1 3514 175 IDIOPATHIC PULMONARY FIBROSIS: PATHOGENESIS AND THERAPEUTIC APPROACHES. IDIOPATHIC PULMONARY FIBROSIS (IPF), ALSO TERMED CRYPTOGENIC FIBROSING ALVEOLITIS, IS A CLINICOPATHOLOGICAL SYNDROME CHARACTERISED BY COUGH, EXERTIONAL DYSPNEOA, BASILAR CRACKLES, A RESTRICTIVE DEFECT ON PULMONARY FUNCTION TESTS, HONEYCOMBING ON HIGH-RESOLUTION, THIN-SECTION COMPUTED TOMOGRAPHIC SCANS AND THE HISTOLOGICAL DIAGNOSIS OF USUAL INTERSTITIAL PNEUMONIA ON LUNG BIOPSY. THE COURSE IS USUALLY INDOLENT BUT INEXORABLE. MOST PATIENTS DIE OF PROGRESSIVE RESPIRATORY FAILURE WITHIN 3-8 YEARS OF THE ONSET OF SYMPTOMS. CURRENT THERAPIES ARE OF UNPROVEN BENEFIT. ALTHOUGH THE PATHOGENESIS OF IPF HAS NOT BEEN ELUCIDATED, EARLY CONCEPTS FOCUSED ON LUNG INJURY LEADING TO A CYCLE OF CHRONIC ALVEOLAR INFLAMMATION EVENTUATING IN FIBROSIS AND DESTRUCTION OF THE LUNG ARCHITECTURE. ANTI-INFLAMMATORY THERAPIES EMPLOYING CORTICOSTEROIDS OR IMMUNOSUPPRESSIVE OR CYTOTOXIC AGENTS HAVE BEEN DISAPPOINTING. MORE RECENT HYPOTHESES ACKNOWLEDGE THAT SEQUENTIAL ALVEOLAR EPITHELIAL CELL INJURY IS LIKELY TO BE A KEY EVENT IN THE PATHOGENESIS OF IPF, BUT THE CARDINAL EVENT IS AN ABERRANT HOST RESPONSE TO WOUND HEALING. IN THIS CONTEXT, ABNORMAL EPITHELIAL-MESENCHYMAL INTERACTIONS, ALTERED FIBROBLAST PHENOTYPES, EXAGGERATED FIBROBLAST PROLIFERATION, AND EXCESSIVE DEPOSITION OF COLLAGEN AND EXTRACELLULAR MATRIX ARE PIVOTAL TO THE FIBROTIC PROCESS. SEVERAL CLINICAL TRIALS ARE CURRENTLY UNDERWAY OR IN THE PLANNING STAGES, AND INCLUDE DRUGS SUCH AS INTERFERON-GAMMA 1B, PIRFENIDONE, ACETYLCYSTEINE, ETANERCEPT (A TUMOR NECROSIS FACTOR-ALPHA ANTAGONIST), BOSENTAN (AN ENDOTHELIN-1 RECEPTOR ANTAGONIST) AND ZILEUTON (A 5-LYPOXYGENASE INHIBITOR). FUTURE THERAPEUTIC STRATEGIES SHOULD BE FOCUSED ON ALVEOLAR EPITHELIAL CELLS AIMED AT ENHANCING RE-EPITHELIALISATION AND ON FIBROBLASTIC/MYOFIBROBLASTIC FOCI, WHICH PLAY AN ESSENTIAL ROLE IN THE DEVELOPMENT OF IPF. STEM CELL PROGENITORS OF THE ALVEOLAR EPITHELIAL CELLS AND GENETIC AND EPIGENETIC THERAPIES ARE ATTRACTIVE FUTURE APPROACHES FOR THIS AND OTHER FIBROTIC LUNG DISORDERS. 2004 2 6223 51 THE LEADING ROLE OF EPITHELIAL CELLS IN THE PATHOGENESIS OF IDIOPATHIC PULMONARY FIBROSIS. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A RELENTLESSLY PROGRESSIVE AND DEVASTATING INTERSTITIAL LUNG DISEASE OF UNKNOWN ETIOLOGY, WHERE THE NORMAL LUNG ARCHITECTURE IS LOST AND REPLACED BY FIBROTIC TISSUE LEADING TO AN IRREVERSIBLE AND PROGRESSIVE RESPIRATORY INSUFFICIENCY. HISTORICALLY, IPF WAS CONSIDERED A CHRONIC INFLAMMATORY DISORDER, WHICH GRADUALLY PROGRESSED TO ESTABLISHED FIBROSIS. HOWEVER, STRONG CLINICAL AND EXPERIMENTAL EVIDENCE INDICATES THAT THE DISEASE REPRESENTS AN EPITHELIAL-DRIVEN DISORDER WHICH RESULTS FROM A COMPLEX INTERPLAY OF GENETIC AND ENVIRONMENTAL RISK FACTORS, AGING-ASSOCIATED PROCESSES AND A PROFIBROTIC EPIGENETIC REPROGRAMMING. THE CONVERGENCE OF THESE FACTORS RESULTS IN THE ABERRANT ACTIVATION OF EPITHELIAL CELLS THAT INITIATE THE DEVELOPMENT OF THE DISEASE, PRODUCING VIRTUALLY ALL THE MEDIATORS THAT PARTICIPATE IN THE MIGRATION, PROLIFERATION AND ACTIVATION OF FIBROBLASTS, THEIR DIFFERENTIATION TO MYOFIBROBLASTS AND THE EXCESSIVE AND CHAOTIC SECRETION OF EXTRACELLULAR MATRIX PROTEINS. ALTHOUGH PROGRESS HAS BEEN MADE IN UNDERSTANDING THE CAUSES AND CONSEQUENCES OF THIS ABNORMAL BEHAVIOR OF DISTAL AIRWAYS AND ALVEOLAR EPITHELIUM, THE MECHANISMS THAT INITIATE AND PERPETUATE THE VICIOUS CIRCLE OF MULTIDIRECTIONAL ABNORMAL COMMUNICATIONS BETWEEN THE EPITHELIUM AND FIBROBLASTS AND OTHER RESIDENT CELLS HAVE NOT BEEN ELUCIDATED. IN THIS REVIEW, WE DISCUSS THE ROLE OF EPITHELIAL CELLS AND THE MECHANISMS UNDERLYING THE FIBROTIC RESPONSE IN IPF, AND HIGHLIGHT SOME PROMISING THERAPEUTIC TARGETS FOR THESE CELLS. 2020 3 4480 42 MOLECULAR PATHWAYS AND ROLE OF EPIGENETICS IN THE IDIOPATHIC PULMONARY FIBROSIS. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A FATAL LUNG DISEASE WITH UNKNOWN ETIOLOGICAL FACTORS THAT CAN PROGRESS TO OTHER DANGEROUS DISEASES LIKE LUNG CANCER. ENVIRONMENTAL AND GENETIC PREDISPOSITION ARE THE TWO MAJOR ETIOLOGICAL OR RISK FACTORS INVOLVED IN THE PATHOLOGY OF THE IPF. AMONG THE ENVIRONMENTAL RISK FACTORS, SMOKING IS ONE OF THE MAJOR CAUSES FOR THE DEVELOPMENT OF IPF. EPIGENETIC PATHWAYS LIKE NUCLEOSOMES REMODELING, DNA METHYLATION, HISTONE MODIFICATIONS AND MIRNA MEDIATED GENES PLAY A CRUCIAL ROLE IN DEVELOPMENT OF IPF. MUTATIONS IN THE GENES MAKE THE EPIGENETIC FACTORS AS IMPORTANT DRUG TARGETS IN IPF. TRANSCRIPTIONAL CHANGES DUE TO ENVIRONMENTAL FACTORS ARE ALSO INVOLVED IN THE PROGRESSION OF IPF. THE MUTATIONS IN HUMAN TELOMERASE REVERSE TRANSCRIPTASE (HTERT) HAVE SHOWN DECREASED LIFE EXPECTANCY IN IPF PATIENTS. THE TERT-GENE IS HIGHLY EXPRESSED IN CHRONIC SMOKERS AND MAKES THE ROLE OF EPIGENETICS EVIDENT. DRUG LIKE NINTEDANIB ACTS THROUGH VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTORS (VEGFR), WHILE DRUG PIRFENIDONE ACTS THROUGH TRANSFORMING GROWTH FACTOR (TGF), WHICH IS USEFUL IN IPF. GEFITINIB, A TYROSINE KINASE INHIBITOR OF EGFR, IS USEFUL AS AN ANTI-FIBROSIS AGENT IN PRECLINICAL MODELS. NEWER DRUGS SUCH AS CELGENE-CC90001 AND FIBROGEN-FG-3019 ARE CURRENTLY UNDER INVESTIGATIONS ACTS THROUGH THE MODULATING EPIGENETIC MECHANISMS. THUS, THE STUDY ON EPIGENETICS OPENS A WIDE WINDOW FOR THE DISCOVERY OF NEWER DRUGS. THIS STUDY PROVIDES AN ELEMENTARY ANALYSIS OF MULTIPLE REGULATORS OF EPIGENETICS AND THEIR ROLES ASSOCIATED WITH THE PATHOLOGY OF IPF. FURTHER, THIS REVIEW ALSO INCLUDES EPIGENETIC DRUGS UNDER DEVELOPMENT IN PRECLINICAL AND CLINICAL STAGES. 2022 4 5456 32 RESEARCH ADVANCES ON DNA METHYLATION IN IDIOPATHIC PULMONARY FIBROSIS. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A CHRONIC COMPLEX LUNG DISEASE WITH NO SPECIFIC TREATMENT AND POOR PROGNOSIS, CHARACTERIZED BY THE PULMONARY PROGRESSIVE FIBROSIS AND DYSFUNCTIONS THAT LEAD TO RESPIRATORY FAILURE. SEVERAL FACTORS MAY IMPACT THE PROGRESS OF IPF, INCLUDING AGE, CIGARETTE SMOKING, AND DUSTS, OF WHICH GENETIC AND EPIGENETIC FACTORS MAINLY CONTRIBUTE TO LUNG TISSUE FIBROSIS. DNA METHYLATION IS ONE OF EPIGENETIC PROCESSES THAT OCCUR IN MANY DISEASES AND REGULATE CHROMOSOMAL AND EXTRACHROMOSOMAL DNA FUNCTIONS IN RESPONSE TO ENVIRONMENTAL EXPOSURES. THE METHYLATION PLAYS PIVOTAL ROLES IN REGULATION OF GENE EXPRESSION TO FACILITATE THE FORMATION OF FIBROBLASTIC FOCI AND LUNG FIBROSIS. THIS CHAPTER WILL DESCRIBE ALTERATIONS AND EFFECTS OF THE DNA METHYLATION ON GENE EXPRESSION, THE POTENTIAL APPLICATION OF DNA METHYLATION AS A BIOMARKER, AND SIGNIFICANCE AS THERAPEUTIC TARGETS. THOSE UNDERSTANDING WILL PROVIDE US NEW INSIGHT INTO THE TREATMENT AND PROGNOSIS OF IPF. 2020 5 5484 51 REVEALING THE PATHOGENIC AND AGING-RELATED MECHANISMS OF THE ENIGMATIC IDIOPATHIC PULMONARY FIBROSIS. AN INTEGRAL MODEL. A GROWING BODY OF EVIDENCE INDICATES THAT ABERRANT ACTIVATION OF ALVEOLAR EPITHELIAL CELLS AND FIBROBLASTS IN AN AGING LUNG PLAYS A CRITICAL ROLE IN THE PATHOGENESIS OF IDIOPATHIC PULMONARY FIBROSIS (IPF). HOWEVER, THE BIOPATHOLOGICAL PROCESSES LINKING AGING WITH IPF AND THE MECHANISMS RESPONSIBLE FOR THE ABNORMAL ACTIVATION OF EPITHELIAL CELLS AND FIBROBLASTS HAVE NOT BEEN ELUCIDATED. MANY OF THE HALLMARKS OF AGING (E.G., GENOMIC INSTABILITY, TELOMERE ATTRITION, EPIGENETIC ALTERATIONS, MITOCHONDRIAL DYSFUNCTION, AND CELLULAR SENESCENCE) HAVE BEEN PROPOSED AS ESSENTIAL MECHANISMS FOR THE DEVELOPMENT OF IPF; HOWEVER, THESE DISTURBANCES ARE NOT RESTRICTED TO IPF AND ALSO OCCUR IN OTHER AGING-RELATED LUNG DISORDERS, PRIMARILY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). THEREFORE, AN UNANSWERED QUESTION IS WHY A CURRENT/FORMER SMOKER OF ABOUT 60 YEARS OF AGE WITH SHORTER TELOMERES, ALVEOLAR EPITHELIAL SENESCENCE, EXCESSIVE OXIDATIVE STRESS, AND MITOCHONDRIAL DYSFUNCTION DEVELOPS IPF AND NOT COPD; IN OTHER WORDS, WHAT MAKES OLD LUNGS SPECIFICALLY SUSCEPTIBLE TO DEVELOP IPF? IN THIS PERSPECTIVE, WE PROPOSE AN INTEGRAL MODEL IN WHICH THE COMBINATION OF SOME GENE VARIANTS AND/OR GENE EXPRESSION IN THE AGING LUNG RESULTS IN THE LOSS OF EPITHELIAL INTEGRITY AND CONSEQUENTLY IN THE FAILURE OF THE ALVEOLI TO CORRECTLY RESPOND TO INJURY AND TO FACE THE STRESS ASSOCIATED WITH MECHANICAL STRETCH. AFTERWARD, A DISTINCTIVE EPIGENETIC "REPROGRAMMING" THAT AFFECTS BOTH EPITHELIAL CELLS AND FIBROBLASTS PROVOKES, AMONG OTHERS, THE RECAPITULATION OF DEVELOPMENTAL PATHWAYS AND THE ABERRANT ACTIVATION AND MISCOMMUNICATION BETWEEN BOTH CELL TYPES, RESULTING IN THE EXAGGERATED PRODUCTION AND ACCUMULATION OF EXTRACELLULAR MATRIX AND THE SUBSEQUENT DESTRUCTION OF THE LUNG ARCHITECTURE. 2014 6 3628 39 INACTIVATION OF NUCLEAR HISTONE DEACETYLASES BY EP300 DISRUPTS THE MICEE COMPLEX IN IDIOPATHIC PULMONARY FIBROSIS. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A CHRONIC, PROGRESSIVE, AND HIGHLY LETHAL LUNG DISEASE WITH UNKNOWN ETIOLOGY AND POOR PROGNOSIS. IPF PATIENTS DIE WITHIN 2 YEARS AFTER DIAGNOSIS MOSTLY DUE TO RESPIRATORY FAILURE. CURRENT TREATMENTS AGAINST IPF AIM TO AMELIORATE PATIENT SYMPTOMS AND TO DELAY DISEASE PROGRESSION. UNFORTUNATELY, THERAPIES TARGETING THE CAUSES OF OR REVERTING IPF HAVE NOT YET BEEN DEVELOPED. HERE WE SHOW THAT REDUCED LEVELS OF MIRNA LETHAL 7D (MIRLET7D) IN IPF COMPROMISE EPIGENETIC GENE SILENCING MEDIATED BY THE RIBONUCLEOPROTEIN COMPLEX MICEE. IN ADDITION, WE FIND THAT HYPERACTIVE EP300 REDUCES NUCLEAR HDAC ACTIVITY AND INTERFERES WITH MICEE FUNCTION IN IPF. REMARKABLY, EP300 INHIBITION REDUCES FIBROTIC HALLMARKS OF IN VITRO (PATIENT-DERIVED PRIMARY FIBROBLAST), IN VIVO (BLEOMYCIN MOUSE MODEL), AND EX VIVO (PRECISION-CUT LUNG SLICES, PCLS) IPF MODELS. OUR WORK PROVIDES THE MOLECULAR BASIS FOR THERAPIES AGAINST IPF USING EP300 INHIBITION. 2019 7 4980 40 PATHOPHYSIOLOGY OF LIVER FIBROSIS. PROGRESSIVE ACCUMULATION OF FIBRILLAR EXTRACELLULAR MATRIX (ECM) IN THE LIVER IS THE CONSEQUENCE OF REITERATED LIVER TISSUE DAMAGE DUE TO INFECTIVE (MOSTLY HEPATITIS B AND C VIRUSES), TOXIC/DRUG-INDUCED, METABOLIC AND AUTOIMMUNE CAUSES, AND THE RELATIVE CHRONIC ACTIVATION OF THE WOUND-HEALING REACTION. THE PROCESS MAY RESULT IN CLINICALLY EVIDENT LIVER CIRRHOSIS AND HEPATIC FAILURE. ALTHOUGH CIRRHOSIS IS THE COMMON RESULT OF PROGRESSIVE FIBROGENESIS, THERE ARE DISTINCT PATTERNS OF FIBROTIC DEVELOPMENT RELATED TO THE UNDERLYING DISORDERS CAUSING THE FIBROSIS. THESE DIFFERENT PATTERNS OF FIBROGENIC EVOLUTION ARE RELATED TO DIFFERENT FACTORS AND PARTICULARLY: (1) THE TOPOGRAPHIC LOCALIZATION OF TISSUE DAMAGE, (2) THE RELATIVE CONCENTRATION OF PROFIBROGENIC FACTORS AND (3) THE PREVALENT PROFIBROGENIC MECHANISM(S). THE MECHANISMS RESPONSIBLE FOR THE FIBROGENIC EVOLUTION OF CHRONIC LIVER DISEASES CAN BE SUMMARIZED IN THREE MAIN GROUPS: CHRONIC ACTIVATION OF THE WOUND-HEALING REACTION, OXIDATIVE STRESS-RELATED MOLECULAR MECHANISMS, AND THE DERANGEMENT OF THE SO-CALLED 'EPITHELIAL-MESENCHYMAL' INTERACTION LEADING TO THE GENERATION OF REACTIVE CHOLANGIOCYTES AND PERIBILIARY FIBROSIS. MOST OF THE KNOWLEDGE ON THE CELL AND MOLECULAR BIOLOGY OF HEPATIC FIBROSIS DERIVES FROM IN VITRO STUDIES EMPLOYING CULTURE OF ACTIVATED HEPATIC STELLATE CELLS ISOLATED FROM RAT, MOUSE OR HUMAN LIVER. IT IS NOW EVIDENT THAT OTHER ECM-PRODUCING CELLS, I.E. FIBROBLASTS AND MYOFIBROBLASTS OF THE PORTAL TRACT AND CIRCULATING 'FIBROCYTES', ARE LIKELY TO CONTRIBUTE TO LIVER FIBROSIS. MORE RECENTLY, THE ATTENTION IS PROGRESSIVELY SHIFTING TO THE PROFIBROTIC MICROENVIRONMENT OF THE LIVER WITH INCREASING INTEREST FOR THE ROLE OF IMMUNE CELLS AND SPECIFIC SUBSETS OF MACROPHAGES REGULATING THE PROGRESSION OR THE REGRESSION OF FIBROSIS, THE ROLE OF INTESTINAL MICROBIOTA AND THE INFLUENCE OF TISSUE STIFFNESS. OTHER MAJOR AREAS OF DEVELOPMENT INCLUDE THE ROLE OF TISSUE HYPOXIA AND THE ESTABLISHMENT OF AN ANAEROBIC PROINFLAMMATORY ENVIRONMENT AND THE INFLUENCE OF EPIGENETIC MODIFICATION IN CONDITIONING THE PROGRESSION OF FIBROSIS. 2015 8 289 31 AGING AND INTERSTITIAL LUNG DISEASES: UNRAVELING AN OLD FORGOTTEN PLAYER IN THE PATHOGENESIS OF LUNG FIBROSIS. AGING IS A NATURAL PROCESS CHARACTERIZED BY A PROGRESSIVE FUNCTIONAL IMPAIRMENT AND REDUCED CAPACITY TO RESPOND ADAPTIVELY TO ENVIRONMENTAL STIMULI. AGING IS ASSOCIATED WITH INCREASED SUSCEPTIBILITY TO A VARIETY OF CHRONIC DISEASES, INCLUDING TYPE 2 DIABETES MELLITUS, CANCER, AND NEUROLOGICAL DISEASES. LUNG PATHOLOGIES ARE NOT THE EXCEPTION, AND THE PREVALENCE OF SEVERAL INTERSTITIAL LUNG DISEASES (ILDS), PRIMARILY IDIOPATHIC PULMONARY FIBROSIS, HAS BEEN FOUND TO INCREASE CONSIDERABLY WITH AGE. ALTHOUGH OUR UNDERSTANDING OF THE BIOLOGY OF AGING HAS ADVANCED REMARKABLY IN THE LAST 2 DECADES, THE MOLECULAR MECHANISMS LINKING AGING TO ILD REMAIN UNCLEAR. IMMUNOSENESCENCE, OXIDATIVE STRESS, ABNORMAL SHORTENING OF TELOMERES, APOPTOSIS, AND EPIGENETIC CHANGES AFFECTING GENE EXPRESSION HAVE BEEN PROPOSED TO CONTRIBUTE TO THE AGING PROCESS, AND AGING-ASSOCIATED DISEASES. HERE, WE REVIEW THE EMERGING CONCEPTS HIGHLIGHTING THE PUTATIVE AGING-ASSOCIATED ABNORMALITIES INVOLVED IN SOME HUMAN ILDS. 2010 9 6906 34 [THE ROLE OF GLYCANS IN CANCER DEVELOPMENT AND PROGRESSION. CLINICAL APPLICATIONS]. CHANGES IN GLYCOSYLATION PATTERN OF CELL SURFACE, BODY FLUIDS AND EXTRACELLULAR MATRIX GLYCOCONJUGATES IS A CHARACTERISTIC FEATURE OF TUMOR CELL MALIGNANCY. THESE CHANGES ARE THE RESULT OF MUTATIONS OF TUMOR-ASSOCIATED GENES AS WELL AS EPIGENETIC CHANGES IN THE TUMOR ENVIRONMENT, INCLUDING NUTRIENT INFLUX, HYPOXIA, CYTOKINE EXPRESSION AND STIMULATION OF CHRONIC INFLAMMATION. THE UNIQUE SET OF CELL SURFACE GLYCOANTIGENS ON NEOPLASTIC CELLS IS RECOGNIZED BY ENDOGENOUS LECTINS LOCATED IN THE EXTRACELLULAR MATRIX, VASCULAR ENDOTHELIUM, ON LEUKOCYTES OR PLATELETS, AND HAS AN IMPACT ON DISRUPTING BASIC CELLULAR PROCESSES, SUCH AS INTERCELLULAR RECOGNITION, CELL-CELL ADHESION OR CELL-ECM INTERACTION. THESE CHANGES HAVE A CRITICAL IMPACT ON THE MIGRATION, INVASIVE AND METASTATIC POTENTIAL OF NEOPLASTIC CELLS AND MODULATE THE IMMUNE RESPONSE. THIS UNIQUE PATTERN OF SUGAR ANTIGENS ON THE CANCER CELLS CAN BE A VAULABLE MARKER TO IDENTIFY THEM, DETERMINE THE STAGE OF THE DISEASE AS WELL AS BE A TARGET OF ANTI-CANCER THERAPY. 2021 10 1113 38 COMMON PATHWAYS IN IDIOPATHIC PULMONARY FIBROSIS AND CANCER. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS MARKED BY A VERY DISAPPOINTING SURVIVAL RATE AND STILL REPRESENTS A CLINICAL DILEMMA. ACCORDING TO THE CURRENT PATHOGENIC HYPOTHESIS, CHRONIC DAMAGE OF THE ALVEOLAR EPITHELIUM IS FOLLOWED BY ABNORMAL TISSUE REPAIR AND IMPAIRMENT OF THE ALVEOLAR STRUCTURE. THIS PROCESS IS DRIVEN BY PATHOGENIC EVENTS VERY SIMILAR TO CANCER, INCLUDING EPIGENETIC AND GENETIC CHANGES, ALTERED RESPONSE TO REGULATORY SIGNALS, ABNORMAL EXPRESSION OF MICRORNAS AND ACTIVATION OF SPECIFIC SIGNALLING PATHWAYS. IPF ALSO RESEMBLES CANCER WITH REGARD TO ITS POOR RESPONSE TO MEDICAL TREATMENT AND PROGNOSIS, WHICH IS VERY OFTEN WORSE THAN MANY CANCERS. WE HAVE HYPOTHESISED THAT IPF MIGHT BE ASSIMILATED TO A NEOPROLIFERATIVE DISORDER OF THE LUNG. VIEWING IPF AS A CANCER-LIKE DISEASE MAY SATISFY THE NEED FOR A BETTER UNDERSTANDING OF THE PATHOGENESIS OF IPF BY EXPLOITING THE LARGE AMOUNT OF KNOWLEDGE THAT CANCER BIOLOGY EVOKES. THE RECOGNITION OF COMMON PATHOGENIC PATHWAYS BETWEEN THE TWO DISEASES MAY STIMULATE NEW CLINICAL TRIALS WITH CANCER DRUGS, DIFFERENT DRUG COMBINATIONS AND DIFFERENT LINES OF DRUGS, AS ALREADY EXPERIMENTED IN ONCOLOGY. MOREOVER, THE CONCEPT OF IPF AS A CANCER-LIKE DISORDER MAY IMPROVE THE ATTENTION GIVEN TO THIS DREADFUL DISEASE ON A PUBLIC, POLITICAL AND HEALTHCARE LEVEL. 2013 11 6212 39 THE INTERPLAY OF THE GENETIC ARCHITECTURE, AGING, AND ENVIRONMENTAL FACTORS IN THE PATHOGENESIS OF IDIOPATHIC PULMONARY FIBROSIS. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A CHRONIC FIBROSING LUNG DISEASE OF INDETERMINATE ETIOLOGY AND LIMITED THERAPEUTIC OPTIONS. THE INITIATION, DEVELOPMENT, AND PROGRESSION OF IPF ARE INFLUENCED BY GENETIC PREDISPOSITION, AGING, AND HOST AND ENVIRONMENTAL FACTORS, BUT THE MAGNITUDE OF THE CONTRIBUTION OF EACH OF THEM AND THE SEQUENCE OF THE PATHOGENIC EVENTS ARE UNCERTAIN. CURRENT EVIDENCE INDICATES THAT ACCUMULATED ENVIRONMENTAL EXPOSURES IN A GENETICALLY PREDISPOSED INDIVIDUAL, USUALLY OVER 60 YEARS OF AGE, LEADS TO PHENOTYPIC AND FUNCTIONAL ALTERATIONS OF THE LUNG EPITHELIUM. ABERRANT ACTIVATION OF EPITHELIAL CELLS RESULTS, THROUGH A COMPLEX RELEASE OF NUMEROUS MEDIATORS, IN THE LOCAL EXPANSION OF PECULIAR SUBSETS OF AGGRESSIVE FIBROBLASTS AND MYOFIBROBLASTS, WHICH ARE CRUCIAL EFFECTOR CELLS OF FIBROTIC REMODELING AND LOSS OF THE NORMAL LUNG ARCHITECTURE AND FUNCTION. PROGRESSIVE INCREASE OF THE MECHANICAL STIFFNESS ACTIVATES CELL-AUTONOMOUS AND MATRIX-DEPENDENT PROCESSES CONTRIBUTING TO THE PERPETUATION OF THE FIBROTIC RESPONSE. THIS PERSPECTIVE PROVIDES AN INTEGRAL OVERVIEW OF THE MAJOR RISK FACTORS UNDERPINNING THE PATHOGENESIS OF IPF, INCLUDING GENE VARIANTS, AGING ALTERATIONS, ENVIRONMENTAL FACTORS, HOST RISK FACTORS, AND EPIGENETIC REPROGRAMMING. 2021 12 3674 49 INFLAMMATION AND DYSREGULATED FIBROBLAST PROLIFERATION--NEW MECHANISMS? IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A DEVASTATING, AGE-RELATED LUNG DISEASE OF UNKNOWN CAUSE THAT HAS FEW TREATMENT OPTIONS. ONCE THOUGHT TO BE A CHRONIC INFLAMMATORY PROCESS, CURRENT EVIDENCE INDICATES THAT THE FIBROTIC RESPONSE MAY PRIMARILY BE DRIVEN BY ABNORMALLY ACTIVATED ALVEOLAR EPITHELIAL CELLS AND THE UNDERLYING MESENCHYME. THE MEDIATORS PRODUCED AND PRESENT IN THIS MICROENVIRONMENT INDUCE THE FORMATION OF FIBROBLAST FOCI THROUGH THE PROLIFERATION OF RESIDENT MESENCHYMAL CELLS, ATTRACTION OF CIRCULATING FIBROCYTES, AND STIMULATION OF EPITHELIAL TO MESENCHYMAL TRANSITION. THE FIBROBLAST AND MYOFIBROBLAST FOCI SECRETE EXCESSIVE AMOUNTS OF EXTRACELLULAR MATRIX, MAINLY COLLAGENS, RESULTING IN SCARRING AND DESTRUCTION OF THE LUNG ARCHITECTURE. THE DETAILED MECHANISMS THAT LINK IPF WITH AGEING AND ABERRANT EPITHELIAL ACTIVATION ARE UNKNOWN, BUT SOME EVIDENCE SUGGESTS THAT THE ABNORMAL RECAPITULATION OF DEVELOPMENTAL PATHWAYS AND EPIGENETIC CHANGES MAY PLAY A ROLE. THIS REVIEW PROVIDES A BRIEF SYNOPSIS OF HIGHLIGHTS IN THE CURRENT UNDERSTANDING OF THE PATHOPHYSIOLOGY OF IPF, AS WELL AS NOVEL THERAPEUTICS BEING EXPLORED IN CLINICAL TRIALS FOR THE TREATMENT OF THIS DEVASTATING DISEASE. 2013 13 2169 37 EPIGENETIC MECHANISMS IN PARENCHYMAL LUNG DISEASES: BYSTANDERS OR THERAPEUTIC TARGETS? EPIGENETIC RESPONSES DUE TO ENVIRONMENTAL CHANGES ALTER CHROMATIN STRUCTURE, WHICH IN TURN MODIFIES THE PHENOTYPE, GENE EXPRESSION PROFILE, AND ACTIVITY OF EACH CELL TYPE THAT HAS A ROLE IN THE PATHOPHYSIOLOGY OF A DISEASE. PULMONARY DISEASES ARE ONE OF THE MAJOR CAUSES OF DEATH IN THE WORLD, INCLUDING LUNG CANCER, IDIOPATHIC PULMONARY FIBROSIS (IPF), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), PULMONARY HYPERTENSION (PH), LUNG TUBERCULOSIS, PULMONARY EMBOLISM, AND ASTHMA. SEVERAL LINES OF EVIDENCE INDICATE THAT EPIGENETIC MODIFICATIONS MAY BE ONE OF THE MAIN FACTORS TO EXPLAIN THE INCREASING INCIDENCE AND PREVALENCE OF LUNG DISEASES INCLUDING IPF AND COPD. INTERESTINGLY, ISOLATED FIBROBLASTS AND SMOOTH MUSCLE CELLS FROM PATIENTS WITH PULMONARY DISEASES SUCH AS IPF AND PH THAT WERE CULTURED EX VIVO MAINTAINED THE DISEASE PHENOTYPE. THE CELLS OFTEN SHOW A HYPER-PROLIFERATIVE, APOPTOSIS-RESISTANT PHENOTYPE WITH INCREASED EXPRESSION OF EXTRACELLULAR MATRIX (ECM) AND ACTIVATED FOCAL ADHESIONS SUGGESTING THE PRESENCE OF AN EPIGENETICALLY IMPRINTED PHENOTYPE. MOREOVER, MANY ABNORMALITIES OBSERVED IN MOLECULAR PROCESSES IN IPF PATIENTS ARE SHOWN TO BE EPIGENETICALLY REGULATED, SUCH AS INNATE IMMUNITY, CELLULAR SENESCENCE, AND APOPTOTIC CELL DEATH. DNA METHYLATION, HISTONE MODIFICATION, AND MICRORNA REGULATION CONSTITUTE THE MOST COMMON EPIGENETIC MODIFICATION MECHANISMS. 2022 14 2791 32 FAT-FREE P300 IS GOOD FOR SCAR-FREE TISSUE REPAIR. FIBROSIS, THE DEADLY PATHOLOGICAL MANIFESTATION OF AN ABNORMAL TISSUE REMODELING IN ANY ORGAN DUE TO EXCESSIVE COLLAGEN DEPOSITION, IS ASSOCIATED WITH A WIDE VARIETY OF ORGAN FAILURE-RELATED HUMAN DISEASES. CHRONIC STRESS OR REPEATED INJURY IN A PARTICULAR ORGAN INDUCES ABNORMAL MOLECULAR SIGNALS THAT LEAD TO SUPER-ACTIVATION OF MATRIX PROTEIN PRODUCING FIBROBLASTS, EXCESSIVE MATRIX PROTEINS ACCUMULATION, LOSS OF PHYSIOLOGICAL TISSUE ARCHITECTURE OR ELASTICITY, AND ULTIMATELY LEADING TO ORGAN FAILURE. THERE IS NO EFFECTIVE THERAPY FOR FIBROSIS. FACTOR ACETYLTRANSFERASE P300 (FATP300), A MAJOR EPIGENETIC REGULATOR THAT ACETYLATES SPECIFIC LYSINES IN HISTONES AND TRANSCRIPTION FACTORS, IS ESSENTIAL FOR ELEVATED COLLAGEN SYNTHESIS AND THE LEVELS OF FATP300 ARE SIGNIFICANTLY ELEVATED IN DIFFERENT FIBROTIC TISSUES. PHARMACOLOGICAL INHIBITION OF FAT ACTIVITY OF P300 IS ASSOCIATED WITH DECREASED COLLAGEN SYNTHESIS BY FIBROBLASTS IN TISSUES AND AMELIORATION OF ORGAN FIBROSIS. THEREFORE, FAT-FREE P300 IS SUPERIOR FOR PHYSIOLOGICAL TISSUE REPAIR AND MUST BE EXPLOITED AS A VIABLE THERAPEUTIC TARGET AGAINST MULTI-ORGAN FIBROSIS. 2014 15 2533 37 EPIGENETICS IN AUTOIMMUNE CONNECTIVE TISSUE DISEASES. BACKGROUND. AUTOIMMUNE CONNECTIVE TISSUE DISEASES (ACTDS) ENCOMPASS A HETEROGENEOUS GROUP OF CHRONIC IMMUNE-MEDIATED INFLAMMATORY DISORDERS, PRIMARILY AFFECTING CONNECTIVE TISSUES AND CLINICALLY CHARACTERIZED BY VARIABLE MULTISYSTEM MANIFESTATIONS, FREQUENTLY OVERLAPPING. ENVIRONMENTAL FACTORS ARE THOUGHT TO PROMOTE ACTD DEVELOPMENT IN GENETIC PREDISPOSING/ENDOCRINE PERMISSIVE BACKGROUND THROUGH THE INDUCTION OF EPIGENETIC MODIFICATIONS, CONSISTING OF STABLE, HERITABLE, BUT POTENTIALLY REVERSIBLE CHANGES IN GENE EXPRESSION, OCCURRING WITHOUT ALTERATIONS OF THE DNA SEQUENCE. ACTUALLY, EPIGENETIC MECHANISMS (SUCH AS HISTONE MODIFICATIONS, DNA METHYLATION, NUCLEOSOME POSITIONING, AND RNA INTERFERENCE) LINK GENOTYPE UPSTREAM AND PHENOTYPE DOWNSTREAM, AND, IF PERSISTENTLY ABERRANT, MAY CAUSE A VARIETY OF HUMAN DISEASES, INCLUDING ACTDS. WE AIMED TO REVIEW THE RECENT ADVANCES IN THE KNOWLEDGE OF THE ACTD EPIGENETIC ALTERATIONS. METHODS: A DETAILED SEARCH OF THE AVAILABLE LITERATURE WAS PERFORMED IN THE PUBMED (U.S. NATIONAL LIBRARY OF MEDICINE) DATABASE. RESULTS: GROWING EVIDENCE UNDERLINES THE RELEVANT ROLE OF EPIGENETIC DEFECTS IN THE ACTD PATHOGENESIS, AND SPECIFIC EPIGENETIC PATTERNS CAN REPRESENT DISEASE BIOMARKERS. IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA), EPIGENETIC VARIATIONS INTERACT DETERMINING THE TYPICAL "AGGRESSIVE" PHENOTYPE DISPLAYED BY RA SYNOVIAL FIBROBLASTS. EPIGENETIC MODIFICATIONS ARE INVOLVED IN THE PROFIBROTIC PROCESS THAT CHARACTERIZES SYSTEMIC SCLEROSIS. IN SYSTEMIC LUPUS ERYTHEMATOSUS AND SJOGREN'S SYNDROME, COMPLEX EPIGENETIC CHANGES ALTERING GENE EXPRESSION HAVE BEEN DEMONSTRATED. CONCLUSIONS: COMPREHENSIVE STUDIES WILL CONTRIBUTE TO FURTHER DEFINE THE ABERRANT EPIGENETIC MECHANISMS INVOLVED IN THE ACTDS ETIOPATHOGENESIS. MOREOVER, BEING EPIGENETIC CHANGES POTENTIALLY REVERSIBLE, THE IDENTIFICATION OF ACTDS EPIGENETIC BIOMARKERS WILL ALLOW THE DEVELOPMENT OF THERAPEUTIC STRATEGIES ADDRESSED TO TARGET DYSREGULATED GENES AND CORRECT ABERRANT EPIGENOMIC ALTERATIONS. 2014 16 6053 36 THE CRUCIAL ROLE OF NLRP3 INFLAMMASOME IN VIRAL INFECTION-ASSOCIATED FIBROSING INTERSTITIAL LUNG DISEASES. IDIOPATHIC PULMONARY FIBROSIS (IPF), ONE OF THE MOST COMMON FIBROSING INTERSTITIAL LUNG DISEASES (ILD), IS A CHRONIC-AGE-RELATED RESPIRATORY DISEASE THAT RISES FROM REPEATED MICRO-INJURY OF THE ALVEOLAR EPITHELIUM. ENVIRONMENTAL INFLUENCES, INTRINSIC FACTORS, GENETIC AND EPIGENETIC RISK FACTORS THAT LEAD TO CHRONIC INFLAMMATION MIGHT BE IMPLICATED IN THE DEVELOPMENT OF IPF. THE EXACT TRIGGERS THAT INITIATE THE FIBROTIC RESPONSE IN IPF REMAIN ENIGMATIC, BUT THERE IS NOW INCREASING EVIDENCE SUPPORTING THE ROLE OF CHRONIC EXPOSURE OF VIRAL INFECTION. DURING VIRAL INFECTION, ACTIVATION OF THE NLRP3 INFLAMMASOME BY INTEGRATING MULTIPLE CELLULAR AND MOLECULAR SIGNALING IMPLICATES ROBUST INFLAMMATION, FIBROBLAST PROLIFERATION, ACTIVATION OF MYOFIBROBLAST, MATRIX DEPOSITION, AND ABERRANT EPITHELIAL-MESENCHYMAL FUNCTION. OVERALL, THE CROSSTALK OF THE NLRP3 INFLAMMASOME AND VIRUSES CAN ACTIVATE IMMUNE RESPONSES AND INFLAMMASOME-ASSOCIATED MOLECULES IN THE DEVELOPMENT, PROGRESSION, AND EXACERBATION OF IPF. 2021 17 4038 34 MACROPHAGE IMPLICATION IN IPF: UPDATES ON IMMUNE, EPIGENETIC, AND METABOLIC PATHWAYS. IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A LETHAL INTERSTITIAL LUNG DISEASE OF UNKNOWN ETIOLOGY WITH A POOR PROGNOSIS. IT IS A CHRONIC AND PROGRESSIVE DISEASE THAT HAS A DISTINCT RADIOLOGICAL AND PATHOLOGICAL PATTERN FROM COMMON INTERSTITIAL PNEUMONIA. THE USE OF IMMUNOSUPPRESSIVE MEDICATION WAS SHOWN TO BE COMPLETELY INEFFECTIVE IN CLINICAL TRIALS, RESULTING IN YEARS OF NEGLECT OF THE IMMUNE COMPONENT. HOWEVER, RECENT DEVELOPMENTS IN FUNDAMENTAL AND TRANSLATIONAL SCIENCE DEMONSTRATE THAT IMMUNE CELLS PLAY A SIGNIFICANT REGULATORY ROLE IN IPF, AND MACROPHAGES APPEAR TO BE AMONG THE MOST CRUCIAL. THESE HIGHLY PLASTIC CELLS GENERATE MULTIPLE GROWTH FACTORS AND MEDIATORS THAT HIGHLY AFFECT THE INITIATION AND PROGRESSION OF IPF. IN THIS REVIEW, WE WILL PROVIDE AN UPDATE ON THE ROLE OF MACROPHAGES IN IPF THROUGH A SYSTEMIC DISCUSSION OF VARIOUS REGULATORY MECHANISMS INVOLVING IMMUNE RECEPTORS, CYTOKINES, METABOLISM, AND EPIGENETICS. 2023 18 2059 30 EPIGENETIC CONTROL OF GENE EXPRESSION IN THE LUNG. EPIGENETICS IS TRADITIONALLY DEFINED AS THE STUDY OF HERITABLE CHANGES IN GENE EXPRESSION CAUSED BY MECHANISMS OTHER THAN CHANGES IN THE UNDERLYING DNA SEQUENCE. THERE ARE THREE MAIN CLASSES OF EPIGENETIC MARKS--DNA METHYLATION, MODIFICATIONS OF HISTONE TAILS, AND NONCODING RNAS--EACH OF WHICH MAY BE INFLUENCED BY THE ENVIRONMENT, DIET, DISEASES, AND AGEING. IMPORTANTLY, EPIGENETIC MARKS HAVE BEEN SHOWN TO INFLUENCE IMMUNE CELL MATURATION AND ARE ASSOCIATED WITH THE RISK OF DEVELOPING VARIOUS FORMS OF CANCER, INCLUDING LUNG CANCER. MOREOVER, THERE IS EMERGING EVIDENCE THAT THESE EPIGENETIC MARKS AFFECT GENE EXPRESSION IN THE LUNG AND ARE ASSOCIATED WITH BENIGN LUNG DISEASES, SUCH AS ASTHMA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND INTERSTITIAL LUNG DISEASE. TECHNOLOGICAL ADVANCES HAVE MADE IT FEASIBLE TO STUDY EPIGENETIC MARKS IN THE LUNG, AND IT IS ANTICIPATED THAT THIS KNOWLEDGE WILL ENHANCE OUR UNDERSTANDING OF THE DYNAMIC BIOLOGY IN THE LUNG AND LEAD TO THE DEVELOPMENT OF NOVEL DIAGNOSTIC AND THERAPEUTIC APPROACHES FOR OUR PATIENTS WITH LUNG DISEASE. 2011 19 4158 37 MECHANOTRANSDUCTION DETERMINES THE STRUCTURE AND FUNCTION OF LUNG AND BONE: A THEORETICAL MODEL FOR THE PATHOPHYSIOLOGY OF CHRONIC DISEASE. MULTICELLULAR ORGANISMS HAVE EVOLVED IN ADAPTATION TO THE EARTH'S GRAVITATIONAL AND OXYGEN ENVIRONMENT. THIS EPIGENETIC PROCESS IS DEPENDENT ON THE CAPACITY OF MESODERMAL CELLS TO ACT AS MECHANOSENSORS THAT CAN CONFORM, DEFORM, AND REFORM IN ADAPTATION TO THE ORGANISM'S PHYSICAL ENVIRONMENT. MECHANICAL FORCES, SUCH AS HYDROSTATIC PRESSURE AND GRAVITY, PLAY IMPORTANT ROLES IN THE EMBRYONIC DEVELOPMENT, HOMEOSTASIS, AND REPAIR OF LUNG AND BONE. WE DISCUSS THE ROLE OF PARATHYROID HORMONE-RELATED PROTEIN (PTHRP) AS A MECHANOTRANSDUCER FOR STRETCH IN THESE ORGANS DURING NORMAL DEVELOPMENT, PARTICULARLY AS IT LENDS ITSELF TO HOMEOSTASIS; WE FURTHER DEMONSTRATE THAT "UNCOUPLING" OF SUCH MECHANISMS MAY PLAY A CENTRAL ROLE IN INJURY REPAIR, PARTICULARLY AS IT RELATES TO CHRONIC DISEASES OF LUNG AND BONE. ENDOTHERMAL PTHRP SIGNALING THROUGH ITS G-PROTEIN COUPLED RECEPTOR PROMOTES NORMAL CELL-CELL SIGNALING THAT MAINTAINS THE HOMEOSTATIC PHENOTYPES OF LUNG AND BONE. MOLECULAR DISRUPTION OF THE PTHRP/PTHRP RECEPTOR PATHWAY FROM ENDODERM TO MESODERM, BECAUSE OF SUCH FACTORS AS VOLUTRAUMA, HYPEROXIA, INFLAMMATION, AND MICROGRAVITY, ALTERS INTRACELLULAR SIGNALING, CAUSING MALADAPTIVE CELLULAR CHANGES, RESULTING IN MYOFIBROBLAST PROLIFERATION AND GRANULATION. EXAMPLES OF SUCH PATHOLOGIC CHANGES SPECIFICALLY RELATED TO THIS CELLULAR/MOLECULAR MECHANISM OF MALADAPTATION ARE CHRONIC LUNG DISEASE AND OSTEOPOROSIS. WE SUGGEST A NEW PARADIGM THAT MAY HELP IN THE FUTURE CREATION OF DIAGNOSTIC AND THERAPEUTIC MODALITIES FOR A WIDE RANGE OF DEVELOPMENTAL AND CHRONIC DISEASES RANGING FROM BRONCHOPULMONARY DYSPLASIA IN NEWBORNS TO IDIOPATHIC PULMONARY FIBROSIS AND OSTEOPOROSIS AS A RESULT OF AGING OR MICROGRAVITY. 2003 20 3933 34 LIVER SINUSOIDAL ENDOTHELIAL CELLS ARE IMPLICATED IN MULTIPLE FIBROTIC MECHANISMS. CHRONIC LIVER DISEASES ARE ATTRIBUTED TO LIVER INJURY. DEVELOPMENT OF FIBROSIS FROM CHRONIC LIVER DISEASES IS A DYNAMIC PROCESS THAT INVOLVES MULTIPLE MOLECULAR AND CELLULAR PROCESSES. AS THE FIRST TO BE IMPACTED BY INJURY, LIVER SINUSOIDAL ENDOTHELIAL CELLS (LSECS) ARE INVOLVED IN THE PATHOGENESIS OF LIVER DISEASES CAUSED BY A VARIETY OF ETIOLOGIES. MOREOVER, CAPILLARIZATION OF LSECS HAS BEEN RECOGNIZED AS AN IMPORTANT EVENT IN THE DEVELOPMENT OF CHRONIC LIVER DISEASES AND FIBROSIS. STUDIES HAVE REPORTED THAT VARIOUS CYTOKINES (SUCH AS VASCULAR ENDOTHELIAL GROWTH FACTOR, TRANSFORMING GROWTH FACTOR-BETA), AND PATHWAYS (SUCH AS HEDGEHOG, AND NOTCH), AS WELL AS EPIGENETIC AND METABOLIC FACTORS ARE INVOLVED IN THE DEVELOPMENT OF LSEC-MEDIATED LIVER FIBROSIS. THIS REVIEW DESCRIBES THE COMPLEXITY AND PLASTICITY OF LSECS IN FIBROTIC LIVER DISEASES FROM SEVERAL PERSPECTIVES, INCLUDING THE CROSS-TALK BETWEEN LSECS AND OTHER INTRA-HEPATIC CELLS. MOREOVER, IT SUMMARIZES THE MECHANISMS OF SEVERAL KINDS OF LSECS-TARGETING ANTI-FIBROSIS CHEMICALS, AND PROVIDES A THEORETICAL BASIS FOR FUTURE STUDIES. 2021