1 3737 153 INNATE IMMUNITY, EPIGENETICS AND AUTOIMMUNITY IN RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY AUTOIMMUNE DISEASE CHARACTERIZED BY THE PROGRESSIVE AND IRREVERSIBLE DESTRUCTION OF JOINTS. RA REMAINS AN INCURABLE CONDITION, ALTHOUGH A NEW CLASS OF DRUGS, BIOLOGICALS, HAVE MADE A MAJOR BREAKTHROUGH IN TARGETING AND/OR ELIMINATING THE IMMUNE CELLS, INCLUDING T CELLS, B CELLS AND MONOCYTES/MACROPHAGES FROM THE JOINTS. THAT WE CANNOT (YET?) CURE THE DISEASE IS MOST LIKELY DUE TO THE LACK OF THERAPEUTIC TARGETING THE ENDOGENOUSLY ACTIVATED RA SYNOVIAL FIBROBLASTS (RASF). MOST INTERESTINGLY, RASF EXPRESS TOLL-LIKE RECEPTORS (TLRS) 1-6 RENDERING THEM PRONE TO ACTIVATION BY EXOGENOUS AND ENDOGENOUS TLR LIGANDS AND RESULTING IN THE PRODUCTION OF NUMEROUS POWERFUL CHEMOKINES AND CYTOKINES. THESE FACTORS ARE RESPONSIBLE FOR THE REPOPULATION OF IMMUNE CELLS IN THE JOINTS AFTER CEASING CELL DEPLETING THERAPIES. TO CHARACTERIZE THE MOLECULAR MECHANISMS OF SYNOVIAL ACTIVATION, A NEW APPROACH STUDYING THE EPIGENETIC CHARACTERISTICS OF RASF HAS BEEN RECENTLY UNDERTAKEN. THEREBY, THE PATTERN OF HISTONE ACETYLATION, DNA METHYLATION AND GENE EXPRESSION REGULATING MICRORNA ARE BEING EXPLORED. SINCE AUTO-ANTIBODIES HAVE THE MOST PREDICTIVE AND DIAGNOSTIC VALUE FOR RA, IT IS CHALLENGING TO STUDY MORE COMPREHENSIVELY THE CONTRIBUTION OF AUTO-ANTIBODIES TO THE DISEASE. A NEW SCREENING TECHNIQUE, SEROLOGICAL ANALYSIS OF RECOMBINANT HUMAN CDNA EXPRESSION LIBRARY (SEREX), ADAPTED FROM CANCER RESEARCH ALLOWED FOR THE IDENTIFICATION OF NOVEL AUTO-ANTIBODIES IN RA, INCLUDING ANTI-SERPIN E2 AUTO-ANTIBODIES. THE SERPIN E2 AUTO-ANTIBODIES WERE FOUND TO INHIBIT THE ACTIVITY OF SERPIN E2 AND HAVE POTENTIALLY A FUNCTIONAL ROLE IN THE DISEASE. THE RECENT FINDINGS IN THE FIELD OF INNATE IMMUNITY, EPIGENETICS AND AUTOIMMUNITY RELATED TO THE PATHOGENESIS OF RA ARE IN THE SCOPE OF THIS REVIEW. 2009 2 2054 58 EPIGENETIC CONTRIBUTIONS IN THE DEVELOPMENT OF RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS AN AUTOIMMUNE DISEASE, CHARACTERIZED BY CHRONIC INFLAMMATION OF THE JOINTS WITH SEVERE PAIN AND SWELLING, JOINT DAMAGE AND DISABILITY, WHICH LEADS TO JOINT DESTRUCTION AND LOSS OF FUNCTION. DESPITE EXTENSIVE RESEARCH EFFORTS, THE UNDERLYING CAUSE FOR RA IS STILL UNKNOWN AND CURRENT THERAPIES ARE MORE OR LESS EFFECTIVE IN CONTROLLING SYMPTOMS BUT STILL FAIL TO CURE THE DISEASE. IN RECENT YEARS, EPIGENETIC MODIFICATIONS WERE FOUND TO STRONGLY CONTRIBUTE TO THE DEVELOPMENT OF RA BY AFFECTING DIVERSE ASPECTS OF THE DISEASE AND MODIFYING GENE EXPRESSION LEVELS AND BEHAVIOR OF SEVERAL CELL TYPES, FIRST AND FOREMOST JOINT RESIDENT SYNOVIAL FIBROBLASTS (SF). RASF ARE THE MOST COMMON CELL TYPE AT THE SITE OF INVASION. OWING TO THEIR AGGRESSIVE, INTRINSICALLY ACTIVATED PHENOTYPE, RASF ARE ACTIVE CONTRIBUTORS IN JOINT DAMAGE. RASF ARE CHARACTERIZED BY THEIR ABILITY TO SECRETE CYTOKINES, CHEMOKINES AND JOINT-DAMAGING ENZYMES. FURTHERMORE, THESE CELLS ARE RESISTANT TO APOPTOSIS, LEADING TO HYPERPLASIA OF THE SYNOVIUM. IN ADDITION, RASF HAVE INVASIVE AND MIGRATORY PROPERTIES THAT COULD LEAD TO SPREADING OF THE DISEASE TO UNAFFECTED JOINTS. EPIGENETIC MODIFICATIONS, INCLUDING DNA METHYLATION AND POST-TRANSLATIONAL HISTONE MODIFICATIONS, SUCH AS HISTONE (DE)ACETYLATION, HISTONE METHYLATION AND HISTONE SUMOYLATION WERE IDENTIFIED AS REGULATORY MECHANISMS IN CONTROLLING AGGRESSIVE CELL ACTIVATION IN VITRO AND IN DISEASE OUTCOME IN ANIMAL MODELS IN VIVO. IN THE LAST 5 YEARS, THE FIELD OF EPIGENETICS IN RA HAS IMPRESSIVELY INCREASED. IN THIS REVIEW WE CONSIDER THE ROLE OF DIVERSE EPIGENETIC MODIFICATIONS IN THE DEVELOPMENT OF RA, WITH A SPECIAL FOCUS ON EPIGENETIC MODIFICATIONS IN RASF. 2012 3 1608 50 DNA METHYLATION-GOVERNED GENE EXPRESSION IN AUTOIMMUNE ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY AUTOIMMUNE DISEASE HALLMARKED BY PROGRESSIVE AND IRREVERSIBLE JOINT DESTRUCTION. RA PATHOGENESIS IS A T CELL-REGULATED AND B CELL-MEDIATED PROCESS IN WHICH ACTIVATED LYMPHOCYTE-PRODUCED CHEMOKINES AND CYTOKINES PROMOTE LEUKOCYTE INFILTRATION THAT ULTIMATELY LEADS TO DESTRUCTION OF THE JOINTS. THERE IS AN OBVIOUS NEED TO DISCOVER NEW DRUGS FOR RA TREATMENT THAT HAVE DIFFERENT BIOLOGICAL TARGETS OR MODES OF ACTION THAN THE CURRENTLY EMPLOYED THERAPEUTICS. ENVIRONMENTAL FACTORS SUCH AS CIGARETTE SMOKE, CERTAIN DIET COMPONENTS, AND ORAL PATHOGENS CAN SIGNIFICANTLY AFFECT GENE REGULATION VIA EPIGENETIC FACTORS. EPIGENETICS OPENED A NEW FIELD FOR PHARMACOLOGY, AND DNA METHYLATION AND HISTONE MODIFICATION-IMPLICATED FACTORS ARE FEASIBLE TARGETS FOR RA THERAPY. EXPLORING RA PATHOGENESIS INVOLVED EPIGENETIC FACTORS AND MECHANISMS IS CRUCIAL FOR DEVELOPING MORE EFFICIENT RA THERAPIES. HERE WE REVIEW EPIGENETIC ALTERATIONS ASSOCIATED WITH RA PATHOGENESIS INCLUDING DNA METHYLATION AND INTERACTING FACTORS. ADDITIONALLY, WE WILL SUMMARIZE THE LITERATURE REVEALING THE INVOLVED MOLECULAR STRUCTURES AND INTERACTIONS. FINALLY, POTENTIAL EPIGENETIC FACTOR-BASED THERAPIES WILL BE DISCUSSED THAT MAY HELP IN BETTER MANAGEMENT OF RA IN THE FUTURE. 2019 4 3699 35 INFLAMMATORY MEMORIES: IS EPIGENETICS THE MISSING LINK TO PERSISTENT STROMAL CELL ACTIVATION IN RHEUMATOID ARTHRITIS? RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY DISEASE LEADING TO JOINT DESTRUCTION. SYNOVIAL FIBROBLASTS ARE RECOGNIZED AS KEY CELLS IN THE PATHOGENESIS OF RA SINCE THEY ATTRACT AND ACTIVATE IMMUNE CELLS AND PRODUCE MATRIX DEGRADING ENZYMES. MOST NOTABLY SYNOVIAL FIBROBLASTS FROM PATIENTS WITH RA ARE STABLY ACTIVATED AND PRODUCE HIGH LEVELS OF DISEASE-PROMOTING MOLECULES WITHOUT FURTHER STIMULATION BY IMMUNE CELLS. ACCUMULATING DATA SUGGEST THAT EPIGENETIC CHANGES IN STROMAL CELL POPULATIONS MIGHT BE CRUCIALLY INVOLVED IN THE PATHOLOGY OF RA AND OTHER CHRONIC INFLAMMATORY DISEASES. IN THE CURRENT REVIEW, WE DISCUSS THE MECHANISMS BY WHICH EPIGENETIC CHANGES MIGHT CAUSE THE STABLE ACTIVATION OF SYNOVIAL FIBROBLASTS IN RA AND HOW CHANGES IN THE EPIGENOME MIGHT ALTER IMMUNE FUNCTION AND INFLAMMATORY RESPONSE AND THEREBY PROMOTE THE DEVELOPMENT OF CHRONIC DISEASES. 2011 5 4842 45 ONE YEAR IN REVIEW 2017: PATHOGENESIS OF RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY AUTOIMMUNE DISEASE INFLUENCED BY BOTH GENETIC AND ENVIRONMENTAL FACTORS. IT HAS BEEN POSTULATED THAT A HIGH-RISK GENETIC BACKGROUND, IN COMBINATION WITH EPIGENETIC MARKS AND ENVIRONMENTAL EXPOSURES, LEADS TO A CASCADE OF EVENTS INDUCING SYNOVITIS AND CONSEQUENT DESTRUCTIVE ARTHRITIS. THE CLINICAL PICTURE OF JOINT INVOLVEMENT IN RA IS THE RESULT OF CHRONIC INFLAMMATION OF THE SYNOVIUM, CHARACTERISED BY INTERACTIONS OF RESIDENT CELLS SUCH AS FIBROBLAST-LIKE SYNOVIOCYTES (FLS) WITH CELLS OF THE INNATE (E.G. MACROPHAGES, DENDRITIC CELLS, MAST CELLS AND NK CELLS, NEUTROPHILS) AND ADAPTIVE IMMUNE SYSTEM (E.G. B AND T LYMPHOCYTES). CURRENTLY, OUR UNDERSTANDING OF THE ROLE OF INNATE AND ADAPTIVE IMMUNITY IN THE PATHOGENESIS OF RA IS EXPANDING. THE CONCEPT OF HOW IMMUNE RESPONSES CONTRIBUTE TO THE DISEASE HAS DRAMATICALLY EVOLVED OVER THE LAST 50 YEARS. SHEDDING SOME LIGHT ON THE DIFFERENT ASPECTS OF RA PATHOGENESIS WILL HELP TO IDENTIFY NEW TARGETS FOR THE DEVELOPMENT OF DISEASE-MODIFYING THERAPIES. THUS, IN THIS REVIEW WE REPORT NEW INSIGHTS IN RA PATHOGENESIS, RESULTING FROM A LITERATURE RESEARCH DATE PUBLISHED IN THE LAST YEAR. 2017 6 783 35 CELL-SPECIFIC EPIGENETIC DRIVERS OF PATHOGENESIS IN RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS IS A COMPLEX, INFLAMMATORY AUTOIMMUNE DISEASE, WHICH IS CHARACTERIZED BY PAIN, SWELLING AND JOINT DAMAGE DRIVEN BY THE ALTERED BEHAVIOR OF A NUMBER OF DIFFERENT CELL TYPES SUCH AS SYNOVIAL FIBROBLASTS MACROPHAGES AND LYMPHOCYTES. THE MECHANISM UNDERLYING PATHOGENESIS IS UNCLEAR BUT INCREASING EVIDENCE POINTS TO ALTERED EPIGENETIC REGULATION WITHIN THESE CELL TYPES WHICH PROMOTES THE ACTIVATED DESTRUCTIVE BEHAVIOR THAT UNDERLIES DISEASE PATHOGENESIS. THIS REVIEW SUMMARIZES THE KEY EPIGENETIC MODIFICATIONS IN THE MOST IMPORTANT CELLS TYPES IN RHEUMATOID ARTHRITIS, WHICH ARE ASSOCIATED WITH DISEASE ACTIVITY. WE ALSO DISCUSS EMERGING AVENUES OF RESEARCH FOCUSING ON READERS OF EPIGENETIC MARKERS WHICH MAY SERVE TO BE POTENTIAL THERAPEUTIC TARGETS. 2021 7 6597 51 TUNING MONOCYTES AND MACROPHAGES FOR PERSONALIZED THERAPY AND DIAGNOSTIC CHALLENGE IN RHEUMATOID ARTHRITIS. MONOCYTES/MACROPHAGES PLAY A CENTRAL ROLE IN CHRONIC INFLAMMATORY DISORDERS, INCLUDING RHEUMATOID ARTHRITIS (RA). ACTIVATION OF THESE CELLS RESULTS IN THE PRODUCTION OF VARIOUS MEDIATORS RESPONSIBLE FOR INFLAMMATION AND RA PATHOGENESIS. ON THE OTHER HAND, THE DEPLETION OF MACROPHAGES USING SPECIFIC ANTIBODIES OR CHEMICAL AGENTS CAN PREVENT THEIR SYNOVIAL TISSUE INFILTRATION AND SUBSEQUENTLY ATTENUATES INFLAMMATION. THEIR PLASTICITY IS A MAJOR FEATURE THAT HELPS THE SWITCH FROM A PRO-INFLAMMATORY PHENOTYPE (M1) TO AN ANTI-INFLAMMATORY STATE (M2). THEREFORE, UNDERSTANDING THE PRECISE STRATEGY TARGETING PRO-INFLAMMATORY MONOCYTES/MACROPHAGES SHOULD BE A POWERFUL WAY OF INHIBITING CHRONIC INFLAMMATION AND BONE EROSION. IN THIS REVIEW, WE DEMONSTRATE POTENTIAL CONSEQUENCES OF DIFFERENT EPIGENETIC REGULATIONS ON INFLAMMATORY CYTOKINES PRODUCTION BY MONOCYTES. IN ADDITION, WE PRESENT UNIQUE PROFILES OF MONOCYTES/MACROPHAGES CONTRIBUTING TO IDENTIFICATION OF NEW BIOMARKERS OF DISEASE ACTIVITY OR PREDICTING TREATMENT RESPONSE IN RA. WE ALSO OUTLINE NOVEL APPROACHES OF TUNING MONOCYTES/MACROPHAGES BY BIOLOGIC DRUGS, SMALL MOLECULES OR BY OTHER THERAPEUTIC MODALITIES TO REDUCE ARTHRITIS. FINALLY, THE IMPORTANCE OF CELLULAR HETEROGENEITY OF MONOCYTES/MACROPHAGES IS HIGHLIGHTED BY SINGLE-CELL TECHNOLOGIES, WHICH LEADS TO THE DESIGN OF CELL-SPECIFIC THERAPEUTIC PROTOCOLS FOR PERSONALIZED MEDICINE IN RA IN THE FUTURE. 2021 8 2221 43 EPIGENETIC MODIFICATIONS IN RHEUMATOID ARTHRITIS, A REVIEW. RHEUMATOID ARTHRITIS IS AN AUTOIMMUNE DISEASE CHARACTERIZED BY CHRONIC JOINT INFLAMMATION AND PROGRESSIVE DESTRUCTION OF CARTILAGE AND BONE WHICH LEADS TO ULTIMATELY LOSS OF FUNCTION AND PAIN. ACTIVATED SYNOVIAL FIBROBLASTS ARE KEY EFFECTOR CELLS IN THE PATHOGENESIS OF RHEUMATOID ARTHRITIS. IN THE RECENT YEARS, EPIGENETIC CHANGES INCLUDING DNA METHYLATION, HISTONE ACETYLATION AND OTHER HISTONE MODIFICATIONS WERE IDENTIFIED THAT ARE ASSOCIATED WITH AN INTRINSIC ACTIVATION AND THE AGGRESSIVE PHENOTYPE OF THESE CELLS. SO FAR, NO THERAPIES TARGETING RHEUMATOID ARTHRITIS SYNOVIAL FIBROBLASTS EXIST. THIS REVIEW COMPRISES RECENT RESEARCH EFFORTS THAT PROPOSE EPIGENETIC MECHANISMS BEHIND THE ACTIVATION OF RHEUMATOID ARTHRITIS SYNOVIAL FIBROBLASTS AND OTHER CELL TYPES. 2013 9 1565 39 DNA METHYLATION OF T LYMPHOCYTES AS A THERAPEUTIC TARGET: IMPLICATIONS FOR RHEUMATOID ARTHRITIS ETIOLOGY. RHEUMATOID ARTHRITIS (RA) IS AN AUTOIMMUNE DISEASE THAT CAN CAUSE JOINT DAMAGE AND DISABILITY. EPIGENETIC VARIATION, ESPECIALLY DNA METHYLATION, HAS BEEN SHOWN TO BE INVOLVED IN ALMOST ALL THE STAGES OF THE PATHOLOGY OF RA, FROM AUTOANTIBODY PRODUCTION TO VARIOUS SELF-EFFECTOR T CELLS AND THE DEFECTS OF PROTECTIVE T CELLS THAT CAN LEAD TO CHRONIC INFLAMMATION AND EROSION OF BONES AND JOINTS. GIVEN THE CRITICAL ROLE OF T CELLS IN THE PATHOLOGY OF RA, THE REGULATORY FUNCTIONS OF DNA METHYLATION IN T CELL BIOLOGY REMAIN UNCLEAR. IN THIS REVIEW, WE ELABORATE ON THE RELATIONSHIP BETWEEN RA PATHOGENESIS AND DNA METHYLATION IN THE CONTEXT OF DIFFERENT T CELL POPULATIONS. WE SUMMARIZE THE RELEVANT METHYLATION EVENTS IN T CELL DEVELOPMENT, DIFFERENTIATION, AND T CELL-RELATED GENES IN DISEASE PREDICTION AND DRUG EFFICACY. UNDERSTANDING THE EPIGENETIC REGULATION OF T CELLS HAS THE POTENTIAL TO PROFOUNDLY TRANSLATE PRECLINICAL RESULTS INTO CLINICAL PRACTICE AND PROVIDE A FRAMEWORK FOR THE DEVELOPMENT OF NOVEL, INDIVIDUALIZED RA THERAPEUTICS. 2022 10 4412 36 MOLECULAR AND CELLULAR BASIS OF RHEUMATOID JOINT DESTRUCTION. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY DISEASE ASSOCIATED WITH JOINT DESTRUCTION. SYNOVIAL FIBROBLASTS ARE KEY PLAYERS IN THIS PATHOLOGICAL PROCESS. THEY FAVORISE A PRO-INFLAMMATORY ENVIRONMENT IN THE SYNOVIAL TISSUE, INTERACT WITH THE IMMUNE SYSTEM AND REGULATE THE DIFFERENTIATION OF MONOCYTES INTO OSTEOCLASTS. SYNOVIAL HYPERPLASIA IS ANOTHER CHARACTERISTIC OF RA, REFLECTING NOT ONLY AN IMBALANCE BETWEEN PROLIFERATION AND APOPTOSIS, BUT ALSO THE MIGRATION OF CELLS INTO THE SYNOVIAL TISSUE. GENE TRANSFER EXPERIMENTS HAVE BEEN USED AS IMPORTANT TOOLS FOR THE UNDERSTANDING OF MOLECULAR AND CELLULAR CHANGES THAT CHARACTERIZE THE ACTIVATED RA SYNOVIAL FIBROBLASTS. ACTIVATED SYNOVIAL FIBROBLASTS CAN INVADE CARTILAGE AND BONE. SYNOVIAL ACTIVATION IS DRIVEN BY CYTOKINES, SUCH AS TNFALPHA AND IL-1, AS WELL AS IL-15, 16, 17, 18, 22, 23, BUT ALSO BY CYTOKINE-INDEPENDENT MECHANISMS THAT INVOLVE THE INNATE IMMUNE SYSTEM (I.E. TLRS), A UNIQUE COMMUNICATION NETWORK OF MICROPARTICLES AND EPIGENETIC CHANGES (E.G. L1 RETROELEMENTS). 2006 11 6476 37 TOLL-LIKE RECEPTORS, INFECTIONS, AND RHEUMATOID ARTHRITIS. TOLL-LIKE RECEPTORS (TLR) THAT BELONG TO THE GROUP OF PROTEIN RECOGNITION RECEPTOR (PPR) PROVIDE AN INNATE IMMUNE RESPONSE FOLLOWING THE SENSING OF CONSERVED PATHOGEN-ASSOCIATED MICROBIAL PATTERNS (PAMPS) AND CHANGES IN DANGER-ASSOCIATED MOLECULAR PATTERNS (DAMPS) THAT ARE GENERATED AS A CONSEQUENCE OF CELLULAR INJURY. ANALYSIS OF THE TLR PATHWAY HAS MOREOVER OFFERED NEW INSIGHTS INTO THE PATHOGENESIS OF RHEUMATOID ARTHRITIS (RA). INDEED, A DYSFUNCTIONAL TLR-MEDIATED RESPONSE CHARACTERIZES RA PATIENTS AND PARTICIPATES IN ESTABLISHMENT OF A CHRONIC INFLAMMATORY STATE. SUCH AN INAPPROPRIATE TLR RESPONSE HAS BEEN ATTRIBUTED (I) TO THE REPORT OF IMPORTANT ALTERATIONS IN THE MICROBIOTA AND ABNORMAL RESPONSES TO INFECTIOUS AGENTS AS PART OF RA; (II) TO THE ABNORMAL PRESENCE OF TLR-LIGANDS IN THE SERUM AND SYNOVIAL FLUID OF RA PATIENTS; (III) TO THE OVEREXPRESSION OF TLR MOLECULES; (IV) TO THE PRODUCTION OF A LARGE PANEL OF PRO-INFLAMMATORY CYTOKINES DOWNSTREAM OF THE TLR PATHWAY; AND (V) TO GENETIC VARIANTS AND EPIGENETIC FACTORS IN SUSCEPTIBLE RA PATIENTS PROMOTING A HYPER TLR RESPONSE. AS A CONSEQUENCE, THE DEVELOPMENT OF PROMISING THERAPEUTIC STRATEGIES TARGETING TLRS FOR THE TREATMENT AND PREVENTION OF RA IS EMERGING. 2020 12 1136 41 COMPREHENSIVE OVERVIEW OF MICRORNA FUNCTION IN RHEUMATOID ARTHRITIS. MICRORNAS (MIRNAS), A CLASS OF ENDOGENOUS SINGLE-STRANDED SHORT NONCODING RNAS, HAVE EMERGED AS VITAL EPIGENETIC REGULATORS OF BOTH PATHOLOGICAL AND PHYSIOLOGICAL PROCESSES IN ANIMALS. THEY DIRECT FUNDAMENTAL CELLULAR PATHWAYS AND PROCESSES BY FINE-TUNING THE EXPRESSION OF MULTIPLE GENES AT THE POSTTRANSCRIPTIONAL LEVEL. GROWING EVIDENCE SUGGESTS THAT MIRNAS ARE IMPLICATED IN THE ONSET AND DEVELOPMENT OF RHEUMATOID ARTHRITIS (RA). RA IS A CHRONIC INFLAMMATORY DISEASE THAT MAINLY AFFECTS SYNOVIAL JOINTS. THIS COMMON AUTOIMMUNE DISORDER IS CHARACTERIZED BY A COMPLEX AND MULTIFACETED PATHOGENESIS, AND ITS MORBIDITY, DISABILITY AND MORTALITY RATES REMAIN CONSISTENTLY HIGH. MORE IN-DEPTH INSIGHTS INTO THE UNDERLYING MECHANISMS OF RA ARE REQUIRED TO ADDRESS UNMET CLINICAL NEEDS AND OPTIMIZE TREATMENT. HEREIN, WE COMPREHENSIVELY REVIEW THE DEREGULATED MIRNAS AND IMPAIRED CELLULAR FUNCTIONS IN RA TO SHED LIGHT ON SEVERAL ASPECTS OF RA PATHOGENESIS, WITH A FOCUS ON EXCESSIVE INFLAMMATION, SYNOVIAL HYPERPLASIA AND PROGRESSIVE JOINT DAMAGE. THIS REVIEW ALSO PROVIDES PROMISING TARGETS FOR INNOVATIVE THERAPIES OF RA. IN ADDITION, WE DISCUSS THE REGULATORY ROLES AND CLINICAL POTENTIAL OF EXTRACELLULAR MIRNAS IN RA, HIGHLIGHTING THEIR PROSPECTIVE APPLICATIONS AS DIAGNOSTIC AND PREDICTIVE BIOMARKERS. 2023 13 6245 48 THE MECHANISMS UNDERLYING CHRONIC INFLAMMATION IN RHEUMATOID ARTHRITIS FROM THE PERSPECTIVE OF THE EPIGENETIC LANDSCAPE. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY AUTOIMMUNE DISEASE THAT IS CHARACTERIZED BY SYNOVIAL HYPERPLASIA AND PROGRESSIVE JOINT DESTRUCTION. THE ACTIVATION OF RA SYNOVIAL FIBROBLASTS (SFS), ALSO CALLED FIBROBLAST-LIKE SYNOVIOCYTES (FLS), CONTRIBUTES SIGNIFICANTLY TO PERPETUATION OF THE DISEASE. GENETIC AND ENVIRONMENTAL FACTORS HAVE BEEN REPORTED TO BE INVOLVED IN THE ETIOLOGY OF RA BUT ARE INSUFFICIENT TO EXPLAIN IT. IN RECENT YEARS, ACCUMULATING RESULTS HAVE SHOWN THE POTENTIAL ROLE OF EPIGENETIC MECHANISMS, INCLUDING HISTONE MODIFICATIONS, DNA METHYLATION, AND MICRORNAS, IN THE DEVELOPMENT OF RA. EPIGENETIC MECHANISMS REGULATE CHROMATIN STATE AND GENE TRANSCRIPTION WITHOUT ANY CHANGE IN DNA SEQUENCE, RESULTING IN THE ALTERATION OF PHENOTYPES IN SEVERAL CELL TYPES, ESPECIALLY RASFS. EPIGENETIC CHANGES POSSIBLY PROVIDE RASFS WITH AN ACTIVATED PHENOTYPE. IN THIS PAPER, WE REVIEW THE ROLES OF EPIGENETIC MECHANISMS RELEVANT FOR THE PROGRESSION OF RA. 2016 14 4657 44 NEW ADVANCES OF DNA METHYLATION AND HISTONE MODIFICATIONS IN RHEUMATOID ARTHRITIS, WITH SPECIAL EMPHASIS ON MECP2. EPIGENETICS IS A STEADILY GROWING RESEARCH AREA IN MANY HUMAN DISEASES, ESPECIALLY IN AUTOIMMUNE DISEASES SUCH AS RHEUMATOID ARTHRITIS (RA). RA IS AN AUTOIMMUNE DISEASE WITH UNCLEAR ETIOLOGY CHARACTERIZED BY CHRONIC INFLAMMATION AND JOINT DESTRUCTION AND FIBROBLAST-LIKE SYNOVIOCYTES (FLS) DISPLAY A CRUCIAL ROLE IN THE PATHOGENESIS OF RA. EVEN THOUGH THE ETIOLOGY IS NOT YET FULLY UNDERSTOOD, RA IS GENERALLY CONSIDERED TO BE CAUSED BY A COMBINATION OF EPIGENETIC MODIFICATION, DEREGULATED IMMUNOMODULATION, AND ENVIRONMENTAL FACTORS. EPIGENETIC MODIFICATIONS, INCLUDING DNA METHYLATION AND POST-TRANSLATIONAL HISTONE MODIFICATIONS, SUCH AS HISTONE METHYLATION AND HISTONE (DE)ACETYLATION ARE IDENTIFIED AS REGULATORY MECHANISMS IN CONTROLLING AGGRESSIVE FLS ACTIVATION IN PATIENTS AND ANIMAL MODELS. IN THE LAST 3YEARS, THE FIELD OF EPIGENETICS IN RA HAS IMPRESSIVELY INCREASED. METHYL-CPG-BINDING PROTEIN 2 (MECP2) IS FIRST IDENTIFIED AS A TRANSCRIPTIONAL REPRESSOR THAT INHIBITS GENE EXPRESSION THROUGH THE INTERPRETATION OF TWO EPIGENETIC MARKERS, DNA METHYLATION AND HISTONE MODIFICATION. THE COOPERATIVE ACTION AMONG MECP2, DNA METHYLATION AND HISTONE MODIFICATIONS INDICATES THAT MECP2 SHOULD PARTICIPATE IN THE PATHOGENESIS OF RA THROUGH SILENCE OF CERTAIN GENE TRANSCRIPTION. IN THIS REVIEW, WE CONSIDER THE ROLE OF DNA METHYLATION AND HISTONE MODIFICATIONS IN THE DEVELOPMENT OF RA, WITH A SPECIAL FOCUS ON INCREASED MECP2 EXPRESSION IN RA ANIMAL MODELS. 2013 15 4684 41 NEW POTENTIAL THERAPEUTIC APPROACHES TARGETING SYNOVIAL FIBROBLASTS IN RHEUMATOID ARTHRITIS. SYNOVIAL CELLS PLAY A KEY ROLE IN JOINT DESTRUCTION DURING CHRONIC INFLAMMATION. IN PARTICULAR, ACTIVATED SYNOVIAL FIBROBLASTS (SFS) UNDERGO INTRINSIC ALTERATIONS LEADING TO AN AGGRESSIVE PHENOTYPE MEDIATING CARTILAGE DESTRUCTION AND BONE EROSION IN RHEUMATOID ARTHRITIS (RA). RECENT RESEARCH HAS REVEALED A NUMBER OF TARGETS TO CONTROL ARTHRITOGENIC CHANGES IN SFS. THEREFORE, IDENTIFICATION OF SF PHENOTYPES, CONTROL OF EPIGENETIC CHANGES, MODULATION OF CELLULAR FUNCTIONS, OR REGULATION OF THE ACTIVITY OF CATION CHANNELS AND DIFFERENT SIGNALING PATHWAYS HAS BEEN INVESTIGATED. ALTHOUGH MANY OF THESE APPROACHES HAVE SHOWN EFFICACY IN VITRO AND IN ANIMAL MODELS OF RA, FURTHER RESEARCH IS NEEDED TO SELECT THE MOST RELEVANT TARGETS FOR DRUG DEVELOPMENT. THIS REVIEW IS FOCUSED ON THE ROLE OF SFS AS A POTENTIAL STRATEGY TO DISCOVER NOVEL THERAPEUTIC TARGETS IN RA AIMED AT PRESERVING JOINT ARCHITECTURE AND FUNCTION. 2021 16 2294 47 EPIGENETIC REGULATION IN THE PATHOGENESIS OF SJOGREN SYNDROME AND RHEUMATOID ARTHRITIS. AUTOIMMUNE RHEUMATIC DISEASES, SUCH AS SJOGREN SYNDROME (SS) AND RHEUMATOID ARTHRITIS (RA), ARE CHARACTERIZED BY CHRONIC INFLAMMATION AND AUTOIMMUNITY, WHICH CAUSE JOINT TISSUE DAMAGE AND DESTRUCTION BY TRIGGERING REDUCED MOBILITY AND DEBILITATION IN PATIENTS WITH THESE DISEASES. INITIATION AND MAINTENANCE OF CHRONIC INFLAMMATORY STAGES ACCOUNT FOR SEVERAL MECHANISMS THAT INVOLVE IMMUNE CELLS AS KEY PLAYERS AND THE INTERACTION OF THE IMMUNE CELLS WITH OTHER TISSUES. INDEED, THE OVERLAPPING OF CERTAIN CLINICAL AND SEROLOGIC MANIFESTATIONS BETWEEN SS AND RA MAY INDICATE THAT NUMEROUS IMMUNOLOGIC-RELATED MECHANISMS ARE INVOLVED IN THE PHYSIOPATHOLOGY OF BOTH THESE DISEASES. IT IS WIDELY ACCEPTED THAT EPIGENETIC PATHWAYS PLAY AN ESSENTIAL ROLE IN THE DEVELOPMENT AND FUNCTION OF THE IMMUNE SYSTEM. ALTHOUGH MANY PUBLISHED STUDIES HAVE ATTEMPTED TO ELUCIDATE THE RELATION BETWEEN EPIGENETIC MODIFICATIONS (E.G. DNA METHYLATION, HISTONE POST-TRANSLATIONAL MODIFICATIONS, MIRNAS) AND AUTOIMMUNE DISORDERS, THE CONTRIBUTION OF EPIGENETIC REGULATION TO THE PATHOGENESIS OF SS AND RA IS AT PRESENT POORLY UNDERSTOOD. THIS REVIEW ATTEMPTS TO SHED LIGHT FROM A CRITICAL POINT OF VIEW ON THE IDENTIFICATION OF THE MOST RELEVANT EPIGENETIC MECHANISMS RELATED TO RA AND SS BY EXPLAINING INTRICATE REGULATORY PROCESSES AND PHENOTYPIC FEATURES OF BOTH AUTOIMMUNE DISEASES. MOREOVER, WE POINT OUT SOME EPIGENETIC MARKERS WHICH CAN BE USED TO MONITOR THE INFLAMMATION STATUS AND THE DYSREGULATED IMMUNITY IN SS AND RA. FINALLY, WE DISCUSS THE INCONVENIENCE OF USING EPIGENETIC DATA OBTAINED FROM BULK IMMUNE CELL POPULATIONS INSTEAD SPECIFIC IMMUNE CELL SUBPOPULATIONS. 2019 17 6041 38 THE CLASS III HISTONE DEACETYLASE SIRTUIN 1 IN IMMUNE SUPPRESSION AND ITS THERAPEUTIC POTENTIAL IN RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC DEBILITATING DISEASE OF THE JOINTS. BOTH THE INNATE AND ADAPTIVE IMMUNE RESPONSES PARTICIPATE IN THE DEVELOPMENT AND PROGRESSION OF RA. WHILE SEVERAL THERAPEUTIC REAGENTS, SUCH AS TNF-ALPHA AGONISTS, HAVE BEEN SUCCESSFULLY DEVELOPED FOR THE CLINICAL USE IN THE TREATMENT OF RA, MORE THAN HALF OF THE PATIENTS DO NOT RESPOND TO ANTI-TNF THERAPY. THEREFORE, NEW THERAPEUTIC REAGENTS ARE NEEDED. RECENT STUDIES HAVE SHOWN THAT SIRTUIN 1 (SIRT1), A NICOTINAMIDE ADENINE DINUCLEOTIDE (NAD)-DEPENDENT HISTONE DEACETYLASE, IS A CRITICAL NEGATIVE REGULATOR OF BOTH THE INNATE AND ADAPTIVE IMMUNE RESPONSE IN MICE, AND ITS ALTERED FUNCTIONS ARE LIKELY TO BE INVOLVED IN AUTOIMMUNE DISEASES. SMALL MOLECULES THAT MODULATE SIRT1 FUNCTIONS ARE POTENTIAL THERAPEUTIC REAGENTS FOR AUTOIMMUNE INFLAMMATORY DISEASES. THIS REVIEW HIGHLIGHTS THE ROLE OF SIRT1 IN IMMUNE REGULATION AND RA. 2013 18 5372 40 RECENT ADVANCES IN UNDERSTANDING THE PATHOGENESIS OF RHEUMATOID ARTHRITIS: NEW TREATMENT STRATEGIES. RHEUMATOID ARTHRITIS (RA) IS CONSIDERED A CHRONIC SYSTEMIC, MULTI-FACTORIAL, INFLAMMATORY, AND PROGRESSIVE AUTOIMMUNE DISEASE AFFECTING MANY PEOPLE WORLDWIDE. WHILE PATIENTS SHOW VERY INDIVIDUAL COURSES OF DISEASE, WITH RA FOCUSING ON THE MUSCULOSKELETAL SYSTEM, JOINTS ARE OFTEN SEVERELY AFFECTED, LEADING TO LOCAL INFLAMMATION, CARTILAGE DESTRUCTION, AND BONE EROSION. TO PREVENT JOINT DAMAGE AND PHYSICAL DISABILITY AS ONE OF MANY SYMPTOMS OF RA, EARLY DIAGNOSIS IS CRITICAL. AUTO-ANTIBODIES PLAY A PIVOTAL CLINICAL ROLE IN PATIENTS WITH SYSTEMIC RA. AS BIOMARKERS, THEY COULD HELP TO MAKE A MORE EFFICIENT DIAGNOSIS, PROGNOSIS, AND TREATMENT DECISION. BESIDES AUTO-ANTIBODIES, SEVERAL OTHER FACTORS ARE INVOLVED IN THE PROGRESSION OF RA, SUCH AS EPIGENETIC ALTERATIONS, POST-TRANSLATIONAL MODIFICATIONS, GLYCOSYLATION, AUTOPHAGY, AND T-CELLS. UNDERSTANDING THE INTERPLAY BETWEEN THESE FACTORS WOULD CONTRIBUTE TO A DEEPER INSIGHT INTO THE CAUSES, MECHANISMS, PROGRESSION, AND TREATMENT OF THE DISEASE. IN THIS REVIEW, THE LATEST RA RESEARCH FINDINGS ARE DISCUSSED TO BETTER UNDERSTAND THE PATHOGENESIS, AND FINALLY, TREATMENT STRATEGIES FOR RA THERAPY ARE PRESENTED, INCLUDING BOTH CONVENTIONAL APPROACHES AND NEW METHODS THAT HAVE BEEN DEVELOPED IN RECENT YEARS OR ARE CURRENTLY UNDER INVESTIGATION. 2021 19 6178 37 THE HISTONE MODIFICATION CODE IN THE PATHOGENESIS OF AUTOIMMUNE DISEASES. AUTOIMMUNE DISEASES ARE CHRONIC INFLAMMATORY DISORDERS CAUSED BY A LOSS OF SELF-TOLERANCE, WHICH IS CHARACTERIZED BY THE APPEARANCE OF AUTOANTIBODIES AND/OR AUTOREACTIVE LYMPHOCYTES AND THE IMPAIRED SUPPRESSIVE FUNCTION OF REGULATORY T CELLS. THE PATHOGENESIS OF AUTOIMMUNE DISEASES IS EXTREMELY COMPLEX AND REMAINS LARGELY UNKNOWN. RECENT ADVANCES INDICATE THAT ENVIRONMENTAL FACTORS TRIGGER AUTOIMMUNE DISEASES IN GENETICALLY PREDISPOSED INDIVIDUALS. IN ADDITION, ACCUMULATING RESULTS HAVE INDICATED A POTENTIAL ROLE OF EPIGENETIC MECHANISMS, SUCH AS HISTONE MODIFICATIONS, IN THE DEVELOPMENT OF AUTOIMMUNE DISEASES. HISTONE MODIFICATIONS REGULATE THE CHROMATIN STATES AND GENE TRANSCRIPTION WITHOUT ANY CHANGE IN THE DNA SEQUENCE, POSSIBLY RESULTING IN PHENOTYPE ALTERATION IN SEVERAL DIFFERENT CELL TYPES. IN THIS PAPER, WE DISCUSS THE SIGNIFICANT ROLES OF HISTONE MODIFICATIONS INVOLVED IN THE PATHOGENESIS OF AUTOIMMUNE DISEASES, INCLUDING RHEUMATOID ARTHRITIS, SYSTEMIC LUPUS ERYTHEMATOSUS, SYSTEMIC SCLEROSIS, PRIMARY BILIARY CIRRHOSIS, AND TYPE 1 DIABETES. 2017 20 3789 36 INTERLEUKIN 17 CONTRIBUTES TO THE CHRONICITY OF INFLAMMATORY DISEASES SUCH AS RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY DISEASE LEADING TO JOINT DESTRUCTION AND BONE RESORPTION. THE PROINFLAMMATORY CYTOKINE INTERLEUKIN 17 (IL-17), PRIMARILY PRODUCED BY TH17 CELLS, HAS BEEN SHOWN TO BE INVOLVED IN ALL STAGES OF THE DISEASE AND TO BE AN IMPORTANT CONTRIBUTOR OF RA CHRONICITY. THREE MAJOR PROCESSES DRIVE THE IL-17-MEDIATED CHRONICITY. SEVERAL EPIGENETIC EVENTS, ENHANCED IN RA PATIENTS, LEAD TO THE INCREASED PRODUCTION OF IL-17 BY TH17 CELLS. IL-17 THEN INDUCES THE PRODUCTION OF SEVERAL INFLAMMATORY MEDIATORS IN THE DISEASED SYNOVIUM, WHICH ARE FURTHER SYNERGISTICALLY ENHANCED VIA COMBINATIONS OF IL-17 WITH OTHER CYTOKINES. IL-17 ALSO PROMOTES THE SURVIVAL OF BOTH THE SYNOVIOCYTES AND INFLAMMATORY CELLS AND PROMOTES THE MATURATION OF THESE IMMUNE CELLS. THIS LEADS TO AN INCREASED NUMBER OF SYNOVIOCYTES AND INFLAMMATORY CELLS IN THE SYNOVIAL FLUID AND IN THE SYNOVIUM LEADING TO THE HYPERPLASIA AND EXACERBATED INFLAMMATION OBSERVED IN JOINTS OF RA PATIENTS. FURTHERMORE, THESE IL-17-DRIVEN EVENTS INITIATE SEVERAL FEEDBACK-LOOP MECHANISMS LEADING TO INCREASED EXPANSION OF TH17 CELLS AND THEREBY INCREASED PRODUCTION OF IL-17. IN THIS REVIEW, WE AIM TO DEPICT A COMPLETE PICTURE OF THE IL-17-DRIVEN VICIOUS CIRCLE LEADING TO RA CHRONICITY AND TO PINPOINT THE KEY ASPECTS THAT REQUIRE FURTHER EXPLORATION. 2014