1 2822 195 FIRST-IN-HUMAN STUDY OF INHALED AZACITIDINE IN PATIENTS WITH ADVANCED NON-SMALL CELL LUNG CANCER. BACKGROUND: AEROSOLIZED AZACITIDINE HAS BEEN SHOWN TO INHIBIT ORTHOTOPIC LUNG CANCER GROWTH AND INDUCE RE-EXPRESSION OF METHYLATED TUMOR SUPPRESSOR GENES IN MURINE MODELS. WE HYPOTHESIZED THAT INHALED AZACITIDINE IS SAFE AND EFFECTIVE IN REVERSING EPIGENETIC CHANGES IN THE BRONCHIAL EPITHELIUM SECONDARY TO CHRONIC SMOKING. PATIENTS AND METHODS: WE REPORT THE FIRST IN HUMAN STUDY OF INHALED AZACITIDINE. AZACITIDINE IN AQUEOUS SOLUTION WAS USED TO GENERATE AN AEROSOL SUSPENSION OF 0.25-5 MUM PARTICLE SIZE. MAIN INCLUSION CRITERIA: STAGE IV OR RECURRENT NSCLC WITH PREDOMINANTLY LUNG INVOLVEMENT, >/=1 PRIOR SYSTEMIC THERAPY, ECOG PS 0-1, AND ADEQUATE PULMONARY FUNCTION. PATIENTS RECEIVED INHALED AZACITIDINE DAILY ON DAYS 1-5 AND 15-19 OF 28-DAY CYCLES, AT 3 ESCALATING DOSES (15, 30 AND 45 MG/M(2) DAILY). THE PRIMARY OBJECTIVE WAS TO DETERMINE THE FEASIBILITY AND TOLERABILITY OF THIS NEW THERAPEUTIC MODALITY. THE KEY SECONDARY OBJECTIVES INCLUDED PHARMACOKINETICS, METHYLATION PROFILES AND EFFICACY. RESULTS: FROM 3/2015 TO 2/2018, EIGHT PATIENTS RECEIVED A MEDIAN NUMBER OF 2 (IQR = 1) CYCLES OF INHALED AZACITIDINE. NO CLINICALLY SIGNIFICANT ADVERSE EVENTS WERE OBSERVED, EXCEPT ONE PATIENT TREATED AT THE HIGHEST DOSE DEVELOPED AN ASYMPTOMATIC GRADE 2 DECREASED DLCO WHICH RESOLVED SPONTANEOUSLY. ONE PATIENT RECEIVING 12 CYCLES OF THERAPY HAD AN OBJECTIVE AND DURABLE PARTIAL RESPONSE, AND TWO PATIENTS HAD STABLE DISEASE. PLASMA AZACITIDINE WAS ONLY BRIEFLY DETECTABLE IN PATIENTS TREATED AT THE HIGHER DOSES. MOREOVER, IN 2 OF 3 PARTICIPANTS WHO AGREED AND UNDERWENT PRE- AND POST-TREATMENT BRONCHOSCOPY, THE GLOBAL DNA METHYLATION IN THE BRONCHIAL EPITHELIUM DECREASED BY 24 % AND 79 % POST-THERAPY, RESPECTIVELY. THE INTERVAL BETWEEN LAST INHALED TREATMENT AND BRONCHOSCOPY WAS 3 DAYS. CONCLUSIONS: INHALED AZACITIDINE RESULTED IN NEGLIGIBLE PLASMA LEVELS COMPARED TO THE PREVIOUSLY REPORTED SUBCUTANEOUS ADMINISTRATION AND WAS WELL-TOLERATED. THE RESULTS JUSTIFY THE CONTINUED DEVELOPMENT OF INHALED AZACITIDINE AT NON-CYTOTOXIC DOSES FOR PATIENTS WITH LUNG-CONFINED MALIGNANT AND/OR PREMALIGNANT LESIONS.	2021	
                                                                                                            
2 5613  47 SAFETY AND EFFICACY OF ABEXINOSTAT, A PAN-HISTONE DEACETYLASE INHIBITOR, IN NON-HODGKIN LYMPHOMA AND CHRONIC LYMPHOCYTIC LEUKEMIA: RESULTS OF A PHASE II STUDY. HISTONE DEACETYLASE INHIBITORS ARE MEMBERS OF A CLASS OF EPIGENETIC DRUGS THAT HAVE PROVEN ACTIVITY IN T-CELL MALIGNANCIES, BUT LITTLE IS KNOWN ABOUT THEIR EFFICACY IN B-CELL LYMPHOMAS. ABEXINOSTAT IS AN ORALLY AVAILABLE HYDROXAMATE-CONTAINING HISTONE DEACETYLASE INHIBITOR THAT DIFFERS FROM APPROVED INHIBITORS; ITS UNIQUE PHARMACOKINETIC PROFILE AND ORAL DOSING SCHEDULE, TWICE DAILY FOUR HOURS APART, ALLOWS FOR CONTINUOUS EXPOSURE AT CONCENTRATIONS REQUIRED TO EFFICIENTLY KILL TUMOR CELLS. IN THIS PHASE II STUDY, PATIENTS WITH RELAPSED/REFRACTORY NON-HODGKIN LYMPHOMA OR CHRONIC LYMPHOCYTIC LEUKEMIA RECEIVED ORAL ABEXINOSTAT AT 80 MG BID FOR 14 DAYS OF A 21-DAY CYCLE AND CONTINUED UNTIL PROGRESSIVE DISEASE OR UNACCEPTABLE TOXICITY. A TOTAL OF 100 PATIENTS WITH B-CELL MALIGNANCIES AND T-CELL LYMPHOMAS WERE ENROLLED BETWEEN OCTOBER 2011 AND JULY 2014. ALL PATIENTS RECEIVED AT LEAST ONE DOSE OF STUDY DRUG. PRIMARY REASONS FOR DISCONTINUATION INCLUDED PROGRESSIVE DISEASE (56%) AND ADVERSE EVENTS (25%). GRADE 3 OR OVER ADVERSE EVENTS AND ANY SERIOUS ADVERSE EVENTS WERE REPORTED IN 88% AND 73% OF PATIENTS, RESPECTIVELY. THE MOST FREQUENTLY REPORTED GRADE 3 OR OVER TREATMENT-EMERGENT RELATED ADVERSE EVENTS WERE THROMBOCYTOPENIA (80%), NEUTROPENIA (27%), AND ANEMIA (12%). AMONG THE 87 PATIENTS EVALUABLE FOR EFFICACY, OVERALL RESPONSE RATE WAS 28% (COMPLETE RESPONSE 5%), WITH HIGHEST RESPONSES OBSERVED IN PATIENTS WITH FOLLICULAR LYMPHOMA (OVERALL RESPONSE RATE 56%), T-CELL LYMPHOMA (OVERALL RESPONSE RATE 40%), AND DIFFUSE LARGE B-CELL LYMPHOMA (OVERALL RESPONSE RATE 31%). FURTHER INVESTIGATION OF THE SAFETY AND EFFICACY OF ABEXINOSTAT IN FOLLICULAR LYMPHOMA, T-CELL LYMPHOMA, AND DIFFUSE LARGE B-CELL LYMPHOMA IMPLEMENTING A LESS DOSE-INTENSE WEEK-ON-WEEK-OFF SCHEDULE IS WARRANTED. (TRIAL REGISTERED AT: EUDRACT-2009-013691-47).	2017	
                                                                                                                                                                                                                                                                                                                                 
3 5055  48 PHASE 2 TRIAL OF THE HISTONE DEACETYLASE INHIBITOR ROMIDEPSIN FOR THE TREATMENT OF REFRACTORY MULTIPLE MYELOMA. BACKGROUND: EPIGENETIC DYSREGULATION IS A HALLMARK OF CANCER, INCLUDING MULTIPLE MYELOMA. INHIBITORS OF HISTONE DEACETYLASES (HDACS) INDUCE DNA HYPERACETYLATION BY INHIBITING REMOVAL OF ACETYL GROUPS FROM AMINO TAILS ON HISTONE PROTEINS, THEREBY UNCOILING CONDENSED CHROMATIN FAVORING TRANSCRIPTION OF SILENCED GENES, INCLUDING TUMOR SUPPRESSOR GENES. ROMIDEPSIN IS AN HDAC INHIBITOR THAT EXHIBITS ANTIPROLIFERATIVE AND APOPTOTIC EFFECTS AGAINST MULTIPLE MYELOMA CELL LINES. METHODS: A PHASE 2 TRIAL WAS PERFORMED OF ROMIDEPSIN IN PATIENTS WITH MULTIPLE MYELOMA WHO WERE REFRACTORY TO STANDARD THERAPY. TREATMENT WAS COMPRISED OF ROMIDEPSIN (13 MG/M(2)) GIVEN AS A 4-HOUR INTRAVENOUS INFUSION ON DAYS 1, 8, AND 15 EVERY 28 DAYS). THIRTEEN PATIENTS RECEIVED A MEDIAN OF 2 CYCLES OF THERAPY (RANGE, 1-7 CYCLES). RESULTS: ALTHOUGH NO PATIENTS HAD AN OBJECTIVE RESPONSE, 4 OF 12 PATIENTS WITH SECRETORY MYELOMA EXHIBITED EVIDENCE OF M-PROTEIN STABILIZATION, AND SEVERAL OTHER PATIENTS EXPERIENCED IMPROVEMENT IN BONE PAIN AND RESOLUTION OF HYPERCALCEMIA. CONCLUSIONS: THE RESULTS OF THE CURRENT STUDY DEMONSTRATE THAT ROMIDEPSIN, AS A SINGLE AGENT, IS UNLIKELY TO BE ASSOCIATED WITH A RESPONSE RATE OF >/=30% IN PATIENTS WITH REFRACTORY MYELOMA, ALTHOUGH THERE WAS SOME CLINICAL EVIDENCE SUGGESTING A BIOLOGICAL EFFECT ASSOCIATED WITH THERAPY.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
4 5056  45 PHASE I TRIAL OF LOW DOSE DECITABINE TARGETING DNA HYPERMETHYLATION IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKAEMIA AND NON-HODGKIN LYMPHOMA: DOSE-LIMITING MYELOSUPPRESSION WITHOUT EVIDENCE OF DNA HYPOMETHYLATION. TARGETING ABERRANT DNA HYPERMETHYLATION IN CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL) AND NON-HODGKIN LYMPHOMA (NHL) WITH DECITABINE MAY REVERSE EPIGENETIC SILENCING IN B-CELL MALIGNANCIES. TWENTY PATIENTS WERE ENROLLED IN TWO PHASE I TRIALS TO DETERMINE THE MINIMUM EFFECTIVE PHARMACOLOGICAL DOSE OF DECITABINE IN PATIENTS WITH RELAPSED/REFRACTORY CLL (N = 16) AND NHL (N = 4). PATIENTS RECEIVED 1-3 CYCLES OF DECITABINE. DOSE-LIMITING TOXICITY (DLT) WAS OBSERVED IN 2 OF 4 CLL AND 2 OF 2 NHL PATIENTS RECEIVING DECITABINE AT 15 MG/M(2) PER D DAYS 1-10, CONSISTING OF GRADE 3-4 THROMBOCYTOPENIA AND HYPERBILIRUBINAEMIA. SIX PATIENTS WITH CLL RECEIVED DECITABINE AT 10 MG/M(2) PER D DAYS 1-10 WITHOUT DLT; HOWEVER, RE-EXPRESSION OF METHYLATED GENES OR CHANGES IN GLOBAL DNA METHYLATION WERE NOT OBSERVED. THEREFORE, A 5-DAY DECITABINE SCHEDULE WAS EXAMINED. WITH 15 MG/M(2) PER D DECITABINE DAYS 1-5, DLT OCCURRED IN 2 OF 6 CLL AND 2 OF 2 NHL PATIENTS, CONSISTING OF GRADE 3-4 NEUTROPENIA, THROMBOCYTOPENIA, AND FEBRILE NEUTROPENIA. EIGHT PATIENTS HAD STABLE DISEASE. IN 17 PATIENTS, THERE WERE NO SIGNIFICANT CHANGES IN GENOME-WIDE METHYLATION OR IN TARGET GENE RE-EXPRESSION. IN CONCLUSION, DOSE-LIMITING MYELOSUPPRESSION AND INFECTIOUS COMPLICATIONS PREVENTED DOSE ESCALATION OF DECITABINE TO LEVELS ASSOCIATED WITH CHANGES IN GLOBAL METHYLATION OR GENE RE-EXPRESSION IN CLL AND NHL.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
5 1537  30 DNA METHYLATION IN ADOLESCENTS WITH ANXIETY DISORDER: A LONGITUDINAL STUDY. ANXIETY DISORDERS (AD) TYPICALLY MANIFEST IN CHILDREN AND ADOLESCENTS AND MIGHT PERSIST INTO ADULTHOOD. HOWEVER, THERE ARE STILL FEW DATA CONCERNING EPIGENETIC MECHANISMS ASSOCIATED WITH ONSET, PERSISTENCE OR REMISSION OF AD OVER TIME. WE INVESTIGATED A COHORT OF ADOLESCENTS AND YOUNG ADULTS AT BASELINE (AGE; 13.19 +/- 2.38) AND AFTER 5 YEARS AND CLASSIFIED THEM ACCORDING TO THE AD DIAGNOSIS AND THEIR LONGITUDINAL TRAJECTORIES INTO 4 GROUPS: (1) TYPICALLY DEVELOPING COMPARISONS (TDC; CONTROL GROUP, N = 14); (2) INCIDENT (AD IN THE SECOND EVALUATION ONLY, N = 11); (3) PERSISTENT (AD IN BOTH EVALUATIONS, N = 14) AND (4) REMITTENT (AD IN THE FIRST EVALUATION ONLY, N = 8). DNA METHYLATION WAS EVALUATED WITH THE INFINIUM HUMANMETHYLATION450 BEADCHIP FROM SALIVA SAMPLES COLLECTED AT BOTH EVALUATIONS. GENE SET ENRICHMENT ANALYSIS WAS APPLIED TO CONSIDER BIOLOGICAL PATHWAYS. WE FOUND DECREASED DNA METHYLATION IN TDC GROUP WHILE THE CHRONIC CASES OF AD PRESENTED HYPERMETHYLATION IN CENTRAL NERVOUS SYSTEM DEVELOPMENT PATHWAYS. MOREOVER, WE SHOWED THAT THIS PERSISTENT GROUP ALSO PRESENTED HYPERMETHYLATION WHILE THE OTHER THREE GROUPS WERE ASSOCIATED WITH HYPOMETHYLATION IN NERVOUS SYSTEM DEVELOPMENT PATHWAY. INCIDENCE AND REMISSION GROUPS WERE ASSOCIATED WITH INCREASED AND DECREASED METHYLATION IN NEURON DEVELOPMENT PATHWAYS, RESPECTIVELY. LARGER STUDIES ARE LIKELY TO DETECT SPECIFIC GENES RELEVANT TO AD.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
6 6689  46 VALPROIC ACID AT THERAPEUTIC PLASMA LEVELS MAY INCREASE 5-AZACYTIDINE EFFICACY IN HIGHER RISK MYELODYSPLASTIC SYNDROMES. PURPOSE: EPIGENETIC CHANGES PLAY A ROLE AND COOPERATE WITH GENETIC ALTERATIONS IN THE PATHOGENESIS OF MYELODYSPLASTIC SYNDROMES (MDS). WE CONDUCTED A PHASE II MULTICENTER STUDY ON THE COMBINATION OF THE DNA-METHYLTRANSFERASE INHIBITOR 5-AZACYTIDINE (5-AZA) AND THE HISTONE DEACETYLASE INHIBITOR VALPROIC ACID (VPA) IN PATIENTS WITH HIGHER RISK MDS. EXPERIMENTAL DESIGN: WE ENROLLED 62 PATIENTS WITH MDS (REFRACTORY ANEMIA WITH EXCESS BLASTS, 39 PATIENTS; REFRACTORY ANEMIA WITH EXCESS BLASTS IN TRANSFORMATION, 19 PATIENTS; AND CHRONIC MYELOMANOCYTIC LEUKEMIA (CMML), 4 PATIENTS) AND AN INTERNATIONAL PROGNOSTIC SCORING SYSTEM (IPSS) RATING OF INTERMEDIATE-2 (42 PATIENTS) OR HIGH (20 PATIENTS). VPA WAS GIVEN TO REACH A PLASMA CONCENTRATION OF >50 MICROG/ML, THEN 5-AZA WAS ADDED S.C. AT 75 MG/M(2) FOR 7 DAYS IN EIGHT MONTHLY CYCLES. RESULTS: THE MEDIAN OVERALL SURVIVAL WAS 14.4 MONTHS. AT A MEDIAN FOLLOW-UP OF 12 MONTHS (RANGE, 0.7-21.0), THE DISEASE PROGRESSED IN 20 PATIENTS, WITH 21% CUMULATIVE INCIDENCE OF PROGRESSION. OF 26 PATIENTS WHO COMPLETED EIGHT CYCLES, 30.7% OBTAINED COMPLETE OR PARTIAL REMISSION, 15.4% HAD A MAJOR HEMATOLOGIC IMPROVEMENT, WHEREAS 38.5% SHOWED STABLE DISEASE. DRUG-RELATED TOXICITY WAS MILD. FAVORABLE PROGNOSTIC FACTORS FOR SURVIVAL WERE IPSS INTERMEDIATE-2 AND PLASMA VPA OF > OR =50 MICROG/ML (LOG RANK = 0.013 AND 0.007, RESPECTIVELY). ANALYSIS OF POLYMORPHISMS IMPORTANT FOR THE METABOLISM OF THE DRUGS USED IN THE TRIAL SHOWED THAT CARRIERS OF THE CYP2C19*2 VARIANT OF CYTOCHROME P450 REQUIRED HIGHER VPA DOSES TO ACHIEVE THE TARGET VPA PLASMA CONCENTRATION OF 50 MICROG/ML ON DAY 1 OF 5-AZA TREATMENT (P = 0.0021). CONCLUSION: OUR DATA SHOW THAT THE 5-AZA/VPA COMBINATION IS ACTIVE AND SAFE IN PATIENTS WITH MDS WITH A POOR PROGNOSIS. ACHIEVEMENT OF VPA THERAPEUTIC LEVELS MAY INDEED INCREASE 5-AZA EFFICACY.	2009	
                                                                                                                                                                                                                                                                                                                                                                   
7 2464  62 EPIGENETIC THERAPY USING BELINOSTAT FOR PATIENTS WITH UNRESECTABLE HEPATOCELLULAR CARCINOMA: A MULTICENTER PHASE I/II STUDY WITH BIOMARKER AND PHARMACOKINETIC ANALYSIS OF TUMORS FROM PATIENTS IN THE MAYO PHASE II CONSORTIUM AND THE CANCER THERAPEUTICS RESEARCH GROUP. PURPOSE: EPIGENETIC ABERRATIONS HAVE BEEN REPORTED IN HEPATOCELLULAR CARCINOMA (HCC). IN THIS STUDY OF PATIENTS WITH UNRESECTABLE HCC AND CHRONIC LIVER DISEASE, EPIGENETIC THERAPY WITH THE HISTONE DEACETYLASE INHIBITOR BELINOSTAT WAS ASSESSED. THE OBJECTIVES WERE TO DETERMINE DOSE-LIMITING TOXICITY AND MAXIMUM-TOLERATED DOSE (MTD), TO ASSESS PHARMACOKINETICS IN PHASE I, AND TO ASSESS ACTIVITY OF AND EXPLORE POTENTIAL BIOMARKERS FOR RESPONSE IN PHASE II. PATIENTS AND METHODS: MAJOR ELIGIBILITY CRITERIA INCLUDED HISTOLOGICALLY CONFIRMED UNRESECTABLE HCC, EUROPEAN COOPERATIVE ONCOLOGY GROUP PERFORMANCE SCORE </= 2, AND ADEQUATE ORGAN FUNCTION. PHASE I CONSISTED OF 18 PATIENTS; BELINOSTAT WAS GIVEN INTRAVENOUSLY ONCE PER DAY ON DAYS 1 TO 5 EVERY 3 WEEKS; DOSE LEVELS WERE 600 MG/M(2) PER DAY (LEVEL 1), 900 MG/M(2) PER DAY (LEVEL 2), 1,200 MG/M(2) PER DAY (LEVEL 3), AND 1,400 MG/M(2) PER DAY (LEVEL 4). PHASE II CONSISTED OF 42 PATIENTS. THE PRIMARY END POINT WAS PROGRESSION-FREE SURVIVAL (PFS), AND THE MAIN SECONDARY END POINTS WERE RESPONSE ACCORDING TO RESPONSE EVALUATION CRITERIA IN SOLID TUMORS (RECIST) AND OVERALL SURVIVAL (OS). EXPLORATORY ANALYSIS WAS CONDUCTED ON PRETREATMENT TUMOR TISSUES TO DETERMINE WHETHER HR23B EXPRESSION IS A POTENTIAL BIOMARKER FOR RESPONSE. RESULTS: BELINOSTAT PHARMACOKINETICS WERE LINEAR FROM 600 TO 1,400 MG/M(2) WITHOUT SIGNIFICANT ACCUMULATION. THE MTD WAS NOT REACHED AT THE MAXIMUM DOSE ADMINISTERED. DOSE LEVEL 4 WAS USED IN PHASE II. THE MEDIAN NUMBER OF CYCLES WAS TWO (RANGE, ONE TO 12). THE PARTIAL RESPONSE (PR) AND STABLE DISEASE (SD) RATES WERE 2.4% AND 45.2%, RESPECTIVELY. THE MEDIAN PFS AND OS WERE 2.64 AND 6.60 MONTHS, RESPECTIVELY. EXPLORATORY ANALYSIS REVEALED THAT DISEASE STABILIZATION RATE (COMPLETE RESPONSE PLUS PR PLUS SD) IN TUMORS HAVING HIGH AND LOW HR23B HISTOSCORES WERE 58% AND 14%, RESPECTIVELY (P = .036). CONCLUSION: EPIGENETIC THERAPY WITH BELINOSTAT DEMONSTRATES TUMOR STABILIZATION AND IS GENERALLY WELL-TOLERATED. HR23B EXPRESSION WAS ASSOCIATED WITH DISEASE STABILIZATION.	2012	

8 2465  52 EPIGENETIC THERAPY WITH HYDRALAZINE AND MAGNESIUM VALPROATE REVERSES IMATINIB RESISTANCE IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA. THE EPIGENETIC DRUGS HYDRALAZINE AND VALPROATE WERE ADMINISTERED IN A COMPASSIONATE MANNER TO 8 PATIENTS WITH CHRONIC MYELOID LEUKEMIA (CML) REFRACTORY TO IMATINIB. TWO PATIENTS HAD A COMPLETE HEMATOLOGIC RESPONSE (25%),1 MAJOR CYTOGENETIC RESPONSE, 1 COMPLETE CYTOGENETIC RESPONSE (25% ANY CYTOGENETIC RESPONSE), AND 3 (37.5%)STABLE DISEASE. NO GRADE 3 OR 4 TOXICITY WAS OBSERVED. THESE RESULTS SHOW THE ABILITY OF EPIGENETIC THERAPY TO REVERT IMATINIB RESISTANCE. BACKGROUND: EPIGENETIC ALTERATIONS PARTICIPATE IN THE DEVELOPMENT OF ACQUIRED RESISTANCE TO IMATINIB, HENCE, THE DNA METHYLATION, AND HISTONE DEACETYLASE INHIBITORS HYDRALAZINE AND VALPROATE, RESPECTIVELY, HAS THE POTENTIAL TO OVERCOME IT. PATIENT AND METHODS: A SERIES OF 8 PATIENTS WITH CHRONIC MYELOID LEUKEMIA (CML) REFRACTORY TO IMATINIB MESYLATE WITH NO ACCESS TO SECOND-GENERATION TYROSINE KINASE INHIBITORS WERE TREATED WITH HYDRALAZINE AND VALPROATE IN A COMPASSIONATE MANNER. CLINICAL EFFICACY AND SAFETY OF THESE DRUGS ADDED TO IMATINIB MESYLATE WERE EVALUATED. RESULTS: TWO PATIENTS WERE IN THE BLAST PHASE, 5 WERE IN THE ACCELERATED PHASE, AND 1 WAS IN THE CHRONIC PHASE. ALL THE PATIENTS CONTINUED WITH THE SAME DOSE OF IMATINIB THAT THEY HAD BEEN RECEIVING AT THE TIME OF DEVELOPMENT OF RESISTANCE, WITH A MEDIAN DOSE OF 600 MG DAILY (RANGE, 400-800 MG). THE MEDIAN TIME FROM DIAGNOSIS OF CML TO THE START OF HYDRALAZINE AND VALPROATE WAS 53.6 MONTHS (RANGE, 19-84 MONTHS). TWO (25%) PATIENTS HAD A COMPLETE HEMATOLOGIC RESPONSE, ONE (12.5%) HAD AN MAJOR CYTOGENETIC RESPONSE, AND ONE (12.5%) HAD A COMPLETE CYTOGENETIC RESPONSE. THREE (37.5%) PATIENTS HAD STABLE DISEASE, AND ONLY ONE (12.5%) PATIENT FAILED TO RESPOND. AT A MEDIAN FOLLOW-UP TIME OF 18 MONTHS (RANGE, 3-18 MONTHS), THE MEDIAN SURVIVAL HAD NOT BEEN REACHED, AND THE PROJECTED OVERALL SURVIVAL WAS 63%. ALL THE PATIENTS HAD MILD NEUROLOGIC TOXICITY, INCLUDING DISTAL TREMOR AND SOMNOLENCE. NO GRADE 3 OR 4 TOXICITY WAS OBSERVED. CONCLUSIONS: OUR RESULTS SUGGEST THAT THE EPIGENETIC DRUGS HYDRALAZINE AND VALPROATE REVERT THE RESISTANCE TO IMATINIB IN PATIENTS WITH CML.	2012	
                                                                                 
9 1561  36 DNA METHYLATION OF CHRONIC LYMPHOCYTIC LEUKEMIA WITH DIFFERENTIAL RESPONSE TO CHEMOTHERAPY. ACQUIRED RESISTANCE TO CHEMOTHERAPY IS AN IMPORTANT CLINICAL PROBLEM AND CAN ALSO OCCUR WITHOUT DETECTABLE CYTOGENETIC ABERRATIONS OR GENE MUTATIONS. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS MOLECULARLY WELL CHARACTERIZED AND HAS BEEN ELEMENTAL FOR ESTABLISHING CENTRAL PARADIGMS IN ONCOLOGY. THIS PROMPTED US TO CHECK WHETHER SPECIFIC EPIGENETIC CHANGES AT THE LEVEL OF DNA METHYLATION MIGHT UNDERLIE DEVELOPMENT OF TREATMENT RESISTANCE. WE USED ILLUMINA INFINIUM HUMANMETHYLATION450 BEADCHIPS TO OBTAIN DNA METHYLATION PROFILES OF 71 CLL PATIENTS WITH DIFFERENTIAL RESPONSES. THIRTY-SIX PATIENTS WERE CATEGORIZED AS RELAPSED/REFRACTORY AFTER TREATMENT WITH FLUDARABINE OR BENDAMUSTINE AND 21 OF THEM HAD GENETIC ABERRATIONS OF TP53. THE OTHER 35 PATIENTS WERE UNTREATED AT THE TIME OF SAMPLING AND 15 OF THEM HAD GENETIC ABERRATION OF TP53. ALTHOUGH WE COULD NOT CORRELATE CHEMORESISTANCE WITH EPIGENETIC CHANGES, THE PATIENTS WERE COMPREHENSIVELY CHARACTERIZED REGARDING RELEVANT PROGNOSTIC AND MOLECULAR MARKERS (E.G. IGHV MUTATION STATUS, CHROMOSOME ABERRATIONS, TP53 MUTATION STATUS, CLINICAL PARAMETERS), WHICH MAKES OUR DATASET A UNIQUE AND VALUABLE RESOURCE THAT CAN BE USED BY RESEARCHERS TO TEST ALTERNATIVE HYPOTHESES.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
10 5499  36 REVIEW: RECENT CLINICAL TRIALS IN EPIGENETIC THERAPY. EPIGENETIC FACTORS SUCH AS DNA METHYLATION AND HISTONE DEACETYLATION ARE KNOWN TO CONTRIBUTE TO THE MALIGNANT TRANSFORMATION OF CELLS BY SILENCING CRITICAL GENES. DRUGS THAT INHIBIT DNA METHYLTRANSFERASES OR HISTONE DEACETYLASES WERE SHOWN TO HAVE THE POTENTIAL TO REACTIVATE SILENCED GENES AND INDUCE DIFFERENTIATION OR APOPTOSIS OF MALIGNANT CELLS. THE MOST INTENSIVELY STUDIED CLASS OF SUCH AGENTS IS DNA METHYLTRANSFERASE INHIBITORS, INCLUDING 5-AZACYTIDINE (AZACITIDINE) AND 5-AZA-2'-DEOXYCYTIDINE (DECITABINE). IN 2004, AZACITIDINE WAS APPROVED FOR THE TREATMENT OF MYELODYSPLASTIC SYNDROME ON THE BASIS OF PHASE II AND III STUDIES THAT SHOWED A RESPONSE RATE (COMPLETE AND PARTIAL RESPONSES) OF 15%. AZACITIDINE IS ALSO BEING EVALUATED IN CLINICAL TRIALS FOR OTHER MALIGNANT DISEASES. DECITABINE HAS RESPONSE RATES OF 17-49% IN MYELODYSPLASTIC SYNDROME IN MULTIPLE PHASE II AND III STUDIES AND ALSO ACTIVITY IN ACUTE AND CHRONIC MYELOGENOUS LEUKEMIA. HISTONE DEACETYLASE INHIBITORS BELONG TO ANOTHER CLASS OF EPIGENETIC MODIFYING AGENTS THAT INCLUDE DEPSIPEPTIDE, BUTYRATE DERIVATIVES, SUBEROYLANILIDE HYDROXAMIC ACID AND VALPROIC ACID. NO AGENT IN THIS CLASS HAS BEEN STUDIED IN A PHASE III TRIAL, BUT SEVERAL AGENTS HAVE BEEN OR ARE BEING STUDIED IN PHASE II TRIALS. FURTHER RESEARCH IS NEEDED TO DETERMINE THE APPROPRIATE PATIENT SELECTION AND DOSING SCHEDULES.	2006	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
11 6680  33 USING PERIPHERAL BLOOD CIRCULATING DNAS TO DETECT CPG GLOBAL METHYLATION STATUS AND GENETIC MUTATIONS IN PATIENTS WITH MYELODYSPLASTIC SYNDROME. MYELODYSPLASTIC SYNDROME (MDS) IS A HEMATOPOIETIC STEM CELL DISORDER. SEVERAL GENETIC/EPIGENETIC ABNORMALITIES ARE DEEPLY ASSOCIATED WITH THE PATHOGENESIS OF MDS. ALTHOUGH BONE MARROW (BM) ASPIRATION IS A COMMON STRATEGY TO OBTAIN MDS CELLS FOR EVALUATING THEIR GENETIC/EPIGENETIC ABNORMALITIES, BM ASPIRATION IS DIFFICULT TO PERFORM REPEATEDLY TO OBTAIN SERIAL SAMPLES BECAUSE OF PAIN AND SAFETY CONCERNS. HERE, WE REPORT THAT CIRCULATING CELL-FREE DNAS FROM PLASMA AND SERUM OF PATIENTS WITH MDS CAN BE USED TO DETECT GENETIC/EPIGENETIC ABNORMALITIES. THE PLASMA DNA CONCENTRATION WAS FOUND TO BE RELATIVELY HIGH IN PATIENTS WITH HIGHER BLAST CELL COUNTS IN BM, AND ACCUMULATION OF DNA FRAGMENTS FROM MONO-/DI-NUCLEOSOMES WAS CONFIRMED. USING SERIAL PERIPHERAL BLOOD (PB) SAMPLES FROM PATIENTS TREATED WITH HYPOMETHYLATING AGENTS, GLOBAL METHYLATION ANALYSIS USING BISULFITE PYROSEQUENCING WAS PERFORMED AT THE SPECIFIC CPG SITES OF THE LINE-1 PROMOTER. THE RESULTS CONFIRMED A DECREASE OF THE METHYLATION PERCENTAGE AFTER TREATMENT WITH AZACITIDINE (DAYS 3-9) USING DNAS FROM PLASMA, SERUM, AND PB MONO-NUCLEAR CELLS (PBMNC). PLASMA DNA TENDS TO SHOW MORE RAPID CHANGE AT DAYS 3 AND 6 COMPARED WITH SERUM DNA AND PBMNC. FURTHERMORE, THE TET2 GENE MUTATION IN DNAS FROM PLASMA, SERUM, AND BM CELLS WAS QUANTITATED BY PYROSEQUENCING ANALYSIS. THE EXISTENCE RATIO OF MUTATED GENES IN PLASMA AND SERUM DNA SHOWED ALMOST EQUIVALENT LEVEL WITH THAT IN THE CD34+/38- STEM CELL POPULATION IN BM. THESE DATA SUGGEST THAT GENETIC/EPIGENETIC ANALYSES USING PB CIRCULATING DNA CAN BE A SAFER AND PAINLESS ALTERNATIVE TO USING BM CELLS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
12 1046  37 CLINICAL DEVELOPMENT OF DECITABINE AS A PROTOTYPE FOR AN EPIGENETIC DRUG PROGRAM. THIS REVIEW HIGHLIGHTS DECITABINE AS A PROTOTYPE EPIGENETIC MODIFYING DRUG TO SHOW HOW THE CLINICAL DEVELOPMENT OF EPIGENETIC AGENTS DIFFERS FROM THAT OF TRADITIONAL CYTOTOXIC CHEMOTHERAPIES. DECITABINE, A CYTOSINE ANALOGUE, IS CYTOTOXIC AT HIGH DOSES BUT HAS SELECTIVE DNA DEMETHYLATING ACTIVITY AT LOW DOSES. THE FOCUS OF CURRENT DECITABINE INVESTIGATIONS IS TWOFOLD: TO ELUCIDATE ALL OF THE MECHANISMS OF ACTION AND TO DETERMINE THE OPTIMAL DOSE, SCHEDULE, AND CONCOMITANT THERAPIES. NEW PHASE I TRIALS HAVE IDENTIFIED A "BIOLOGICALLY EFFECTIVE DOSE," WHICH IS 1 TO 2 LOGS LOWER THAN THE CYTOTOXIC DOSE. A CLINICAL DEVELOPMENT PROGRAM WITH LOW-DOSE DECITABINE IN MALIGNANT DISEASES IS FOCUSED ON MYELODYSPLASTIC SYNDROME (MDS), ACUTE MYELOGENOUS LEUKEMIA (AML), AND CHRONIC MYELOGENOUS LEUKEMIA (CML). A PHASE III TRIAL IN MDS SHOWED OBJECTIVE RESPONSES (COMPLETE [CR] PLUS PARTIAL [PR] REMISSION) AND LONGER MEDIAN TIME TO PROGRESSION TO AML OR DEATH WITH DECITABINE THAN WITH SUPPORTIVE CARE ALONE. THE OPTIMAL USE OF DECITABINE MAY BE IN COMBINATION WITH OTHER AGENTS THAT PROMOTE GENE EXPRESSION, NAMELY, HISTONE DEACETYLASE (HDAC) INHIBITORS. OPTIMIZED DECITABINE DOSES AND COMBINATIONS WITH OTHER EPIGENETIC THERAPIES THAT CAN BE USED AT MINIMALLY TOXIC DOSES PROVIDE POTENTIALLY SAFER THERAPEUTIC OPTIONS AND INTRODUCE NOVEL COMBINATION THERAPIES.	2005	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
13 3588  40 IMPACT OF TP53 GENE PROMOTER METHYLATION ON CHRONIC LYMPHOCYTIC LEUKEMIA PATHOGENESIS AND PROGRESSION. BACKGROUND: CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS A MALIGNANT LYMPHOID DISORDER THAT RESULTS FROM THE OVERGROWTH OF MATURE-LOOKING LYMPHOID CELLS IN THE BLOOD AND LYMPHATIC TISSUE. VARIOUS CLINICAL PRESENTATIONS HAVE BEEN ATTRIBUTED TO THE DISEASE AS A RESULT OF THE DIFFERENT UNDERLYING GENETIC AND EPIGENETIC ALTERATIONS. THE CURRENT STUDY HAS BEEN INITIATED TO STUDY THE ROLE OF AN EPIGENETIC ALTERATION AFFECTING THE PROMOTER OF THE TP53GENE ON CLL PATHOGENESIS AND PROGRESSION. METHODS: THE CURRENT STUDY INVOLVED 54 NEWLY DIAGNOSED PATIENTS PRESENTING WITH CLL AS WELL AS 30 NORMAL INDIVIDUALS AS CONTROLS. AFTER OBTAINING VERBAL CONSENT, DATA COLLECTION WAS DONE AND THE BLOOD COLLECTED FROM ALL ENROLLED INDIVIDUALS FOR HEMATOLOGICAL INVESTIGATIONS AS WELL AS FOR MOLECULAR CATEGORIZATION OF TP53 METHYLATION STATUS. METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION (MS-PCR) TECHNIQUE WAS USED TO DEFINE THE METHYLATION STATUS OF THE TP53 GENE PROMOTER THAT ENCOMPASSES DNA EXTRACTION, BISULFITE CONVERSION, CONVENTIONAL PCR AMPLIFICATION, RUNNING ON AGAROSE GEL AND DOCUMENTATION. FINALLY, STATISTICAL ANALYSIS WAS DONE TO ASSESS ANY CORRELATION OF THE TP53 EPIGENETIC ALTERATION TO THE DISEASE ETIOLOGY AND THE PROGRESSION. RESULTS: IN THE CURRENT STUDY, ALL CONTROLS AND 42 OF 54 PATIENTS SHOW UNMETHYLATED TP53 GENE PROMOTER; ON THE OTHER HAND, THE METHYLATED PROMOTER WAS DETECTED AMONG 12 PATIENTS WITH A P-VALUE OF 0.001. TP53 GENE PROMOTER METHYLATION SIGNIFICANTLY LINKED TO REDUCED PLATELET COUNT (P-VALUE OF 0.047) AND ADVANCED STAGE AT PRESENTATION (P-VALUE OF 0.076). NO SIGNIFICANT DIFFERENCES WERE SEEN AMONG BOTH METHYLATED AND UNMETHYLATED TP53 PROMOTERS IN RELATION TO THE AGE OF THE AFFECTED INDIVIDUALS, TOTAL WHITE BLOOD CELL COUNTS AND HEMOGLOBIN LEVEL OF THE AFFECTED INDIVIDUALS. CONCLUSION: THE CURRENT STUDY REVEALED A SIGNIFICANT CORRELATION OF TP53 GENE PROMOTER METHYLATION TO CHRONIC LYMPHOCYTIC LEUKEMIA PATHOGENESIS AND LOWER PLATELET COUNTS.	2019	
                                                                                                                                                                                                                                                     
14   18  38 5-AZACYTIDINE MODULATES CPG METHYLATION LEVELS OF EZH2 AND NOTCH1 IN MYELODYSPLASTIC SYNDROMES. PURPOSE: MOLECULAR MECHANISMS OF RESPONSE TO HYPOMETHYLATING AGENTS IN PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS) AND CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) STILL REMAIN LARGELY UNKNOWN. THEREFORE, THE EFFECTS OF 5-AZACYTIDINE (AZA) ON CLONAL ARCHITECTURE AND DNA METHYLATION WERE INVESTIGATED IN THIS STUDY. METHODS: USING NEXT-GENERATION SEQUENCING (NGS), 30 MYELOID LEUKEMIA-ASSOCIATED GENES WERE ANALYZED IN 15 MDS/CMML PATIENTS WITH EXCELLENT RESPONSE TO AZA. EFFECTS ON METHYLATION LEVELS WERE ANALYZED BY QUANTITATIVE METHYLATION ANALYSIS USING PYROSEQUENCING FOR THE GLOBAL METHYLATION MARKER LINE-1 IN PATIENTS AND MYELOID CELL LINES. VARIOUS MYELOID CELL LINES AND A HEALTHY COHORT WERE SCREENED FOR METHYLATION LEVELS IN 23 GENES. SELECTED TARGETS WERE VERIFIED ON THE MDS/CMML COHORT. RESULTS: THE STUDY PRESENTED HERE SHOWED A STABLE VARIANT ALLELE FREQUENCY AND STABLE GLOBAL METHYLATION LEVELS IN RESPONDING PATIENTS. A SIGNIFICANT DEMETHYLATION OF EZH2 AND NOTCH1 WAS REVEALED IN PATIENTS WITH AZA RESPONSE. CONCLUSIONS: A RESPONSE TO AZA IS NOT ASSOCIATED WITH ERADICATION OF MALIGNANT CLONES, BUT RATHER WITH A STABILIZATION OF THE CLONAL ARCHITECTURE. WE SUGGEST CHANGES IN CPG METHYLATION LEVELS OF EZH2 AND NOTCH1 AS POTENTIAL TARGETS OF EPIGENETIC RESPONSE TO AZA TREATMENT WHICH MAY ALSO SERVE AS USEFUL BIOMARKERS AFTER CLINICAL EVALUATION.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
15 1345  39 DETECTION OF DIFFERENTIALLY METHYLATED REGIONS USING BAYES FACTOR FOR ORDINAL GROUP RESPONSES. RESEARCHERS IN GENOMICS ARE INCREASINGLY INTERESTED IN EPIGENETIC FACTORS SUCH AS DNA METHYLATION, BECAUSE THEY PLAY AN IMPORTANT ROLE IN REGULATING GENE EXPRESSION WITHOUT CHANGES IN THE DNA SEQUENCE. THERE HAVE BEEN SIGNIFICANT ADVANCES IN DEVELOPING STATISTICAL METHODS TO DETECT DIFFERENTIALLY METHYLATED REGIONS (DMRS) ASSOCIATED WITH BINARY DISEASE STATUS. MOST OF THESE METHODS ARE BEING DEVELOPED FOR DETECTING DIFFERENTIAL METHYLATION RATES BETWEEN CASES AND CONTROLS. WE CONSIDER MULTIPLE SEVERITY LEVELS OF DISEASE, AND DEVELOP A BAYESIAN STATISTICAL METHOD TO DETECT THE REGION WITH INCREASING (OR DECREASING) METHYLATION RATES AS THE DISEASE SEVERITY INCREASES. PATIENTS ARE CLASSIFIED INTO MORE THAN TWO GROUPS, BASED ON THE DISEASE SEVERITY (E.G., STAGES OF CANCER), AND DMRS ARE DETECTED BY USING MOVING WINDOWS ALONG THE GENOME. WITHIN EACH WINDOW, THE BAYES FACTOR IS CALCULATED TO TEST THE HYPOTHESIS OF MONOTONIC INCREASE IN METHYLATION RATES CORRESPONDING TO SEVERITY OF THE DISEASE VERSUS NO DIFFERENCE. A MIXED-EFFECT MODEL IS USED TO INCORPORATE THE CORRELATION OF METHYLATION RATES OF NEARBY CPG SITES IN THE REGION. RESULTS FROM EXTENSIVE SIMULATION INDICATE THAT OUR PROPOSED METHOD IS STATISTICALLY VALID AND REASONABLY POWERFUL. WE DEMONSTRATE OUR APPROACH ON A BISULFITE SEQUENCING DATASET FROM A CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) STUDY.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
16   59  36 A GENOME-WIDE SCREEN IDENTIFIES FREQUENTLY METHYLATED GENES IN HAEMATOLOGICAL AND EPITHELIAL CANCERS. BACKGROUND: GENETIC AS WELL AS EPIGENETIC ALTERATIONS ARE A HALLMARK OF BOTH EPITHELIAL AND HAEMATOLOGICAL MALIGNANCIES. HIGH THROUGHPUT SCREENS ARE REQUIRED TO IDENTIFY EPIGENETIC MARKERS THAT CAN BE USEFUL FOR DIAGNOSTIC AND PROGNOSTIC PURPOSES ACROSS MALIGNANCIES. RESULTS: HERE WE REPORT FOR THE FIRST TIME THE USE OF THE MIRA ASSAY (METHYLATED CPG ISLAND RECOVERY ASSAY) IN COMBINATION WITH GENOME-WIDE CPG ISLAND ARRAYS TO IDENTIFY EPIGENETIC MOLECULAR MARKERS IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) ON A GENOME-WIDE SCALE. WE IDENTIFIED 30 GENES DEMONSTRATING METHYLATION FREQUENCIES OF > OR =25% IN CHILDHOOD ALL, NINE GENES SHOWED SIGNIFICANTLY DIFFERENT METHYLATION FREQUENCIES IN B VS T-ALL. FOR MAJORITY OF THE GENES EXPRESSION COULD BE RESTORED IN METHYLATED LEUKEMIA LINES AFTER TREATMENT WITH 5-AZADC. FORTY-FOUR PERCENT OF THE GENES REPRESENT TARGETS OF THE POLYCOMB COMPLEX. IN CHRONIC MYELOID LEUKEMIA (CML) TWO OF THE GENES, (TFAP2A AND EBF2), DEMONSTRATED INCREASED METHYLATION IN BLAST CRISIS COMPARED TO CHRONIC PHASE (P < 0.05). FURTHERMORE HYPERMETHYLATION OF AN AUTOPHAGY RELATED GENE ATG16L2 WAS ASSOCIATED WITH POORER PROGNOSIS IN TERMS OF MOLECULAR RESPONSE TO IMATINIB TREATMENT. LASTLY WE DEMONSTRATED THAT TEN OF THESE GENES WERE ALSO FREQUENTLY METHYLATED IN COMMON EPITHELIAL CANCERS. CONCLUSION: IN SUMMARY WE HAVE IDENTIFIED A LARGE NUMBER OF GENES SHOWING FREQUENT METHYLATION IN CHILDHOOD ALL, METHYLATION STATUS OF TWO OF THESE GENES IS ASSOCIATED WITH ADVANCED DISEASE IN CML AND METHYLATION STATUS OF ANOTHER GENE IS ASSOCIATED WITH PROGNOSIS. IN ADDITION A SUBSET OF THESE GENES MAY ACT AS EPIGENETIC MARKERS ACROSS HEMATOLOGICAL MALIGNANCIES AS WELL AS COMMON EPITHELIAL CANCERS.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
17 3136  42 GLOBAL DNA METHYLATION LEVELS IN WHITE BLOOD CELLS OF PATIENTS WITH CHRONIC HEROIN USE DISORDER. A PROSPECTIVE STUDY. BACKGROUND: INCREASING SCIENTIFIC EVIDENCE SHOWS THE SIGNIFICANT ROLE OF EPIGENETIC MECHANISMS IN DRUG USE DISORDER, ABSTINENCE AND RELAPSE. STUDIES ON HUMAN SUBJECTS ARE LIMITED COMPARED TO THOSE ON ANIMALS, FOR VARIOUS REASONS SUCH AS POLY-SUBSTANCE ABUSE, HIGH DROP-OUT RATE AND TECHNICAL DIFFICULTIES. OBJECTIVES: OUR GOAL WAS TO EVALUATE WHETHER A MONITORED ABSTINENCE PERIOD OF 21 DAYS COULD INDUCE CHANGES IN GLOBAL DNA METHYLATION IN CHRONIC HEROIN USERS. METHOD: IN THE CURRENT STUDY, WE PRESENT DATA ON GLOBAL DNA METHYLATION ON A SET OF 18 MALE PATIENTS WITH CHRONIC HEROIN USE DISORDER, CAREFULLY SELECTED BASED ON INCLUSION AND EXCLUSION CRITERIA, WHO WERE HOSPITALIZED AND CLOSELY MONITORED DURING A 21-DAY DETOXIFICATION PROGRAM, ONE OF THE FEW WHERE NO OPIOID AGONIST IS ADMINISTERED. THE PARTICIPANTS WERE SAMPLED TWICE, ONCE UPON ENROLMENT TO THE PROGRAM AND ONCE UPON COMPLETION. RESULTS: ACCORDING TO OUR RESULTS, NO DIFFERENCE IN GLOBAL DNA METHYLATION WAS DETECTED BETWEEN SAMPLES COLLECTED UPON ENROLMENT AND SAMPLES COLLECTED UPON COMPLETION OF THE PROGRAM. CONCLUSION: THE FINDINGS OF THIS STUDY DO NOT RULE OUT THE POSSIBILITY THAT THE 21-DAY ABSTINENCE PERIOD WAS NOT LONG ENOUGH TO OBSERVE CHANGES IN GLOBAL DNA METHYLATION, OR THAT ABSTINENCE INDUCED SITE-SPECIFIC METHYLATION CHANGES (BUT NOT GLOBAL CHANGES), THAT CERTAINLY MERIT FURTHER EVALUATION.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
18 6311  34 THE RELATION BETWEEN DNA METHYLATION PATTERNS AND SERUM CYTOKINE LEVELS IN COMMUNITY-DWELLING ADULTS: A PRELIMINARY STUDY. BACKGROUND: THE LEVELS OF CIRCULATING CYTOKINES FLUCTUATE WITH AGE, ACUTE ILLNESS, AND CHRONIC DISEASE, AND ARE PREDICTIVE OF MORTALITY; THIS IS ALSO TRUE FOR PATTERNS OF DNA (CPG) METHYLATION. GIVEN THAT IMMUNE CELLS ARE PARTICULARLY SENSITIVE TO CHANGES IN THE CONCENTRATION OF CYTOKINES IN THEIR MICROENVIRONMENT, WE HYPOTHESIZED THAT SERUM LEVELS OF TNF, IL-6, IL-8 AND IL-10 WOULD CORRELATE WITH GENOME-WIDE ALTERATIONS IN THE DNA METHYLATION LEVELS OF BLOOD LEUKOCYTES. TO TEST THIS, WE EVALUATED COMMUNITY-DWELLING ADULTS (N = 14; 48-78 YEARS OLD) RECRUITED TO A PILOT STUDY FOR THE CANADIAN LONGITUDINAL STUDY ON AGING (CLSA), EXAMINING DNA METHYLATION PATTERNS IN PERIPHERAL BLOOD MONONUCLEAR CELLS USING THE ILLUMINA HUMANMETHYLATION 450 K BEADCHIP. RESULTS: WE SHOW THAT, APART FROM AGE, SERUM IL-10 LEVELS EXHIBITED THE MOST SUBSTANTIAL ASSOCIATION TO DNA METHYLATION PATTERNS, FOLLOWED BY TNF, IL-6 AND IL-8. FURTHERMORE, WHILE THE LEVELS OF THESE CYTOKINES WERE HIGHER IN ELDERLY ADULTS, NO ASSOCIATIONS WITH EPIGENETIC ACCELERATED AGING, DERIVED USING THE EPIGENETIC CLOCK, WERE OBSERVED. CONCLUSIONS: AS A PRELIMINARY STUDY WITH A SMALL SAMPLE SIZE, THE CONCLUSIONS DRAWN FROM THIS WORK MUST BE VIEWED WITH CAUTION; HOWEVER, OUR OBSERVATIONS ARE ENCOURAGING AND CERTAINLY WARRANT MORE SUITABLY POWERED STUDIES OF THIS RELATIONSHIP.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
19 5304  40 PROTEOMIC ANALYSIS OF INFLAMMATORY BIOMARKERS ASSOCIATED WITH BREAST CANCER RECURRENCE. INTRODUCTION: BREAST CANCER IS THE MOST FREQUENT CANCER DETECTED FOR WOMEN, AND WHILE OUR ABILITY TO TREAT BREAST CANCER HAS IMPROVED SUBSTANTIALLY OVER THE YEARS, RECURRENCE REMAINS A MAJOR OBSTACLE. STANDARD SCREENING FOR NEW AND RECURRENT BREAST CANCER INVOLVES CLINICAL BREAST IMAGING. HOWEVER, THERE IS NO CLINICALLY APPROVED NONINVASIVE BODY FLUID TEST FOR THE EARLY DETECTION OF RECURRENT BREAST CANCER. MATERIALS AND METHOD: IN THIS STUDY, WE ANALYZED SERUM SAMPLES FROM BOTH RECURRENT AND NONRECURRENT BREAST CANCER PATIENTS BY DIFFERENT PROTEOMICS METHODS TO IDENTIFY BIOMARKERS IN PATIENTS WITH RECURRENCE OF DISEASE. RESULTS: COMPARATIVE DATA ANALYSIS IDENTIFIED SEVERAL HISTONE DEACETYLASE (HDAC) PROTEINS, WHICH WERE FOUND AT SIGNIFICANTLY HIGHER LEVELS IN THE SERUM OF RECURRENT BREAST CANCER PATIENTS: HDAC9 (C-TERM) (P = 0.0035), HDAC5 (C-TERM) (P = 0.013), SMALL UBIQUITIN-LIKE MODIFIER 1 (N-TERM) (P = 0.017), EMBRYONIC STEM CELL-EXPRESSED RAS (INTER) (P = 0.018), AND HDAC7 (C-TERM) (P = 0.020). CHRONIC INFLAMMATION PLAYS A CRITICAL ROLE IN THE DEVELOPMENT OF THE BREAST CANCER RECURRENCE, AND WE IDENTIFIED SEVERAL PROINFLAMMATORY CYTOKINES THAT WERE PRESENT AT ELEVATED LEVELS ONLY IN RECURRENT BREAST CANCER PATIENT SERUM. CONCLUSIONS: OUR DATA INDICATED THAT THE EPIGENETIC REGULATION OF INFLAMMATORY PROCESSES PLAYS A CRITICAL ROLE IN BREAST CANCER RECURRENCE. THE IDENTIFIED PROTEINS COULD LAY THE GROUNDWORK FOR THE DEVELOPMENT OF A SERUM-BASED BREAST CANCER RECURRENCE ASSAY.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
20 3652  35 INDIVIDUAL DNA METHYLATION PATTERN SHIFTS IN NANOPARTICLES-EXPOSED WORKERS ANALYZED IN FOUR CONSECUTIVE YEARS. A DNA METHYLATION PATTERN REPRESENTS AN ORIGINAL PLAN OF THE FUNCTION SETTINGS OF INDIVIDUAL CELLS AND TISSUES. THE BASIC STRATEGIES OF ITS DEVELOPMENT AND CHANGES DURING THE HUMAN LIFETIME ARE KNOWN, BUT THE DETAILS RELATED TO ITS MODIFICATION OVER THE YEARS ON AN INDIVIDUAL BASIS HAVE NOT YET BEEN STUDIED. MOREOVER, CURRENT EVIDENCE SHOWS THAT ENVIRONMENTAL EXPOSURE COULD GENERATE CHANGES IN DNA METHYLATION SETTINGS AND, SUBSEQUENTLY, THE FUNCTION OF GENES. IN THIS STUDY, WE ANALYZED THE EFFECT OF CHRONIC EXPOSURE TO NANOPARTICLES (NP) IN OCCUPATIONALLY EXPOSED WORKERS REPEATEDLY SAMPLED IN FOUR CONSECUTIVE YEARS (2016-2019). A DETAILED METHYLATION PATTERN ANALYSIS OF 14 PERSONS (10 EXPOSED AND 4 CONTROLS) WAS PERFORMED ON AN INDIVIDUAL BASIS. A MICROARRAY-BASED APPROACH USING CHIPS, ALLOWING THE ASSESSMENT OF MORE THAN 850 K CPG LOCI, WAS USED. INDIVIDUAL DNA METHYLATION PATTERNS WERE COMPARED BY PRINCIPAL COMPONENT ANALYSIS (PCA). THE RESULTS SHOW THE SHIFT IN DNA METHYLATION PATTERNS IN INDIVIDUAL YEARS IN ALL THE EXPOSED AND CONTROL SUBJECTS. THE OVERALL RANGE OF DIFFERENCES VARIED BETWEEN THE YEARS IN INDIVIDUAL PERSONS. THE DIFFERENCES BETWEEN THE FIRST AND LAST YEAR OF EXAMINATION (A THREE-YEAR TIME PERIOD) SEEM TO BE CONSISTENTLY GREATER IN THE NP-EXPOSED SUBJECTS IN COMPARISON WITH THE CONTROLS. THE SELECTED 14 MOST DIFFERENTLY METHYLATED CG LOCI WERE RELATIVELY STABLE IN THE CHRONICALLY EXPOSED SUBJECTS. IN SUMMARY, THE SPECIFIC TYPE OF LONG-TERM EXPOSURE CAN CONTRIBUTE TO THE FIXING OF RELEVANT EPIGENETIC CHANGES RELATED TO A SPECIFIC ENVIRONMENT AS, E.G., NP INHALATION.	2021