1 619 102 BIOCHEMICAL ASPECTS AND THERAPEUTIC MECHANISMS OF CANNABIDIOL IN EPILEPSY. EPILEPSY IS A CHRONIC NEUROLOGICAL DISEASE CHARACTERIZED BY RECURRENT EPILEPTIC SEIZURES. STUDIES HAVE SHOWN THE COMPLEXITY OF EPILEPTOGENESIS AND ICTOGENESIS, IN WHICH IMMUNOLOGICAL PROCESSES AND EPIGENETIC AND STRUCTURAL CHANGES IN NEURONAL TISSUES HAVE BEEN IDENTIFIED AS TRIGGERING EPILEPSY. CANNABIDIOL (CBD) IS A MAJOR ACTIVE COMPONENT OF THE CANNABIS PLANT AND THE SOURCE OF CBD-ENRICHED PRODUCTS FOR THE TREATMENT OF EPILEPSY AND ASSOCIATED DISEASES. IN THIS REVIEW, WE PROVIDE AN UP-TO-DATE DISCUSSION ON CELLULAR AND MOLECULAR MECHANISMS TRIGGERED DURING EPILEPSY CRISES, AND THE PHYTOCHEMICAL CHARACTERISTICS OF CBD THAT MAKE IT AN ATTRACTIVE CANDIDATE FOR CONTROLLING RARE SYNDROMES, WITH EXCELLENT THERAPEUTIC PROPERTIES. WE ALSO DISCUSS POSSIBLE CBD ANTICONVULSANT MECHANISMS AND MOLECULAR TARGETS IN NEURODEGENERATIVE DISORDERS AND EPILEPSY. BASED ON THESE ARGUMENTS, WE CONCLUDE THAT CBD PRESENTS A BIOTECNOLOGICAL POTENTIAL IN THE ANTICONVULSANT PROCESS, INCLUDING DECREASING DEPENDENCE ON HEALTH CARE IN HOSPITALS, AND COULD MAKE THE PATIENT'S LIFE MORE STABLE, WITH REGARD TO NEUROLOGICAL CONDITIONS. 2022 2 239 37 ADENOSINERGIC SIGNALING IN EPILEPSY. DESPITE THE INTRODUCTION OF AT LEAST 20 NEW ANTIEPILEPTIC DRUGS (AEDS) INTO CLINICAL PRACTICE OVER THE PAST DECADES, ABOUT ONE THIRD OF ALL EPILEPSIES REMAIN REFRACTORY TO CONVENTIONAL FORMS OF TREATMENT. IN ADDITION, CURRENTLY USED AEDS HAVE BEEN DEVELOPED TO SUPPRESS NEURONAL HYPEREXCITABILITY, BUT NOT NECESSARILY TO ADDRESS PATHOGENIC MECHANISMS INVOLVED IN EPILEPSY DEVELOPMENT OR PROGRESSION (EPILEPTOGENESIS). FOR THOSE REASONS ENDOGENOUS SEIZURE CONTROL MECHANISMS OF THE BRAIN MAY PROVIDE ALTERNATIVE THERAPEUTIC OPPORTUNITIES. ADENOSINE IS A WELL CHARACTERIZED ENDOGENOUS ANTICONVULSANT AND SEIZURE TERMINATOR OF THE BRAIN. SEVERAL LINES OF EVIDENCE SUGGEST THAT ENDOGENOUS ADENOSINE-MEDIATED SEIZURE CONTROL MECHANISMS FAIL IN CHRONIC EPILEPSY, WHEREAS THERAPEUTIC ADENOSINE AUGMENTATION EFFECTIVELY PREVENTS EPILEPTIC SEIZURES, EVEN THOSE THAT ARE REFRACTORY TO CONVENTIONAL AEDS. NEW FINDINGS DEMONSTRATE THAT DYSREGULATION OF ADENOSINERGIC MECHANISMS ARE INTRICATELY INVOLVED IN THE DEVELOPMENT OF EPILEPSY AND ITS COMORBIDITIES, WHEREAS ADENOSINE-ASSOCIATED EPIGENETIC MECHANISMS MAY PLAY A ROLE IN EPILEPTOGENESIS. THE FIRST GOAL OF THIS REVIEW IS TO DISCUSS HOW MALADAPTIVE CHANGES OF ADENOSINERGIC MECHANISMS CONTRIBUTE TO THE EXPRESSION OF SEIZURES (ICTOGENESIS) AND THE DEVELOPMENT OF EPILEPSY (EPILEPTOGENESIS) BY FOCUSING ON PHARMACOLOGICAL (ADENOSINE RECEPTOR DEPENDENT) AND BIOCHEMICAL (ADENOSINE RECEPTOR INDEPENDENT) MECHANISMS AS WELL AS ON ENZYMATIC AND TRANSPORT BASED MECHANISMS THAT CONTROL THE AVAILABILITY (HOMEOSTASIS) OF ADENOSINE. THE SECOND GOAL OF THIS REVIEW IS TO HIGHLIGHT INNOVATIVE ADENOSINE-BASED OPPORTUNITIES FOR THERAPEUTIC INTERVENTION AIMED AT RECONSTRUCTING NORMAL ADENOSINE FUNCTION AND SIGNALING FOR IMPROVED SEIZURE CONTROL IN CHRONIC EPILEPSY. NEW FINDINGS SUGGEST THAT TRANSIENT ADENOSINE AUGMENTATION CAN HAVE LASTING EPIGENETIC EFFECTS WITH DISEASE MODIFYING AND ANTIEPILEPTOGENIC OUTCOME. THIS ARTICLE IS PART OF THE SPECIAL ISSUE ENTITLED 'PURINES IN NEURODEGENERATION AND NEUROREGENERATION'. 2016 3 262 41 ADVANCES IN THE POTENTIAL BIOMARKERS OF EPILEPSY. EPILEPSY IS A GROUP OF CHRONIC NEUROLOGICAL DISORDERS CHARACTERIZED BY RECURRENT, SPONTANEOUS, AND UNPREDICTABLE SEIZURES. IT IS ONE OF THE MOST COMMON NEUROLOGICAL DISORDERS, AFFECTING TENS OF MILLIONS OF PEOPLE WORLDWIDE. COMPREHENSIVE STUDIES ON EPILEPSY IN RECENT DECADES HAVE REVEALED THE COMPLEXITY OF EPILEPTOGENESIS, IN WHICH IMMUNOLOGICAL PROCESSES, EPIGENETIC MODIFICATIONS, AND STRUCTURAL CHANGES IN NEURONAL TISSUES HAVE BEEN IDENTIFIED AS PLAYING A CRUCIAL ROLE. THIS REVIEW DISCUSSES THE RECENT ADVANCES IN THE BIOMARKERS OF EPILEPSY. WE EVALUATE THE POSSIBLE MOLECULAR BACKGROUND UNDERLYING THE CLINICAL CHANGES OBSERVED IN RECENT STUDIES, FOCUSING ON THERAPEUTIC INVESTIGATIONS, AND THE EVIDENCE OF THEIR SAFETY AND EFFICACY IN THE HUMAN POPULATION. THIS ARTICLE REVIEWS THE PATHOPHYSIOLOGY OF EPILEPSY, INCLUDING RECENT REPORTS ON THE EFFECTS OF OXIDATIVE STRESS AND HYPOXIA, AND FOCUSES ON SPECIFIC BIOMARKERS AND THEIR CLINICAL IMPLICATIONS, ALONG WITH FURTHER PERSPECTIVES IN EPILEPSY RESEARCH. 2019 4 6024 37 THE BIOCHEMISTRY AND EPIGENETICS OF EPILEPSY: FOCUS ON ADENOSINE AND GLYCINE. EPILEPSY, ONE OF THE MOST PREVALENT NEUROLOGICAL CONDITIONS, PRESENTS AS A COMPLEX DISORDER OF NETWORK HOMEOSTASIS CHARACTERIZED BY SPONTANEOUS NON-PROVOKED SEIZURES AND ASSOCIATED COMORBIDITIES. CURRENTLY USED ANTIEPILEPTIC DRUGS HAVE BEEN DESIGNED TO SUPPRESS NEURONAL HYPEREXCITABILITY AND THEREBY TO SUPPRESS EPILEPTIC SEIZURES. HOWEVER, THE CURRENT ARMAMENTARIUM OF ANTIEPILEPTIC DRUGS IS NOT EFFECTIVE IN OVER 30% OF PATIENTS, DOES NOT AFFECT THE COMORBIDITIES OF EPILEPSY, AND DOES NOT PREVENT THE DEVELOPMENT AND PROGRESSION OF EPILEPSY (EPILEPTOGENESIS). PREVENTION OF EPILEPSY AND ITS PROGRESSION REMAINS THE HOLY GRAIL FOR EPILEPSY RESEARCH AND THERAPY DEVELOPMENT, REQUIRING NOVEL CONCEPTUAL ADVANCES TO FIND A SOLUTION TO THIS URGENT MEDICAL NEED. THE METHYLATION HYPOTHESIS OF EPILEPTOGENESIS SUGGESTS THAT CHANGES IN DNA METHYLATION ARE IMPLICATED IN THE PROGRESSION OF THE DISEASE. IN PARTICULAR, GLOBAL DNA HYPERMETHYLATION APPEARS TO BE ASSOCIATED WITH CHRONIC EPILEPSY. CLINICAL AS WELL AS EXPERIMENTAL EVIDENCE DEMONSTRATES THAT EPILEPSY AND ITS PROGRESSION CAN BE PREVENTED BY BIOCHEMICAL MANIPULATIONS AND THOSE THAT TARGET PREVIOUSLY UNRECOGNIZED EPIGENETIC FUNCTIONS CONTRIBUTING TO EPILEPSY DEVELOPMENT AND MAINTENANCE OF THE EPILEPTIC STATE. THIS MINI-REVIEW WILL DISCUSS, EPIGENETIC MECHANISMS IMPLICATED IN EPILEPTOGENESIS AND BIOCHEMICAL INTERACTIONS BETWEEN ADENOSINE AND GLYCINE AS A CONCEPTUAL ADVANCE TO UNDERSTAND THE CONTRIBUTION OF MALADAPTIVE CHANGES IN BIOCHEMISTRY AS A MAJOR CONTRIBUTING FACTOR TO THE DEVELOPMENT OF EPILEPSY. NEW FINDINGS BASED ON BIOCHEMICAL MANIPULATION OF THE DNA METHYLOME SUGGEST THAT: (I) EPIGENETIC MECHANISMS PLAY A FUNCTIONAL ROLE IN EPILEPTOGENESIS; AND (II) THERAPEUTIC RECONSTRUCTION OF THE EPIGENOME IS AN EFFECTIVE ANTIEPILEPTOGENIC THERAPY. 2016 5 2536 37 EPIGENETICS IN EPILEPSY. EPILEPSY AFFECTS OVER 50 MILLION INDIVIDUALS GLOBALLY, MAKING IT THE MOST PREVALENT CHRONIC AND SERIOUS NEUROLOGICAL CONDITION. A PRECISE THERAPEUTIC STRATEGY IS COMPLICATED BY POOR UNDERSTANDING OF THE PATHOLOGICAL CHANGES IN EPILEPSY THUS, 30% OF TLE PATIENTS ARE RESISTANT TO DRUG THERAPY. IN THE BRAIN, EPIGENETIC PROCESSES TRANSLATE INFORMATION FROM TRANSIENT CELLULAR IMPULSES AND ADJUSTMENTS IN NEURONAL ACTIVITY INTO LONG-LASTING IMPACTS ON GENE EXPRESSION. RESEARCH SUGGESTS THAT EPIGENETIC PROCESSES CAN BE MANIPULATED IN THE FUTURE TO TREAT OR PREVENT EPILEPSY AS EPIGENETICS HAS BEEN SHOWN TO HAVE A PROFOUND INFLUENCE ON HOW GENES ARE EXPRESSED IN EPILEPSY. AS WELL AS BEING POTENTIAL BIOMARKERS FOR EPILEPSY DIAGNOSIS, EPIGENETIC CHANGES CAN ALSO BE USED AS PROGNOSTIC INDICATORS OF TREATMENT RESPONSE. IN THIS CHAPTER, WE REVIEW THE MOST RECENT FINDINGS IN SEVERAL MOLECULAR PATHWAYS LINKED WITH THE PATHOGENESIS OF TLE THAT ARE CONTROLLED BY EPIGENETIC MECHANISMS HIGHLIGHTING THEIR POTENTIAL UTILITY AS BIOMARKERS FOR UPCOMING TREATMENT STRATEGIES. 2023 6 2498 32 EPIGENETICS AND EPILEPSY PREVENTION: THE THERAPEUTIC POTENTIAL OF ADENOSINE AND METABOLIC THERAPIES. PREVENTION OF EPILEPSY AND ITS PROGRESSION REMAINS THE MOST URGENT NEED FOR EPILEPSY RESEARCH AND THERAPY DEVELOPMENT. NOVEL CONCEPTUAL ADVANCES ARE REQUIRED TO MEANINGFULLY ADDRESS THIS FUNDAMENTAL CHALLENGE. MALADAPTIVE EPIGENETIC CHANGES, WHICH INCLUDE METHYLATION OF DNA AND ACETYLATION OF HISTONES - AMONG OTHER MECHANISMS, ARE NOW WELL RECOGNIZED TO PLAY A FUNCTIONAL ROLE IN THE DEVELOPMENT OF EPILEPSY AND ITS PROGRESSION. THE METHYLATION HYPOTHESIS OF EPILEPTOGENESIS SUGGESTS THAT CHANGES IN DNA METHYLATION ARE IMPLICATED IN THE PROGRESSION OF THE DISEASE. IN THIS CONTEXT, GLOBAL DNA HYPERMETHYLATION IS PARTICULARLY ASSOCIATED WITH CHRONIC EPILEPSY. LIKEWISE, ACETYLATION CHANGES OF HISTONES HAVE BEEN LINKED TO EPILEPSY DEVELOPMENT. CLINICAL AS WELL AS EXPERIMENTAL EVIDENCE DEMONSTRATE THAT EPILEPSY AND ITS PROGRESSION CAN BE PREVENTED BY METABOLIC AND BIOCHEMICAL MANIPULATIONS THAT TARGET PREVIOUSLY UNRECOGNIZED EPIGENETIC FUNCTIONS CONTRIBUTING TO EPILEPSY DEVELOPMENT AND MAINTENANCE OF THE EPILEPTIC STATE. THIS REVIEW WILL DISCUSS EPIGENETIC MECHANISMS IMPLICATED IN EPILEPSY DEVELOPMENT AS WELL AS METABOLIC AND BIOCHEMICAL INTERACTIONS THOUGHT TO DRIVE EPILEPTOGENESIS. THEREFORE, METABOLIC AND BIOCHEMICAL MECHANISMS ARE IDENTIFIED AS NOVEL TARGETS FOR EPILEPSY PREVENTION. WE WILL SPECIFICALLY DISCUSS ADENOSINE BIOCHEMISTRY AS A NOVEL THERAPEUTIC STRATEGY TO RECONSTRUCT THE DNA METHYLOME AS ANTIEPILEPTOGENIC STRATEGY AS WELL AS METABOLIC MEDIATORS, SUCH AS BETA-HYDROXYBUTYRATE, WHICH AFFECT HISTONE ACETYLATION. FINALLY, METABOLIC DIETARY INTERVENTIONS (SUCH AS THE KETOGENIC DIET) WHICH HAVE THE UNIQUE POTENTIAL TO PREVENT EPILEPTOGENESIS THROUGH RECENTLY IDENTIFIED EPIGENETIC MECHANISMS WILL BE REVIEWED. THIS ARTICLE IS PART OF THE SPECIAL ISSUE ENTITLED 'NEW EPILEPSY THERAPIES FOR THE 21ST CENTURY - FROM ANTISEIZURE DRUGS TO PREVENTION, MODIFICATION AND CURE OF EPILEPSY'. 2020 7 722 26 CAN CANNABIDIOL AFFECT THE EFFICACY OF CHEMOTHERAPY AND EPIGENETIC TREATMENTS IN CANCER? THE SUCCESS OF CANNABINOIDS WITH CHRONIC NEUROPATHIC PAIN AND ANXIETY HAS BEEN DEMONSTRATED IN A MULTITUDE OF STUDIES. WITH THE HIGH AVAILABILITY OF A NON-INTOXICATING COMPOUND, CANNABIDIOL (CBD), AN OVER-THE-COUNTER MEDICATION, HAS GENERATED HEIGHTENED INTEREST IN ITS USE IN THE FIELD OF ONCOLOGY. THIS REVIEW FOCUSES ON THE WIDESPREAD THERAPEUTIC POTENTIAL OF CBD WITH REGARD TO ENHANCED WOUND HEALING, LOWERED TOXICITY PROFILES OF CHEMOTHERAPEUTICS, AND AUGMENTED ANTITUMORIGENIC EFFECTS. THE CURRENT LITERATURE IS SPARSE WITH REGARD TO DETERMINING THE CLINICALLY RELEVANT CONCENTRATIONS OF CBD GIVEN THE BIPHASIC NATURE OF THE COMPOUND'S RESPONSE. THEREFORE, THERE IS AN IMMINENT NEED FOR FURTHER DOSE-FINDING STUDIES IN ORDER TO DETERMINE THE OPTIMAL DOSE OF CBD FOR BOTH INTERMITTENT AND REGULAR USERS. WE ADDRESS THE POTENTIAL INFLUENCE OF REGULAR OR OCCASIONAL CBD USAGE ON THERAPEUTIC OUTCOMES IN OVARIAN CANCER PATIENTS. ADDITIONALLY, AS THE DEVELOPMENT OF CHEMORESISTANCE IN OVARIAN CANCER RESULTS IN TREATMENT FAILURE, THE POTENTIAL FOR CBD TO AUGMENT THE EFFICACY OF CONVENTIONAL CHEMOTHERAPEUTIC AND EPIGENETIC DRUGS IS A TOPIC OF SIGNIFICANT IMPORTANCE. OUR REVIEW IS FOCUSED ON THE WIDESPREAD THERAPEUTIC POTENTIAL OF CBD AND WHETHER OR NOT A SYNERGISTIC ROLE EXISTS IN COMBINATION WITH EPIGENETIC AND CLASSIC CHEMOTHERAPY MEDICATIONS. 2021 8 5047 31 PHARMACOLOGICAL AND THERAPEUTIC APPROACHES IN THE TREATMENT OF EPILEPSY. EPILEPSY AFFECTS AROUND 50 MILLION PEOPLE ACROSS THE GLOBE AND IS THE THIRD MOST COMMON CHRONIC BRAIN DISORDER. IT IS A NON-COMMUNICABLE DISEASE OF THE BRAIN THAT AFFECTS PEOPLE OF ALL AGES. IT IS ACCOMPANIED BY DEPRESSION, ANXIETY, AND SUBSTANTIALLY INCREASED MORBIDITY AND MORTALITY. A LARGE NUMBER OF THIRD-GENERATION ANTI-EPILEPTIC DRUGS ARE AVAILABLE, BUT THEY HAVE MULTIPLE SIDE-EFFECTS CAUSING A DECLINE IN THE QUALITY OF LIFE. THE INHERITANCE AND ETIOLOGY OF EPILEPSY ARE COMPLEX WITH MULTIPLE UNDERLYING GENETIC AND EPIGENETIC MECHANISMS. DIFFERENT NEUROTRANSMITTERS PLAY INTRICATE FUNCTIONS TO MAINTAIN THE NORMAL PHYSIOLOGY OF VARIOUS NEURONS. IF THERE IS ANY DYSREGULATION OF NEUROTRANSMISSION DUE TO ABERRANT TRANSMITTER LEVELS OR THEIR RECEPTOR BIOLOGY, IT CAN RESULT IN SEIZURES. IN THIS REVIEW, WE HAVE DISCUSSED THE ROLES PLAYED BY VARIOUS NEUROTRANSMITTERS AND THEIR RECEPTORS IN THE PATHOPHYSIOLOGY OF EPILEPSY. DRUG-RESISTANT EPILEPSY (DRE) HAS REMAINED ONE OF THE FOREFRONT AREAS OF EPILEPSY RESEARCH FOR A LONG TIME. UNDERSTANDING THE MECHANISMS UNDERLYING DRE IS OF UTMOST IMPORTANCE BECAUSE OF ITS HIGH INCIDENCE RATE AMONG EPILEPSY PATIENTS AND INCREASED RISKS OF PSYCHOSOCIAL PROBLEMS AND PREMATURE DEATH. HERE WE HAVE ENUMERATED VARIOUS HYPOTHESES OF DRE. FURTHER, WE HAVE DISCUSSED DIFFERENT NON-CONVENTIONAL THERAPEUTIC STRATEGIES, INCLUDING COMBINATION THERAPY AND NON-DRUG TREATMENT. THE RECENT STUDIES SUPPORTING THE MODERN APPROACHES FOR THE TREATMENT OF EPILEPSY HAVE BEEN DELIBERATED WITH PARTICULAR REFERENCE TO THE MTOR PATHWAY, BREAKDOWN OF THE BLOOD-BRAIN BARRIER, AND INFLAMMATORY PATHWAYS. 2021 9 2141 37 EPIGENETIC INTERVENTIONS FOR EPILEPTOGENESIS: A NEW FRONTIER FOR CURING EPILEPSY. THIS ARTICLE HIGHLIGHTS THE EMERGING THERAPEUTIC POTENTIAL OF SPECIFIC EPIGENETIC MODULATORS AS PROMISING ANTIEPILEPTOGENIC OR DISEASE-MODIFYING AGENTS FOR CURING EPILEPSY. CURRENTLY, THERE IS AN UNMET NEED FOR ANTIEPILEPTOGENIC AGENTS THAT TRULY PREVENT THE DEVELOPMENT OF EPILEPSY IN PEOPLE AT RISK. THERE IS STRONG EVIDENCE THAT EPIGENETIC SIGNALING, WHICH EXERTS HIGH FIDELITY REGULATION OF GENE EXPRESSION, PLAYS A CRUCIAL ROLE IN THE PATHOPHYSIOLOGY OF EPILEPTOGENESIS AND CHRONIC EPILEPSY. THESE MODIFICATIONS ARE NOT HARD-WIRED INTO THE GENOME AND ARE CONSTANTLY REPROGRAMMED BY ENVIRONMENTAL INFLUENCES. THE POTENTIAL EPIGENETIC MECHANISMS, INCLUDING HISTONE MODIFICATIONS, DNA METHYLATION, MICRORNA-BASED TRANSCRIPTIONAL CONTROL, AND BROMODOMAIN READING ACTIVITY, CAN DRASTICALLY ALTER THE NEURONAL GENE EXPRESSION PROFILE BY EXERTING THEIR SUMMATIVE EFFECTS IN A COORDINATED FASHION. SUCH AN EPIGENETIC INTERVENTION APPEARS MORE RATIONAL STRATEGY FOR PREVENTING EPILEPSY BECAUSE IT TARGETS THE PRIMARY PATHWAY THAT INITIALLY TRIGGERS THE NUMEROUS DOWNSTREAM CELLULAR AND MOLECULAR EVENTS MEDIATING EPILEPTOGENESIS. AMONG CURRENTLY APPROVED EPIGENETIC DRUGS, THE MAJORITY ARE ANTICANCER DRUGS WITH WELL-ESTABLISHED PROFILES IN CLINICAL TRIALS AND PRACTICE. EVIDENCE FROM PRECLINICAL STUDIES SUPPORTS THE PREMISE THAT THESE DRUGS MAY BE APPLIED TO A WIDE RANGE OF BRAIN DISORDERS. TARGETING HISTONE DEACETYLATION BY INHIBITING HISTONE DEACETYLASE ENZYMES APPEARS TO BE ONE PROMISING EPIGENETIC THERAPY SINCE CERTAIN INHIBITORS HAVE BEEN SHOWN TO PREVENT EPILEPTOGENESIS IN ANIMAL MODELS. HOWEVER, DEVELOPING NEURONAL SPECIFIC EPIGENETIC MODULATORS REQUIRES RATIONAL, PATHOPHYSIOLOGY-BASED OPTIMIZATION TO EFFICIENTLY INTERCEPT THE UPSTREAM PATHWAYS IN EPILEPTOGENESIS. OVERALL, EPIGENETIC AGENTS HAVE BEEN WELL POSITIONED AS NEW FRONTIER TOOLS TOWARDS THE NATIONAL GOAL OF CURING EPILEPSY. 2017 10 4128 30 MECHANISMS OF DRUG RESISTANCE IN THE PATHOGENESIS OF EPILEPSY: ROLE OF NEUROINFLAMMATION. A LITERATURE REVIEW. EPILEPSY IS A CHRONIC NEUROLOGICAL DISORDER CHARACTERIZED BY RECURRING SPONTANEOUS SEIZURES. DRUG RESISTANCE APPEARS IN 30% OF PATIENTS AND IT CAN LEAD TO PREMATURE DEATH, BRAIN DAMAGE OR A REDUCED QUALITY OF LIFE. THE PURPOSE OF THE STUDY WAS TO ANALYZE THE DRUG RESISTANCE MECHANISMS, ESPECIALLY NEUROINFLAMMATION, IN THE EPILEPTOGENESIS. THE INFORMATION BASES OF BIOMEDICAL LITERATURE SCOPUS, PUBMED, GOOGLE SCHOLAR AND SCIVERSE WERE USED. TO OBTAIN FULL-TEXT DOCUMENTS, ELECTRONIC RESOURCES OF PUBMED CENTRAL AND RESEARCH GATE WERE USED. THE ARTICLE EXAMINES THE RECENT RESEARCH OF THE MECHANISMS OF DRUG RESISTANCE IN EPILEPSY AND DISCUSSES THE HYPOTHESES OF DRUG RESISTANCE DEVELOPMENT (GENETIC, EPIGENETIC, TARGET HYPOTHESIS, ETC.). DRUG-RESISTANT EPILEPSY IS ASSOCIATED WITH NEUROINFLAMMATORY, AUTOIMMUNE AND NEURODEGENERATIVE PROCESSES. NEUROINFLAMMATION CAUSES IMMUNE, PATHOPHYSIOLOGICAL, BIOCHEMICAL AND PSYCHOLOGICAL CONSEQUENCES. FOCAL OR SYSTEMIC UNREGULATED INFLAMMATORY PROCESSES LEAD TO THE FORMATION OF ABERRANT NEURAL CONNECTIONS AND HYPEREXCITABLE NEURAL NETWORKS. INFLAMMATORY MEDIATORS AFFECT THE ENDOTHELIUM OF CEREBRAL VESSELS, DESTROY CONTACTS BETWEEN ENDOTHELIAL CELLS AND INDUCE ABNORMAL ANGIOGENESIS (THE FORMATION OF "LEAKY" VESSELS), THEREBY AFFECTING THE BLOOD-BRAIN BARRIER PERMEABILITY. THUS, THE ANALYSIS OF PRO-INFLAMMATORY AND OTHER COMPONENTS OF EPILEPTOGENESIS CAN CONTRIBUTE TO THE FURTHER DEVELOPMENT OF THE THERAPEUTIC TREATMENT OF DRUG-RESISTANT EPILEPSY. 2021 11 5038 18 PHARMACOGENETICS OF CHRONIC PAIN AND ITS TREATMENT. THIS PAPER REVIEWS THE IMPACT OF GENETIC VARIABILITY OF DRUG METABOLIZING ENZYMES, TRANSPORTERS, RECEPTORS, AND PATHWAYS INVOLVED IN CHRONIC PAIN PERCEPTION ON THE EFFICACY AND SAFETY OF ANALGESICS AND OTHER DRUGS USED FOR CHRONIC PAIN TREATMENT. SEVERAL CANDIDATE GENES HAVE BEEN IDENTIFIED IN THE LITERATURE, WHILE THERE IS USUALLY ONLY LIMITED CLINICAL EVIDENCE SUBSTANTIATING FOR THE PENETRATION OF THE TESTING FOR THESE CANDIDATE BIOMARKERS INTO THE CLINICAL PRACTICE. FURTHER, THE PAIN-PERCEPTION REGULATION AND MODULATION ARE STILL NOT FULLY UNDERSTOOD, AND THUS MORE COMPLEX KNOWLEDGE OF GENETIC AND EPIGENETIC BACKGROUND FOR ANALGESIA WILL BE NEEDED PRIOR TO THE CLINICAL USE OF THE CANDIDATE GENETIC BIOMARKERS. 2013 12 6846 26 [MIGRAINE: IGNITION OF THE BRAIN]. ALTHOUGH OUR KNOWLEDGE OF WHICH SYSTEMS ARE ACTIVATED DURING MIGRAINE IS REASONABLY COMPLETE, WHY THE SYSTEM IS ACTIVATED REMAINS UNKNOWN. INCORPORATING THE FINDINGS OBTAINED IN STUDIES ON PAIN IN GENERAL HAS ALLOWED A MORE INTEGRATED MODEL TO BE GENERATED. ACCORDING TO THIS NEW MODEL, THERE IS AN ANATOMICAL SUBSTRATE CONSISTING IN A COMPLEX FRAMEWORK OF PAIN THAT IS MADE UP NOT ONLY OF THE TRIGEMINOVASCULAR SYSTEM (END PATHWAY) BUT OF A NUMBER OF NETWORKS THAT ARE IN TURN CONNECTED TO ONE ANOTHER, LIKE THE NEUROLIMBIC, THE ASCENDING AND DESCENDING MODULATORY SYSTEM. THIS COMPLEX NETWORK IS RESPONSIBLE FOR MODULATING AND CONVEYING NOCICEPTIVE SIGNALS. IN PATIENTS WITH MIGRAINE, HYPEREXCITABILITY OF THIS FRAMEWORK IS CONDITIONED BY GENETIC AND EPIGENETIC ALTERATIONS. EPIGENETIC CHANGES ARE CHEMICAL MODIFICATIONS AFFECTING CHROMATIN, WHICH MODULATES THE ACTIVITY OF GENES WITHOUT MODIFYING THE DNA SEQUENCE, AND WHICH ARE CAPABLE OF MODULATING THE EXPRESSION OF GENES INVOLVED IN A NUMBER OF DIFFERENT ASPECTS, SUCH AS PLASTICITY, SYSTEM EXCITABILITY, MEMORY OF PAIN OR MOODS. IN TURN, THE PRESENCE OF EXTERNAL FACTORS (SUCH AS ENVIRONMENTAL CHANGES OR ALCOHOL) AND INTERNAL FACTORS (SUCH AS HORMONES OR SLEEP DISORDERS) CONTRIBUTE TO ACTIVATE THIS LOADED ANATOMICAL SUBSTRATE, RESULTING IN THE ATTACK OF MIGRAINE. 2013 13 1199 30 CORTICOTROPIN RELEASING FACTOR-BINDING PROTEIN (CRF-BP) AS A POTENTIAL NEW THERAPEUTIC TARGET IN ALZHEIMER'S DISEASE AND STRESS DISORDERS. ALZHEIMER'S DISEASE IS THE MOST COMMON CAUSE OF DEMENTIA AND ONE OF THE MOST COMPLEX HUMAN NEURODEGENERATIVE DISEASES. NUMEROUS STUDIES HAVE DEMONSTRATED A CRITICAL ROLE OF THE ENVIRONMENT IN THE PATHOGENESIS AND PATHOPHYSIOLOGY OF THE DISEASE, WHERE DAILY LIFE STRESS PLAYS AN IMPORTANT ROLE. A LOT OF EPIGENETIC STUDIES HAVE LED TO THE CONCLUSION THAT CHRONIC STRESS AND STRESS-RELATED DISORDERS PLAY AN IMPORTANT PART IN THE ONSET OF NEURODEGENERATIVE DISORDERS, AND AN ENORMOUS AMOUNT OF RESEARCH YIELDED VALUABLE DISCOVERIES BUT HAS SO FAR NOT LED TO THE DEVELOPMENT OF EFFECTIVE TREATMENT STRATEGIES FOR ALZHEIMER'S DISEASE. CORTICOTROPIN-RELEASING FACTOR (CRF) IS ONE OF THE MAJOR HORMONES AND AT THE SAME TIME A NEUROPEPTIDE ACTING IN STRESS RESPONSE. DEREGULATION OF PROTEIN LEVELS OF CRF IS INVOLVED IN THE PATHOGENESIS OF ALZHEIMER'S DISEASE, BUT LITTLE IS KNOWN ABOUT THE PRECISE ROLES OF CRF AND ITS BINDING PROTEIN, CRF-BP, IN NEURODEGENERATIVE DISEASES. IN THIS REVIEW, WE SUMMARIZE THE KEY EVIDENCE FOR AND AGAINST THE INVOLVEMENT OF STRESS-ASSOCIATED MODULATION OF THE CRF SYSTEM IN THE PATHOGENESIS OF ALZHEIMER'S DISEASE AND DISCUSS HOW RECENT FINDINGS COULD LEAD TO NEW POTENTIAL TREATMENT POSSIBILITIES IN ALZHEIMER'S DISEASE BY USING CRF-BP AS A THERAPEUTIC TARGET. 2019 14 2871 29 FUNCTIONAL GENOMICS IN EXPERIMENTAL AND HUMAN TEMPORAL LOBE EPILEPSY: POWERFUL NEW TOOLS TO IDENTIFY MOLECULAR DISEASE MECHANISMS OF HIPPOCAMPAL DAMAGE. THE HUMAN GENOME PROJECT IS A MILESTONE FOR MOLECULAR GENETIC STUDIES ON COMPLEX, SPORADIC DISORDERS IN THE HUMAN CENTRAL NERVOUS SYSTEM (CNS). FUNCTIONAL ANALYSIS AND TISSUE-/CELL-SPECIFIC EXPRESSION PROFILES WILL BE OF PARTICULAR IMPORTANCE ANTICIPATING THE MAGNITUDE OF EXPRESSED GENES IN THE BRAIN AND THEIR DYNAMIC EPIGENETIC MODIFICATIONS. THE RECENT PROGRESS IN MICROARRAY TECHNOLOGIES ALLOWS EXPRESSION STUDIES FOR A LARGE NUMBER OF GENES. IN COMBINATION WITH LASER-MICRODISSECTION AND QUANTITATIVE REVERSE TRANSCRIPTION-POLYMERASE CHAIN REACTION TECHNOLOGIES, SUCH LARGE-SCALE EXPRESSION ANALYSES CAN BE SUCCESSFULLY ADDRESSED IN WELL-DEFINED TISSUE SPECIMENS OR CELLULAR SUBPOPULATIONS. COMPLEX, SPORADIC DISEASES, SUCH AS TEMPORAL LOBE EPILEPSY (TLE), ARE CHALLENGING FOR FUNCTIONAL GENOMICS. ISSUES OF PARTICULAR IMPORTANCE IN THIS FIELD INCLUDE MOLECULAR MECHANISMS OF NEURODEVELOPMENTAL ABNORMALITIES, NEURONAL PLASTICITY AND HYPEREXCITABILITY AS WELL AS NEURONAL CELL DAMAGE IN AFFECTED CNS AREAS. THE AVAILABILITY OF ANATOMICALLY WELL-PRESERVED SURGICAL SPECIMENS, I.E. HIPPOCAMPUS OBTAINED FROM EPILEPSY PATIENTS WITH AMMON'S HORN SCLEROSIS OR FOCAL LESIONS NOT AFFECTING THE HIPPOCAMPUS PROPER AS WELL AS COMPARISONS WITH EXPERIMENTAL TLE MODELS MAY HELP TO ELUCIDATE SPECIFIC MOLECULAR-PATHOLOGICAL MECHANISMS DURING EPILEPTOGENESIS AND IN CHRONIC CONDITIONS OF THE DISEASE. 2002 15 2611 24 EPIGENETICS: A PROMISING PARADIGM FOR BETTER UNDERSTANDING AND MANAGING PAIN. EPIGENETIC REGULATION OF GENE EXPRESSION IS A RAPIDLY GROWING AREA OF RESEARCH. CONSIDERING THE LONGEVITY AND PLASTICITY OF NEURONS, THE STUDIES ON EPIGENETIC PATHWAYS IN THE NERVOUS SYSTEM SHOULD BE OF SPECIAL INTEREST FOR BOTH EPIGENETICISTS AND NEUROSCIENTISTS. ACTIVATION OR INACTIVATION OF DIFFERENT EPIGENETIC PATHWAYS BECOMES MORE PRONOUNCED WHEN THE CELLS EXPERIENCE RAPID CHANGES IN THEIR ENVIRONMENT, AND SUCH CHANGES CAN BE EASILY CAUSED BY INJURY AND INFLAMMATION, RESULTING IN PAIN PERCEPTION OR DISTORTION OF PAIN PERCEPTION (EG, HYPERALGESIA). THEREFORE, IN THIS REGARD, THE FIELD OF PAIN IS AT AN ADVANTAGE TO STUDY THE EPIGENETIC PATHWAYS. MORE IMPORTANTLY, UNDERSTANDING PAIN FROM AN EPIGENETICS POINT OF VIEW WOULD PROVIDE A NEW PARADIGM FOR DEVELOPING DRUGS OR STRATEGIES FOR PAIN MANAGEMENT. IN THIS REVIEW, WE INTRODUCE BASIC CONCEPTS OF EPIGENETICS, INCLUDING CHROMATIN DYNAMICS, HISTONE MODIFICATIONS, DNA METHYLATION, AND RNA-INDUCED GENE SILENCING. IN ADDITION, WE PROVIDE EVIDENCE FROM PUBLISHED STUDIES SUGGESTING WIDE IMPLICATION OF DIFFERENT EPIGENETIC PATHWAYS WITHIN PAIN PATHWAYS. PERSPECTIVE: THIS ARTICLE PROVIDES A BRIEF OVERVIEW OF EPIGENETIC PATHWAYS FOR GENE REGULATION AND HIGHLIGHTS THEIR INVOLVEMENT IN PAIN. OUR GOAL IS TO EXPOSE THE READERS TO THESE CONCEPTS SO THAT PAIN-RELATED PHENOTYPES CAN BE INVESTIGATED FROM THE EPIGENETIC POINT OF VIEW. 2013 16 2586 26 EPIGENETICS OF PAIN MEDIATORS. PURPOSE OF REVIEW: THE FIELD OF EPIGENETICS CONTINUES ITS INFLUENTIAL RISE AS A MEANS TO BETTER UNDERSTAND AN ORGANISM'S UNIQUE DEVELOPMENTAL IDENTITY OVER A LIFESPAN. WHEREAS A GENOME IS CONSTANT AND UNCHANGING, AN EPIGENOME IS DYNAMIC AND ALTERABLE. EPIGENETIC CHANGES ARE IN RESPONSE TO INNUMERABLE INTERNAL AND EXTERNAL INFLUENCES INCLUDING ENVIRONMENTAL CHANGES SUCH AS DIET, EXERCISE, DISEASE, TOXINS, AND STRESS. EPIGENETICS IS OF PARTICULAR INTEREST IN THE MEDICAL RESEARCH COMMUNITY BOTH FOR THE POTENTIAL TO CAUSE DISEASE AND AS A TARGET FOR THERAPEUTIC INTERVENTIONS. THIS ARTICLE PROVIDES A SUCCINCT EXPLANATION OF THE POTENTIAL FOR EPIGENETICS TO INFLUENCE THE UNDERSTANDING OF PAIN AS WELL AS A REVIEW OF RELEVANT RESEARCH ON THE TOPIC. RECENT FINDINGS: STUDIES ON EPIGENETICS AND PAIN REMAIN LARGELY PRECLINICAL AND INVESTIGATE THE THEORETICAL ABILITY OF EPIGENETICS TO ALTER THE NOCICEPTIVE PATHWAYS BOTH IN THE PERIPHERY AND CENTRALLY. SIGNIFICANT EVIDENCE NOW EXISTS FOR THE ABILITY OF EPIGENETICS TO MODIFY BROADLY CATEGORIZED PAIN TYPES, INCLUDING INFLAMMATORY, NEUROPATHIC, VISCERAL, AND CANCER RELATED. SUMMARY: BOTH PATIENTS AND PROVIDERS RECOGNIZE THAT NOVEL MEDICATIONS FOR THE TREATMENT OF BOTH ACUTE AND CHRONIC PAIN CONDITIONS ARE SORELY NEEDED. THE UNDERSTANDING OF EPIGENETICS AND ITS INFLUENCE ON NOCICEPTION REMAINS IN RELATIVE INFANCY BUT EARLY EVIDENCE IS STRONG FOR POTENTIAL THERAPEUTIC BENEFITS TO TREAT THESE CONDITIONS. 2018 17 2010 31 EPIGENETIC BASIS OF LEAD-INDUCED NEUROLOGICAL DISORDERS. ENVIRONMENTAL LEAD (PB) EXPOSURE IS CLOSELY ASSOCIATED WITH PATHOGENESIS OF A RANGE OF NEUROLOGICAL DISORDERS, INCLUDING ALZHEIMER'S DISEASE (AD), PARKINSON'S DISEASE (PD), AMYOTROPHIC LATERAL SCLEROSIS (ALS), ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD), ETC. EPIGENETIC MACHINERY MODULATES NEURAL DEVELOPMENT AND ACTIVITIES, WHILE FAULTY EPIGENETIC REGULATION CONTRIBUTES TO THE DIVERSE FORMS OF CNS (CENTRAL NERVOUS SYSTEM) ABNORMALITIES AND DISEASES. AS A POTENT EPIGENETIC MODIFIER, LEAD IS THOUGHT TO CAUSE NEUROLOGICAL DISORDERS THROUGH MODULATING EPIGENETIC MECHANISMS. SPECIFICALLY, INCREASING EVIDENCE LINKED ABERRANT DNA METHYLATIONS, HISTONE MODIFICATIONS AS WELL AS NCRNAS (NON-CODING RNAS) WITH AD CASES, AMONG WHICH CIRCRNA (CIRCULAR RNA) STANDS OUT AS A NEW AND PROMISING FIELD FOR ASSOCIATION STUDIES. IN 23-YEAR-OLD PRIMATES WITH DEVELOPMENTAL LEAD TREATMENT, ZAWIA GROUP DISCOVERED A VARIETY OF EPIGENETIC CHANGES RELATING TO AD PATHOGENESIS. THIS IS A DIRECT EVIDENCE IMPLICATING EPIGENETIC BASIS IN LEAD-INDUCED AD ANIMALS WITH AN ENTIRE LIFESPAN. ADDITIONALLY, SOME EPIGENETIC MOLECULES ASSOCIATED WITH AD ETIOLOGY WERE ALSO KNOWN TO RESPOND TO CHRONIC LEAD EXPOSURE IN COMPARABLE DISEASE MODELS, INDICATING POTENTIALLY INTERLACED MECHANISMS WITH RESPECT TO THE STUDIED NEUROTOXIC AND PATHOLOGICAL EVENTS. OF NOTE, EPIGENETIC MOLECULES ACTED VIA GLOBALLY OR SELECTIVELY INFLUENCING THE EXPRESSION OF DISEASE-RELATED GENES. COMPARED TO AD, THE ASSOCIATION OF LEAD EXPOSURE WITH OTHER NEUROLOGICAL DISORDERS WERE PRIMARILY SUPPORTED BY EPIDEMIOLOGICAL SURVEY, WITH FEWER REPORTS CONNECTING EPIGENETIC REGULATORS WITH LEAD-INDUCED PATHOGENESIS. SOME PHARMACEUTICALS, SUCH AS HDAC (HISTONE DEACETYLASE) INHIBITORS AND DNA METHYLATION INHIBITORS, WERE DEVELOPED TO DEAL WITH CNS DISEASE BY TARGETING EPIGENETIC COMPONENTS. STILL, UNDERSTANDINGS ARE INSUFFICIENT REGARDING THE CAUSE-CONSEQUENCE RELATIONS OF EPIGENETIC FACTORS AND NEUROLOGICAL ILLNESS. THEREFORE, CLEAR EVIDENCE SHOULD BE PROVIDED IN FUTURE INVESTIGATIONS TO ADDRESS DETAILED ROLES OF NOVEL EPIGENETIC FACTORS IN LEAD-INDUCED NEUROLOGICAL DISORDERS, AND EFFORTS OF DEVELOPING SPECIFIC EPIGENETIC THERAPEUTICS SHOULD BE APPRAISED. 2020 18 2254 27 EPIGENETIC MODULATION: RESEARCH PROGRESS ON HISTONE ACETYLATION LEVELS IN MAJOR DEPRESSIVE DISORDERS. DEPRESSION IS A SERIOUS MENTAL ILLNESS AND A PREVALENT CONDITION WITH MULTIPLE AETIOLOGIES. THE IMPACT OF THE CURRENT THERAPEUTIC STRATEGIES IS LIMITED AND THE PATHOGENESIS OF THE ILLNESS IS NOT WELL UNDERSTOOD. ACCORDING TO PREVIOUS STUDIES, DEPRESSION ONSET IS INFLUENCED BY A VARIETY OF ENVIRONMENTAL AND GENETIC FACTORS, INCLUDING CHRONIC STRESS, ABERRANT CHANGES IN GENE EXPRESSION, AND HEREDITARY PREDISPOSITION. TRANSCRIPTIONAL REGULATION IN EUKARYOTES IS CLOSELY RELATED TO CHROMOSOME PACKING AND IS CONTROLLED BY HISTONE POST-TRANSLATIONAL MODIFICATIONS. THE DEVELOPMENT OF NEW ANTIDEPRESSANTS MAY PROCEED ALONG A NEW PATH WITH MEDICATIONS THAT TARGET EPIGENETICS. HISTONE DEACETYLASE INHIBITORS (HDACIS) ARE A CLASS OF COMPOUNDS THAT INTERFERE WITH THE FUNCTION OF HISTONE DEACETYLASES (HDACS). THIS REVIEW EXPLORES THE RELATIONSHIP BETWEEN HDACS AND DEPRESSION AND FOCUSES ON THE CURRENT KNOWLEDGE ON THEIR REGULATORY MECHANISM IN DEPRESSION AND THE POTENTIAL THERAPEUTIC USE OF HDACIS WITH ANTIDEPRESSANT EFFICACY IN PRECLINICAL RESEARCH. FUTURE RESEARCH ON INHIBITORS IS ALSO PROPOSED AND DISCUSSED. 2023 19 5926 32 TARGETING EPIGENETIC MECHANISMS FOR CHRONIC PAIN: A VALID APPROACH FOR THE DEVELOPMENT OF NOVEL THERAPEUTICS. CHRONIC PAIN IS A MULTIFACETED AND COMPLEX CONDITION. BROADLY CLASSIFIED INTO SOMATIC, VISCERAL, OR NEUROPATHIC PAIN, IT IS POORLY MANAGED DESPITE ITS PREVALENCE. CURRENT DRUGS USED FOR THE TREATMENT OF CHRONIC PAIN ARE LIMITED BY TOLERANCE WITH LONG-TERM USE, ABUSE POTENTIAL, AND MULTIPLE ADVERSE SIDE EFFECTS. THE PERSISTENT NATURE OF PAIN SUGGESTS THAT EPIGENETIC MACHINERY MAY BE A CRITICAL FACTOR DRIVING CHRONIC PAIN. IN THIS REVIEW, WE DISCUSS THE LATEST INSIGHTS INTO EPIGENETIC PROCESSES, INCLUDING DNA METHYLATION, HISTONE MODIFICATIONS, AND MICRORNAS, AND WE DESCRIBE THEIR INVOLVEMENT IN THE PATHOPHYSIOLOGY OF CHRONIC PAIN AND WHETHER EPIGENETIC MODIFICATIONS COULD BE APPLIED AS FUTURE THERAPEUTIC TARGETS FOR CHRONIC PAIN. WE PROVIDE EVIDENCE FROM EXPERIMENTAL MODELS AND TRANSLATIONAL RESEARCH IN HUMAN TISSUE THAT HAVE ENHANCED OUR UNDERSTANDING OF EPIGENETIC PROCESSES MEDIATING NOCICEPTION, AND WE THEN SPECULATE ON THE POTENTIAL FUTURE USE OF MORE SPECIFIC AND SELECTIVE AGENTS THAT TARGET EPIGENETIC MECHANISMS TO ATTENUATE PAIN. 2016 20 5928 18 TARGETING EPIGENETIC MECHANISMS FOR PAIN RELIEF. EPIGENETIC CHANGES ARE CHEMICAL MODIFICATIONS TO CHROMATIN THAT MODULATE GENE ACTIVITY WITHOUT ALTERING THE DNA SEQUENCE. WHILE RESEARCH ON EPIGENETICS HAS GROWN EXPONENTIALLY OVER THE PAST FEW YEARS, VERY FEW STUDIES HAVE INVESTIGATED EPIGENETIC MECHANISMS IN RELATION TO PAIN STATES. HOWEVER, EPIGENETIC MECHANISMS ARE CRUCIAL TO MEMORY FORMATION THAT REQUIRES SIMILAR SYNAPTIC PLASTICITY TO PAIN PROCESSING, INDICATING THAT THEY MAY PLAY A KEY ROLE IN THE CONTROL OF PAIN STATES. THIS ARTICLE REVIEWS THE EARLY EVIDENCE SUGGESTING THAT EPIGENETIC MECHANISMS ARE ENGAGED AFTER INJURY AND IN CHRONIC PAIN STATES, AND THAT DRUGS USED CLINICALLY TO TARGET THE EPIGENETIC MACHINERY FOR THE TREATMENT OF CANCER MIGHT BE USEFUL FOR THE MANAGEMENT OF CHRONIC PAIN. 2012