1 2972 106 GENETIC AND EPIGENETIC STUDIES IN DIABETIC KIDNEY DISEASE. CHRONIC KIDNEY DISEASE IS A WORLDWIDE HEALTH CRISIS, WHILE DIABETIC KIDNEY DISEASE (DKD) HAS BECOME THE LEADING CAUSE OF END-STAGE RENAL DISEASE (ESRD). DKD IS A MICROVASCULAR COMPLICATION AND OCCURS IN 30-40% OF DIABETES PATIENTS. EPIDEMIOLOGICAL INVESTIGATIONS AND CLINICAL OBSERVATIONS ON THE FAMILIAL CLUSTERING AND HERITABILITY IN DKD HAVE HIGHLIGHTED AN UNDERLYING GENETIC SUSCEPTIBILITY. FURTHERMORE, DKD IS A PROGRESSIVE AND LONG-TERM DIABETIC COMPLICATION, IN WHICH EPIGENETIC EFFECTS AND ENVIRONMENTAL FACTORS INTERACT WITH AN INDIVIDUAL'S GENETIC BACKGROUND. IN RECENT YEARS, RESEARCHERS HAVE UNDERTAKEN GENETIC AND EPIGENETIC STUDIES OF DKD IN ORDER TO BETTER UNDERSTAND ITS MOLECULAR MECHANISMS. IN THIS REVIEW, CLINICAL MATERIAL, RESEARCH APPROACHES AND EXPERIMENTAL DESIGNS THAT HAVE BEEN USED FOR GENETIC AND EPIGENETIC STUDIES OF DKD ARE DESCRIBED. CURRENT INFORMATION FROM GENETIC AND EPIGENETIC STUDIES OF DKD AND ESRD IN PATIENTS WITH DIABETES, INCLUDING THE APPROACHES OF GENOME-WIDE ASSOCIATION STUDY (GWAS) OR EPIGENOME-WIDE ASSOCIATION STUDY (EWAS) AND CANDIDATE GENE ASSOCIATION ANALYSES, ARE SUMMARIZED. FURTHER INVESTIGATION OF MOLECULAR DEFECTS IN DKD WITH NEW APPROACHES SUCH AS NEXT GENERATION SEQUENCING ANALYSIS AND PHENOME-WIDE ASSOCIATION STUDY (PHEWAS) IS ALSO DISCUSSED. 2019 2 1832 46 EFFECTS OF METABOLIC MEMORY ON INFLAMMATION AND FIBROSIS ASSOCIATED WITH DIABETIC KIDNEY DISEASE: AN EPIGENETIC PERSPECTIVE. DIABETIC KIDNEY DISEASE (DKD) IS ONE OF THE MOST COMMON MICROVASCULAR COMPLICATION OF BOTH TYPE 1 (T1DM) AND TYPE 2 DIABETES MELLITUS (T2DM), AND THE LEADING CAUSE OF END-STAGE RENAL DISEASE (ESRD) WORLDWIDE. PERSISTENT INFLAMMATION AND SUBSEQUENT CHRONIC FIBROSIS ARE MAJOR CAUSES OF LOSS OF RENAL FUNCTION, WHICH IS ASSOCIATED WITH THE PROGRESSION OF DKD TO ESRD. IN FACT, DKD PROGRESSION IS AFFECTED BY A COMBINATION OF GENETIC AND ENVIRONMENTAL FACTORS. APPROXIMATELY, ONE-THIRD OF DIABETIC PATIENTS PROGRESS TO DEVELOP DKD DESPITE INTENSIVE GLYCEMIC CONTROL, WHICH PROPOSE AN ESSENTIAL CONCEPT "METABOLIC MEMORY." EPIGENETIC MODIFICATIONS, AN EXTENSIVELY STUDIED MECHANISM OF METABOLIC MEMORY, HAVE BEEN SHOWN TO CONTRIBUTE TO THE SUSCEPTIBILITY TO DEVELOP DKD. EPIGENETIC MODIFICATIONS ALSO PLAY A REGULATORY ROLE IN THE INTERACTIONS BETWEEN THE GENES AND THE ENVIRONMENTAL FACTORS. THE EPIGENETIC CONTRIBUTIONS TO THE PROCESSES OF INFLAMMATION AND FIBROGENESIS INVOLVED IN DKD OCCUR AT DIFFERENT REGULATORY LEVELS, INCLUDING DNA METHYLATION, HISTONE MODIFICATION AND NON-CODING RNA MODULATION. COMPARED WITH GENETIC FACTORS, EPIGENETICS REPRESENTS A NEW THERAPEUTIC FRONTIER IN UNDERSTANDING THE DEVELOPMENT DKD AND MAY LEAD TO THERAPEUTIC BREAKTHROUGHS DUE TO THE POSSIBILITY TO REVERSE THESE MODIFICATIONS THERAPEUTICALLY. EARLY RECOGNITION OF EPIGENETIC EVENTS AND BIOMARKERS IS CRUCIAL FOR TIMELY DIAGNOSIS AND INTERVENTION OF DKD, AND FOR THE PREVENTION OF THE PROGRESSION OF DKD TO ESRD. HEREIN, WE WILL REVIEW THE LATEST EPIGENETIC MECHANISMS INVOLVED IN THE RENAL PATHOLOGY OF BOTH TYPE 1 (T1DN) AND TYPE 2 DIABETIC NEPHROPATHY (T2DN) AND HIGHLIGHT THE EMERGING ROLE AND POSSIBLE THERAPEUTIC STRATEGIES BASED ON THE UNDERSTANDING OF THE ROLE OF EPIGENETICS IN DKD-ASSOCIATED INFLAMMATION AND FIBROGENESIS. 2021 3 2121 41 EPIGENETIC HISTONE MODIFICATIONS IN THE PATHOGENESIS OF DIABETIC KIDNEY DISEASE. DIABETIC KIDNEY DISEASE (DKD), AS THE MAIN COMPLICATION OF DIABETES MELLITUS, IS THE PRIMARY CAUSE OF THE END-STAGE RENAL DISEASE (ESRD) AND THE MOST COMMON CHRONIC KIDNEY DISEASE. OVERALL, 30-40% OF PATIENTS WITH TYPE 1 AND TYPE 2 DIABETES EVENTUALLY DEVELOP DKD. ALTHOUGH SOME DIABETES PATIENTS HAVE INTENSIFIED GLYCEMIC CONTROL, THEY STILL DEVELOP DIABETIC KIDNEY DISEASE. CURRENT TREATMENT METHODS CAN ALLEVIATE BUT DO NOT MARKEDLY HALT DISEASE DEVELOPMENT, RESULTING IN RENAL FAILURE AND SEVERE COMPLICATIONS, EVEN CONTRIBUTING TO ELEVATED MORBIDITY AND MORTALITY RATES. DKD IS A DISEASE WITH INTERACTIONS OF GENES AND THE ENVIRONMENT. EMERGING EVIDENCE INDICATES THAT DKD-ASSOCIATED KEY GENES ARE ALSO REGULATED BY THE EPIGENETIC MECHANISM. RECENTLY, INCREASING RESEARCHES INVOLVING CELLS AND EXPERIMENTAL ANIMALS DEMONSTRATED THAT HISTONE POST-TRANSLATIONAL MODIFICATIONS CAN MEDIATE GENE EXPRESSION, WHICH CORRELATED WITH DIABETIC KIDNEY DISEASE. NOVEL THERAPEUTIC STRATEGIES FOR EPIGENETIC EVENTS COULD BE BENEFICIAL FOR THE EARLY DETECTION AND TREATMENT OF DKD TO PREVENT IT FROM DEVELOPING INTO END-STAGE RENAL DISEASE (ESRD). IN THIS REVIEW, WE DISCUSS PRIOR FINDINGS IN THE FIELD OF HISTONE MODIFICATIONS IN DKD, ESPECIALLY HISTONE ACETYLATION AND HISTONE METHYLATION. WE THEN FOCUS ON RECENT DEVELOPMENTS IN HISTONE ACETYLATION AND METHYLATION INVOLVED IN THE PATHOGENESIS OF DKD. 2021 4 6075 35 THE DYNAMICS AND PLASTICITY OF EPIGENETICS IN DIABETIC KIDNEY DISEASE: THERAPEUTIC APPLICATIONS VIS-A-VIS. CHRONIC KIDNEY DISEASE (CKD) REFERS TO THE PHENOMENON OF PROGRESSIVE DECLINE IN THE GLOMERULAR FILTRATION RATE ACCOMPANIED BY ADVERSE CONSEQUENCES, INCLUDING FLUID RETENTION, ELECTROLYTE IMBALANCE, AND AN INCREASED CARDIOVASCULAR RISK COMPARED TO THOSE WITH NORMAL RENAL FUNCTION. THE TRIGGERS FOR THE IRREVERSIBLE RENAL FUNCTION DETERIORATION ARE MULTIFACTORIAL, AND DIABETES MELLITUS SERVES AS A MAJOR CONTRIBUTOR TO THE DEVELOPMENT OF CKD, NAMELY DIABETIC KIDNEY DISEASE (DKD). RECENTLY, EPIGENETIC DYSREGULATION EMERGED AS A PIVOTAL PLAYER STEERING THE PROGRESSION OF DKD, PARTLY RESULTING FROM HYPERGLYCEMIA-ASSOCIATED METABOLIC DISTURBANCES, RISING OXIDATIVE STRESS, AND/OR UNCONTROLLED INFLAMMATION. IN THIS REVIEW, WE DESCRIBE THE MAJOR EPIGENETIC MOLECULAR MECHANISMS, FOLLOWED BY SUMMARIZING CURRENT UNDERSTANDINGS OF THE EPIGENETIC ALTERATIONS PERTAINING TO DKD. WE HIGHLIGHT THE EPIGENETIC REGULATORY PROCESSES INVOLVED IN SEVERAL CRUCIAL RENAL CELL TYPES: MESANGIAL CELLS, PODOCYTES, TUBULAR EPITHELIA, AND GLOMERULAR ENDOTHELIAL CELLS. FINALLY, WE HIGHLIGHT EPIGENETIC BIOMARKERS AND RELATED THERAPEUTIC CANDIDATES THAT HOLD PROMISING POTENTIAL FOR THE EARLY DETECTION OF DKD AND THE AMELIORATION OF ITS PROGRESSION. 2022 5 2579 27 EPIGENETICS OF KIDNEY DISEASE. DNA METHYLATION AND HISTONE MODIFICATIONS DETERMINE RENAL PROGRAMMING AND THE DEVELOPMENT AND PROGRESSION OF RENAL DISEASE. THE IDENTIFICATION OF THE WAY IN WHICH THE RENAL CELL EPIGENOME IS ALTERED BY ENVIRONMENTAL MODIFIERS DRIVING THE ONSET AND PROGRESSION OF RENAL DISEASES HAS EXTENDED OUR UNDERSTANDING OF THE PATHOPHYSIOLOGY OF KIDNEY DISEASE PROGRESSION. IN THIS REVIEW, WE FOCUS ON CURRENT KNOWLEDGE CONCERNING THE IMPLICATIONS OF EPIGENETIC MODIFICATIONS DURING RENAL DISEASE FROM EARLY DEVELOPMENT TO CHRONIC KIDNEY DISEASE PROGRESSION INCLUDING RENAL FIBROSIS, DIABETIC NEPHROPATHY AND THE TRANSLATIONAL POTENTIAL OF IDENTIFYING NEW BIOMARKERS AND TREATMENTS FOR THE PREVENTION AND THERAPY OF CHRONIC KIDNEY DISEASE AND END-STAGE KIDNEY DISEASE. 2017 6 125 40 A SYSTEMS BIOLOGY OVERVIEW ON HUMAN DIABETIC NEPHROPATHY: FROM GENETIC SUSCEPTIBILITY TO POST-TRANSCRIPTIONAL AND POST-TRANSLATIONAL MODIFICATIONS. DIABETIC NEPHROPATHY (DN), A MICROVASCULAR COMPLICATION OCCURRING IN APPROXIMATELY 20-40% OF PATIENTS WITH TYPE 2 DIABETES MELLITUS (T2DM), IS CHARACTERIZED BY THE PROGRESSIVE IMPAIRMENT OF GLOMERULAR FILTRATION AND THE DEVELOPMENT OF KIMMELSTIEL-WILSON LESIONS LEADING TO END-STAGE RENAL FAILURE (ESRD). THE CAUSES AND MOLECULAR MECHANISMS MEDIATING THE ONSET OF T2DM CHRONIC COMPLICATIONS ARE YET SKETCHY AND IT IS NOT CLEAR WHY DISEASE PROGRESSION OCCURS ONLY IN SOME PATIENTS. WE PERFORMED A SYSTEMATIC ANALYSIS OF THE MOST RELEVANT STUDIES INVESTIGATING GENETIC SUSCEPTIBILITY AND SPECIFIC TRANSCRIPTOMIC, EPIGENETIC, PROTEOMIC, AND METABOLOMIC PATTERNS IN ORDER TO SUMMARIZE THE MOST SIGNIFICANT TRAITS ASSOCIATED WITH THE DISEASE ONSET AND PROGRESSION. THE PICTURE THAT EMERGES IS COMPLEX AND FASCINATING AS IT INCLUDES THE REGULATION/DYSREGULATION OF NUMEROUS BIOLOGICAL PROCESSES, CONVERGING TOWARD THE ACTIVATION OF INFLAMMATORY PROCESSES, OXIDATIVE STRESS, REMODELING OF CELLULAR FUNCTION AND MORPHOLOGY, AND DISTURBANCE OF METABOLIC PATHWAYS. THE GROWING INTEREST IN THE CHARACTERIZATION OF PROTEIN POST-TRANSLATIONAL MODIFICATIONS AND THE IMPORTANCE OF HANDLING LARGE DATASETS USING A SYSTEMS BIOLOGY APPROACH ARE ALSO DISCUSSED. 2016 7 6377 40 THE ROLE OF NON-CODING RNAS IN DIABETIC NEPHROPATHY: POTENTIAL APPLICATIONS AS BIOMARKERS FOR DISEASE DEVELOPMENT AND PROGRESSION. DIABETIC NEPHROPATHY, A PROGRESSIVE KIDNEY DISEASE THAT DEVELOPS SECONDARY TO DIABETES, IS THE MAJOR CAUSE OF CHRONIC KIDNEY DISEASE IN DEVELOPED COUNTRIES, AND CONTRIBUTES SIGNIFICANTLY TO INCREASED MORBIDITY AND MORTALITY AMONG INDIVIDUALS WITH DIABETES. ALTHOUGH THE CAUSES OF DIABETIC NEPHROPATHY ARE NOT FULLY UNDERSTOOD, RECENT STUDIES DEMONSTRATE A ROLE FOR EPIGENETIC FACTORS IN THE DEVELOPMENT OF THE DISEASE. FOR EXAMPLE, NON-CODING RNA (NCRNA) MOLECULES, INCLUDING MICRORNAS (MIRNAS), HAVE BEEN SHOWN TO BE FUNCTIONALLY IMPORTANT IN MODULATING RENAL RESPONSE TO HYPERGLYCEMIA AND PROGRESSION OF DIABETIC NEPHROPATHY. CHARACTERIZATION OF MIRNA EXPRESSION IN DIABETIC NEPHROPATHY FROM STUDIES OF ANIMAL MODELS OF DIABETES, AND IN VITRO INVESTIGATIONS USING DIFFERENT TYPES OF KIDNEY CELLS ALSO SUPPORT THIS ROLE. THE GOAL OF THIS REVIEW, THEREFORE, IS TO SUMMARIZE THE CURRENT STATE OF KNOWLEDGE OF SPECIFIC NCRNAS INVOLVED IN THE DEVELOPMENT OF DIABETIC NEPHROPATHY, WITH A FOCUS ON THE POTENTIAL ROLE OF MIRNAS TO SERVE AS SENSITIVE, NON-INVASIVE BIOMARKERS OF KIDNEY DISEASE AND PROGRESSION. NON-CODING RNAS ARE CURRENTLY RECOGNIZED AS POTENTIALLY IMPORTANT REGULATORS OF GENES INVOLVED IN PROCESSES RELATED TO THE DEVELOPMENT OF DIABETIC NEPHROPATHY, AND AS SUCH, REPRESENT VIABLE TARGETS FOR BOTH CLINICAL DIAGNOSTIC STRATEGIES AND THERAPEUTIC INTERVENTION. 2013 8 6162 36 THE GENETICS OF DIABETIC NEPHROPATHY. UP TO 40% OF PATIENTS WITH TYPE 1 AND TYPE 2 DIABETES WILL DEVELOP DIABETIC NEPHROPATHY (DN), RESULTING IN CHRONIC KIDNEY DISEASE AND POTENTIAL ORGAN FAILURE. THERE IS EVIDENCE FOR A HERITABLE GENETIC SUSCEPTIBILITY TO DN, BUT DESPITE INTENSIVE RESEARCH EFFORTS THE CAUSATIVE GENES REMAIN ELUSIVE. RECENTLY, GENOME-WIDE ASSOCIATION STUDIES HAVE DISCOVERED SEVERAL NOVEL GENETIC VARIANTS ASSOCIATED WITH DN. THE IDENTIFICATION OF SUCH VARIANTS MAY POTENTIALLY ALLOW FOR EARLY IDENTIFICATION OF AT RISK PATIENTS. HERE WE REVIEW THE CURRENT UNDERSTANDING OF THE KEY MOLECULAR MECHANISMS AND GENETIC ARCHITECTURE OF DN, AND DISCUSS THE MERITS OF EMPLOYING AN INTEGRATIVE APPROACH TO INCORPORATE DATASETS FROM MULTIPLE SOURCES (GENETICS, TRANSCRIPTOMICS, EPIGENETIC, PROTEOMIC) IN ORDER TO FULLY ELUCIDATE THE GENETIC ELEMENTS CONTRIBUTING TO THIS SERIOUS COMPLICATION OF DIABETES. 2013 9 931 33 CHRONIC KIDNEY DISEASE IN CHILDREN AND THE ROLE OF EPIGENETICS: FUTURE THERAPEUTIC TRAJECTORIES. GLOBAL DIFFERENCES IN THE OBSERVED CAUSES OF CHRONIC KIDNEY DISEASE (CKD) IN CHILDREN ARE WELL DOCUMENTED AND ARE ATTRIBUTED TO DISSIMILARITIES IN CLIME, RACE, HEREDITARY, AND ANCESTRY. THUS, FAMILIAL CLUSTERING AND DISPARITIES IN CKD PREVALENCE RATES ACROSS ETHNIC AND RACIAL GROUPS INDICATE THAT THE PROGRESSION OF RENAL DISEASE HAS A STRONG GENETIC COMPONENT. MAMMALIAN STUDIES HAVE DEMONSTRATED A FEASIBLE NEXUS BETWEEN NUTRITION AND NON-GENETIC EXPOSURE (AROUND THE TIME OF CONCEPTION AND IN EPIGENETIC CHANGES) IN THE EXPRESSION OF MAJOR GENES IDENTIFIED IN RENAL ORGANOGENESIS. THE MAJOR CONSEQUENCE IS A REDUCTION IN THE NUMBER OF NEPHRONS, WITH SUBSEQUENT PREDISPOSITION TO HYPERTENSION AND CKD. IDENTIFYING THESE EPIGENETIC CHANGES IS CRUCIAL (DUE TO THEIR POTENTIALLY REVERSIBLE NATURE), AS THEY MAY SERVE AS FUTURE THERAPEUTIC TARGETS TO PREVENT KIDNEY FIBROSIS AND CKD. DESPITE PROGRESS IN THE FIELD OF EPIGENETICS IN ONCOLOGY, RESEARCH IN OTHER SUBSPECIALTIES OF MEDICINE IS LARGELY EXPERIMENTAL WITH FEW EXISTING STUDIES REGARDING THE CLINICAL IMPLICATION OF EPIGENETICS IN RENAL DISEASE. THERAPEUTIC TRAJECTORIES FOR CKD IN CHILDREN BASED ON THE INFLUENCE OF EPIGENETICS MAY EVENTUALLY REVOLUTIONIZE THE MANAGEMENT OF THIS DISEASE. THE AIM OF THE CURRENT NARRATIVE REVIEW IS TO APPRAISE THE ROLE OF EPIGENETICS IN CKD, AND HIGHLIGHT THE POTENTIAL FUTURE THERAPEUTIC PATHWAYS. 2016 10 2982 34 GENETIC CONSIDERATIONS IN PEDIATRIC CHRONIC KIDNEY DISEASE. CHRONIC KIDNEY DISEASE (CKD) IN CHILDREN IS AN IRREVERSIBLE PROCESS THAT, IN SOME CASES, MAY LEAD TO END-STAGE RENAL DISEASE. THE MAJORITY OF CHILDREN WITH CKD HAVE A CONGENITAL DISORDER OF THE KIDNEY OR UROLOGICAL TRACT ARISING FROM BIRTH. THERE IS STRONG EVIDENCE FOR BOTH A GENETIC AND EPIGENETIC COMPONENT TO PROGRESSION OF CKD. UTILIZATION OF GENE-MAPPING STRATEGIES, RANGING FROM GENOME-WIDE ASSOCIATION STUDIES TO SINGLE-NUCLEOTIDE POLYMORPHISM ANALYSIS, SERVES TO IDENTIFY POTENTIAL GENETIC VARIANTS THAT MAY LEND TO DISEASE VARIATION. GENOME-WIDE ASSOCIATION STUDIES EVALUATING POPULATION-BASED DATA HAVE IDENTIFIED DIFFERENT LOCI ASSOCIATED WITH CKD PROGRESSION. ANALYSIS OF SINGLE-NUCLEOTIDE POLYMORPHISMS ON AN INDIVIDUAL LEVEL SUGGESTS THAT SECONDARY SYSTEMIC SEQUELAE OF CKD ARE CLOSELY RELATED TO DYSFUNCTION OF THE CARDIOVASCULAR-INFLAMMATORY AXIS AND MAY LEAD TO ADVANCED CARDIOVASCULAR DISEASE THROUGH ABNORMAL VASCULAR CALCIFICATION AND ACTIVATION OF THE RENIN-ANGIOTENSIN SYSTEM. SIMILARLY, GENETIC VARIANTS AFFECTING CYTOKINE CONTROL, FIBROSIS, AND PARENCHYMAL DEVELOPMENT MAY MODULATE CKD THROUGH DEVELOPMENT AND ACCELERATION OF RENAL INTERSTITIAL FIBROSIS. EPIGENETIC STUDIES EVALUATE MODIFICATION OF THE GENOME THROUGH DNA METHYLATION, HISTONE MODIFICATION, OR RNA INTERFERENCE, WHICH MAY BE DIRECTLY INFLUENCED BY EXTERNAL OR ENVIRONMENTAL FACTORS DIRECTING GENOMIC EXPRESSION. LASTLY, IMPROVED UNDERSTANDING OF THE GENETIC AND EPIGENETIC CONTRIBUTION TO CKD PROGRESSION MAY ALLOW PROVIDERS TO IDENTIFY A POPULATION AT ACCELERATED RISK FOR DISEASE PROGRESSION AND APPLY NOVEL THERAPIES TARGETED AT THE GENETIC MECHANISM OF DISEASE. 2016 11 1060 33 CLINICAL RELEVANCE OF EPIGENETIC DYSREGULATION IN CHRONIC KIDNEY DISEASE-ASSOCIATED CARDIOVASCULAR DISEASE. ACROSS THE SPECTRUM OF CLINICAL MEDICINE, THE FIELD OF EPIGENETICS HAS GAINED SUBSTANTIAL SCIENTIFIC INTEREST IN RECENT YEARS. EPIGENETICS REFERS TO MODIFICATIONS IN GENE EXPRESSION WHICH ARE NOT EXPLAINED BY CHANGES IN DNA SEQUENCE. CLASSICAL COMPONENTS OF EPIGENETIC REGULATION COMPRISE DNA METHYLATION, HISTONE MODIFICATIONS AND RNA INTERFERENCE. IN CHRONIC KIDNEY DISEASE (CKD), SEVERAL FEATURES OF URAEMIA, SUCH AS HYPERHOMOCYSTEINEMIA AND INFLAMMATION, MAY CONTRIBUTE TO CHANGES IN EPIGENETIC GENE REGULATION. IT HAS BEEN SUGGESTED THAT THESE CHANGES MAY AFFECT GENES RELATED TO CARDIOVASCULAR DISEASE. THEREBY, A URAEMIA-ASSOCIATED DISTURBANCE IN EPIGENETIC REGULATION MAY CONTRIBUTE TO THE SUBSTANTIAL INCREASE IN CARDIOVASCULAR MORBIDITY IN CKD PATIENTS. THE PRESENT REVIEW AIMS TO SUMMARIZE CURRENT KNOWLEDGE OF EPIGENETIC DYSREGULATION IN CARDIOVASCULAR DISEASE FROM A NEPHROLOGICAL PERSPECTIVE, WITH A SPECIAL FOCUS ON DNA METHYLATION. WE FIRST DESCRIBE THE IMPACT OF ALTERED EPIGENETIC REGULATION IN NON-CKD-ASSOCIATED ARTERIOSCLEROSIS, AND NEXT CHARACTERIZE URAEMIC FEATURES WHICH MAY AFFECT EPIGENETIC GENE REGULATION IN THE CONTEXT OF CARDIOVASCULAR DISEASE. FINALLY, WE CONCLUDE THAT SUBSTANTIAL ADDITIONAL WORK IS NEEDED BEFORE EPIGENETIC REGULATORY MECHANISMS MAY BECOME THERAPEUTIC TARGETS IN CKD-ASSOCIATED CARDIOVASCULAR DISEASE. 2013 12 97 30 A PRIMER ON THE EPIGENETICS OF KIDNEY FIBROSIS. DESPITE EXTENSIVE KNOWLEDGE OF THE VARIOUS MOLECULAR PATHWAYS THAT CONTRIBUTE TO TUBULOINTERSTITIAL FIBROSIS, IT REMAINS AN UNSOLVED QUESTION WHY THE PROGRESSION RATE OF CHRONIC KIDNEY DISEASE VARIES SUBSTANTIALLY FROM PATIENT TO PATIENT, EVEN AMONG PATIENTS WITH COMMON UNDERLYING NEPHROPATHIES AND COMORBIDITIES. POSSIBLE EXPLANATIONS FOR DIFFERENT SUSCEPTIBILITIES OF INDIVIDUAL PATIENTS TO DEVELOP END-STAGE RENAL FAILURE INCLUDE GENETIC OR EPIGENETIC VARIATIONS, WHICH MODIFY HOW INDIVIDUAL PATIENTS RESPOND TO KIDNEY INJURY. HERE WE REVIEW PRINCIPLES OF EPIGENETIC MECHANISMS IN CONTEXT OF CHRONIC KIDNEY DISEASE AND DISCUSS HOW SUCH INSIGHTS MAY BE UTILIZED FOR FUTURE THERAPEUTIC STRATEGIES AND MAY LEAD TO NOVEL DIAGNOSTIC TOOLS IN THE FUTURE. 2012 13 2195 30 EPIGENETIC MODIFICATION MECHANISMS INVOLVED IN INFLAMMATION AND FIBROSIS IN RENAL PATHOLOGY. THE GROWING INCIDENCE OF OBESITY, HYPERTENSION, AND DIABETES, COUPLED WITH THE AGING OF THE POPULATION, IS INCREASING THE PREVALENCE OF RENAL DISEASES IN OUR SOCIETY. CHRONIC KIDNEY DISEASE (CKD) IS CHARACTERIZED BY PERSISTENT INFLAMMATION, FIBROSIS, AND LOSS OF RENAL FUNCTION LEADING TO END-STAGE RENAL DISEASE. NOWADAYS, CKD TREATMENT HAS LIMITED EFFECTIVENESS UNDERSCORING THE IMPORTANCE OF THE DEVELOPMENT OF INNOVATIVE THERAPEUTIC OPTIONS. RECENT STUDIES HAVE IDENTIFIED HOW EPIGENETIC MODIFICATIONS PARTICIPATE IN THE SUSCEPTIBILITY TO CKD AND HAVE EXPLAINED HOW THE ENVIRONMENT INTERACTS WITH THE RENAL CELL EPIGENOME TO CONTRIBUTE TO RENAL DAMAGE. EPIGENETIC MECHANISMS REGULATE CRITICAL PROCESSES INVOLVED IN GENE REGULATION AND DOWNSTREAM CELLULAR RESPONSES. THE MOST RELEVANT EPIGENETIC MODIFICATIONS THAT PLAY A CRITICAL ROLE IN RENAL DAMAGE INCLUDE DNA METHYLATION, HISTONE MODIFICATIONS, AND CHANGES IN MIRNA LEVELS. IMPORTANTLY, THESE EPIGENETIC MODIFICATIONS ARE REVERSIBLE AND, THEREFORE, A SOURCE OF POTENTIAL THERAPEUTIC TARGETS. HERE, WE WILL EXPLAIN HOW EPIGENETIC MECHANISMS MAY REGULATE ESSENTIAL PROCESSES INVOLVED IN RENAL PATHOLOGY AND HIGHLIGHT SOME POSSIBLE EPIGENETIC THERAPEUTIC STRATEGIES FOR CKD TREATMENT. 2018 14 462 29 ARE ALTERATIONS IN DNA METHYLATION RELATED TO CKD DEVELOPMENT? THE MODIFICATIONS IN GENOMIC DNA METHYLATION ARE INVOLVED IN THE REGULATION OF NORMAL AND PATHOLOGICAL CELLULAR PROCESSES. THE EPIGENETIC REGULATION STIMULATES BIOLOGICAL PLASTICITY AS AN ADAPTIVE RESPONSE TO VARIATIONS IN ENVIRONMENTAL FACTORS. THE ROLE OF EPIGENETIC CHANGES IS VITAL FOR THE DEVELOPMENT OF SOME DISEASES, INCLUDING ATHEROGENESIS, CANCERS, AND CHRONIC KIDNEY DISEASE (CKD). THE RESULTS OF STUDIES PRESENTED IN THIS REVIEW HAVE SUGGESTED THAT ALTERED DNA METHYLATION CAN MODULATE THE EXPRESSION OF PRO-INFLAMMATORY AND PRO-FIBROTIC GENES, AS WELL THOSE ESSENTIAL FOR KIDNEY DEVELOPMENT AND FUNCTION, THUS STIMULATING RENAL DISEASE PROGRESSION. ABNORMALLY INCREASED HOMOCYSTEINE, HYPOXIA, AND INFLAMMATION HAVE BEEN SUGGESTED TO ALTER EPIGENETIC REGULATION OF GENE EXPRESSION IN CKD. STUDIES OF RENAL SAMPLES HAVE DEMONSTRATED THE RELATIONSHIP BETWEEN VARIATIONS IN DNA METHYLATION AND FIBROSIS AND VARIATIONS IN ESTIMATED GLOMERULAR FILTRATION RATE (EGFR) IN HUMAN CKD. THE UNRAVELLING OF THE GENETIC-EPIGENETIC PROFILE WOULD ENHANCE OUR UNDERSTANDING OF PROCESSES UNDERLYING THE DEVELOPMENT OF CKD. THE UNDERSTANDING OF MULTIFACETED RELATIONSHIP BETWEEN DNA METHYLATION, GENES EXPRESSION, AND DISEASE DEVELOPMENT AND PROGRESSION COULD IMPROVE THE ABILITY TO IDENTIFY INDIVIDUALS AT RISK OF CKD AND ENABLE THE CHOICE OF APPROPRIATE DISEASE MANAGEMENT. 2022 15 2555 23 EPIGENETICS IN RENAL DISEASES. WITH AGING, PREVALENCE OF OBESITY, HYPERTENSION, DIABETES AND RENAL DISEASES HAVE INCREASED GLOBALLY. OVER THE LAST TWO DECADES, THE PREVALENCE OF RENAL DISEASES HAS BEEN INTENSELY INCREASING. RENAL DISEASE AND RENAL PROGRAMMING ARE REGULATED BY EPIGENETIC MODIFICATIONS LIKE DNA METHYLATION AND HISTONE MODIFICATIONS. ENVIRONMENTAL FACTORS HAVE SIGNIFICANT ROLE IN THE PATHOPHYSIOLOGY OF RENAL DISEASE PROGRESSION. UNDERSTANDING THE POTENTIAL OF EPIGENETIC REGULATION OF GENE EXPRESSION MAY BE USEFUL IN RENAL DISEASE PROGNOSIS, DIAGNOSIS AND PROVIDES NOVEL THERAPEUTIC MEASURES. IN A NUTSHELL, THIS CHAPTER TALKS ABOUT THE ROLE OF EPIGENETIC MECHANISMS-DNA METHYLATION, HISTONE MODIFICATION, AND NONCODING RNA IN DIFFERENT RENAL DISEASES. THESE INCLUDE DIABETIC KIDNEY DISEASE, DIABETIC NEPHROPATHY, RENAL FIBROSIS, ETC. 2023 16 5660 29 SEX-SPECIFIC EPIGENETIC PROGRAMMING IN RENAL FIBROSIS AND INFLAMMATION. THE GROWING PREVALENCE OF HYPERTENSION, HEART DISEASE, DIABETES, AND OBESITY ALONG WITH AN AGING POPULATION, IS LEADING TO HIGHER INCIDENCE OF RENAL DISEASES IN THE SOCIETY. CHRONIC KIDNEY DISEASE (CKD) IS CHARACTERIZED MAINLY BY PERSISTENT INFLAMMATION, FIBROSIS, AND GRADUAL LOSS OF RENAL FUNCTION LEADING TO RENAL FAILURE. SEX IS A KNOWN CONTRIBUTOR TO THE DIFFERENCES IN INCIDENCE AND PROGRESSION OF CKD. EPIGENETIC PROGRAMMING IS AN ESSENTIAL REGULATOR OF RENAL PHYSIOLOGY AND IS CRITICALLY INVOLVED IN THE PATHOPHYSIOLOGY OF RENAL INJURY AND FIBROSIS. EPIGENETIC SIGNALING INTEGRATES INTRINSIC AND EXTRINSIC SIGNALS ONTO THE GENOME, AND VARIOUS ENVIRONMENTAL AND HORMONAL STIMULI, INCLUDING SEX HORMONES, WHICH REGULATE GENE EXPRESSION AND DOWNSTREAM CELLULAR RESPONSES. THE MOST EXTENSIVELY STUDIED EPIGENETIC ALTERATIONS THAT PLAY A CRITICAL ROLE IN RENAL DAMAGE INCLUDE HISTONE MODIFICATIONS AND DNA METHYLATION. NOTABLY, THESE EPIGENETIC ALTERATIONS ARE REVERSIBLE, MAKING THEM CANDIDATES FOR POTENTIAL THERAPEUTIC TARGETS FOR THE TREATMENT OF RENAL DISEASES. HERE, WE WILL SUMMARIZE THE CURRENT KNOWLEDGE ON SEX-DIFFERENCES IN EPIGENETIC MODULATION OF RENAL FIBROSIS AND INFLAMMATION AND HIGHLIGHT SOME POSSIBLE EPIGENETIC THERAPEUTIC STRATEGIES FOR CKD TREATMENT. 2023 17 5024 23 PERSONALIZED EPIGENETIC MANAGEMENT OF DIABETES. THE NOVEL GENOME-WIDE ASSAYS OF EPIGENETIC MARKS HAVE RESULTED IN A GREATER UNDERSTANDING OF HOW GENETICS AND THE ENVIRONMENT INTERACT IN THE DEVELOPMENT AND INHERITANCE OF DIABETES. CHRONIC HYPERGLYCEMIA INDUCES EPIGENETIC CHANGES IN MULTIPLE ORGANS, CONTRIBUTING TO DIABETIC COMPLICATIONS. SPECIFIC EPIGENETIC-MODIFYING COMPOUNDS HAVE BEEN DEVELOPED TO ERASE THESE MODIFICATIONS, POSSIBLY SLOWING DOWN THE ONSET OF DIABETES-RELATED COMPLICATIONS. THE CURRENT REVIEW IS AN UPDATE OF THE PREVIOUSLY PUBLISHED PAPER, DESCRIBING THE MOST RECENT ADVANCES IN THE EPIGENETICS OF DIABETES. 2017 18 6638 31 UNRAVELING THE EPIGENETIC LANDSCAPE OF GLOMERULAR CELLS IN KIDNEY DISEASE. CHRONIC KIDNEY DISEASE (CKD) IS A MAJOR PUBLIC HEALTH CONCERN AND ITS PREVALENCE AND INCIDENCE ARE RISING QUICKLY. IT IS A NON-COMMUNICABLE DISEASE PRIMARILY CAUSED BY DIABETES AND/OR HYPERTENSION AND IS ASSOCIATED WITH HIGH MORBIDITY AND MORTALITY. DESPITE DECADES OF RESEARCH EFFORTS, THE PATHOGENESIS OF CKD REMAINS A PUZZLE WITH MISSING PIECES. UNDERSTANDING THE CELLULAR AND MOLECULAR MECHANISMS THAT GOVERN THE LOSS OF KIDNEY FUNCTION IS CRUCIAL. ABRUPT REGULATION OF GENE EXPRESSION IN KIDNEY CELLS IS APPARENT IN CKD AND SHOWN TO BE RESPONSIBLE FOR DISEASE ONSET AND PROGRESSION. GENE EXPRESSION REGULATION EXTENDS BEYOND DNA SEQUENCE AND INVOLVES EPIGENETIC MECHANISMS INCLUDING CHANGES IN DNA METHYLATION AND POST-TRANSLATIONAL MODIFICATIONS OF HISTONES, DRIVEN BY THE ACTIVITY OF SPECIFIC ENZYMES. RECENT ADVANCES DEMONSTRATE THE ESSENTIAL PARTICIPATION OF EPIGENETICS IN KIDNEY (PATHO)PHYSIOLOGY, AS ITS ACTIONS REGULATE BOTH THE INTEGRITY OF CELLS BUT ALSO TRIGGERS DELETERIOUS SIGNALING PATHWAYS. HERE, WE REVIEW THE KNOWN EPIGENETIC PROCESSES REGULATING THE COMPLEX FILTRATION UNIT OF THE KIDNEY, THE GLOMERULI. THE REVIEW WILL ELABORATE ON NOVEL INSIGHTS INTO HOW EPIGENETICS CONTRIBUTES TO CELL INJURY IN THE CKD SETTING MAJORLY FOCUSING ON KIDNEY GLOMERULAR CELLS: THE GLOMERULAR ENDOTHELIAL CELLS, THE MESANGIAL CELLS, AND THE SPECIALIZED AND TERMINALLY DIFFERENTIATED PODOCYTE CELLS. 2021 19 5364 36 RECENT ADVANCES IN EPIGENETICS OF AGE-RELATED KIDNEY DISEASES. RENAL AGING HAS ATTRACTED INCREASING ATTENTION IN TODAY'S AGING SOCIETY, AS ELDERLY PEOPLE WITH ADVANCED AGE ARE MORE SUSCEPTIBLE TO VARIOUS KIDNEY DISORDERS SUCH AS ACUTE KIDNEY INJURY (AKI) AND CHRONIC KIDNEY DISEASE (CKD). THERE IS NO CLEAR-CUT UNIVERSAL MECHANISM FOR IDENTIFYING AGE-RELATED KIDNEY DISEASES, AND THEREFORE, THEY POSE A CONSIDERABLE MEDICAL AND PUBLIC HEALTH CHALLENGE. EPIGENETICS REFERS TO THE STUDY OF HERITABLE MODIFICATIONS IN THE REGULATION OF GENE EXPRESSION THAT DO NOT REQUIRE CHANGES IN THE UNDERLYING GENOMIC DNA SEQUENCE. A VARIETY OF EPIGENETIC MODIFIERS SUCH AS HISTONE DEACETYLASES (HDAC) INHIBITORS AND DNA METHYLTRANSFERASE (DNMT) INHIBITORS HAVE BEEN PROPOSED AS POTENTIAL BIOMARKERS AND THERAPEUTIC TARGETS IN NUMEROUS FIELDS INCLUDING CARDIOVASCULAR DISEASES, IMMUNE SYSTEM DISEASE, NERVOUS SYSTEM DISEASES, AND NEOPLASMS. ACCUMULATING EVIDENCE IN RECENT YEARS INDICATES THAT EPIGENETIC MODIFICATIONS HAVE BEEN IMPLICATED IN RENAL AGING. HOWEVER, NO PREVIOUS SYSTEMATIC REVIEW HAS BEEN PERFORMED TO SYSTEMATICALLY GENERALIZE THE RELATIONSHIP BETWEEN EPIGENETICS AND AGE-RELATED KIDNEY DISEASES. IN THIS REVIEW, WE AIM TO SUMMARIZE THE RECENT ADVANCES IN EPIGENETIC MECHANISMS OF AGE-RELATED KIDNEY DISEASES AS WELL AS DISCUSS THE APPLICATION OF EPIGENETIC MODIFIERS AS POTENTIAL BIOMARKERS AND THERAPEUTIC TARGETS IN THE FIELD OF AGE-RELATED KIDNEY DISEASES. IN SUMMARY, THE MAIN TYPES OF EPIGENETIC PROCESSES INCLUDING DNA METHYLATION, HISTONE MODIFICATIONS, NON-CODING RNA (NCRNA) MODULATION HAVE ALL BEEN IMPLICATED IN THE PROGRESSION OF AGE-RELATED KIDNEY DISEASES, AND THERAPEUTIC TARGETING OF THESE PROCESSES WILL YIELD NOVEL THERAPEUTIC STRATEGIES FOR THE PREVENTION AND/OR TREATMENT OF AGE-RELATED KIDNEY DISEASES. 2022 20 2163 36 EPIGENETIC MECHANISMS IN DIABETIC VASCULAR COMPLICATIONS. THERE HAS BEEN A RAPID INCREASE IN THE INCIDENCE OF DIABETES AS WELL THE ASSOCIATED VASCULAR COMPLICATIONS. BOTH GENETIC AND ENVIRONMENTAL FACTORS HAVE BEEN IMPLICATED IN THESE PATHOLOGIES. INCREASING EVIDENCE SUGGESTS THAT EPIGENETIC FACTORS PLAY A KEY ROLE IN THE COMPLEX INTERPLAY BETWEEN GENES AND THE ENVIRONMENT. ACTIONS OF MAJOR PATHOLOGICAL MEDIATORS OF DIABETES AND ITS COMPLICATIONS SUCH AS HYPERGLYCAEMIA, OXIDANT STRESS, AND INFLAMMATORY FACTORS CAN LEAD TO DYSREGULATED EPIGENETIC MECHANISMS THAT AFFECT CHROMATIN STRUCTURE AND GENE EXPRESSION. FURTHERMORE, PERSISTENCE OF THIS ALTERED STATE OF THE EPIGENOME MAY BE THE UNDERLYING MECHANISM CONTRIBUTING TO A 'METABOLIC MEMORY' THAT RESULTS IN CHRONIC INFLAMMATION AND VASCULAR DYSFUNCTION IN DIABETES EVEN AFTER ACHIEVING GLYCAEMIC CONTROL. FURTHER EXAMINATION OF EPIGENETIC MECHANISMS BY ALSO TAKING ADVANTAGE OF RECENTLY DEVELOPED NEXT-GENERATION SEQUENCING TECHNOLOGIES CAN PROVIDE NOVEL INSIGHTS INTO THE PATHOLOGY OF DIABETES AND ITS COMPLICATIONS AND LEAD TO THE DISCOVERY OF MUCH NEEDED NEW DRUG TARGETS FOR THESE DISEASES. IN THIS REVIEW, WE HIGHLIGHT THE ROLE OF EPIGENETICS IN DIABETES AND ITS VASCULAR COMPLICATIONS, AND RECENT TECHNOLOGICAL ADVANCES THAT HAVE SIGNIFICANTLY ACCELERATED THE FIELD. 2011