1 3094 188 GENOMIC AND PERSONALIZED MEDICINE APPROACHES FOR SUBSTANCE USE DISORDERS (SUDS) LOOKING AT GENOME-WIDE ASSOCIATION STUDIES. DRUG ADDICTION, OR SUBSTANCE USE DISORDER (SUD), IS A CHRONIC, RELAPSING DISORDER IN WHICH COMPULSIVE DRUG-SEEKING AND DRUG-TAKING BEHAVIOUR PERSIST DESPITE SERIOUS NEGATIVE CONSEQUENCES. DRUG ABUSE REPRESENTS A PROBLEM THAT DESERVES GREAT ATTENTION FROM A SOCIAL POINT OF VIEW, AND FOCUSES ON THE IMPORTANCE OF GENETIC STUDIES TO HELP IN UNDERSTANDING THE GENETIC BASIS OF ADDICTION AND ITS MEDICAL TREATMENT. DESPITE THE COMPLEXITY OF DRUG ADDICTION DISORDERS, AND THE HIGH NUMBER OF ENVIRONMENTAL VARIABLES PLAYING A ROLE IN THE ONSET, RECURRENCE, AND DURATION OF THE SYMPTOMS, SEVERAL STUDIES HAVE HIGHLIGHTED THE NON-NEGLIGIBLE ROLE OF GENETICS, AS DEMONSTRATED BY HERITABILITY AND GENOME-WIDE ASSOCIATION STUDIES. A CORRELATION BETWEEN THE RELATIVE RISK OF ADDICTION TO SPECIFIC SUBSTANCES AND HERITABILITY HAS BEEN RECENTLY OBSERVED, SUGGESTING THAT NEUROBIOLOGICAL MECHANISMS MAY BE, AT LEAST IN PART, INHERITED. ALL THESE OBSERVATIONS POINT TOWARDS A SCENARIO WHERE THE CORE NEUROBIOLOGICAL FACTORS OF ADDICTION, INVOLVING THE REWARD SYSTEM, IMPULSIVITY, COMPULSIVITY, STRESS, AND ANXIETY RESPONSE, ARE TRANSMITTED, AND THEREFORE, GENES AND MUTATIONS UNDERLYING THEIR VARIATION MIGHT BE DETECTED. IN THE LAST FEW YEARS, THE DEVELOPMENT OF NEW AND MORE EFFICIENT SEQUENCING TECHNOLOGIES HAS PAVED THE WAY FOR LARGE-SCALE STUDIES IN SEARCHING FOR GENETIC AND EPIGENETIC FACTORS AFFECTING DRUG ADDICTION DISORDERS AND THEIR TREATMENTS. THESE STUDIES HAVE BEEN CRUCIAL TO PINPOINT SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS) IN GENES THAT AFFECT THE REACTION TO MEDICAL TREATMENTS. THIS IS CRITICALLY IMPORTANT TO IDENTIFY PHARMACOGENOMIC APPROACHES FOR SUBSTANCE USE DISORDER, SUCH AS OPRM1 SNPS AND METHADONE REQUIRED DOSES FOR MAINTENANCE TREATMENT (MMT). NEVERTHELESS, DESPITE THE PROMISING RESULTS OBTAINED BY GENOME-WIDE ASSOCIATION AND PHARMACOGENOMIC STUDIES, SPECIFIC STUDIES RELATED TO POPULATION GENETICS DIVERSITY ARE LACKING, UNDERMINING THE OVERALL APPLICABILITY OF THE PRELIMINARY FINDINGS, AND THUS POTENTIALLY AFFECTING THE PORTABILITY AND THE ACCURACY OF THE GENETIC STUDIES. IN THIS REVIEW, FOCUSING ON CANNABIS, COCAINE AND HEROIN USE, WE REPORT THE STATE-OF-THE-ART GENOMICS AND PHARMACOGENOMICS OF SUDS, AND THE POSSIBLE FUTURE PERSPECTIVES RELATED TO MEDICAL TREATMENT RESPONSE IN PEOPLE THAT ASK FOR ASSISTANCE IN SOLVING DRUG-RELATED PROBLEMS. 2021 2 6155 47 THE GENETIC EPIDEMIOLOGY OF SUBSTANCE USE DISORDER: A REVIEW. BACKGROUND: SUBSTANCE USE DISORDER (SUD) REMAINS A SIGNIFICANT PUBLIC HEALTH ISSUE. A GREATER UNDERSTANDING OF HOW GENES AND ENVIRONMENT INTERACT TO REGULATE PHENOTYPES COMPRISING SUD WILL FACILITATE DIRECTED TREATMENTS AND PREVENTION. METHODS: THE LITERATURE STUDYING THE NEUROBIOLOGICAL CORRELATES OF SUD WITH A FOCUS ON THE GENETIC AND ENVIRONMENTAL INFLUENCES UNDERLYING THESE MECHANISMS WAS REVIEWED. RESULTS FROM TWIN/FAMILY, HUMAN GENETIC ASSOCIATION, GENE-ENVIRONMENT INTERACTION, EPIGENETIC LITERATURE, PHENOME-WIDE ASSOCIATION STUDIES ARE SUMMARIZED FOR ALCOHOL, NICOTINE, CANNABINOIDS, COCAINE, AND OPIOIDS. RESULTS: THERE ARE SUBSTANTIAL GENETIC INFLUENCES ON SUD THAT ARE EXPECTED TO INFLUENCE MULTIPLE NEUROTRANSMISSION PATHWAYS, AND THESE INFLUENCES ARE PARTICULARLY IMPORTANT WITHIN THE DOPAMINERGIC SYSTEM. GENETIC INFLUENCES INVOLVED IN OTHER ASPECTS OF SUD ETIOLOGY INCLUDING DRUG PROCESSING AND METABOLISM ARE ALSO IDENTIFIED. STUDIES OF GENE-ENVIRONMENT INTERACTION EMPHASIZE THE IMPORTANCE OF ENVIRONMENTAL CONTEXT IN SUD. EPIGENETIC STUDIES INDICATE DRUG-SPECIFIC CHANGES IN GENE EXPRESSION AS WELL AS DIFFERENCES IN GENE EXPRESSION RELATED TO THE USE OF MULTIPLE SUBSTANCES. FURTHER, GENE EXPRESSION IS EXPECTED TO DIFFER BY STAGE OF SUD SUCH AS SUBSTANCE INITIATION VERSUS CHRONIC SUBSTANCE USE. WHILE A SUBSTANTIAL LITERATURE HAS DEVELOPED FOR ALCOHOL AND NICOTINE USE DISORDERS, THERE IS COMPARATIVELY LESS INFORMATION FOR OTHER COMMONLY ABUSED SUBSTANCES. CONCLUSIONS: A BETTER UNDERSTANDING OF GENETICALLY-MEDIATED MECHANISMS INVOLVED IN THE NEUROBIOLOGY OF SUD PROVIDES INCREASED OPPORTUNITY TO DEVELOP BEHAVIORAL AND BIOLOGICALLY BASED TREATMENT AND PREVENTION OF SUD. 2017 3 2573 38 EPIGENETICS OF DRUG ABUSE: PREDISPOSITION OR RESPONSE. DRUG ADDICTION CONTINUES TO BE A SERIOUS MEDICAL AND SOCIAL PROBLEM. VULNERABILITY TO DEVELOP AN ADDICTION TO DRUGS IS DEPENDENT ON GENETIC, ENVIRONMENTAL, SOCIAL AND BIOLOGICAL FACTORS. IN PARTICULAR, THE INTERACTIONS OF ENVIRONMENTAL AND GENETIC FACTORS INDICATE THE SIGNIFICANCE OF EPIGENETIC MECHANISMS, WHICH HAVE BEEN FOUND TO OCCUR IN RESPONSE TO ILLICIT DRUG USE OR AS UNDERLYING FACTORS IN CHRONIC SUBSTANCE ABUSE AND RELAPSE. EPIGENETICS IS DEFINED AS THE HERITABLE AND POSSIBLY REVERSIBLE MODIFICATIONS IN GENE EXPRESSION THAT DO NOT INVOLVE ALTERATIONS IN THE DNA SEQUENCE. THIS REVIEW DISCUSSES THE VARIOUS TYPES OF EPIGENETIC MODIFICATIONS AND THEIR RELEVANCE TO DRUG ADDICTION TO ELUCIDATE WHETHER EPIGENETICS IS A PREDISPOSING FACTOR, OR A RESPONSE TO, DEVELOPING AN ADDICTION TO DRUGS OF ABUSE. 2012 4 1687 46 DRUGS OF ABUSE: EPIGENETIC MECHANISMS IN TOXICITY AND ADDICTION. THE ABUSE OF SUBSTANCES SUCH AS ETHANOL, COCAINE, AMPHETAMINES AND HEROIN IS ASSOCIATED WITH TOXIC EFFECTS ON ALMOST EVERY SYSTEM OF THE ORGANISM. FURTHERMORE, THE TRANSITION FROM OCCASIONAL-RECREATIONAL USE TO CHRONIC ABUSE AND ADDICTION IS A SERIOUS PSYCHIATRIC DISORDER WITH ONLY FEW CHANCES FOR EFFECTIVE AND DEFINITIVE TREATMENT SINCE MOST INDIVIDUALS RELAPSE, EVEN AFTER LONG PERIODS OF ABSTINENCE. IT IS THEREFORE OF UTMOST IMPORTANCE TO ELUCIDATE THE MECHANISMS BY WHICH THESE SUBSTANCES EXERT THEIR TOXICITY AND MEDIATE ADDICTION, IN ORDER TO DEVELOP NEW, EFFICIENT THERAPEUTIC STRATEGIES WITH A LONG-TERM OUTCOME, WHICH ARE CURRENTLY LACKING. WE ALREADY KNOW THAT IN A GREAT NUMBER OF THESE MECHANISMS, ALTERED GENE FUNCTION IS INVOLVED. BUT, WITH THE NEW FIELD OF EPIGENETICS, THERE IS INCREASING EVIDENCE THAT CHANGES IN THE EPIGENOME ARE RESPONSIBLE FOR THE ALTERED GENE FUNCTION. THE ADVANCES IN THE FIELD OF EPIGENETICS TOWARDS ELUCIDATION OF THE MECHANISMS UNDERLYING TOXICITY AND ADDICTION FOR ETHANOL, COCAINE, AMPHETAMINES AND HEROIN ARE CURRENTLY PRESENTED AND DISCUSSED IN THIS REVIEW. 2011 5 1252 42 CURRENT PERSPECTIVES ON THE NEUROBIOLOGY OF DRUG ADDICTION: A FOCUS ON GENETICS AND FACTORS REGULATING GENE EXPRESSION. DRUG ADDICTION IS A CHRONIC, RELAPSING DISORDER DEFINED BY CYCLIC PATTERNS OF COMPULSIVE DRUG SEEKING AND TAKING INTERSPERSED WITH EPISODES OF ABSTINENCE. WHILE GENETIC VARIABILITY MAY INCREASE THE RISK OF ADDICTIVE BEHAVIOURS IN AN INDIVIDUAL, EXPOSURE TO A DRUG RESULTS IN NEUROADAPTATIONS IN INTERCONNECTED BRAIN CIRCUITS WHICH, IN SUSCEPTIBLE INDIVIDUALS, ARE BELIEVED TO UNDERLIE THE TRANSITION TO, AND MAINTENANCE OF, AN ADDICTED STATE. THESE ADAPTATIONS CAN OCCUR AT THE CELLULAR, MOLECULAR, OR (EPI)GENETIC LEVEL AND ARE ASSOCIATED WITH SYNAPTIC PLASTICITY AND ALTERED GENE EXPRESSION, THE LATTER BEING MEDIATED VIA BOTH FACTORS AFFECTING TRANSLATION (EPIGENETICS) AND TRANSCRIPTION (NON CODING MICRORNAS) OF THE DNA OR RNA ITSELF. NEW ADVANCES USING TECHNIQUES SUCH AS OPTOGENETICS HAVE THE POTENTIAL TO INCREASE OUR UNDERSTANDING OF THE MICROCIRCUITRY MEDIATING ADDICTIVE BEHAVIOURS. HOWEVER, THE PROCESSES LEADING TO ADDICTION ARE COMPLEX AND MULTIFACTORIAL AND THUS WE FACE A MAJOR CONTEMPORARY CHALLENGE TO ELUCIDATE THE FACTORS IMPLICATED IN THE DEVELOPMENT AND MAINTENANCE OF AN ADDICTED STATE. 2012 6 2526 45 EPIGENETICS APPLIED TO PSYCHIATRY: CLINICAL OPPORTUNITIES AND FUTURE CHALLENGES. PSYCHIATRIC DISORDERS ARE CLINICALLY HETEROGENEOUS AND DEBILITATING CHRONIC DISEASES RESULTING FROM A COMPLEX INTERPLAY BETWEEN GENE VARIANTS AND ENVIRONMENTAL FACTORS. EPIGENETIC PROCESSES, SUCH AS DNA METHYLATION AND HISTONE POSTTRANSLATIONAL MODIFICATIONS, INSTRUCT THE CELL/TISSUE TO CORRECTLY INTERPRET EXTERNAL SIGNALS AND ADJUST ITS FUNCTIONS ACCORDINGLY. GIVEN THAT EPIGENETIC MODIFICATIONS ARE SENSITIVE TO ENVIRONMENT, STABLE, AND REVERSIBLE, EPIGENETIC STUDIES IN PSYCHIATRY COULD REPRESENT A PROMISING APPROACH TO BETTER UNDERSTANDING AND TREATING DISEASE. IN THE PRESENT REVIEW, WE AIM TO DISCUSS THE CLINICAL OPPORTUNITIES AND CHALLENGES ARISING FROM THE EPIGENETIC RESEARCH IN PSYCHIATRY. USING SELECTED EXAMPLES, WE FIRST RECAPITULATE KEY FINDINGS SUPPORTING THE ROLE OF ADVERSE LIFE EVENTS, ALONE OR IN COMBINATION WITH GENETIC RISK, IN EPIGENETIC PROGRAMMING OF NEUROPSYCHIATRIC SYSTEMS. EPIGENETIC STUDIES FURTHER REPORT ENCOURAGING FINDINGS ABOUT THE USE OF METHYLATION CHANGES AS DIAGNOSTIC MARKERS OF DISEASE PHENOTYPE AND PREDICTIVE TOOLS OF PROGRESSION AND RESPONSE TO TREATMENT. THEN WE DISCUSS THE POTENTIAL OF USING TARGETED EPIGENETIC PHARMACOTHERAPY, COMBINED WITH PSYCHOSOCIAL INTERVENTIONS, FOR FUTURE PERSONALIZED MEDICINE FOR PATIENTS. FINALLY, WE REVIEW THE METHODOLOGICAL LIMITATIONS THAT COULD HINDER INTERPRETATION OF EPIGENETIC DATA IN PSYCHIATRY. THEY MAINLY ARISE FROM HETEROGENEITY AT THE INDIVIDUAL AND TISSUE LEVEL AND REQUIRE FUTURE STRATEGIES IN ORDER TO REINFORCE THE BIOLOGICAL RELEVANCE OF EPIGENETIC DATA AND ITS TRANSLATIONAL USE IN PSYCHIATRY. OVERALL, WE SUGGEST THAT EPIGENETICS COULD PROVIDE NEW INSIGHTS INTO A MORE COMPREHENSIVE INTERPRETATION OF MENTAL ILLNESS AND MIGHT EVENTUALLY IMPROVE THE NOSOLOGY, TREATMENT, AND PREVENTION OF PSYCHIATRIC DISORDERS. 2018 7 4911 29 PAIN IMAGING: FUTURE APPLICATIONS TO INTEGRATIVE CLINICAL AND BASIC NEUROBIOLOGY. WE HAVE ENTERED A NEW ERA IN UNDERSTANDING CNS CIRCUITRY INVOLVED IN ACUTE AND CHRONIC PAIN. THE ABILITY TO OBJECTIVELY MEASURE A PAIN OR ANALGESIC STATE OF THE BRAIN USING NON-INVASIVE METHODS THAT DEFINE NEURAL ACTIVATION PROVIDES THE POSSIBILITY FOR TOP-DOWN APPROACHES TO DRUG DISCOVERY. THESE BRAIN MAPS REPRESENT THE SPECIFIC BRAIN STATE. IN THE FUTURE, CORRELATIONS WITH SUCH STATES AND BEHAVIORAL, GENETIC, EPIGENETIC OR OTHER CHEMICAL MARKERS MAY HELP DEFINE SPECIFIC DIAGNOSTIC TOOLS AND NOVEL APPROACHES TO DRUG DISCOVERY. 2003 8 2963 35 GENETIC AND EPIGENETIC MECHANISMS LINKING PAIN AND PSYCHIATRIC DISORDERS. THE NEUROPHYSIOLOGICAL LINK BETWEEN NEUROPATHIC PAIN AND DEPRESSION REMAINS UNKNOWN DESPITE EVIDENT HIGH COMORBIDITY OF THESE TWO DISORDERS. HOWEVER, THERE IS CONVINCING EVIDENCE THAT GENOTYPE PLAYS A ROLE IN BOTH PAIN AND DEPRESSION. USING VARIOUS TYPES OF GENETIC ANALYSIS - POPULATION GENETICS, CYTOGENETICS AND MOLECULAR TECHNOLOGIES - SPECIFIC GENES HAVE BEEN IMPLICATED IN MEDIATING ALMOST ALL ASPECTS OF NOCICEPTION AND MOOD DISORDERS. THE CURRENT REVIEW ATTEMPTS TO IDENTIFY SPECIFIC GENES AND EPIGENETIC MECHANISMS COMMON TO BOTH DISORDERS. IT IS CONCLUDED THAT EXTERNAL AND INTERNAL FACTORS (INFLAMMATION, STRESS, GENDER, ETC.) THAT CONTRIBUTE TO THE PATHOLOGIES MAY DO SO THROUGH EPIGENETIC MECHANISMS THAT MAY AFFECT EXPRESSION OF THESE PARTICULAR GENES. THE POSSIBLE INVOLVEMENT OF EPIGENETIC REGULATION IN PAIN AND PSYCHIATRIC DISORDERS SUGGESTS THAT TREATMENTS TARGETING EPIGENETIC MECHANISMS THAT MEDIATE ADVERSE LIFE EVENTS SHOULD BE CONSIDERED. 2015 9 1736 43 EARLY DETECTION AND PREVENTION OF SCHIZOPHRENIC PSYCHOSIS-A REVIEW. PSYCHOTIC DISORDERS OFTEN RUN A CHRONIC COURSE AND ARE ASSOCIATED WITH A CONSIDERABLE EMOTIONAL AND SOCIAL IMPACT FOR PATIENTS AND THEIR RELATIVES. THEREFORE, EARLY RECOGNITION, COMBINED WITH THE POSSIBILITY OF PREVENTIVE INTERVENTION, IS URGENTLY WARRANTED SINCE THE DURATION OF UNTREATED PSYCHOSIS (DUP) SIGNIFICANTLY DETERMINES THE FURTHER COURSE OF THE DISEASE. IN ADDITION TO ESTABLISHED DIAGNOSTIC TOOLS, NEUROBIOLOGICAL FACTORS IN THE DEVELOPMENT OF SCHIZOPHRENIC PSYCHOSES ARE INCREASINGLY BEING INVESTIGATED. IT IS SHOWN THAT NUMEROUS MOLECULAR ALTERATIONS ALREADY EXIST BEFORE THE CLINICAL ONSET OF THE DISEASE. AS SCHIZOPHRENIC PSYCHOSES ARE NOT ELICITED BY A SINGLE MUTATION IN THE DEOXYRIBONUCLEIC ACID (DNA) SEQUENCE, EPIGENETICS LIKELY CONSTITUTE THE MISSING LINK BETWEEN ENVIRONMENTAL INFLUENCES AND DISEASE DEVELOPMENT AND COULD POTENTIALLY SERVE AS A BIOMARKER. THE RESULTS FROM TRANSCRIPTOMIC AND PROTEOMIC STUDIES POINT TO A DYSREGULATED IMMUNE SYSTEM, LIKELY EVOKED BY EPIGENETIC ALTERATIONS. DESPITE THE INCREASING KNOWLEDGE OF THE NEUROBIOLOGICAL MECHANISMS INVOLVED IN THE DEVELOPMENT OF PSYCHOTIC DISORDERS, FURTHER RESEARCH EFFORTS WITH LARGE POPULATION-BASED STUDY DESIGNS ARE NEEDED TO IDENTIFY SUITABLE BIOMARKERS. IN CONCLUSION, A COMBINATION OF BLOOD EXAMINATIONS, FUNCTIONAL IMAGING TECHNIQUES, ELECTROENCEPHALOGRAPHY (EEG) INVESTIGATIONS AND POLYGENIC RISK SCORES SHOULD BE CONSIDERED AS THE BASIS FOR PREDICTING HOW SUBJECTS WILL TRANSITION INTO MANIFEST PSYCHOSIS. 2021 10 6260 33 THE MOLECULAR NEUROBIOLOGY OF CHRONIC PAIN-INDUCED DEPRESSION. THE INCREASING NUMBER OF INDIVIDUALS WITH COMORBIDITIES POSES AN URGENT NEED TO IMPROVE THE MANAGEMENT OF PATIENTS WITH MULTIPLE CO-EXISTING DISEASES. AMONG THESE COMORBIDITIES, CHRONIC PAIN AND MOOD DISORDERS, TWO LONG-LASTING DISABLING CONDITIONS THAT SIGNIFICANTLY REDUCE THE QUALITY OF LIFE, COULD BE CITED FIRST. THE RECENT DEVELOPMENT OF ANIMAL MODELS ACCELERATED THE STUDIES FOCUSING ON THE UNDERLYING MECHANISMS OF THE CHRONIC PAIN AND DEPRESSION/ANXIETY COMORBIDITY. THIS REVIEW PROVIDES AN OVERVIEW OF CLINICAL AND PRE-CLINICAL STUDIES PERFORMED OVER THE PAST TWO DECADES ADDRESSING THE MOLECULAR ASPECTS OF THE COMORBID RELATIONSHIP OF CHRONIC PAIN AND DEPRESSION. WE THUS FOCUSED ON THE STUDIES THAT INVESTIGATED THE MOLECULAR CHARACTERISTICS OF THE COMORBID RELATIONSHIP BETWEEN CHRONIC PAIN AND MOOD DISORDERS, ESPECIALLY MAJOR DEPRESSIVE DISORDERS, FROM THE GENETIC AND EPIGENETIC POINT OF VIEW TO KEY NEUROMODULATORS WHICH HAVE BEEN SHOWN TO PLAY AN IMPORTANT ROLE IN THIS COMORBIDITY. 2019 11 38 35 A COMMON ROLE FOR PSYCHOTROPIC MEDICATIONS: MEMORY IMPAIRMENT. THE PSYCHOPATHOLOGIC PROFILE OF MENTAL DISORDERS IS VERY DIVERSE AND PSYCHOTROPIC MEDICATIONS USED TO TREAT THEM DIFFER IN THEIR CHEMICAL STRUCTURE. NEVERTHELESS, THESE DRUGS SHARE THESE FOUR CHARACTERISTICS: DELAYED ONSET OF CLINICAL RESPONSE, NOT ONE OF THEM CAN BE SAID TO CURE, THERE IS A HIGH NUMBER OF NON-RESPONDERS, AND THE MECHANISM RESPONSIBLE FOR THEIR THERAPEUTIC ACTION IS NOT KNOWN. IT IS HYPOTHESIZED THAT THE ACTION OF PSYCHOTROPIC MEDICATIONS IS MEMORY IMPAIRMENT, UNDERSTANDING MEMORY AS THE TRACE LEFT IN THE NERVOUS SYSTEM NOT ONLY BY INDIVIDUAL EXPERIENCES BUT ALSO BY GENETIC AND EPIGENETIC PHENOMENA. IT IS SUGGESTED THAT IT WOULD BE BENEFICIAL TO TRANSLATE SOME RESEARCH STRATEGIES FROM THE NEUROBIOLOGY OF LEARNING AND MEMORY TO THE STUDY OF THE EFFECTS OF PSYCHOTROPIC MEDICATIONS. THE HYPOTHESIS IS BRIEFLY ASSESSED ACCORDING TO THE FOLLOWING THREE CRITERIA: (A). THE COMPARISON BETWEEN THE MOLECULAR EFFECTS OF PSYCHOTROPIC MEDICATIONS AND THE SO-CALLED MOLECULAR BIOLOGY OF LEARNING AND MEMORY, (B). THE EFFECTS OF THESE DRUGS, PREFERENTIALLY AFTER CHRONIC USE, ON MEMORY TESTS, AND (C). THE EFFECTS OF DRUGS THAT IMPAIR MEMORY ON TESTS USED FOR SCREENING PSYCHOTROPIC MEDICATIONS. FINALLY, SOME GENERAL SUGGESTIONS FOR FUTURE RESEARCH ARE POINTED OUT. 2003 12 4914 36 PAIN VULNERABILITY: A NEUROBIOLOGICAL PERSPECTIVE. THERE ARE MANY KNOWN RISK FACTORS FOR CHRONIC PAIN CONDITIONS, YET THE BIOLOGICAL UNDERPINNINGS THAT LINK THESE FACTORS TO ABNORMAL PROCESSING OF PAINFUL SIGNALS ARE ONLY JUST BEGINNING TO BE EXPLORED. THIS REVIEW WILL DISCUSS THE POTENTIAL MECHANISMS THAT HAVE BEEN PROPOSED TO UNDERLIE VULNERABILITY AND RESILIENCE TOWARD DEVELOPING CHRONIC PAIN. PARTICULAR FOCUS WILL BE GIVEN TO GENETIC AND EPIGENETIC PROCESSES, PRIMING EFFECTS ON A CELLULAR LEVEL, AND ALTERATIONS IN BRAIN NETWORKS CONCERNED WITH REWARD, MOTIVATION/LEARNING AND DESCENDING MODULATORY CONTROL. ALTHOUGH RESEARCH IN THIS AREA IS STILL IN ITS INFANCY, A BETTER UNDERSTANDING OF HOW PAIN VULNERABILITY EMERGES HAS THE POTENTIAL TO HELP IDENTIFY INDIVIDUALS AT RISK AND MAY OPEN UP NEW THERAPEUTIC AVENUES. 2014 13 6391 41 THE ROLE OF THE GUT MICROBIOME AND MICROBIAL METABOLISM IN MEDIATING OPIOID-INDUCED CHANGES IN THE EPIGENOME. THE CURRENT OPIOID PANDEMIC IS A MAJOR PUBLIC HEALTH CRISIS IN THE UNITED STATES, AFFECTING MILLIONS OF PEOPLE AND IMPOSING SIGNIFICANT HEALTH AND SOCIOECONOMIC BURDENS. PRECLINICAL AND CLINICAL RESEARCH OVER THE PAST FEW DECADES HAS DELINEATED CERTAIN MOLECULAR MECHANISMS AND IDENTIFIED VARIOUS GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS RESPONSIBLE FOR THE PATHOPHYSIOLOGY AND COMORBIDITIES ASSOCIATED WITH OPIOID USE. OPIOID USE-INDUCED EPIGENETIC MODIFICATIONS HAVE BEEN IDENTIFIED AS ONE OF THE IMPORTANT FACTORS THAT MEDIATE GENETIC CHANGES IN BRAIN REGIONS THAT CONTROL REWARD AND DRUG-SEEKING BEHAVIOR AND ARE ALSO IMPLICATED IN THE DEVELOPMENT OF TOLERANCE. RECENTLY, IT HAS BEEN SHOWN THAT OPIOID USE RESULTS IN MICROBIAL DYSBIOSIS, LEADING TO GUT BARRIER DISRUPTION, WHICH DRIVES SYSTEMIC INFLAMMATION, IMPACTING THE PERCEPTION OF PAIN, THE DEVELOPMENT OF ANALGESIC TOLERANCE, AND BEHAVIORAL OUTCOMES. IN THIS REVIEW, WE HIGHLIGHT THE POTENTIAL ROLE OF MICROBIOTA AND MICROBIAL METABOLITES IN MEDIATING THE EPIGENETIC MODIFICATIONS INDUCED BY OPIOID USE. 2023 14 5028 36 PERSONALIZING PEDIATRIC PAIN MEDICINE: USING POPULATION-SPECIFIC PHARMACOGENETICS, GENOMICS, AND OTHER -OMICS APPROACHES TO PREDICT RESPONSE. PERSONALIZED MEDICINE IS THE SCIENCE OF INDIVIDUALIZED PREVENTION AND THERAPY. THE NOTION THAT "ONE SIZE FITS ALL" HAS BEEN REPLACED BY THE IDEA OF PATIENT-TAILORED HEALTH CARE. WITHIN THIS PARADIGM, THE RESEARCH COMMUNITY HAS TURNED TO EXAMINE GENETIC PREDICTORS OF DISEASE AND TREATMENT RESPONSES. PAIN RESEARCHERS HAVE PRODUCED GENETIC STUDIES OVER THE LAST DECADE THAT EVALUATE THE ASSOCIATION OF GENETIC VARIABILITY WITH PAIN SENSITIVITY AND ANALGESIC RESPONSE. WHILE MOST OF THESE STUDIES HAVE BEEN CONDUCTED AMONG COHORTS OF SUBJECTS OF EUROPEAN DESCENT, SOME HAVE INCLUDED OTHER RACIAL AND ETHNIC GROUPS, PROVIDING EVIDENCE OF VARIABLE RESPONSES TO ANALGESICS. SIMULTANEOUSLY, THERE IS AN INCREASED RECOGNITION REGARDING THE COMPLEXITY OF PAIN RESEARCH, ACKNOWLEDGING THE ADDITIONAL ROLE OF EPIGENETIC, TRANSCRIPTOMIC, PROTEOMIC, AND METABOLOMIC FACTORS IN THE DEVELOPMENT, EXPERIENCE, AND TREATMENT OF PAIN. THIS ARTICLE PROVIDES AN INTRODUCTION TO POPULATION-SPECIFIC PHARMACOGENETICS, PROTEOMICS AND OTHER "-OMICS" TECHNOLOGIES TO PREDICT DRUG RESPONSE TO PAIN MEDICATIONS IN CHILDREN. IT AIMS TO PROVIDE ANESTHESIOLOGISTS WITH THE BASIC KNOWLEDGE TO UNDERSTAND THE POTENTIAL IMPLICATIONS OF GENETIC AND EPIGENETIC FACTORS MANAGING THE PAIN OF PEDIATRIC PATIENTS. 2015 15 1796 44 EFFECT OF GERM-FREE STATUS ON TRANSCRIPTIONAL PROFILES IN THE NUCLEUS ACCUMBENS AND TRANSCRIPTOMIC RESPONSE TO CHRONIC MORPHINE. OPIOID USE DISORDER IS A PUBLIC HEALTH CRISIS THAT CAUSES TREMENDOUS SUFFERING FOR PATIENTS AS WELL AS SUBSTANTIAL SOCIAL AND ECONOMIC COSTS FOR SOCIETY. THERE ARE CURRENTLY AVAILABLE TREATMENTS FOR PATIENTS WITH OPIOID USE DISORDER, BUT THEY REMAIN INTOLERABLE OR INEFFECTIVE FOR MANY. THUS THE NEED TO DEVELOP NEW AVENUES FOR THERAPEUTICS DEVELOPMENT IN THIS SPACE IS GREAT. SUBSTANTIAL WORK IN MODELS OF SUBSTANCE USE DISORDERS, INCLUDING OPIOID USE DISORDER, DEMONSTRATES THAT PROLONGED EXPOSURE TO DRUGS OF ABUSE LEADS TO MARKED TRANSCRIPTIONAL AND EPIGENETIC DYSREGULATION IN LIMBIC SUBSTRUCTURES. IT IS WIDELY BELIEVED THAT THESE CHANGES IN GENE REGULATION IN RESPONSE TO DRUGS ARE A KEY DRIVING FACTOR IN THE PERPETUATION OF DRUG TAKING AND SEEKING BEHAVIORS. THUS, DEVELOPMENT OF INTERVENTIONS THAT COULD SHAPE TRANSCRIPTIONAL REGULATION IN RESPONSE TO DRUGS OF ABUSE WOULD BE OF HIGH VALUE. OVER THE PAST DECADE THERE HAS BEEN A SURGE IN RESEARCH DEMONSTRATING THAT THE RESIDENT BACTERIA OF THE GASTROINTESTINAL TRACT, COLLECTIVELY THE GUT MICROBIOME, CAN HAVE TREMENDOUS INFLUENCE ON NEUROBIOLOGICAL AND BEHAVIORAL PLASTICITY. PREVIOUS WORK FROM OUR GROUP AND OTHERS HAS DEMONSTRATED THAT ALTERATIONS IN THE GUT MICROBIOME CAN ALTER BEHAVIORAL RESPONSES TO OPIOIDS IN MULTIPLE PARADIGMS. ADDITIONALLY, WE HAVE PREVIOUSLY REPORTED THAT DEPLETION OF THE GUT MICROBIOME WITH ANTIBIOTICS MARKEDLY SHIFTS THE TRANSCRIPTOME OF THE NUCLEUS ACCUMBENS FOLLOWING PROLONGED MORPHINE EXPOSURE. IN THIS MANUSCRIPT WE PRESENT A COMPREHENSIVE ANALYSIS OF THE EFFECTS OF THE GUT MICROBIOME ON TRANSCRIPTIONAL REGULATION OF THE NUCLEUS ACCUMBENS FOLLOWING MORPHINE BY UTILIZING GERM-FREE, ANTIBIOTIC TREATED, AND CONTROL MICE. THIS ALLOWS FOR DETAILED UNDERSTANDING OF THE ROLE OF THE MICROBIOME IN REGULATING BASELINE TRANSCRIPTOMIC CONTROL, AS WELL AS RESPONSE TO MORPHINE. WE FIND THAT GERM-FREE STATUS LEADS TO A MARKED GENE DYSREGULATION IN A MANNER DISTINCT TO ADULT MICE TREATED WITH ANTIBIOTICS, AND THAT ALTERED GENE PATHWAYS ARE HIGHLY RELATED TO CELLULAR METABOLIC PROCESSES. THESE DATA PROVIDE ADDITIONAL INSIGHT INTO THE ROLE OF THE GUT MICROBIOME IN MODULATING BRAIN FUNCTION AND LAY A FOUNDATION FOR FURTHER STUDY IN THIS AREA. 2023 16 2917 34 GENE-ENVIRONMENT INTERACTIONS IN COMMON MENTAL DISORDERS: AN UPDATE AND STRATEGY FOR A GENOME-WIDE SEARCH. A DECADE OF RESEARCH HAS DEMONSTRATED THE EXPLANATORY POTENTIAL OF INTERPLAY BETWEEN GENETIC VARIANTS AND ENVIRONMENTAL FACTORS IN THE DEVELOPMENT OF COMMON MENTAL DISORDERS. INITIAL FINDINGS HAVE UNDERGONE TESTS OF REPLICABILITY AND SPECIFICITY. SOME GENE-ENVIRONMENT INTERACTIONS HAVE BEEN CONFIRMED, SOME HAVE NOT REPLICATED AND YET OTHER TURNED OUT TO BE MORE SPECIFIC THAN INITIALLY THOUGHT. SPECIFIC AND COMPLEMENTARY ROLES OF GENETIC FACTORS HAVE BEEN DELINEATED: A COMMON FUNCTIONAL LENGTH POLYMORPHISM IN THE SEROTONIN TRANSPORTER GENE (5-HTTLPR) MODERATED THE EFFECT OF CHILDHOOD MALTREATMENT ON CHRONIC DEPRESSION IN ADULTHOOD, BUT DID NOT SUBSTANTIALLY INFLUENCE THE EFFECTS OF ADULT STRESSFUL LIFE EVENTS ON THE ONSET OF NEW DEPRESSIVE EPISODES; IN CONTRAST, A COMMON FUNCTIONAL POLYMORPHISM IN THE BRAIN-DERIVED NEUROTROPHIC FACTOR GENE (BDNF) MODERATED THE EFFECT OF STRESSFUL LIFE EVENTS IN ADULTHOOD IN TRIGGERING NEW DEPRESSIVE EPISODES, BUT DID NOT INFLUENCE THE EFFECTS OF CHILDHOOD MALTREATMENT. MOLECULAR MECHANISMS UNDERLYING GENE-ENVIRONMENT INTERACTIONS ARE BEING UNCOVERED, INCLUDING DNA METHYLATION AND OTHER EPIGENETIC MODIFICATIONS. NEW GENE-ENVIRONMENT INTERACTIONS CONTINUE TO BE REPORTED, STILL LARGELY FROM HYPOTHESIS-DRIVEN RESEARCH. STATISTICAL AND BIOLOGICAL PRIORITIZATION STRATEGIES ARE PROPOSED TO FACILITATE A SYSTEMATIC DISCOVERY OF NOVEL GENE-ENVIRONMENT INTERACTIONS IN GENOME-WIDE ANALYSES. 2014 17 4915 48 PAIN, ANALGESIA AND GENETICS. OBJECTIVES: IN THE CLINICAL SETTING, THERE IS MARKED INTERSUBJECT VARIABILITY IN THE INTENSITY OF PAIN REPORTED BY PATIENTS WITH APPARENTLY SIMILAR PAIN STATES, AS WELL AS WIDELY DIFFERING ANALGESIC DOSING REQUIREMENTS BETWEEN INDIVIDUALS TO PRODUCE SATISFACTORY PAIN RELIEF WITH TOLERABLE SIDE-EFFECTS. GENETIC AND ENVIRONMENTAL FACTORS AS WELL AS THEIR INTERACTION ARE IMPLICATED, AND THESE ARE DISCUSSED IN THIS REVIEW. KEY FINDINGS: PIONEERING WORK UNDERTAKEN IN MICE MORE THAN A DECADE AGO, SHOWED A STRONG GENETIC CONTRIBUTION TO LEVELS OF NOCICEPTION/HYPERSENSITIVITY AS WELL AS LEVELS OF ANTINOCICEPTION PRODUCED BY COMMONLY AVAILABLE ANALGESIC AGENTS. TO DATE MORE THAN 300 CANDIDATE 'PAIN' GENES HAVE BEEN IDENTIFIED AS POTENTIALLY CONTRIBUTING TO HERITABLE DIFFERENCES IN PAIN SENSITIVITY AND ANALGESIC RESPONSIVENESS IN ANIMALS AND HUMANS, WITH THIS INFORMATION AVAILABLE IN A PUBLICLY ACCESSIBLE DATABASE HTTP://WWW.JBLDESIGN.COM/JMOGIL/ENTER.HTML. SINCE THEN, MANY GENETIC ASSOCIATION STUDIES HAVE BEEN CONDUCTED IN HUMANS TO INVESTIGATE THE POSSIBILITY THAT SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS) IN AN INDIVIDUAL GENE MAY EXPLAIN DRUG INEFFICACY OR EXCESSIVE TOXICITY EXPERIENCED BY A SMALL SUBSET OF THE WHOLE POPULATION WHO HAVE THE RARE ALLELE FOR A PARTICULAR SNP. SUMMARY: DESPITE THE FACT THAT SNPS IN MORE THAN 20 GENES THAT AFFECT PAIN SENSITIVITY OR CONTRIBUTE TO INTERINDIVIDUAL VARIABILITY IN RESPONSES TO ANALGESIC MEDICATIONS HAVE BEEN IDENTIFIED IN THE HUMAN GENOME, MUCH OF THE DATA IS CONFLICTING. APART FROM DEFICIENCIES IN THE DESIGN AND CONDUCT OF HUMAN GENETIC ASSOCIATION STUDIES, RECENT RESEARCH FROM OTHER FIELDS HAS IMPLICATED EPIGENETIC MECHANISMS THAT FACILITATE DYNAMIC GENE-ENVIRONMENT COMMUNICATION, AS A POSSIBLE EXPLANATION. 2011 18 3472 40 IDENTIFICATION AND MANAGEMENT OF PAIN MEDICATION ABUSE AND MISUSE: CURRENT STATE AND FUTURE DIRECTIONS. LONG-TERM OPIOID THERAPY POSES A RISK FOR ABUSE AND MISUSE IN SOME PATIENTS. IDENTIFYING WHICH PATIENTS MAY POTENTIALLY BE AT RISK PRIOR TO INITIATION OF THERAPY, AND IDENTIFYING PATIENTS IN WHOM THESE PROBLEMS DEVELOP DURING THERAPY, ARE SIGNIFICANT CHALLENGES. OUTCOME PREDICTION IS IMPEDED BY THE COMPLEXITY OF THE PROBLEM, WHERE CONSIDERABLE HETEROGENEITY RESULTS FROM PSYCHOLOGICAL AND SOCIOECONOMIC FACTORS, AS WELL AS INTERINDIVIDUAL VARIATION IN BIOLOGICAL PATHWAYS DUE TO GENETIC AND EPIGENETIC FACTORS. SCREENING TOOLS DESIGNED TO DETECT OPIOID MISUSE AND URINE DRUG TESTING ARE BOTH USED CLINICALLY; SCANT EVIDENCE CURRENTLY EXISTS TO ALLOW THE FORMULATION OF AN ALGORITHM FOR JUDICIOUS USE OF THESE TOOLS. MOREOVER, THESE TOOLS MAY NOT BE ADDRESSING THE UNDERLYING ALTERATIONS IN BIOLOGICAL PATHWAYS THAT OCCUR OWING TO THE DEVELOPMENT OF CHRONIC PAIN OR IN RESPONSE TO CHRONIC OPIOID ADMINISTRATION. AN EVIDENCE-BASED ALGORITHMIC APPROACH TO RISK MITIGATION THAT CAN BE APPLIED IN A COST-EFFECTIVE MANNER TO GUIDE THERAPY IS URGENTLY NEEDED. 2012 19 1329 49 DEPRESSION ASSOCIATED WITH DIABETES: FROM PATHOPHYSIOLOGY TO TREATMENT. DIABETES IS A CHRONIC AND PROGRESSIVE SYNDROME COMMONLY ASSOCIATED WITH SEVERAL NEUROPSYCHIATRIC COMORBITIES, OF WHICH DEPRESSION IS THE MOST STUDIED. THE PREVALENCE OF DEPRESSION IS ABOUT TWO OR THREE TIMES HIGHER IN DIABETIC PATIENTS COMPARED TO THE GENERAL POPULATION. IT IS BELIEVED THAT THE DIABETES - DEPRESSION RELATION MAY BE BIDIRECTIONAL, I.E., THE DEPRESSION CAN LEAD TO DIABETES AND CONVERSELY DIABETES COULD FACILITATE THE EMERGENCE OF DEPRESSION. DEPRESSION IS ONE OF THE MOST NEGLECTED SYMPTOMS IN DIABETIC PATIENTS AND IS DIRECTLY LINKED WITH LOWERING OF QUALITY OF LIFE. THE TREATMENT OF DEPRESSION IN THESE PATIENTS IS STILL QUITE INEFFECTIVE AND IN MANY CASES TREATMENTREFRACTORY. FURTHERMORE, SOME OF THE FIRST CHOICE DRUGS USED TO TREAT THE DEPRESSION AFFECT THE BLOOD GLUCOSE CONTROL, AGGRAVATING THE HYPERGLYCEMIC STATE. THESE ISSUES UNDERSCORE THE URGENCY IN STUDIES SEARCHING FOR NEW PHARMACOLOGICAL TARGETS FOR THE TREATMENT OF DEPRESSION ASSOCIATED WITH DIABETES. FOR THIS, A BETTER UNDERSTANDING OF THE PATHOPHYSIOLOGY THAT RELATES THIS COMORBIDITY BECOMES CRITICAL. IN THIS RESPECT, THIS REVIEW WILL FOCUS ON SOME HYPOTHESES THAT HAVE BEEN PROPOSED TO EXPLAIN THE MECHANISMS UNDERLYING DEPRESSION ASSOCIATED WITH DIABETES, HIGHLIGHTING THE TREATMENT OPTIONS CURRENTLY AVAILABLE AND THEIR LIMITATIONS. AMONG THESE HYPOTHESES, WE WILL POINT OUT THE HYPERGLYCEMIA AS A PRIMARY METABOLIC CAUSE OF THE DEPRESSION DEVELOPMENT, THE INVOLVEMENT OF THE DYSREGULATION OF HYPOTHALAMIC PITUITARY-ADRENAL (HPA) AXIS AND OF NEUROTRANSMITTER SYSTEMS, SPECIALLY MONOAMINERGIC SYSTEM. BESIDES, THE ROLE OF OXIDATIVE STRESS, NEUROINFLAMMATION AND CELL DEATH, ESPECIALLY IN HIPPOCAMPUS AND PREFRONTAL CORTEX, BRAIN AREAS IMPORTANT FOR THE MEDIATION AND MODULATION OF EMOTIONAL BEHAVIOR WILL ALSO BE DISCUSSED. FINALLY, WE WILL BRING UP THE INFLUENCE OF THE EPIGENETIC REGULATION WITH RESPECT TO NEUROPSYCHIATRIC DISORDERS. 2016 20 5038 29 PHARMACOGENETICS OF CHRONIC PAIN AND ITS TREATMENT. THIS PAPER REVIEWS THE IMPACT OF GENETIC VARIABILITY OF DRUG METABOLIZING ENZYMES, TRANSPORTERS, RECEPTORS, AND PATHWAYS INVOLVED IN CHRONIC PAIN PERCEPTION ON THE EFFICACY AND SAFETY OF ANALGESICS AND OTHER DRUGS USED FOR CHRONIC PAIN TREATMENT. SEVERAL CANDIDATE GENES HAVE BEEN IDENTIFIED IN THE LITERATURE, WHILE THERE IS USUALLY ONLY LIMITED CLINICAL EVIDENCE SUBSTANTIATING FOR THE PENETRATION OF THE TESTING FOR THESE CANDIDATE BIOMARKERS INTO THE CLINICAL PRACTICE. FURTHER, THE PAIN-PERCEPTION REGULATION AND MODULATION ARE STILL NOT FULLY UNDERSTOOD, AND THUS MORE COMPLEX KNOWLEDGE OF GENETIC AND EPIGENETIC BACKGROUND FOR ANALGESIA WILL BE NEEDED PRIOR TO THE CLINICAL USE OF THE CANDIDATE GENETIC BIOMARKERS. 2013