1 2607 130 EPIGENETICS/EPIGENOMICS AND PREVENTION BY CURCUMIN OF EARLY STAGES OF INFLAMMATORY-DRIVEN COLON CANCER. COLORECTAL CANCER (CRC) IS ASSOCIATED WITH SIGNIFICANT MORBIDITY AND MORTALITY IN THE US AND WORLDWIDE. CRC IS THE SECOND MOST COMMON CANCER-RELATED DEATH IN BOTH MEN AND WOMEN GLOBALLY. CHRONIC INFLAMMATION HAS BEEN IDENTIFIED AS ONE OF THE MAJOR RISK FACTORS OF CRC. IT MAY DRIVE GENETIC AND EPIGENETIC/EPIGENOMIC ALTERATIONS, SUCH AS DNA METHYLATION, HISTONE MODIFICATION, AND NON-CODING RNA REGULATION. CURRENT PREVENTION MODALITIES FOR CRC ARE LIMITED AND SOME TREATMENT REGIMENS SUCH AS USE THE NONSTEROIDAL ANTI-INFLAMMATORY DRUG ASPIRIN MAY HAVE SEVERE SIDE EFFECTS, NAMELY GASTROINTESTINAL ULCERATION AND BLEEDING. THEREFORE, THERE IS AN URGENT NEED OF DEVELOPING ALTERNATIVE STRATEGIES. RECENTLY, INCREASING EVIDENCE SUGGESTS THAT SEVERAL DIETARY CANCER CHEMOPREVENTIVE PHYTOCHEMICALS POSSESS ANTI-INFLAMMATION AND ANTIOXIDATIVE STRESS ACTIVITIES, AND MAY PREVENT CANCERS INCLUDING CRC. CURCUMIN (CUR) IS THE YELLOW PIGMENT THAT IS FOUND IN THE RHIZOMES OF TURMERIC (CURCUMA LONGA). MANY STUDIES HAVE DEMONSTRATED THAT CUR EXHIBIT STRONG ANTICANCER, ANTIOXIDATIVE STRESS, AND ANTI-INFLAMMATORY ACTIVITIES BY REGULATING SIGNALING PATHWAYS, SUCH AS NUCLEAR FACTOR ERYTHROID-2-RELATED FACTOR 2, NUCLEAR FACTOR-KAPPAB, AND EPIGENETICS/EPIGENOMICS PATHWAYS OF HISTONES MODIFICATIONS, AND DNA METHYLATION. IN THIS REVIEW, WE WILL DISCUSS THE LATEST EVIDENCE IN EPIGENETICS/EPIGENOMICS ALTERATIONS BY CUR IN CRC AND THEIR POTENTIAL CONTRIBUTION IN THE PREVENTION OF CRC. 2020 2 6325 33 THE ROLE OF ANTI-INFLAMMATORY DRUGS IN COLORECTAL CANCER. A LARGE BODY OF EVIDENCE INDICATES THAT GENETIC MUTATIONS, EPIGENETIC CHANGES, CHRONIC INFLAMMATION, DIET, AND LIFESTYLE ARE KEY RISK FACTORS FOR COLORECTAL CANCER (CRC). PREVENTION OF CRC HAS LONG BEEN CONSIDERED A PLAUSIBLE APPROACH FOR THE POPULATION AND INDIVIDUALS AT HIGH RISK FOR DEVELOPING THIS DISEASE. A SIGNIFICANT EFFORT HAS BEEN MADE IN THE DEVELOPMENT OF NOVEL DRUGS FOR BOTH PREVENTION AND TREATMENT OVER THE PAST TWO DECADES. THIS REVIEW HIGHLIGHTS RECENT ADVANCES IN OUR UNDERSTANDING OF THE ROLE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN CRC PREVENTION AND ADJUVANT TREATMENT. MOREOVER, WE FOCUS ON THE MOLECULAR MECHANISMS UNDERLYING THE ANTITUMOR EFFECTS OF THESE DRUGS IN CRC. THE KNOWLEDGE OF HOW ANTI-INFLAMMATORY AGENTS INHIBIT CANCER FORMATION AND PROGRESSION MAY PROVIDE A RATIONALE FOR THE DEVELOPMENT OF MORE EFFECTIVE CHEMOPREVENTIVE AND CHEMOTHERAPEUTIC AGENTS WITH LESS TOXICITY. 2013 3 1237 52 CURCUMIN AND COLORECTAL CANCER: AN UPDATE AND CURRENT PERSPECTIVE ON THIS NATURAL MEDICINE. COLORECTAL CANCER (CRC) IS ONE OF MOST COMMON MALIGNANCIES WORLDWIDE AND ITS INCIDENCE IS STILL GROWING. IN SPITE OF RECENT ADVANCES IN TARGETED THERAPIES, THEIR CLINICAL EFFICACY HAS BEEN LIMITED, NON-CURATIVE AND UNAFFORDABLE. A GROWING BODY OF LITERATURE INDICATES THAT CRC IS A MULTI-MODAL DISEASE, WHERE A VARIETY OF FACTORS WITHIN THE TUMOR MICROENVIRONMENT PLAY A SIGNIFICANT ROLE IN ITS PATHOGENESIS. FOR INSTANCE, IMBALANCE IN GUT MICROBIAL PROFILES AND IMPAIRED INTESTINAL BARRIER FUNCTION CONTRIBUTE TO THE OVERALL INTESTINAL INFLAMMATION AND INITIATION OF CRC. MOREOVER, PERSISTENT CHRONIC INFLAMMATION FAVORS A TUMOR MICROENVIRONMENT FOR THE GROWTH OF CANCER. IN ADDITION, AUTOPHAGY OR 'SELF-EATING' IS A SURVEILLANCE MECHANISM INVOLVED IN THE DEGRADATION OF CELLULAR CONSTITUENTS THAT ARE GENERATED UNDER STRESSFUL CONDITIONS. CANCER STEM CELLS (CSCS), ON THE OTHER HAND, ENGAGE IN THE ONSET OF CRC AND ARE ABLE TO ENDOW CANCER CELLS WITH CHEMO-RESISTANCE. FURTHERMORE, THE ABERRANT EPIGENETIC ALTERATIONS PROMOTE CRC. THESE EVIDENCES HIGHLIGHT THE NEED FOR MULTI-TARGETED APPROACHES THAT ARE NOT ONLY SAFE AND INEXPENSIVE BUT OFFER A MORE EFFECTIVE ALTERNATIVE TO CURRENT GENERATION OF TARGETED DRUGS. CURCUMIN, DERIVED FROM THE PLANT CURCUMA LONGA, REPRESENTS ONE SUCH OPTION THAT HAS A LONG HISTORY OF ITS USE FOR A VARIETY OF CHRONIC DISEASE INCLUDING CANCER, IN INDIAN AYURVEDIC AND TRADITIONAL CHINESE MEDICINE. SCIENTIFIC EVIDENCE OVER THE PAST FEW DECADES HAVE OVERWHELMINGLY SHOWN THAT CURCUMIN EXHIBITS A MULTITUDE OF ANTI-CANCER ACTIVITIES ORCHESTRATED THROUGH KEY SIGNALING PATHWAYS ASSOCIATED WITH CANCER. IN THIS ARTICLE, WE WILL PRESENT A CURRENT UPDATE AND PERSPECTIVE ON THIS NATURAL MEDICINE - INCORPORATING THE BASIC CELLULAR MECHANISMS IT EFFECTS AND THE CURRENT STATE OF CLINICAL EVIDENCE, CHALLENGES AND PROMISE FOR ITS USE AS A CANCER PREVENTATIVE AND POTENTIAL ADJUNCT TOGETHER WITH MODERN THERAPIES FOR CRC PATIENTS. 2022 4 4671 40 NEW INSIGHTS INTO THE MECHANISM OF ACTION OF ASPIRIN IN THE PREVENTION OF COLORECTAL NEOPLASIA. THE RESULTS OF CLINICAL STUDIES HAVE SHOWN THAT THE CHRONIC ADMINISTRATION OF ASPIRIN, EVEN AT THE LOWDOSES (75-100 MG DAILY) RECOMMENDED FOR THE PREVENTION OF CARDIOVASCULAR DISEASE, IS ASSOCIATED WITH A REDUCTION OF CANCER INCIDENCE AND MORTALITY, IN PARTICULAR COLORECTAL CANCER (CRC). THE MECHANISM OF ACTION OF ASPIRIN AS AN ANTINEOPLASTIC AGENT REMAINS CONTROVERSIAL. HOWEVER, DATA OF CLINICAL PHARMACOLOGY AND SEVERAL FEATURES OF THE CHEMOPREVENTIVE EFFECT OF ASPIRIN, EMERGED FROM CLINICAL TRIALS, SUGGEST THAT THE ANTIPLATELET EFFECT OF ASPIRIN PLAYS A CENTRAL ROLE IN ITS ANTICANCER EFFECTS. IN ADDITION TO THEIR CONTRIBUTION TO TUMOR METASTASIS, PLATELETS MAY PLAY A ROLE IN THE EARLY PHASES OF TUMORIGENESIS. IN RESPONSE TO LIFESTYLE AND ENVIRONMENT FACTORS, INTESTINAL EPITHELIAL DAMAGE/ DYSFUNCTION MAY BE ASSOCIATED WITH PLATELET ACTIVATION, INITIALLY AS A MECHANISM TO REPAIR THE DAMAGE. HOWEVER, IF THE PLATELET RESPONSE IS UNCONSTRAINED, IT MAY CONTRIBUTE TO THE DEVELOPMENT OF CHRONIC INFLAMMATION. ALTOGETHER THESE EVENTS LEAD TO ALTER THE NORMAL FUNCTIONS OF INTESTINAL EPITHELIAL CELLS AND MAY TRANSLATE INTO CELLULAR TRANSFORMATION THROUGH SEVERAL MECHANISMS, INCLUDING THE OVEREXPRESSION OF CYCLOOXYGENASE(COX)-2 AND EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR), WHICH ARE CONSIDERED EARLY EVENTS IN COLORECTAL TUMORIGENESIS. THUS, ANTIPLATELET AGENTS MAY PLAY A ROLE IN THE PREVENTION OF CRC BY MODIFYING EPIGENETIC EVENTS INVOLVED IN EARLY PHASES OF COLORECTAL TUMORIGENESIS. FINALLY, WE CARRIED OUT A CRITICAL REVIEW OF THE LITERATURE ON OFF-TARGET MECHANISMS OF ASPIRIN ACTION AS ANTICANCER DRUG. 2015 5 5554 39 ROLE OF EPIGENETICS IN TRANSFORMATION OF INFLAMMATION INTO COLORECTAL CANCER. MOLECULAR MECHANISMS ASSOCIATED WITH INFLAMMATION-PROMOTED TUMORIGENESIS HAVE BECOME AN IMPORTANT TOPIC IN CANCER RESEARCH. VARIOUS ABNORMAL EPIGENETIC CHANGES, INCLUDING DNA METHYLATION, HISTONE MODIFICATION, CHROMATIN REMODELING, AND NONCODING RNA REGULATION, OCCUR DURING THE TRANSFORMATION OF CHRONIC INFLAMMATION INTO COLORECTAL CANCER (CRC). THESE CHANGES NOT ONLY ACCELERATE TRANSFORMATION BUT ALSO LEAD TO CANCER PROGRESSION AND METASTASIS BY ACTIVATING CARCINOGENIC SIGNALING PATHWAYS. THE NF-KAPPAB AND STAT3 SIGNALING PATHWAYS PLAY A PARTICULARLY IMPORTANT ROLE IN THE TRANSFORMATION OF INFLAMMATION INTO CRC, AND BOTH ARE CRITICAL TO CELLULAR SIGNAL TRANSDUCTION AND CONSTANTLY ACTIVATED IN CANCER BY VARIOUS ABNORMAL CHANGES INCLUDING EPIGENETICS. THE NF-KAPPAB AND STAT3 SIGNALS CONTRIBUTE TO THE MICROENVIRONMENT FOR TUMORIGENESIS THROUGH SECRETION OF A LARGE NUMBER OF PRO-INFLAMMATORY CYTOKINES AND THEIR CROSSTALK IN THE NUCLEUS MAKES IT EVEN MORE DIFFICULT TO TREAT CRC. COMPARED WITH GENE MUTATION THAT IS IRREVERSIBLE, EPIGENETIC INHERITANCE IS REVERSIBLE OR CAN BE ALTERED BY THE INTERVENTION. THEREFORE, UNDERSTANDING THE ROLE OF EPIGENETIC INHERITANCE IN THE INFLAMMATION-CANCER TRANSFORMATION MAY ELUCIDATE THE PATHOGENESIS OF CRC AND PROMOTE THE DEVELOPMENT OF INNOVATIVE DRUGS TARGETING TRANSFORMATION TO PREVENT AND TREAT THIS MALIGNANCY. THIS REVIEW SUMMARIZES THE LITERATURE ON THE ROLES OF EPIGENETIC MECHANISMS IN THE OCCURRENCE AND DEVELOPMENT OF INFLAMMATION-INDUCED CRC. EXPLORING THE ROLE OF EPIGENETICS IN THE TRANSFORMATION OF INFLAMMATION INTO CRC MAY HELP STIMULATE FUTURES STUDIES ON THE ROLE OF MOLECULAR THERAPY IN CRC. 2019 6 4458 36 MOLECULAR MECHANISMS OF ALCOHOL-INDUCED COLORECTAL CARCINOGENESIS. THE ETIOLOGY OF COLORECTAL CANCER (CRC) IS COMPLEX. APPROXIMATELY, 10% OF INDIVIDUALS WITH CRC HAVE PREDISPOSING GERMLINE MUTATIONS THAT LEAD TO FAMILIAL CANCER SYNDROMES, WHEREAS MOST CRC PATIENTS HAVE SPORADIC CANCER RESULTING FROM A COMBINATION OF ENVIRONMENTAL AND GENETIC RISK FACTORS. IT HAS BECOME INCREASINGLY CLEAR THAT CHRONIC ALCOHOL CONSUMPTION IS ASSOCIATED WITH THE DEVELOPMENT OF SPORADIC CRC; HOWEVER, THE EXACT MECHANISMS BY WHICH ALCOHOL CONTRIBUTES TO COLORECTAL CARCINOGENESIS ARE LARGELY UNKNOWN. SEVERAL PROPOSED MECHANISMS FROM STUDIES IN CRC MODELS SUGGEST THAT ALCOHOL METABOLITES AND/OR ENZYMES ASSOCIATED WITH ALCOHOL METABOLISM ALTER CELLULAR REDOX BALANCE, CAUSE DNA DAMAGE, AND EPIGENETIC DYSREGULATION. IN ADDITION, ALCOHOL METABOLITES CAN CAUSE A DYSBIOTIC COLORECTAL MICROBIOME AND INTESTINAL PERMEABILITY, RESULTING IN BACTERIAL TRANSLOCATION, INFLAMMATION, AND IMMUNOSUPPRESSION. ALL OF THESE EFFECTS CAN INCREASE THE RISK OF DEVELOPING CRC. THIS REVIEW AIMS TO OUTLINE SOME OF THE MOST SIGNIFICANT AND RECENT FINDINGS ON THE MECHANISMS OF ALCOHOL IN COLORECTAL CARCINOGENESIS. WE EXAMINE THE EFFECT OF ALCOHOL ON THE GENERATION OF REACTIVE OXYGEN SPECIES, THE DEVELOPMENT OF GENOTOXIC STRESS, MODULATION OF ONE-CARBON METABOLISM, DISRUPTION OF THE MICROBIOME, AND IMMUNOSUPPRESSION. 2021 7 2704 34 EXERCISE AND COLORECTAL CANCER: PREVENTION AND MOLECULAR MECHANISMS. EXERCISE AND PHYSICAL ACTIVITY HAVE BEEN SHOWN TO BE STRONGLY ASSOCIATED WITH A DECREASED INCIDENCE RATE OF VARIOUS CHRONIC DISEASES ESPECIALLY NUMEROUS HUMAN MALIGNANCIES. A HUGE NUMBER OF CLINICAL TRIALS AND META-ANALYSIS HAVE DEMONSTRATED THAT EXERCISE IS SIGNIFICANTLY EFFECTIVE IN LOWERING THE RISK OF COLORECTAL CANCER. IN ADDITION, IT IS SUGGESTED AS AN EFFECTIVE THERAPEUTIC MODALITY AGAINST THIS CANCER TYPE. THEREFORE, IN THIS REVIEW, WE WILL REVIEW COMPREHENSIBLY THE EFFECTS OF EXERCISE IN PREVENTING, TREATING, AND ALLEVIATING THE ADVERSE EFFECTS OF CONVENTIONAL THERAPEUTIC OPTIONS IN COLORECTAL CANCER. MOREOVER, THE POSSIBLE MECHANISMS UNDERLYING THE POSITIVE EFFECTS OF EXERCISE AND PHYSICAL ACTIVITY IN COLORECTAL CANCER, INCLUDING REGULATION OF INFLAMMATION, APOPTOSIS, GROWTH FACTOR AXIS, IMMUNITY, EPIGENETIC, ETC. WILL BE ALSO DISCUSSED. 2022 8 6331 40 THE ROLE OF COX-2 IN INTESTINAL INFLAMMATION AND COLORECTAL CANCER. COLORECTAL CANCER (CRC) IS A HETEROGENEOUS DISEASE, INCLUDING AT LEAST THREE MAJOR FORMS: HEREDITARY, SPORADIC AND COLITIS-ASSOCIATED CRC. A LARGE BODY OF EVIDENCE INDICATES THAT GENETIC MUTATIONS, EPIGENETIC CHANGES, CHRONIC INFLAMMATION, DIET AND LIFESTYLE ARE THE RISK FACTORS FOR CRC. AS ELEVATED CYCLOOXYGENASE-2 (COX-2) EXPRESSION WAS FOUND IN MOST CRC TISSUE AND IS ASSOCIATED WITH WORSE SURVIVAL AMONG CRC PATIENTS, INVESTIGATORS HAVE SOUGHT TO EVALUATE THE EFFECTS OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) AND SELECTIVE COX-2 INHIBITORS (COXIBS) ON CRC. THE EPIDEMIOLOGICAL STUDIES, CLINICAL TRIALS AND ANIMAL EXPERIMENTS INDICATE THAT NSAIDS ARE AMONG THE MOST PROMISING CHEMOPREVENTIVE AGENTS FOR THIS DISEASE. NSAIDS EXERT THEIR ANTI-INFLAMMATORY AND ANTITUMOR EFFECTS PRIMARILY BY REDUCING PROSTAGLANDIN PRODUCTION BY INHIBITION OF COX-2 ACTIVITY. IN THIS REVIEW, WE HIGHLIGHT BREAKTHROUGHS IN OUR UNDERSTANDING OF THE ROLES OF COX-2 IN CRC AND INFLAMMATORY BOWEL DISEASE. THESE RECENT DATA PROVIDE A RATIONALE FOR RE-EVALUATING COX-2 AS BOTH THE PROGNOSTIC AND THE PREDICTIVE MARKER IN A WIDE VARIETY OF MALIGNANCIES AND FOR RENEWING THE INTEREST IN EVALUATING RELATIVE BENEFITS AND RISK OF COXIBS IN APPROPRIATELY SELECTED PATIENTS FOR CANCER PREVENTION AND TREATMENT. 2010 9 1180 37 CONVERGENCE OF GENETIC, NUTRITIONAL AND INFLAMMATORY FACTORS IN GASTROINTESTINAL CANCERS. GASTROINTESTINAL CANCERS ACCOUNT FOR 20% OF ALL CANCER INCIDENCES WORLDWIDE. COLORECTAL CANCER IS THE SECOND MOST COMMON CAUSE OF ALL CANCER-RELATED MORTALITY AND IS INCREASING IN WESTERN SOCIETIES. INFECTION AND INFLAMMATION CONTRIBUTE TO 15-20% OF ALL MALIGNANCIES, AND ARE PREDISPOSING RISK FACTORS FOR GASTROINTESTINAL CANCERS. HELICOBACTER PYLORI INFECTION IS COMMONLY ASSOCIATED WITH GASTRIC CANCERS, AND CHRONIC INFLAMMATION INCREASES THE RISK OF COLORECTAL CANCER BY 1% PER YEAR. MICRONUTRIENT STATUS AND COMMON GENETIC VARIATIONS IN HUMAN POPULATIONS MODIFY RISK FOR GASTROINTESTINAL CANCER. CHRONIC INFLAMMATION PROMOTES CARCINOGENESIS BY INDUCING GENE MUTATIONS, INHIBITING APOPTOSIS, AND STIMULATING ANGIOGENESIS AND CELL PROLIFERATION. INFLAMMATION ALSO INDUCES EPIGENETIC ALTERATIONS THAT ARE ASSOCIATED WITH CANCER DEVELOPMENT. TWO KEY GENES IN THE INFLAMMATORY PROCESS, CYCLOOXYGENASE-2 (COX-2) AND NUCLEAR FACTOR-KAPPA B (NF-KAPPAB), PROVIDE A MECHANISTIC LINK BETWEEN INFLAMMATION AND CANCER AND ARE TARGETS FOR CHEMOPREVENTION. DIETARY COMPONENTS, AND HUMAN GENETIC VARIATION THAT AFFECTS NUTRIENT UTILIZATION, CAN DIRECTLY MODIFY INFLAMMATORY PROCESSES AND/OR SUPPRESS GENOMIC ALTERATIONS THAT ARE THE MOLECULAR ANTECEDENTS OF CANCERS. THE PRESENT REPORT FOCUSES ON THE CONVERGENCE OF GENETIC, NUTRITIONAL, AND INFLAMMATORY FACTORS IN THE INITIATION AND PROGRESSION OF GASTROINTESTINAL CANCERS, AND THE EMERGING DIETARY STRATEGIES FOR CANCER PREVENTION. 2007 10 5373 42 RECENT ADVANCES IN UNDERSTANDING THE ROLE OF DIET AND OBESITY IN THE DEVELOPMENT OF COLORECTAL CANCER. COLORECTAL CANCER (CRC) IS A MAJOR CAUSE OF PREMATURE DEATH IN THE UK AND MANY DEVELOPED COUNTRIES. HOWEVER, THE RISK OF DEVELOPING CRC IS WELL RECOGNISED TO BE ASSOCIATED NOT ONLY WITH DIET BUT ALSO WITH OBESITY AND LACK OF EXERCISE. WHILE EPIDEMIOLOGICAL EVIDENCE SHOWS AN ASSOCIATION WITH FACTORS SUCH AS HIGH RED MEAT INTAKE AND LOW INTAKE OF VEGETABLES, FIBRE AND FISH, THE MECHANISMS UNDERLYING THESE EFFECTS ARE ONLY NOW BEING ELUCIDATED. CRC DEVELOPS OVER MANY YEARS AND IS TYPICALLY CHARACTERISED BY AN ACCUMULATION OF MUTATIONS, WHICH MAY ARISE AS A CONSEQUENCE OF INHERITED POLYMORPHISMS IN KEY GENES, BUT MORE COMMONLY AS A RESULT OF SPONTANEOUSLY ARISING MUTATIONS AFFECTING GENES CONTROLLING CELL PROLIFERATION, DIFFERENTIATION, APOPTOSIS AND DNA REPAIR. EPIGENETIC CHANGES ARE OBSERVED THROUGHOUT THE PROGRESS FROM NORMAL MORPHOLOGY THROUGH FORMATION OF ADENOMA, AND THE SUBSEQUENT DEVELOPMENT OF CARCINOMA. THE REASONS WHY THIS ACCUMULATION OF LOSS OF HOMOEOSTATIC CONTROLS ARISES ARE UNCLEAR BUT CHRONIC INFLAMMATION HAS BEEN PROPOSED TO PLAY A CENTRAL ROLE. OBESITY IS ASSOCIATED WITH INCREASED PLASMA LEVELS OF CHEMOKINES AND ADIPOKINES CHARACTERISTIC OF CHRONIC SYSTEMIC INFLAMMATION, AND DIETARY FACTORS SUCH AS FISH OILS AND PHYTOCHEMICALS HAVE BEEN SHOWN TO HAVE ANTI-INFLAMMATORY PROPERTIES AS WELL AS MODULATING ESTABLISHED RISK FACTORS SUCH AS APOPTOSIS AND CELL PROLIFERATION. THERE IS ALSO SOME EVIDENCE THAT DIET CAN MODIFY EPIGENETIC CHANGES. THIS PAPER BRIEFLY REVIEWS THE CURRENT STATE OF KNOWLEDGE IN RELATION TO CRC DEVELOPMENT AND CONSIDERS EVIDENCE FOR POTENTIAL MECHANISMS BY WHICH DIET MAY MODIFY RISK. 2011 11 2578 40 EPIGENETICS OF INFLAMMATORY BOWEL DISEASES. INFLAMMATORY BOWEL DISEASES ARE MULTIFACTORIAL, CHRONIC, CONTINUOUS, RELAPSING, AND IMMUNE-MEDIATED DISEASES OF THE GASTROINTESTINAL TRACT. IT HAS BEEN BELIEVED THAT MECHANISMS UNDERLYING INFLAMMATORY BOWEL DISEASES INCLUDE GENETIC PREDISPOSITION, ENVIRONMENTAL FACTORS, AND ALTERED IMMUNE RESPONSE TO THE GUT MICROBIOME. THE EPIGENETIC MODULATION TAKES PLACE VIA CHROMATIN MODIFICATIONS, INCLUDING PHOSPHORYLATION, ACETYLATION, METHYLATION, SUMOYLATION, AND UBIQUITINATION. THE METHYLATION LEVELS OF COLONIC TISSUE WERE FOUND WELL CORRELATED TO BLOOD SAMPLES IN INFLAMMATORY BOWEL DISEASES. MOREOVER, THE METHYLATION LEVEL OF SPECIFIC GENES WAS DIFFERENT BETWEEN CROHN'S DISEASE AND ULCERATIVE COLITIS. IT HAS BEEN SHOWN THAT THE ENZYMES AFFECTING HISTONE MODIFICATIONS LIKE HISTONE DEACETYLASES AND HISTONE ACETYLTRANSFERASES DO NOT ACT SOLELY ON HISTONES BUT ALSO AFFECT THE ACETYLATION OF MANY PROTEINS SUCH AS P53 AND STAT3. IT HAS BEEN ALREADY SHOWN THAT A NONSELECTIVE HISTONE DEACETYLASE INHIBITOR, VORINOSTAT (SAHA), WHICH IS CURRENTLY BEING USED IN SEVERAL CANCER TREATMENTS, SHOWED ANTI-INFLAMMATORY ACTIVITIES IN MOUSE MODELS. AMONG EPIGENETIC ALTERATIONS, LONG NON-CODING RNAS AND MICRORNAS PLAY SIGNIFICANT ROLES IN T-CELL MATURATION, DIFFERENTIATION, ACTIVATION, AND SENILITY. THE LONG NON-CODING RNA AND MICRORNA EXPRESSION PROFILES CAN PERFECTLY SEPARATE INFLAMMATORY BOWEL DISEASE PATIENTS FROM HEALTHY CONTROLS AND ARE REMARKED AS BIOMARKERS OF INFLAMMATORY BOWEL DISEASES. OVERALL, MANY STUDIES HAVE SHOWN THAT EPIGENETIC INHIBITORS CAN TARGET SIGNIFICANT SIGNAL PATHWAYS IN THE PATHOGENESIS OF INFLAMMATORY BOWEL DISEASES, AND THE IMPACT OF EPIGENETIC INHIBITORS IS BEING STUDIED IN CLINICAL TRIALS. IN CONCLUSION, EXPLORING MORE EPIGENETIC PATHWAYS REGARDING INFLAMMATORY BOWEL DISEASE PATHOGENESIS WILL HELP US TO DISCOVER THERAPEUTIC TARGETS AND NEW DRUGS AND AGENTS TARGETING MIRNAS IN INFLAMMATORY BOWEL DISEASES. IN GENERAL, DISCOVERING EPIGENETIC TARGETS COULD IMPROVE THE DIAGNOSIS AND TREATMENT OF INFLAMMATORY BOWEL DISEASES. 2023 12 45 30 A COMPREHENSIVE REVIEW ON RNA INTERFERENCE-MEDIATED TARGETING OF INTERLEUKINS AND ITS POTENTIAL THERAPEUTIC IMPLICATIONS IN COLON CANCER. COLON CANCER IS THE WORLD'S FOURTH LEADING CAUSE OF DEATH. IT IS CANCER OF THE LATTER PART OF THE LARGE INTESTINE, I.E. THE COLON. CHRONIC INFLAMMATION OVER A LONG PERIOD ALSO LEADS TO THE DEVELOPMENT OF CANCER. CANCER IN THE COLON REGION IS ARDUOUS TO DIAGNOSE AND IS DETECTED AT A LATER STAGE WHEN IT METASTASIZES TO OTHER PARTS OF THE BODY LIKE THE LIVER, LUNGS, PERITONEUM, ETC. COLON CANCER IS A GREAT EXAMPLE OF SOLID TUMOURS ASSOCIATED WITH CHRONIC INFLAMMATION. ALTHOUGH CONVENTIONAL THERAPIES ARE EFFECTIVE, THEY LOSE THEIR EFFECTIVENESS BEYOND A CERTAIN POINT. RELAPSE OF THE DISEASE OCCURS FREQUENTLY. RNA INTERFERENCE (RNAI) IS EMERGING AS A GREAT TOOL TO SPECIFICALLY ATTACK THE CANCER CELLS OF A TARGET SITE LIKE THE COLON. RNAI DEALS WITH EPIGENETIC CHANGES MADE IN THE DEFECTIVE CELLS WHICH ULTIMATELY LEADS TO THEIR DEATH WITHOUT HARMING THE HEALTHY CELLS. IN THIS REVIEW, TWO TYPES OF EPIGENETIC MODULATORS HAVE BEEN CONSIDERED, NAMELY SIRNA AND MIRNA, AND THEIR EFFECT ON INTERLEUKINS. INTERLEUKINS, A CLASS OF CYTOKINES, ARE MAJOR INFLAMMATORY RESPONSES OF THE BODY THAT ARE RELEASED BY IMMUNE CELLS LIKE LEUKOCYTES AND MACROPHAGES. SOME OF THESE INTERLEUKINS ARE PRO-INFLAMMATORY, THEREBY PROMOTING INFLAMMATION WHICH EVENTUALLY CAUSES CANCER. RNAI CAN PREVENT COLON CANCER BY INHIBITING PRO-INFLAMMATORY INTERLEUKINS. 2023 13 928 27 CHRONIC INFLAMMATION, THE TUMOR MICROENVIRONMENT AND CARCINOGENESIS. CHRONIC INFLAMMATION OFTEN PRECEDES OR ACCOMPANIES A SUBSTANTIAL NUMBER OF CANCERS. INDEED, ANTI-INFLAMMATORY THERAPIES HAVE SHOWN EFFICACY IN CANCER PREVENTION AND TREATMENT. THE EXACT MECHANISMS THAT TURN A WOUND HEALING PROCESS INTO A CANCER PRECURSOR ARE TOPICS OF INTENSE RESEARCH. A PATHOGENIC LINK HAS BEEN IDENTIFIED BETWEEN INFLAMMATORY MEDIATORS, INFLAMMATION RELATED GENE POLYMORPHISMS AND CARCINOGENESIS. ANIMAL MODELS OF CANCER HAVE BEEN INSTRUMENTAL IN DEMONSTRATING THE DIVERSITY OF MECHANISMS THROUGH WHICH EVERY TUMOR COMPARTMENT AND TUMOR STAGE MAY BE AFFECTED BY THE UNDERLYING INFLAMMATORY PROCESS. IN THIS REVIEW, WE FOCUS ON THE INTERACTION BETWEEN CHRONIC INFLAMMATION, TUMOR STEM CELLS AND THE TUMOR MICROENVIRONMENT. WE SUMMARIZE THE PROPOSED MECHANISMS THAT LEAD TO THE RECRUITMENT OF BONE MARROW DERIVED CELLS AND EXPLORE THE GENETIC AND EPIGENETIC ALTERATIONS THAT MAY OCCUR IN INFLAMMATION ASSOCIATED CANCERS. 2009 14 5566 38 ROLE OF INFLAMMATION IN THE DEVELOPMENT OF COLORECTAL CANCER. CHRONIC INFLAMMATION CAN LEAD TO THE DEVELOPMENT OF MANY DISEASES, INCLUDING CANCER. INFLAMMATORY BOWEL DISEASE (IBD) THAT INCLUDES BOTH ULCERATIVE COLITIS (UC) AND CROHNMP'S DISEASE (CD) ARE RISK FACTORS FOR THE DEVELOPMENT OF COLORECTAL CANCER (CRC). MANY CYTOKINES PRODUCED PRIMARILY BY THE GUT IMMUNE CELLS EITHER DURING OR IN RESPONSE TO LOCALIZED INFLAMMATION IN THE COLON AND RECTUM ARE KNOWN TO STIMULATE THE COMPLEX INTERACTIONS BETWEEN THE DIFFERENT CELL TYPES IN THE GUT ENVIRONMENT RESULTING IN ACUTE INFLAMMATION. SUBSEQUENTLY, CHRONIC INFLAMMATION, TOGETHER WITH GENETIC AND EPIGENETIC CHANGES, HAVE BEEN SHOWN TO LEAD TO THE DEVELOPMENT AND PROGRESSION OF CRC. VARIOUS CELL TYPES PRESENT IN THE COLON, SUCH AS ENTEROCYTES, PANETH CELLS, GOBLET CELLS, AND MACROPHAGES, EXPRESS RECEPTORS FOR INFLAMMATORY CYTOKINES AND RESPOND TO TUMOR NECROSIS FACTOR-ALPHA (TNF-ALPHA), INTERLEUKIN-1 BETA (IL-1BETA), IL-6, AND OTHER CYTOKINES. AMONG THE SEVERAL CYTOKINES PRODUCED, TNF-ALPHA AND IL-1BETA ARE THE KEY PRO-INFLAMMATORY MOLECULES THAT PLAY CRITICAL ROLES IN THE DEVELOPMENT OF CRC. THE CURRENT REVIEW IS INTENDED TO CONSOLIDATE THE PUBLISHED FINDINGS TO FOCUS ON THE ROLE OF PRO-INFLAMMATORY CYTOKINES, NAMELY TNF-ALPHA AND IL-1BETA, ON INFLAMMATION (AND THE ALTERED IMMUNE RESPONSE) IN THE GUT, TO BETTER UNDERSTAND THE DEVELOPMENT OF CRC IN IBD, USING VARIOUS EXPERIMENTAL MODEL SYSTEMS, PRECLINICAL AND CLINICAL STUDIES. MOREOVER, THIS REVIEW ALSO HIGHLIGHTS THE CURRENT THERAPEUTIC STRATEGIES AVAILABLE (MONOTHERAPY AND COMBINATION THERAPY) TO ALLEVIATE THE SYMPTOMS OR TREAT INFLAMMATION-ASSOCIATED CRC BY USING MONOCLONAL ANTIBODIES OR APTAMERS TO BLOCK PRO-INFLAMMATORY MOLECULES, INHIBITORS OF TYROSINE KINASES IN THE INFLAMMATORY SIGNALING CASCADE, COMPETITIVE INHIBITORS OF PRO-INFLAMMATORY MOLECULES, AND THE NUCLEIC ACID DRUGS LIKE SMALL ACTIVATING RNAS (SARNAS) OR MICRORNA (MIRNA) MIMICS TO ACTIVATE TUMOR SUPPRESSOR OR REPRESS ONCOGENE/PRO-INFLAMMATORY CYTOKINE GENE EXPRESSION. 2021 15 2335 34 EPIGENETIC REGULATION OF INFLAMMATORY CYTOKINES AND ASSOCIATED GENES IN HUMAN MALIGNANCIES. INFLAMMATION IS A MULTIFACETED DEFENSE RESPONSE OF IMMUNE SYSTEM AGAINST INFECTION. CHRONIC INFLAMMATION HAS BEEN IMPLICATED AS AN IMMINENT THREAT FOR MAJOR HUMAN MALIGNANCIES AND IS DIRECTLY LINKED TO VARIOUS STEPS INVOLVED IN TUMORIGENESIS. INFLAMMATORY CYTOKINES, INTERLEUKINS, INTERFERONS, TRANSFORMING GROWTH FACTORS, CHEMOKINES, AND ADHESION MOLECULES HAVE BEEN ASSOCIATED WITH CHRONIC INFLAMMATION. NUMEROUS CYTOKINES ARE REPORTED TO BE ABERRANTLY REGULATED BY DIFFERENT EPIGENETIC MECHANISMS LIKE DNA METHYLATION AND HISTONE MODIFICATIONS IN TUMOR TISSUES, CONTRIBUTING TO PATHOGENESIS OF TUMOR IN MULTIPLE WAYS. SOME OF THESE CYTOKINES ALSO WORK AS EPIGENETIC REGULATORS OF OTHER CRUCIAL GENES IN TUMOR BIOLOGY, EITHER DIRECTLY OR INDIRECTLY. SUCH REGULATIONS ARE REPORTED IN LUNG, BREAST, CERVICAL, GASTRIC, COLORECTAL, PANCREATIC, PROSTATE, AND HEAD AND NECK CANCERS. EPIGENETICS OF INFLAMMATORY MEDIATORS IN CANCER IS CURRENTLY SUBJECT OF EXTENSIVE RESEARCH. THESE INVESTIGATIONS MAY HELP IN UNDERSTANDING CANCER BIOLOGY AND TO DEVELOP EFFECTIVE THERAPEUTIC STRATEGIES. THE PURPOSE OF THIS PAPER IS TO HAVE A BRIEF VIEW OF THE ABERRANT REGULATION OF INFLAMMATORY CYTOKINES IN HUMAN MALIGNANCIES. 2015 16 4732 45 NOVEL BIOMARKERS FOR INFLAMMATORY BOWEL DISEASE AND COLORECTAL CANCER: AN INTERPLAY BETWEEN METABOLIC DYSREGULATION AND EXCESSIVE INFLAMMATION. PERSISTENT INFLAMMATION CAN TRIGGER ALTERED EPIGENETIC, INFLAMMATORY, AND BIOENERGETIC STATES. INFLAMMATORY BOWEL DISEASE (IBD) IS AN IDIOPATHIC DISEASE CHARACTERIZED BY CHRONIC INFLAMMATION OF THE GASTROINTESTINAL TRACT, WITH EVIDENCE OF SUBSEQUENT METABOLIC SYNDROME DISORDER. STUDIES HAVE DEMONSTRATED THAT AS MANY AS 42% OF PATIENTS WITH ULCERATIVE COLITIS (UC) WHO ARE FOUND TO HAVE HIGH-GRADE DYSPLASIA, EITHER ALREADY HAD COLORECTAL CANCER (CRC) OR DEVELOP IT WITHIN A SHORT TIME. THE PRESENCE OF LOW-GRADE DYSPLASIA IS ALSO PREDICTIVE OF CRC. MANY SIGNALING PATHWAYS ARE SHARED AMONG IBD AND CRC, INCLUDING CELL SURVIVAL, CELL PROLIFERATION, ANGIOGENESIS, AND INFLAMMATORY SIGNALING PATHWAYS. CURRENT IBD THERAPEUTICS TARGET A SMALL SUBSET OF MOLECULAR DRIVERS OF IBD, WITH MANY FOCUSED ON THE INFLAMMATORY ASPECT OF THE PATHWAYS. THUS, THERE IS A GREAT NEED TO IDENTIFY BIOMARKERS OF BOTH IBD AND CRC, THAT CAN BE PREDICTIVE OF THERAPEUTIC EFFICACY, DISEASE SEVERITY, AND PREDISPOSITION TO CRC. IN THIS STUDY, WE EXPLORED THE CHANGES IN BIOMARKERS SPECIFIC FOR INFLAMMATORY, METABOLIC, AND PROLIFERATIVE PATHWAYS, TO HELP DETERMINE THE RELEVANCE TO BOTH IBD AND CRC. OUR ANALYSIS DEMONSTRATED, FOR THE FIRST TIME IN IBD, THE LOSS OF THE TUMOR SUPPRESSOR PROTEIN RAS ASSOCIATED FAMILY PROTEIN 1A (RASSF1A), VIA EPIGENETIC CHANGES, THE HYPERACTIVATION OF THE OBLIGATE KINASE OF THE NOD2 PATHOGEN RECOGNITION RECEPTOR (RECEPTOR INTERACTING PROTEIN KINASE 2 [RIPK2]), THE LOSS OF ACTIVATION OF THE METABOLIC KINASE, AMP ACTIVATED PROTEIN KINASE (AMPKALPHA1), AND, LASTLY, THE ACTIVATION OF THE TRANSCRIPTION FACTOR AND KINASE YES ASSOCIATED PROTEIN (YAP) KINASE, THAT IS INVOLVED IN PROLIFERATION OF CELLS. THE EXPRESSION AND ACTIVATION STATUS OF THESE FOUR ELEMENTS ARE MIRRORED IN IBD, CRC, AND IBD-CRC PATIENTS AND, IMPORTANTLY, IN MATCHED BLOOD AND BIOPSY SAMPLES. THE LATTER WOULD SUGGEST THAT BIOMARKER ANALYSIS CAN BE PERFORMED NON-INVASIVELY, TO UNDERSTAND IBD AND CRC, WITHOUT THE NEED FOR INVASIVE AND COSTLY ENDOSCOPIC ANALYSIS. THIS STUDY, FOR THE FIRST TIME, ILLUSTRATES THE NEED TO UNDERSTAND IBD OR CRC BEYOND AN INFLAMMATORY PERSPECTIVE AND THE VALUE OF THERAPEUTICS DIRECTED TO RESET ALTERED PROLIFERATIVE AND METABOLIC STATES WITHIN THE COLON. THE USE OF SUCH THERAPEUTICS MAY TRULY DRIVE PATIENTS INTO REMISSION. 2023 17 1413 41 DIETARY PHYTOCHEMICALS AND CANCER CHEMOPREVENTION: A PERSPECTIVE ON OXIDATIVE STRESS, INFLAMMATION, AND EPIGENETICS. OXIDATIVE STRESS OCCURS WHEN CELLULAR REACTIVE OXYGEN SPECIES LEVELS EXCEED THE SELF-ANTIOXIDANT CAPACITY OF THE BODY. OXIDATIVE STRESS INDUCES MANY PATHOLOGICAL CHANGES, INCLUDING INFLAMMATION AND CANCER. CHRONIC INFLAMMATION IS BELIEVED TO BE STRONGLY ASSOCIATED WITH THE MAJOR STAGES OF CARCINOGENESIS. THE NUCLEAR FACTOR ERYTHROID 2-RELATED FACTOR 2 (NRF2) PATHWAY PLAYS A CRUCIAL ROLE IN REGULATING OXIDATIVE STRESS AND INFLAMMATION BY MANIPULATING KEY ANTIOXIDANT AND DETOXIFICATION ENZYME GENES VIA THE ANTIOXIDANT RESPONSE ELEMENT. MANY DIETARY PHYTOCHEMICALS WITH CANCER CHEMOPREVENTIVE PROPERTIES, SUCH AS POLYPHENOLS, ISOTHIOCYANATES, AND TRITERPENOIDS, EXERT ANTIOXIDANT AND ANTI-INFLAMMATORY FUNCTIONS BY ACTIVATING THE NRF2 PATHWAY. FURTHERMORE, EPIGENETIC CHANGES, INCLUDING DNA METHYLATION, HISTONE POST-TRANSLATIONAL MODIFICATIONS, AND MIRNA-MEDIATED POST-TRANSCRIPTIONAL ALTERATIONS, ALSO LEAD TO VARIOUS CARCINOGENESIS PROCESSES BY SUPPRESSING CANCER REPRESSOR GENE TRANSCRIPTION. USING EPIGENETIC RESEARCH TOOLS, INCLUDING NEXT-GENERATION SEQUENCING TECHNOLOGIES, MANY DIETARY PHYTOCHEMICALS ARE SHOWN TO MODIFY AND REVERSE ABERRANT EPIGENETIC/EPIGENOME CHANGES, POTENTIALLY LEADING TO CANCER PREVENTION/TREATMENT. THUS, THE BENEFICIAL EFFECTS OF DIETARY PHYTOCHEMICALS ON CANCER DEVELOPMENT WARRANT FURTHER INVESTIGATION TO PROVIDE ADDITIONAL IMPETUS FOR CLINICAL TRANSLATIONAL STUDIES. 2016 18 1522 40 DNA METHYLATION CHANGE PROFILING OF COLORECTAL DISEASE: SCREENING TOWARDS CLINICAL USE. COLON CANCER REMAINS ONE OF THE LEADING CAUSES OF CANCER-RELATED DEATHS WORLDWIDE. TRANSFORMATION OF COLON EPITHELIAL CELLS INTO INVASIVE ADENOCARCINOMAS HAS BEEN WELL KNOWN TO BE DUE TO THE ACCUMULATION OF MULTIPLE GENETIC AND EPIGENETIC CHANGES. IN THE PAST DECADE, THE ETIOLOGY OF INFLAMMATORY BOWEL DISEASE (IBD) WHICH IS CHARACTERIZED BY CHRONIC INFLAMMATION OF THE INTESTINAL MUCOSA, WAS ONLY PARTIALLY EXPLAINED BY GENETIC STUDIES PROVIDING SUSCEPTIBILITY LOCI, BUT RECENTLY EPIGENETIC STUDIES HAVE PROVIDED CRITICAL EVIDENCES AFFECTING IBD PATHOGENESIS. OVER THE PAST DECADE, A DEEP UNDERSTANDING OF EPIGENETICS ALONG WITH TECHNOLOGICAL ADVANCES HAVE LED TO IDENTIFYING NUMEROUS GENES THAT ARE REGULATED BY PROMOTER DNA HYPERMETHYLATION IN COLORECTAL DISEASES. RECENT ADVANCES IN OUR UNDERSTANDING OF THE ROLE OF DNA METHYLATION IN COLORECTAL DISEASES COULD IMPROVE A MULTITUDE OF POWERFUL DNA METHYLATION-BASED BIOMARKERS, PARTICULARLY FOR USE AS DIAGNOSIS, PROGNOSIS, AND PREDICTION FOR THERAPEUTIC APPROACHES. THIS REVIEW FOCUSES ON THE EMERGING POTENTIAL FOR TRANSLATIONAL RESEARCH OF EPIGENETIC ALTERATIONS INTO CLINICAL UTILITY AS MOLECULAR BIOMARKERS. MOREOVER, THIS REVIEW DISCUSSES RECENT PROGRESS REGARDING THE IDENTIFICATION OF UNKNOWN HYPERMETHYLATED GENES IN COLON CANCERS AND IBD, AS WELL AS THEIR POSSIBLE ROLE IN CLINICAL PRACTICE, WHICH WILL HAVE IMPORTANT CLINICAL SIGNIFICANCE, PARTICULARLY IN THE ERA OF THE PERSONALIZED MEDICINE. 2021 19 3681 36 INFLAMMATION, DNA METHYLATION AND COLITIS-ASSOCIATED CANCER. INFLAMMATION CAN RESULT FROM A RANGE OF SOURCES INCLUDING MICROBIAL INFECTIONS, EXPOSURE TO ALLERGENS AND TOXIC CHEMICALS, AUTOIMMUNE DISEASE AND OBESITY. A WELL-BALANCED IMMUNE RESPONSE CAN BE ANTI-TUMORIGENIC; HOWEVER, A SUSTAINED OR CHRONIC INFLAMMATORY RESPONSE IS GENERALLY HARMFUL AS THE IMMUNE RESPONSE BECOMES DISTORTED. A CAUSAL LINK BETWEEN CHRONIC INFLAMMATION AND CANCER IS NOW WELL ACCEPTED AND MANY CHRONICALLY INFLAMED ORGANS OF THE GASTROINTESTINAL TRACT SHOW THIS ASSOCIATION. FOR EXAMPLE, PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD), INCLUDING BOTH ULCERATIVE COLITIS AND CROHN'S DISEASE, HAVE A 2- TO 3-FOLD GREATER LIFETIME RISK OF DEVELOPING COLORECTAL CANCER COMPARED WITH THE GENERAL POPULATION. THE DEVELOPMENT OF COLITIS-ASSOCIATED CANCER (CAC) IS THOUGHT TO BE MULTIFACETED AND IS PROBABLY DUE TO A COMBINATION OF GENETIC FACTORS, EPIGENETIC FACTORS AND THE DURATION, EXTENT AND SEVERITY OF DISEASE. RECENTLY, EPIGENETIC ALTERATIONS, IN PARTICULAR ALTERATIONS IN DNA METHYLATION, HAVE BEEN OBSERVED DURING INFLAMMATION AND INFLAMMATION-ASSOCIATED CARCINOGENESIS. THE MEDIATORS OF THIS, THE SIGNIFICANCE OF THESE CHANGES IN DNA METHYLATION AND THE EFFECT THIS HAS ON GENE EXPRESSION AND THE MALIGNANT TRANSFORMATION OF THE EPITHELIAL CELLS DURING IBD AND CAC ARE DISCUSSED IN THIS REVIEW. THE RECENT ADVANCES IN TECHNOLOGIES TO STUDY GENOME-WIDE DNA METHYLATION AND THE THERAPEUTIC POTENTIAL OF UNDERSTANDING THESE MOLECULAR MECHANISMS ARE ALSO HIGHLIGHTED. 2012 20 4800 38 OBESITY AND INFLAMMATION: COLORECTAL CANCER ENGINES. THE PREVALENCE OF OBESITY CONTINUES TO INCREASE TO THE EXTENT THAT IT BECAME A WORLDWIDE PANDEMIC. AN ACCUMULATING BODY OF EVIDENCE HAS ASSOCIATED OBESITY WITH THE DEVELOPMENT OF DIFFERENT TYPES OF CANCER, INCLUDING COLORECTAL CANCER, WHICH IS A NOTORIOUS DISEASE WITH A HIGH MORTALITY RATE. AT THE MOLECULAR LEVEL, COLORECTAL CANCER IS A HETEROGENOUS DISEASE CHARACTERIZED BY A MYRIAD OF GENETIC AND EPIGENETIC ALTERATIONS ASSOCIATED WITH VARIOUS FORMS OF GENOMIC INSTABILITY (DETAILED IN SUPPLEMENTARY MATERIALS). RECENTLY, THE MICROENVIRONMENT HAS EMERGED AS A MAJOR FACTOR IN CARCINOGENESIS. OUR AIM IS TO DEFINE THE DIFFERENT MOLECULAR ALTERATIONS LEADING TO THE DEVELOPMENT OF COLORECTAL CANCER IN OBESE PATIENTS WITH A FOCUS ON THE ROLE OF THE MICROENVIRONMENT IN CARCINOGENESIS. WE ALSO HIGHLIGHT ALL EXISTENT MOLECULES IN CLINICAL TRIALS THAT TARGET THE ACTIVATED PATHWAYS IN OBESITY-ASSOCIATED COLORECTAL CANCER, WHETHER USED AS SINGLE TREATMENTS OR IN COMBINATION. OBESITY PREDISPOSES TO COLORECTAL CANCER VIA CREATING A STATE OF CHRONIC INFLAMMATION WITH DYSREGULATED ADIPOKINES, INFLAMMATORY MEDIATORS, AND OTHER FACTORS SUCH AS IMMUNE CELL INFILTRATION. A UNIFYING THEME IN OBESITY-MEDIATED COLORECTAL CANCER IS THE ACTIVATION OF THE PI3K/AKT, MTOR/MAPK, AND STAT3 SIGNALING PATHWAYS. DIFFERENT INHIBITORY MOLECULES TOWARDS THESE PATHWAYS EXIST, INCREASING THE THERAPEUTIC CHOICE OF OBESITY-ASSOCIATED COLON CANCER. HOWEVER, OBESE PATIENTS ARE MORE LIKELY TO SUFFER FROM CHEMOTHERAPY OVERDOSING. PREVENTING OBESITY THROUGH MAINTAINING A HEALTHY AND ACTIVE LIFESTYLE REMAINS TO BE THE BEST REMEDY. 2022