group>
            <issn pub-type="epub">2046-1402</issn>
            <publisher>
                <publisher-name>F1000 Research Limited</publisher-name>
                <publisher-loc>London, UK</publisher-loc>
            </publisher>
        </journal-meta>
        <article-meta>
            <article-id pub-id-type="doi">10.12688/f1000research.7608.1</article-id>
            <article-categories>
                <subj-group subj-group-type="heading">
                    <subject>Review</subject>
                </subj-group>
                <subj-group>
                    <subject>Articles</subject>
                    <subj-group>
                        <subject>Animal Genetics</subject>
                    </subj-group>
                    <subj-group>
                        <subject>Substance Abuse</subject>
                    </subj-group>
                </subj-group>
            </article-categories>
            <title-group>
                <article-title>Implications of circadian rhythm and stress in addiction vulnerability</article-title>
                <fn-group content-type="pub-status">
                    <fn>
                        <p>[version 1; peer review: 2 approved]</p>
                    </fn>
                </fn-group>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Becker-Krail</surname>
                        <given-names>Darius</given-names>
                    </name>
                    <uri content-type="orcid">https://orcid.org/0000-0002-1751-0598</uri>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="yes">
                    <name>
                        <surname>McClung</surname>
                        <given-names>Colleen</given-names>
                    </name>
                    <xref ref-type="corresp" rid="c1">a</xref>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <aff id="a1">
                    <label>1</label>School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA</aff>
            </contrib-group>
            <author-notes>
                <corresp id="c1">
                    <label>a</label>
                    <email xlink:href="mailto:McClungCA@upmc.edu">McClungCA@upmc.edu</email>
                </corresp>
                <fn fn-type="con">
                    <p>DDBK prepared the manuscript. DDBK and CAM contributed equally to the revision of the draft manuscript and have agreed to the final content.</p>
                </fn>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>13</day>
                <month>1</month>
                <year>2016</year>
            </pub-date>
            <pub-date pub-type="collection">
                <year>2016</year>
            </pub-date>
            <volume>5</volume>
            <elocation-id>59</elocation-id>
            <history>
                <date date-type="accepted">
                    <day>29</day>
                    <month>12</month>
                    <year>2015</year>
                </date>
            </history>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2016 Becker-Krail D and McClung C</copyright-statement>
                <copyright-year>2016</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <self-uri content-type="pdf" xlink:href="https://f1000research.com/articles/5-59/pdf"/>
            <abstract>
                <p>In the face of chronic stress, some individuals can maintain normal function while others go on to develop mental illness. Addiction, affecting one in every twelve people in America, is a substance use disorder long associated with stressful life events and disruptions in the sleep/wake cycle. The circadian and stress response systems have evolved to afford adaptability to environmental changes and allow for maintenance of functional stability, or homeostasis. This mini-review will discuss how circadian rhythms and stress individually affect drug response, affect each other, and how their interactions may regulate reward-related behavior. In particular, we will focus on the interactions between the circadian clock and the regulation of glucocorticoids by the hypothalamic-pituitary-adrenal (HPA) axis. Determining how these two systems act on dopaminergic reward circuitry may not only reveal the basis for vulnerability to addiction, but may also illuminate potential therapeutic targets for future investigation.</p>
            </abstract>
            <kwd-group kwd-group-type="author">
                <kwd>Addiction</kwd>
                <kwd>Circadian</kwd>
                <kwd>Clock</kwd>
                <kwd>Glucocorticoids</kwd>
                <kwd>HPA</kwd>
                <kwd>Reward</kwd>
                <kwd>Stress</kwd>
                <kwd>Vulnerability</kwd>
            </kwd-group>
            <funding-group>
                <funding-statement>The author(s) declared that no grants were involved in supporting this work.</funding-statement>
            </funding-group>
        </article-meta>
    </front>
    <body>
        <sec sec-type="intro">
            <title>Introduction</title>
            <p>Within any given environment, an organism must learn to anticipate and adapt to external changes/stressors in order to survive. Two systems, the circadian and stress response systems, have evolved to afford adaptability to both recurring and spontaneous environmental changes. Through the active process of allostasis (
                <xref ref-type="bibr" rid="ref-65">McEwen, 1998</xref>; 
                <xref ref-type="bibr" rid="ref-94">Sterling &amp; Eyer, 1988</xref>), these systems and many others work to maintain an internal state of stability, or homeostasis, in the presence of these changes. In the face of acute and/or chronic stressors, the ability for an organism to adapt and avoid negative biological consequences is known as resilience. Within the context of psychopathology, resilience can be seen as a person&#x2019;s ability to maintain physiological and psychobiological homeostasis, in spite of adversity (
                <xref ref-type="bibr" rid="ref-15">Charney, 2004</xref>; 
                <xref ref-type="bibr" rid="ref-29">Feder 
                    <italic toggle="yes">et al.</italic>, 2009</xref>). While resilient individuals uphold &#x201c;normal&#x201d; mental health and homeostatic function when exposed to stress, other individuals may go on to develop neuropsychiatric or behavioral disorders. According to the vulnerability-stress model (
                <xref ref-type="bibr" rid="ref-43">Ingram &amp; Luxton, 2005</xref>; Zubin &amp; Spring, 1977), some individuals may be more biologically vulnerable to developing neuropsychiatric disorders when faced with acute and/or chronic stressors (
                <xref ref-type="bibr" rid="ref-77">Pihl &amp; Nantel-Vivier, 2005</xref>). To fully understand this phenomenon, current research seeks to understand the effects of stress in the brain (reviewed in 
                <xref ref-type="bibr" rid="ref-63">McEwen 
                    <italic toggle="yes">et al.</italic>, 2015</xref>), and elucidate potential structural and/or molecular bases resulting in the vulnerability to develop mental illnesses.</p>
            <p>Many neuropsychiatric disorders have long been associated with altered circadian rhythm (
                <xref ref-type="bibr" rid="ref-66">Mills 
                    <italic toggle="yes">et al.</italic>, 1977</xref>; 
                <xref ref-type="bibr" rid="ref-102">Van Cauter &amp; Turek, 1986</xref>; 
                <xref ref-type="bibr" rid="ref-103">Wehr 
                    <italic toggle="yes">et al.</italic>, 1983</xref>) and stress response (
                <xref ref-type="bibr" rid="ref-2">Albus 
                    <italic toggle="yes">et al.</italic>, 1982</xref>; 
                <xref ref-type="bibr" rid="ref-5">Amsterdam 
                    <italic toggle="yes">et al.</italic>, 1983</xref>; 
                <xref ref-type="bibr" rid="ref-83">Roy 
                    <italic toggle="yes">et al.</italic>, 1988</xref>); highlighted here, disruptions in both systems are also known to have implications in substance use disorder/addiction and reward-related behaviors (
                <xref ref-type="bibr" rid="ref-13">Briand &amp; Blendy, 2010</xref>; 
                <xref ref-type="bibr" rid="ref-27">Falc&#x00f3;n &amp; McClung, 2009</xref>; 
                <xref ref-type="bibr" rid="ref-52">Koob, 2008</xref>; 
                <xref ref-type="bibr" rid="ref-57">Logan 
                    <italic toggle="yes">et al.</italic>, 2014</xref>). While abnormal circadian and stress response function can independently affect reward-related behavior, understanding the interface of these two systems, during both typical and atypical functioning, may provide greater insight into the complexities of disorder etiology. This mini-review examines the interplay of the circadian and stress response systems, and how this interaction may affect addiction vulnerability.</p>
        </sec>
        <sec>
            <title>Circadian rhythm and the molecular clock</title>
            <p>Highly conserved across most living organisms, circadian rhythms facilitate the anticipation and adaptation of behavior to daily changes in environmental stimuli. In mammalian organisms, system and cellular level rhythms are maintained by a rhythm-generating nucleus in the hypothalamus, the suprachiasmatic nucleus (SCN). The SCN can be entrained by both photic and non-photic cues called zeitgebers, or &#x201c;time-keepers&#x201d;, but can ultimately generate a ~24 hour rhythm independent of these cues. At the molecular level, across all cell types, circadian rhythms are upheld by a &#x201c;molecular clock&#x201d; consisting of auto-regulatory transcription-translation feedback loops in the nucleus (see 
                <xref ref-type="fig" rid="f1">Figure 1A</xref>). The key proteins that make up the molecular clock are transcription factors: circadian locomotor output cycles kaput (CLOCK), or neuronal PAS domain protein 2 (NPAS2), and brain   and muscle Arnt-like protein 1 (BMAL1). Throughout the day, CLOCK/BMAL1 (or NPAS2/BMAL1) heterodimerize to promote the transcription of 
                <italic toggle="yes">Period</italic> (PER1,2,3), 
                <italic toggle="yes">Cryptochrome</italic> (CRY1,2), and many other clock controlled genes (CCGs). The feedback loop is established when PER and CRY proteins accumulate in the cytoplasm, form hetero- and homodimers, and eventually shuttle back into the nucleus to inhibit their own expression. Additionally, clock regulated RAR-related orphan receptor alpha (ROR&#x03b1;) and reverse-ErbA alpha (REV-ERB&#x03b1;) nuclear receptors act in an auxiliary oscillatory feedback loop to regulate expression of 
                <italic toggle="yes">Bmal1,</italic> stabilizing the core feedback loop (
                <xref ref-type="bibr" rid="ref-33">Guillaumond 
                    <italic toggle="yes">et al.</italic>, 2005</xref>). The circadian molecular clock cycles on a timescale of ~24 hours and regulates the expression of many genes controlling neuronal, metabolic, endocrine, and immune function (
                <xref ref-type="bibr" rid="ref-46">Jin 
                    <italic toggle="yes">et al.</italic>, 1999</xref>; 
                <xref ref-type="bibr" rid="ref-58">Lowrey &amp; Takahashi, 2000</xref>).</p>
            <fig fig-type="figure" id="f1" orientation="portrait" position="float">
                <label>Figure 1. </label>
                <caption>
                    <title>The circadian molecular clock and its interactions with the stress axis.</title>
                    <p>
			
                        <bold>A</bold>. The mammalian circadian molecular clock consists of multiple transcription and translation feedback (TTF) loops. Central to the TTF loops, the transcription factors CLOCK (or NPAS2) and BMAL1 heterodimerize and bind to the enhancer box (E-Box) sequence to promote transcription of many target and clock controlled genes (CCGs). The main TTF loop is achieved when PERIOD (PER1,2,3) and CRYPTOCHROME (CRY1,2) proteins accumulate, dimerize, undergo phosphorylation, and shuttle back into the nucleus to inhibit both CLOCK/BMAL1 and, as a result, their own transcription.  This negative feedback loop cycles every ~24 hours and is crucial for regulation of circadian rhythm. Among its target genes, CLOCK/BMAL1 also regulates the expression of the nuclear receptors ROR&#x03b1; and REV-ERB&#x03b1;, both of which can regulate BMAL1 activity via binding at a response element in its promoter. A recently discovered circadian protein, CHRONO, is clock-regulated and can also inhibit CLOCK/BMAL1 activity via interactions at the E-Box. Taken together, these proteins make up auxiliary TTF loops that work to both stabilize and reinforce rhythm. 
                        <bold>B</bold>. The circadian molecular clock can interact with the stress axis through regulating activity of both glucocorticoid (GCC) and its receptor (GCR). GC is known to be released under tight circadian regulation, with peak levels in the animal&#x2019;s active phase. Additionally, several circadian proteins are known to rhythmically regulate GCR-dependent transcription activity. CLOCK/BMAL1 can directly attenuate GCR activity via acetylation (A), thereby reducing its binding ability at the Glucocorticoid Response Element (GRE). Simultaneously, CHRONO and CRY1,2 proteins can repress GCR activity via direct interaction in ligand-fashion. CRY proteins can also regulate GCR-dependent transcription through association at the GRE. (+), promote/activate; (-), repress/inhibit.</p>
                </caption>
                <graphic orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/8194/60001467-1bdd-4df3-b83f-51d33c9dc77d_figure1.gif"/>
            </fig>
        </sec>
        <sec>
            <title>Circadian genes and reward</title>
            <p>Several studies in the past two decades have shown core circadian genes to be important regulators of reward-related behavior in response to common substances of abuse, as reviewed by 
                <xref ref-type="bibr" rid="ref-74">Parekh 
                    <italic toggle="yes">et al.</italic> (2015)</xref>. One of the first studies investigating this link demonstrated that fruit flies
                <italic toggle="yes"/> with mutations in the 
                <italic toggle="yes">Period</italic>, 
                <italic toggle="yes">Clock</italic>, and/or 
                <italic toggle="yes">Cycle</italic> (similar to 
                <italic toggle="yes">Bmal1</italic> in mammals) genes fail to show behavioral sensitization to cocaine (
                <xref ref-type="bibr" rid="ref-7">Andretic 
                    <italic toggle="yes">et al.</italic>, 1999</xref>). In mice, mutations in the 
                <italic toggle="yes">mPer1</italic> and 
                <italic toggle="yes">mPer2</italic> genes seem to produce a similar but unique effect on cocaine response; mutation in 
                <italic toggle="yes">mPer2</italic> increased behavioral sensitization to cocaine but mutation in 
                <italic toggle="yes">mPer1</italic> abolished sensitization (
                <xref ref-type="bibr" rid="ref-1">Abarca 
                    <italic toggle="yes">et al.</italic>, 2002</xref>). Recently, our lab has been studying a similar differential regulation of reward, but with CLOCK and its functional homologue, NPAS2. While CLOCK is known to be expressed almost ubiquitously, NPAS2 is primarily expressed in the liver and forebrain (
                <xref ref-type="bibr" rid="ref-11">Bertolucci 
                    <italic toggle="yes">et al.</italic>, 2008</xref>; 
                <xref ref-type="bibr" rid="ref-80">Reick 
                    <italic toggle="yes">et al.</italic>, 2001</xref>) and can regulate circadian transcription when CLOCK expression is absent or low. With notable implications for reward, NPAS2 has been shown to have a unique expression pattern in the mesolimbic pathway; NPAS2 is highly enriched in the nucleus accumbens (NAc), but has little to no expression in the ventral tegmental area (VTA) (
                <xref ref-type="bibr" rid="ref-31">Garcia 
                    <italic toggle="yes">et al.</italic>, 2000</xref>).</p>
            <p>The observation that NPAS2 is specifically enriched in the NAc motivated our most recent studies investigating the potential for CLOCK and NPAS2 to differentially regulate gene expression and reward-related behavior, following cocaine exposure. Interestingly, in response to chronic cocaine, only NPAS2 is upregulated in the NAc and caudate putamen (normal rhythm abolished) and has increased binding activity at 
                <italic toggle="yes">Period</italic> gene promoters; CLOCK did not show these changes in the NAc or caudate putamen (
                <xref ref-type="bibr" rid="ref-28">Falc&#x00f3;n 
                    <italic toggle="yes">et al.</italic>, 2013</xref>). Knock-down of CLOCK or NPAS2 in these regions also has different effects on the regulation of reward-related behavior following cocaine administration. Mice containing a globally expressed, dominant negative, single-point mutation in the CLOCK protein (
                <italic toggle="yes">Clock</italic>&#x2206;19) exhibit a mania-like phenotype with increased baseline activity, decreased anxiety- and depression-like behavior, and increased sensitivity to rewarding stimuli; in response to cocaine, 
                <italic toggle="yes">Clock</italic>&#x2206;19 mice show increased conditioned place preference (CPP) and increased cocaine self-administration, relative to wild-type mice (
                <xref ref-type="bibr" rid="ref-61">McClung 
                    <italic toggle="yes">et al.</italic>, 2005</xref>; 
                <xref ref-type="bibr" rid="ref-73">Ozburn 
                    <italic toggle="yes">et al.</italic>, 2012</xref>; 
                <xref ref-type="bibr" rid="ref-84">Roybal 
                    <italic toggle="yes">et al.</italic>, 2007</xref>). However, using AAV-shRNA to selectively knock-down CLOCK or NPAS2 in the NAc, near entire reduction of CLOCK in the NAc does not recapitulate increased preference seen in 
                <italic toggle="yes">Clock</italic>&#x2206;19; while mice with either a mutated form of NPAS2 or a NAc specific knock-down of NPAS2 showed decreased cocaine CPP and self-administration (
                <xref ref-type="bibr" rid="ref-72">Ozburn 
                    <italic toggle="yes">et al.</italic>, 2015</xref>).</p>
            <p>The genes central to the circadian molecular clock may have differential roles in the regulation of reward-related behavior depending on the time of day, brain region, and/or the drug&#x2019;s effect on the specific protein in a particular region. Given the involvement of these core circadian genes in the regulation of reward and behavioral response, it is likely that disruption to the normal functioning/activity of these circadian proteins can contribute to the vulnerability of developing an addiction.</p>
        </sec>
        <sec>
            <title>HPA axis and reward</title>
            <p>When encountering physical and/or psychological stressors, activation of the hypothalamic-pituitary-adrenal (HPA) axis is a fundamental, evolutionarily conserved response allowing the organism to adapt both physiologically and behaviorally. Regulated by the HPA axis, glucocorticoids (cortisol in humans and corticosterone in rodents) are a class of steroid hormones responsible for driving the changes seen in stress response. Upon activation by limbic structures, neurons in the hypothalamic paraventricular nucleus (PVN) release corticotropin-releasing hormone (CRH) at the median eminence into the hypophyseal portal system, connecting the hypothalamus with the anterior pituitary. Once stimulated by CRH, the anterior pituitary increases secretion of adrenocorticotropic hormone (ACTH) into the bloodstream, where it will then travel to the adrenal gland. At the adrenal cortex, ACTH causes an increase in synthesis and release of glucocorticoids into the circulatory system to then act on energy metabolism, protein synthesis, immune function, cardiovascular function, attention/arousal/vigilance, and even memory function. Much like the circadian molecular clock, the HPA axis is regulated via a negative feedback loop in which accumulation of glucocorticoids in the hypothalamus (PVN) and anterior pituitary can block the production of CRH and ACTH. (
                <xref ref-type="bibr" rid="ref-21">de Kloet 
                    <italic toggle="yes">et al.</italic>, 2005</xref>; 
                <xref ref-type="bibr" rid="ref-47">Johnson 
                    <italic toggle="yes">et al.</italic>, 1992</xref>; 
                <xref ref-type="bibr" rid="ref-101">Uchoa 
                    <italic toggle="yes">et al.</italic>, 2014</xref>).</p>
            <p>While the effects of the HPA axis are transient in response to acute stress, chronic stress and prolonged presence of glucocorticoids can have deleterious outcomes, ranging from neurotoxicity and cell death to impaired metabolic/mitochondrial function and immunosuppression (
                <xref ref-type="bibr" rid="ref-21">de Kloet 
                    <italic toggle="yes">et al.</italic>, 2005</xref>; 
                <xref ref-type="bibr" rid="ref-25">Dhabhar &amp; McEwen, 1997</xref>; 
                <xref ref-type="bibr" rid="ref-64">McEwen 
                    <italic toggle="yes">et al.</italic>, 1999</xref>; 
                <xref ref-type="bibr" rid="ref-76">Picard 
                    <italic toggle="yes">et al.</italic>, 2014</xref>). Considering the potential detrimental effects of chronic stress, recent studies have investigated the implications of the HPA axis and glucocorticoids in neuropsychiatric disorder etiology (
                <xref ref-type="bibr" rid="ref-39">Herane Vives 
                    <italic toggle="yes">et al.</italic>, 2015</xref>; 
                <xref ref-type="bibr" rid="ref-45">Jacobson, 2014</xref>; 
                <xref ref-type="bibr" rid="ref-86">Sapolsky, 2000</xref>;  
                <xref ref-type="bibr" rid="ref-105">Yehuda 
                    <italic toggle="yes">et al.</italic>, 2015</xref>). In the context of addiction, animal model studies have long demonstrated a strong association between chronic stress and increased behavioral response to drugs of abuse (
                <xref ref-type="bibr" rid="ref-8">Antelman 
                    <italic toggle="yes">et al.</italic>, 1980</xref>; 
                <xref ref-type="bibr" rid="ref-23">Deroche 
                    <italic toggle="yes">et al.</italic>, 1995</xref>; 
                <xref ref-type="bibr" rid="ref-40">Herman 
                    <italic toggle="yes">et al.</italic>, 1984</xref>; 
                <xref ref-type="bibr" rid="ref-59">MacLennan &amp; Maier, 1983</xref>). This increased response can be seen through augmented locomotor effects and increased reward/preference &#x2013; both of which are associated with elevated glucocorticoid activity (
                <xref ref-type="bibr" rid="ref-23">Deroche 
                    <italic toggle="yes">et al.</italic>, 1995</xref>; 
                <xref ref-type="bibr" rid="ref-36">Haile 
                    <italic toggle="yes">et al.</italic>, 2001</xref>; Lepsch 
                <italic toggle="yes">et al.</italic>, 2005). Further confirming the role of glucocorticoids in this phenomenon, if normal stress-induced increases in corticosterone (in rats) are blocked (via adrenalectomy), the stress-related increase in drug behavioral response is abolished; notably, the response remains intact if normal elevation of corticosterone is artificially maintained (
                <xref ref-type="bibr" rid="ref-23">Deroche 
                    <italic toggle="yes">et al.</italic>, 1995</xref>; 
                <xref ref-type="bibr" rid="ref-78">Prasad 
                    <italic toggle="yes">et al.</italic>, 1998</xref>; 
                <xref ref-type="bibr" rid="ref-82">Roug&#x00e9;-Pont 
                    <italic toggle="yes">et al.</italic>, 1995</xref>). Corticosterone has even been shown to be necessary for drug-induced sensitization in general, suggesting its importance in overall behavioral response and drug-seeking behavior, with or without stress as a factor (
                <xref ref-type="bibr" rid="ref-20">de Jong 
                    <italic toggle="yes">et al.</italic>, 2009</xref>; 
                <xref ref-type="bibr" rid="ref-79">Przegali&#x0144;ski 
                    <italic toggle="yes">et al.</italic>, 2000</xref>).</p>
            <p>Though it is clear that chronic stress and the biological mediators of stress response may alter one&#x2019;s sensitivity to the behavioral and/or rewarding effects of drugs of abuse, further investigation into the cellular and molecular bases of this relationship is necessary. Given that the circadian rhythm and stress response systems are both known to be involved in mediating behavioral responses to rewarding-substances, perhaps their interactions may be the key to understanding what drives vulnerability to addiction.</p>
        </sec>
        <sec>
            <title>Circadian regulation of the HPA axis</title>
            <p>	Like many other processes in the body, the HPA axis and its hormonal components are under direct circadian regulation by both the SCN and a peripheral clock in the adrenal cortex (
                <xref ref-type="bibr" rid="ref-44">Ishida 
                    <italic toggle="yes">et al.</italic>, 2005</xref>; 
                <xref ref-type="bibr" rid="ref-68">Nader 
                    <italic toggle="yes">et al.</italic>, 2010</xref>; 
                <xref ref-type="bibr" rid="ref-71">Oster 
                    <italic toggle="yes">et al.</italic>, 2006</xref>; 
                <xref ref-type="bibr" rid="ref-91">Son 
                    <italic toggle="yes">et al.</italic>, 2008</xref>).  Glucocorticoids, along with the other hormones in the axis, display a prominent diurnal variation in which peak levels correspond with the organism&#x2019;s active phase (reviewed in: 
                <xref ref-type="bibr" rid="ref-50">Kalsbeek 
                    <italic toggle="yes">et al.</italic>, 2012</xref>; 
                <xref ref-type="bibr" rid="ref-93">Spiga 
                    <italic toggle="yes">et al.</italic>, 2014</xref>). Rhythms in glucocorticoids are not only mediated by both direct and indirect projections to the CRH producing PVN neurons at the fore-end of the HPA axis (
                <xref ref-type="bibr" rid="ref-26">Engeland &amp; Arhnhold, 2005</xref>; 
                <xref ref-type="bibr" rid="ref-49">Kalsbeek 
                    <italic toggle="yes">et al.</italic>, 2006</xref>), but also through modulation of receptors by core circadian proteins (See 
                <xref ref-type="fig" rid="f1">Figure 1B</xref>). 
                <xref ref-type="bibr" rid="ref-71">Oster 
                    <italic toggle="yes">et al.</italic> (2006)</xref> demonstrated the importance of a functional adrenal molecular clock in &#x201c;gating&#x201d; sensitivity to ACTH (via ACTH receptors) in the adrenal cortex, as means of regulating glucocorticoid synthesis. Moreover, the actual glucocorticoid&#x2019;s effect across the body can also be regulated through acting on glucocorticoid receptor (GCR) function; multiple studies have demonstrated the ability for CLOCK/BMAL1 to modulate GCRs and their sensitivity via circadian mediated acetylation (
                <xref ref-type="bibr" rid="ref-14">Charmandari 
                    <italic toggle="yes">et al.</italic>, 2011</xref>; 
                <xref ref-type="bibr" rid="ref-51">Kino &amp; Chrousos, 2011</xref>; 
                <xref ref-type="bibr" rid="ref-67">Nader 
                    <italic toggle="yes">et al.</italic>, 2009</xref>). Alongside CLOCK/BMAL1, CRY1,2 have also been shown to repress GCR-dependent transcription activity via association with GCRs and/or at the glucocorticoid responsive element (GRE) (
                <xref ref-type="bibr" rid="ref-53">Lamia 
                    <italic toggle="yes">et al.</italic>, 2011</xref>). In recent literature, a novel circadian protein named CHRONO, or computationally-highlighted/ChIP-derived repressor of network oscillator, acts as a negative regulator of the molecular clock and may even interact with GCRs to rhythmically repress their function (
                <xref ref-type="bibr" rid="ref-6">Anafi 
                    <italic toggle="yes">et al.</italic>, 2014</xref>; 
                <xref ref-type="bibr" rid="ref-32">Goriki 
                    <italic toggle="yes">et al.</italic>, 2014</xref>). While investigation into CHRONO&#x2019;s function is still in its early stages, there is potential for this novel protein to play an even greater role in connecting the circadian and stress response systems.</p>
            <p>Several circadian-gene mutant mouse studies have further verified the role of core molecular clock proteins in regulating the HPA axis. In 
                <italic toggle="yes">Bmal1</italic> null mutant mice, deficiency in BMAL1 causes a significant reduction in glucocorticoid levels, sensitivity, and altered rhythmicity (
                <xref ref-type="bibr" rid="ref-55">Leliavski 
                    <italic toggle="yes">et al.</italic>, 2014</xref>); similarly, 
                <italic toggle="yes">Clock</italic> mutant mice lacking functional CLOCK protein also show altered glucocorticoid rhythmicity and decreased total levels (
                <xref ref-type="bibr" rid="ref-70">Oishi 
                    <italic toggle="yes">et al.</italic>, 2006</xref>; 
                <xref ref-type="bibr" rid="ref-97">Takita 
                    <italic toggle="yes">et al.</italic>, 2013</xref>). Along with the core CLOCK/BMAL1 complex, null mutations in the 
                <italic toggle="yes">Cryptochrome</italic> (CRY1,2) or 
                <italic toggle="yes">Period</italic> (PER1) genes also yield altered rhythmicity and, unlike 
                <italic toggle="yes">Clock</italic> and 
                <italic toggle="yes">Bmal1</italic> mutants, increased total glucocorticoid levels (
                <xref ref-type="bibr" rid="ref-19">Dallmann 
                    <italic toggle="yes">et al.</italic>, 2006</xref>; 
                <xref ref-type="bibr" rid="ref-24">Destici 
                    <italic toggle="yes">et al.</italic>, 2013</xref>; 
                <xref ref-type="bibr" rid="ref-53">Lamia 
                    <italic toggle="yes">et al.</italic>, 2011</xref>). Even more interesting, cultured BMAL1 and/or PER1,2 deficient mouse embryonic fibroblasts (MEFs) show altered GCR transactivation resulting in hypersensitivity to glucocorticoids (
                <xref ref-type="bibr" rid="ref-38">Han 
                    <italic toggle="yes">et al.</italic>, 2014</xref>). Taken together, these studies demonstrate the importance of the molecular clock in regulating both the output of the stress axis and its efficacy.</p>
        </sec>
        <sec>
            <title>Stress effects on circadian rhythm	</title>
            <p>Occurring simultaneously, the same components of the molecular clock that regulate HPA axis function can also be reciprocally affected by the stress itself. Most notably, chronic stress is known to affect the rhythmic expression of the core circadian genes. A key example can be found through glucocorticoids mediating the expression of 
                <italic toggle="yes">Period</italic> genes. With either acute or chronic stress, levels of 
                <italic toggle="yes">mPer1</italic> and PER1 are elevated in some neural and peripheral tissues (
                <xref ref-type="bibr" rid="ref-3">Al-Safadi 
                    <italic toggle="yes">et al.</italic>, 2014</xref>; 
                <xref ref-type="bibr" rid="ref-4">Al-Safadi 
                    <italic toggle="yes">et al.</italic>, 2015</xref>; 
                <xref ref-type="bibr" rid="ref-96">Takahashi 
                    <italic toggle="yes">et al.</italic>, 2013</xref>). PER2 has a similar response to stress (
                <xref ref-type="bibr" rid="ref-87">Segall &amp; Amir, 2010</xref>; 
                <xref ref-type="bibr" rid="ref-89">So 
                    <italic toggle="yes">et al.</italic>, 2009</xref>) and even loses rhythmic expression in the bed nucleus of the stria terminalis (BNST) and in the amygdala, following adrenalectomy (
                <xref ref-type="bibr" rid="ref-54">Lamont 
                    <italic toggle="yes">et al.</italic>, 2005</xref>). Additionally, it was later revealed that PER2 actually requires functional GCRs for its rhythmic expression (
                <xref ref-type="bibr" rid="ref-88">Segall 
                    <italic toggle="yes">et al.</italic>, 2009</xref>). Both 
                <italic toggle="yes">Period</italic> genes are afforded this unique relationship with glucocorticoids due to the presence of GREs in their promotor regions (
                <xref ref-type="bibr" rid="ref-89">So 
                    <italic toggle="yes">et al.</italic>, 2009</xref>; 
                <xref ref-type="bibr" rid="ref-104">Yamamoto 
                    <italic toggle="yes">et al.</italic>, 2005</xref>). Glucocorticoids can target genes that have these GREs, bind, and thus promote their expression. This stress-induced change in
                <italic toggle="yes"/> gene expression, if occurring chronically, can even result in clock entrainment (
                <xref ref-type="bibr" rid="ref-95">Tahara 
                    <italic toggle="yes">et al.</italic>, 2015</xref>).</p>
            <p>Previous work in our lab has shown that mice exposed to chronic social defeat stress show increased anxiety that correlates with decreased 
                <italic toggle="yes">mPer1/2</italic> expression in the NAc (
                <xref ref-type="bibr" rid="ref-92">Spencer 
                    <italic toggle="yes">et al.</italic>, 2012</xref>). While this may appear to conflict with aforementioned stress effects on 
                <italic toggle="yes">Period</italic> genes, it is likely that region specific changes occur depending on the type of stressor, GCR distribution, and region/network involvement. Illustrating this, we recently showed mice subjected to the unpredictable chronic mild stress (UCMS) paradigm (used to model depression-like behavior) have increased 
                <italic toggle="yes">Per2</italic> rhythm amplitude in the NAc, but decreased rhythm amplitude in the SCN (
                <xref ref-type="bibr" rid="ref-56">Logan 
                    <italic toggle="yes">et al.</italic>, 2015</xref>). This is likely due to GCR concentration being high in the NAc (
                <xref ref-type="bibr" rid="ref-10">Barik 
                    <italic toggle="yes">et al.</italic>, 2010</xref>; 
                <xref ref-type="bibr" rid="ref-22">Der-Avakian 
                    <italic toggle="yes">et al.</italic>, 2006</xref>) but low/absent in the SCN (
                <xref ref-type="bibr" rid="ref-9">Balsalobre 
                    <italic toggle="yes">et al.</italic>, 2000</xref>; 
                <xref ref-type="bibr" rid="ref-75">Pezuk 
                    <italic toggle="yes">et al.</italic>, 2012</xref>; 
                <xref ref-type="bibr" rid="ref-81">Rosenfeld 
                    <italic toggle="yes">et al.</italic>, 1988</xref>). The interaction between stress response and the circadian molecular clock in a region specific manner may perhaps be the basis that allows for manifestation of disorder specific vulnerability.</p>
        </sec>
        <sec>
            <title>Circadian rhythm and stress interactions in dopaminergic transmission</title>
            <p>	As described above, a lot can be understood by just examining how each system not only affects each other, but also how they individually affect behavioral response to drugs of abuse. However, in the framework of addiction and reward, the effects on vulnerability may more likely arise from the two systems&#x2019; interactions while simultaneously regulating the same reward-related processes. Both systems have been show to directly regulate/affect the dopaminergic reward circuitry and its functions involved in addiction (reviewed in: 
                <xref ref-type="bibr" rid="ref-60">Marinelli &amp; Piazza, 2003</xref>; Parekh 
                <italic toggle="yes">et al.</italic>, 2014). Implemented in addiction, the mesolimbic pathway is a system of dopaminergic neurons connecting the VTA to the NAc, and is important for mediating reward-related behavior. This pathway&#x2019;s activity is known to be directly affected by both the circadian system and the stress response system (McClung 
                <italic toggle="yes">et al.</italic>, 2007; 
                <xref ref-type="bibr" rid="ref-100">Trainor, 2011</xref>). In controlling dopamine synthesis, circadian molecular clock proteins and glucocorticoids may be working in opposing fashion to regulate expression of tyrosine hydroxylase (TH), a key enzyme in synthesis of dopamine from tyrosine (see 
                <xref ref-type="fig" rid="f2">Figure 2</xref>).</p>
            <fig fig-type="figure" id="f2" orientation="portrait" position="float">
                <label>Figure 2. </label>
                <caption>
                    <title>Dynamic circadian and stress interactions at the 
                        <italic toggle="yes">TH</italic> promoter.</title>
                    <p>Important for reward-related behavior, tyrosine hydroxylase (TH) is an enzyme involved in the synthesis of dopamine from the amino acid L-Tyrosine. Transcription of 
                        <italic toggle="yes">TH</italic> is mediated by the binding of cAMP response element-binding protein (CREB) at its response element (CRE) in the 
                        <italic toggle="yes">TH</italic> promoter. Dopamine synthesis is known to be directly regulated by both circadian and stress-related proteins/hormones. At the 
                        <italic toggle="yes">TH</italic> promoter, the core circadian CLOCK/BMAL1 complex binds to the enhancer-box (E-Box) sequence in antiphase with CREB:CRE binding, and negatively regulates the transcription of 
                        <italic toggle="yes">TH</italic> in a time dependent manner. Additionally, the circadian nuclear receptor REV-ERB&#x03b1; and nuclear receptor-related 1 (NURR1) protein regulate TH expression via competitive binding at the REV-ERB/ROR response element (RRE)/NGF1B-response element (NBRE); while NURR1 promotes the expression of TH, REV-ERB&#x03b1; represses expression. Glucocorticoids (GCs) and its receptor (GCR) can also promote expression of TH by binding at the glucocorticoid response element (GRE) in the 
                        <italic toggle="yes">TH</italic> promoter. The above response element spacing is not shown to scale. (+), promote/activate; (-), repress/inhibit.</p>
                </caption>
                <graphic orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/8194/60001467-1bdd-4df3-b83f-51d33c9dc77d_figure2.gif"/>
            </fig>
            <p>Under circadian control, recent work in our lab has demonstrated that CLOCK/BMAL1 acts as a time-dependent, negative regulator of 
                <italic toggle="yes">TH</italic> transcription via binding at the 
                <italic toggle="yes">TH</italic> promotor in anti-phase with CREB (Sidor 
                <italic toggle="yes">et al.</italic>, 2015). Opposite of CLOCK/BMAL1, glucocorticoids may positively regulate the expression and activity of TH   (
                <xref ref-type="bibr" rid="ref-30">Fossom 
                    <italic toggle="yes">et al.</italic>, 1992</xref>; 
                <xref ref-type="bibr" rid="ref-48">Kalinina 
                    <italic toggle="yes">et al.</italic>, 2012</xref>; 
                <xref ref-type="bibr" rid="ref-69">N&#x00fa;&#x00f1;ez 
                    <italic toggle="yes">et al.</italic>, 2009</xref>; 
                <xref ref-type="bibr" rid="ref-98">Tank 
                    <italic toggle="yes">et al.</italic>, 1986</xref>). While the exact mechanism by which glucocorticoids increase TH   expression is still being investigated, it has been shown that the 
                <italic toggle="yes">TH</italic> promotor contains a GRE to which glucocorticoids can bind and promote expression independent of CRE (
                <xref ref-type="bibr" rid="ref-35">Hagerty 
                    <italic toggle="yes">et al.</italic>, 2001a</xref>; 
                <xref ref-type="bibr" rid="ref-34">Hagerty 
                    <italic toggle="yes">et al.</italic>, 2001b</xref>). An additional explanation may arise through glucocorticoid regulation of the circadian nuclear receptor, REV-ERB&#x03b1;. In a recent paper by 
                <xref ref-type="bibr" rid="ref-17">Chung 
                    <italic toggle="yes">et al.</italic> (2014)</xref>, REV-ERB&#x03b1; has been shown to repress 
                <italic toggle="yes">TH</italic> transcription through competitive binding with nuclear receptor-related 1 protein (NURR1) at the 
                <italic toggle="yes">TH</italic> promotor. Given that glucocorticoids have been shown to control REV-ERB&#x03b1; expression in the liver (
                <xref ref-type="bibr" rid="ref-99">Torra 
                    <italic toggle="yes">et al.</italic>, 2000</xref>), it may be possible for glucocorticoids to increase TH through a disinhibition type mechanism.</p>
            <p>In addition to regulation of TH, the two systems can simultaneously act on dopamine receptor (DR) expression/function (
                <xref ref-type="bibr" rid="ref-12">Biron 
                    <italic toggle="yes">et al.</italic>, 1992</xref>; 
                <xref ref-type="bibr" rid="ref-41">Iasevoli 
                    <italic toggle="yes">et al.</italic>, 2013</xref>; 
                <xref ref-type="bibr" rid="ref-42">Ikeda 
                    <italic toggle="yes">et al.</italic>, 2013</xref>; 
                <xref ref-type="bibr" rid="ref-92">Spencer 
                    <italic toggle="yes">et al.</italic>, 2012</xref>) and monoamine oxidase-A (MAO-A) expression/function, an enzyme responsible for degradation of dopamine (
                <xref ref-type="bibr" rid="ref-16">Chevillard 
                    <italic toggle="yes">et al.</italic>, 1981</xref>; 
                <xref ref-type="bibr" rid="ref-18">Cviji&#x0107; 
                    <italic toggle="yes">et al.</italic>, 1995</xref>; 
                <xref ref-type="bibr" rid="ref-37">Hampp 
                    <italic toggle="yes">et al.</italic>, 2008</xref>; 
                <xref ref-type="bibr" rid="ref-90">Soliman 
                    <italic toggle="yes">et al.</italic>, 2012</xref>). Taken together, these studies demonstrate the interactions of both the circadian system and stress response system in regulating the same aspects of reward related function/behavior. With slight disruption in either of the systems, the negative effects of one can alter the other and result in a self-perpetuating consequence. It is at this level that an understanding of vulnerability to addiction can be more readily obtained.</p>
        </sec>
        <sec sec-type="conclusions">
            <title>Conclusion</title>
            <p>Reward-related behavior and sensitivity to drug response have both been shown to be regulated by the circadian and stress response systems. Described above, disruption in either of the systems individually can have pronounced effects on the rewarding effects of substances of abuse. Understanding both the tight circadian regulation of the stress axis and how stress/response can affect the molecular clock, the possibility for their interaction to drive vulnerability to addiction is entirely plausible. Both systems act in parallel regulating many aspects of reward related behavior and function.  Slight mutations in either system causing minor functional disruption may be innocuous alone, but given the interface of the two systems, a minor change has the potential to be amplified in a reverberating fashion. The once subtle change may even become deleterious with time. It is in this logic that vulnerability to addiction is rooted; as a biological predisposition that becomes exploited in the face of chronic stressors. As an outlook, future studies can begin to consider one or both systems as potential therapeutic targets to mediate drug response in addiction and combat vulnerability.</p>
        </sec>
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    </back>
    <sub-article article-type="reviewer-report" id="report11935">
        <front-stub>
            <article-id pub-id-type="doi">10.5256/f1000research.8194.r11935</article-id>
            <title-group>
                <article-title>Reviewer response for version 1</article-title>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author">
                    <name>
                        <surname>Nelson</surname>
                        <given-names>Randy</given-names>
                    </name>
                    <xref ref-type="aff" rid="r11935a1">1</xref>
                    <role>Referee</role>
                </contrib>
                <contrib contrib-type="author">
                    <name>
                        <surname>Borniger</surname>
                        <given-names>Jeremy</given-names>
                    </name>
                    <xref ref-type="aff" rid="r11935a1">1</xref>
                    <role>Co-referee</role>
                </contrib>
                <aff id="r11935a1">
                    <label>1</label>Department of Neuroscience, Ohio State University College of Medicine, Columbus, OH, USA</aff>
            </contrib-group>
            <author-notes>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>2</day>
                <month>2</month>
                <year>2016</year>
            </pub-date>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2016 Nelson R and Borniger J</copyright-statement>
                <copyright-year>2016</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <related-article ext-link-type="doi" id="relatedArticleReport11935" related-article-type="peer-reviewed-article" xlink:href="10.12688/f1000research.7608.1"/>
            <custom-meta-group>
                <custom-meta>
                    <meta-name>recommendation</meta-name>
                    <meta-value>approve</meta-value>
                </custom-meta>
            </custom-meta-group>
        </front-stub>
        <body>
            <p>The authors provide an excellent and timely mini-review of the interactions between the circadian and stress response systems, and their actions on dopaminergic reward circuitry underlying addiction and diseases of drug abuse. They highlight the differential expression levels of BMAL1 binding partners CLOCK and NPAS2 throughout the brain, indicating that NPAS2 is specifically enriched in the nucleus accumbens. This sets the stage for the idea that selective manipulation of the circadian clock through NPAS2 in the nucleus accumbens could influence reward-seeking behavior. Additional evidence is discussed regarding the binding of CLOCK/BMAL1 at the tyrosine hydroxylase promoter to repress transcription and therefore dopamine synthesis.</p>
            <p>The authors further discuss the fundamental link between the HPA axis and the circadian clock through glucocorticoid-response elements in clock gene and tyrosine hydroxylase promoters, acetylation of the glucocorticoid receptor by CLOCK/BMAL1, and other potential interactions with the newly discovered clock component CHRONO. The review is concise and provides an excellent starting point for anyone interested in the etiology, treatment, or molecular biology of addiction or drug abuse.</p>
            <p>It may be beyond the scope of this review, but future discussion of the effects drugs of abuse on the circadian clock may be warranted.
                <list list-type="bullet">
                    <list-item>
                        <p>Is there any evidence for circadian control of opioid reward signaling? It may be worth discussing stress effects on opioid or opioid-receptor expression in the VTA or NAc on a circadian basis.&#x00a0;(e.g., Polter 
                            <italic>et al,</italic> 2014, Biological Psychiatry Vol 76: 785-793).</p>
                    </list-item>
                </list>
            </p>
            <p>Reviewer Expertise:</p>
            <p>NA</p>
            <p>We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.</p>
        </body>
    </sub-article>
    <sub-article article-type="reviewer-report" id="report12056">
        <front-stub>
            <article-id pub-id-type="doi">10.5256/f1000research.8194.r12056</article-id>
            <title-group>
                <article-title>Reviewer response for version 1</article-title>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author">
                    <name>
                        <surname>Pantazopoulos</surname>
                        <given-names>Harry</given-names>
                    </name>
                    <xref ref-type="aff" rid="r12056a1">1</xref>
                    <role>Referee</role>
                </contrib>
                <contrib contrib-type="author">
                    <name>
                        <surname>Bukhari</surname>
                        <given-names>Syed</given-names>
                    </name>
                    <xref ref-type="aff" rid="r12056a1">1</xref>
                    <role>Co-referee</role>
                </contrib>
                <aff id="r12056a1">
                    <label>1</label>Translational Neuroscience Laboratory, McLean Hospital, Belmont, MA, USA</aff>
            </contrib-group>
            <author-notes>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>1</day>
                <month>2</month>
                <year>2016</year>
            </pub-date>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2016 Pantazopoulos H and Bukhari S</copyright-statement>
                <copyright-year>2016</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <related-article ext-link-type="doi" id="relatedArticleReport12056" related-article-type="peer-reviewed-article" xlink:href="10.12688/f1000research.7608.1"/>
            <custom-meta-group>
                <custom-meta>
                    <meta-name>recommendation</meta-name>
                    <meta-value>approve</meta-value>
                </custom-meta>
            </custom-meta-group>
        </front-stub>
        <body>
            <p>This is a well written and timely summary of interactions between the circadian system and the stress response system set in the framework of drug addiction/reward. The article provides an accurate summary of the current literature and a helpful introduction of these biological systems to readers who are unfamiliar with the field. The figures are clear, well-described, and aid the reader in understanding the molecular mechanisms described in the text. In addition, the evolution/environmental interaction perspective in the introduction provides an excellent framework for the following discussion of how interactions between the circadian and stress systems can go awry. This mini-review is a useful reference to researchers studying basic neuroscience questions on these systems and how these systems are disrupted in psychiatric disorders. The review highlights the importance of recognizing the potential interactions between these systems in both normal and pathological conditions.</p>
            <p>Reviewer Expertise:</p>
            <p>NA</p>
            <p>We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.</p>
        </body>
    </sub-article>
</article>
