The circadian clock is an evolutionarily conserved time-keeping system that coordinates the physiology of the organism with daily changes in the environment. A growing body of evidence gradually leads to the conception that virtually all aspects of the biochemical, physiological, and behavioral functions of the animal are linked to circadian regulation. Moreover, proper synchronization of various processes through the activity of circadian components is important for the well-being of many organisms, including humans. The focus of this review is the circadian control of an organism's response to genotoxic stress, which is a major contributor to life-threatening human pathologies such as cancer and cardiovascular disease. (Circ Res. 2010;106:68-78.)Key Words: circadian rhythms Ⅲ cell cycle Ⅲ genotoxic stress Ⅲ oxidative stress Ⅲ carcinogenesis Ⅲ cardiovascular Ⅲ chronotherapy T he structural and molecular organization of the mammalian circadian system has been the subject of extensive studies, which are reviewed in detail elsewhere. 1 It has been shown that the clock is operative in virtually every cell and tissue and that it is generated by a network of transcription/ translation feedback loops (Figure 1). The positive components of the loop are the transcription factors CLOCK and BMAL1. In the form of a heterodimer, they drive the rhythmic expression of numerous genes through E-box elements in their promoter regions. Among the transcriptional targets of the CLOCK/BMAL1 complex are the Period (Per1 and Per2) and Cryptochrome (Cry1 and Cry2) genes. PER and CRY proteins function as negative components of the circadian loop by inhibiting CLOCK/BMAL1-mediated transactivation. The Bmal1 gene is also regulated by 2 of its transcriptional targets, the nuclear receptors REV-ERB␣ and ROR␣ (retinoic acid receptor-related orphan receptor ␣), which function respectively as a repressor or an activator of Bmal1 transcription by competing for the RORE (ROR␣ response element) in its promoter. [2][3][4] In addition to the core components of circadian oscillatory machinery, the CLOCK/BMAL1 complex drives the rhythmic expression of numerous output genes harboring E-box sequences in their promoters, allowing for daily variations in cellular, metabolic and physiological functions. 5 The results of global temporal transcriptional profiling of various tissues using a microarray hybridization approach have estimated that as much as 10% of mammalian transcriptome oscillate in a circadian manner. 6 In addition to direct transcriptional regulation, this oscillation is achieved at posttranscriptional level through the regulation of RNA stability. Recent data have implicated microRNAs and RNA-binding proteins as essential contributors to circadian output rhythmicity. [7][8][9] Mechanistically, CLOCK/BMAL1-mediated transactivation is associated with rhythmic changes in histone acetylation, 10,11 which suggests that, as in many other systems, chromatin remodeling constitutes an important regulatory step governing the circadian clock...