The goal of this proposal is to test the novel hypothesis that disruption of synchrony between brain-gut circadian rhythms either directly by alcohol, or by environmental or genetic manipulations, is the "vulnerability" factor responsible for the differential susceptibility for EtOH-induced intestinal hyperpermeability that explains why only subset of alcoholics develop gut leakiness to endotoxins and steatohepatitis [ASH]. Our hypothesis is supported by: (1) Gut leakiness is a major contributor to endotoxemia and gut-derived endotoxin is required for ASH;(2) while EtOH universally disrupts intestinal epithelial monolayer permeability, gut leakiness occurs in only a subset of alcoholics, suggesting other factors might be involved-variability in gut leakiness;(3) The core circadian clock molecular machinery is within all organs including the central circadian clock in the hypothalamic suprachiasmatic nucleus (SCN), and intestinal epithelial cells. The SCN regulates and coordinates the expression and timing of multiple peripheral circadian molecular rhythms, possibly including brain-gut interactions of the so called "brain-gut axis," (BGA);(4) The BGA can regulate intestinal permeability, and pathological stimuli like physical and psychological stress can cause gut leakiness;(5) The circadian modulation of the brain gut communication could affect intestinal permeability since circadian genes regulate apical junctional complex (AJC) protein genes that are directly involved in regulation of intestinal permeability. Our recent in vivo mice data showed that disruption of circadian rhythms makes the intestine susceptible to injury. Also, our pilot data in Caco-2 intestinal monolayers show that alcohol stimulates expression of the clock genes Clock and Per2 and that siRNA knockdown of these genes prevents alcohol-induced monolayer hyperpermeability. We also show that Clock and Per2 proteins are increased in the intestines of alcohol fed rats with leaky gut. To test our hypothesis, we will take two different approaches. First (in Aim 1), we will use both environmental [constant phase shifts in the entraining LD cycle] &genetic [Clock mutant and Per1/Per2 KO mice] approaches to disrupt the overall circadian organization of mice to determine if such disruption leads to increased vulnerability for EtOH-induced gut leakage to endotoxins in alcohol-fed mice (8 wk chronic model). We predict that these circadian manipulations will elucidate the roles of circadian brain-gut synchrony and intestinal cell clock genes in regulating intestinal apical tight junctional proteins and gut permeability in response to chronic alcohol feeding. Second (in Aim 2), we will assess how EtOH-induced changes in central and peripheral clock function and gene expression impacts permeability to endotoxin (3 day acute and 8 wk chronic models). We predict that alcohol-mediated central and/or intestinal circadian desynchrony will result in increased injury to apical junctional complex (AJC) leading to gut leakiness. Demonstrating that circadian- mediated disrupted brain-gut communication is one critical contributing "susceptibility" factor for alcohol- induced endotoxemia would provide new targets for preventive and therapeutic interventions in ASH.

Public Health Relevance

NARRATIVE Most people are aware that our bodies operate according to biological rhythms. These biological rhythms appear to regulate many aspects of our health but little is known about the cellular mechanisms involved. This study will test how alcohol affects the biological rhythms of the intestine as well as the brain and liver to see if this is one way alcohol can cause diseases such as alcoholic liver disease. Identifying how alcohol affects these biological rhythms in these organs may help us design new treatments for alcoholic liver disease and other alcohol related diseases.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Special Emphasis Panel (ZAA1-JJ (01))
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Hereld, Dale
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Rush University Medical Center
Internal Medicine/Medicine
Schools of Medicine
United States
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