1 4109 127 MECHANISMS AND DRUG THERAPY OF PULMONARY HYPERTENSION AT HIGH ALTITUDE. PULMONARY VASOCONSTRICTION REPRESENTS A PHYSIOLOGICAL ADAPTIVE MECHANISM TO HIGH ALTITUDE. IF EXAGGERATED, HOWEVER, IT IS ASSOCIATED WITH IMPORTANT MORBIDITY AND MORTALITY. RECENT MECHANISTIC STUDIES USING SHORT-TERM ACUTE HIGH ALTITUDE EXPOSURE HAVE PROVIDED INSIGHT INTO THE IMPORTANCE OF DEFECTIVE VASCULAR ENDOTHELIAL AND RESPIRATORY EPITHELIAL NITRIC OXIDE (NO) SYNTHESIS, INCREASED ENDOTHELIN-1 BIOAVAILABILITY, AND OVERACTIVATION OF THE SYMPATHETIC NERVOUS SYSTEM IN CAUSING EXAGGERATED HYPOXIC PULMONARY HYPERTENSION IN HUMANS. BASED ON THESE STUDIES, DRUGS THAT INCREASE NO BIOAVAILABILITY, ATTENUATE ENDOTHELIN-1 INDUCED PULMONARY VASOCONSTRICTION, OR PREVENT EXAGGERATED SYMPATHETIC ACTIVATION HAVE BEEN SHOWN TO BE USEFUL FOR THE TREATMENT/PREVENTION OF EXAGGERATED PULMONARY HYPERTENSION DURING ACUTE SHORT-TERM HIGH ALTITUDE EXPOSURE. THE MECHANISMS UNDERPINNING CHRONIC PULMONARY HYPERTENSION IN HIGH ALTITUDE DWELLERS ARE LESS WELL UNDERSTOOD, BUT RECENT EVIDENCE SUGGESTS THAT THEY DIFFER IN SOME ASPECTS FROM THOSE INVOLVED IN SHORT-TERM ADAPTATION TO HIGH ALTITUDE. THESE DIFFERENCES HAVE CONSEQUENCES FOR THE CHOICE OF THE TREATMENT FOR CHRONIC PULMONARY HYPERTENSION AT HIGH ALTITUDE. FINALLY, RECENT DATA INDICATE THAT FETAL PROGRAMMING OF PULMONARY VASCULAR DYSFUNCTION IN OFFSPRING OF PREECLAMPSIA AND CHILDREN GENERATED BY ASSISTED REPRODUCTIVE TECHNOLOGIES REPRESENTS A NOVEL AND FREQUENT CAUSE OF PULMONARY HYPERTENSION AT HIGH ALTITUDE. IN ANIMAL MODELS OF FETAL PROGRAMMING OF HYPOXIC PULMONARY HYPERTENSION, EPIGENETIC MECHANISMS PLAY A ROLE, AND TARGETING OF THESE MECHANISMS WITH DRUGS LOWERS PULMONARY ARTERY PRESSURE. IF EPIGENETIC MECHANISMS ALSO ARE OPERATIONAL IN THE FETAL PROGRAMMING OF PULMONARY VASCULAR DYSFUNCTION IN HUMANS, SUCH DRUGS MAY BECOME NOVEL TOOLS FOR THE TREATMENT OF HYPOXIC PULMONARY HYPERTENSION. 2013 2 2567 39 EPIGENETICS MODIFIERS: POTENTIAL HUB FOR UNDERSTANDING AND TREATING NEURODEVELOPMENTAL DISORDERS FROM HYPOXIC INJURY. BACKGROUND: THE FETAL BRAIN IS ADAPTED TO THE HYPOXIC CONDITIONS PRESENT DURING NORMAL IN UTERO DEVELOPMENT. RELATIVELY MORE HYPOXIC STATES, EITHER CHRONIC OR ACUTE, ARE PATHOLOGIC AND CAN LEAD TO SIGNIFICANT LONG-TERM NEURODEVELOPMENTAL SEQUELAE. IN UTERO HYPOXIC INJURY IS ASSOCIATED WITH NEONATAL MORTALITY AND MILLIONS OF LIVES LIVED WITH VARYING DEGREES OF DISABILITY. MAIN BODY: GENETIC STUDIES OF CHILDREN WITH NEURODEVELOPMENTAL DISEASE INDICATE THAT EPIGENETIC MODIFIERS REGULATING DNA METHYLATION AND HISTONE REMODELING ARE CRITICAL FOR NORMAL BRAIN DEVELOPMENT. EPIGENETIC MODIFIERS ARE ALSO REGULATED BY ENVIRONMENTAL STIMULI, SUCH AS HYPOXIA. INDEED, EPIGENETIC MODIFIERS THAT ARE MUTATED IN CHILDREN WITH GENETIC NEURODEVELOPMENTAL DISEASES ARE REGULATED BY HYPOXIA IN A NUMBER OF PRECLINICAL MODELS AND MAY BE PART OF THE MECHANISM FOR THE LONG-TERM NEURODEVELOPMENTAL SEQUELAE SEEM IN CHILDREN WITH HYPOXIC BRAIN INJURY. THUS, A COMPREHENSIVE UNDERSTANDING THE ROLE OF DNA METHYLATION AND HISTONE MODIFICATIONS IN HYPOXIC INJURY IS CRITICAL FOR DEVELOPING NOVEL STRATEGIES TO TREAT CHILDREN WITH HYPOXIC INJURY. CONCLUSIONS: THIS REVIEW FOCUSES ON OUR CURRENT UNDERSTANDING OF THE INTERSECTION BETWEEN EPIGENETICS, BRAIN DEVELOPMENT, AND HYPOXIA. OPPORTUNITIES FOR THE USE OF EPIGENETICS AS BIOMARKERS OF NEURODEVELOPMENTAL DISEASE AFTER HYPOXIC INJURY AND POTENTIAL CLINICAL EPIGENETICS TARGETS TO IMPROVE OUTCOMES AFTER INJURY ARE ALSO DISCUSSED. WHILE THERE HAVE BEEN MANY PUBLISHED STUDIES ON THE EPIGENETICS OF HYPOXIA, MORE ARE NEEDED IN THE DEVELOPING BRAIN IN ORDER TO DETERMINE WHICH EPIGENETIC PATHWAYS MAY BE MOST IMPORTANT FOR MITIGATING THE LONG-TERM CONSEQUENCES OF HYPOXIC BRAIN INJURY. 2020 3 4125 27 MECHANISMS OF DISEASE: IN UTERO PROGRAMMING IN THE PATHOGENESIS OF HYPERTENSION. NUTRITIONAL AND OTHER ENVIRONMENTAL CUES DURING DEVELOPMENT CAN PERMANENTLY ALTER THE STRUCTURE, HOMEOSTATIC SYSTEMS, AND FUNCTIONS OF THE BODY. THIS PHENOMENON HAS BEEN REFERRED TO AS 'PROGRAMMING'. EPIDEMIOLOGICAL AND ANIMAL STUDIES SHOW THAT PROGRAMMED EFFECTS OPERATE WITHIN THE NORMAL RANGE OF GROWTH AND DEVELOPMENT, AND INFLUENCE THE RISK OF CHRONIC DISEASE IN ADULT LIFE. WE REVIEW THE EVIDENCE THAT THESE EFFECTS INCLUDE REDUCED NEPHRON NUMBER AND COMPENSATORY ADAPTATIONS, WHICH MIGHT LEAD TO HYPERTENSION, AND PERHAPS ACCELERATE THE DECLINE IN RENAL FUNCTION THAT ACCOMPANIES AGING. THESE PROCESSES MIGHT BE EXACERBATED BY PROGRAMMED CHANGES IN VASCULAR STRUCTURE AND FUNCTION, AND ALTERATIONS IN ENDOCRINE AND METABOLIC HOMEOSTASIS. PROGRAMMED EFFECTS MIGHT BE INITIATED AS EARLY AS THE PERICONCEPTUAL PHASE OF DEVELOPMENT, AND COULD INVOLVE EPIGENETIC CHANGES IN GENE EXPRESSION OR ALTERED STEM CELL ALLOCATION. BETTER UNDERSTANDING OF THESE PROCESSES COULD LEAD TO THE DEVELOPMENT OF NOVEL DIAGNOSTIC AND PREVENTIVE MEASURES, AND TO EARLY DETECTION OF AT-RISK INDIVIDUALS. BY MONITORING BLOOD PRESSURE, WEIGHT, AND RENAL FUNCTION IN CHILDREN, IT MIGHT BE POSSIBLE TO REDUCE THE RISK OF CARDIOVASCULAR AND RENAL DISEASE IN LATER LIFE. 2006 4 1371 35 DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE: NEW INSIGHTS. EPIDEMIOLOGICAL AND ANIMAL STUDIES SHOW THAT SMALL CHANGES IN THE DEVELOPMENTAL ENVIRONMENT CAN INDUCE PHENOTYPIC CHANGES AFFECTING AN INDIVIDUAL'S RESPONSES TO THEIR LATER ENVIRONMENT. THESE MAY ALTER THE RISK OF CHRONIC DISEASE SUCH AS METABOLIC SYNDROME OR CARDIOVASCULAR DISEASE. RECENT RESEARCH SHOWS THAT ANIMALS EXPOSED TO SUCH A MISMATCH BETWEEN PRENATAL AND POSTNATAL ENVIRONMENT DEVELOP OBESITY, REDUCED ACTIVITY, LEPTIN AND INSULIN RESISTANCE, ELEVATED BLOOD PRESSURE AND VASCULAR ENDOTHELIAL DYSFUNCTION. EPIGENETIC PROCESSES ARE INVOLVED IN SUCH EFFECTS, TARGETED TO PROMOTER REGIONS OF SPECIFIC GENES IN SPECIFIC TISSUES. SUCH FINE CONTROL OF GENE EXPRESSION SUGGESTS THAT THE MECHANISMS HAVE BEEN RETAINED THROUGH EVOLUTION THROUGH THEIR ADAPTIVE ADVANTAGE, RATHER THAN REPRESENTING EXTREME EFFECTS OF DEVELOPMENTAL DISRUPTION AKIN TO TERATOGENESIS. THERE MAY BE ADAPTIVE ADVANTAGE IN A DEVELOPMENTAL CUE INDUCING A PHENOTYPIC CHANGE IN GENERATIONS BEYOND THE IMMEDIATE PREGNANCY, AND A RANGE OF DATA THAT SUPPORT THIS CONCEPT. IN ANIMALS, EPIGENETIC EFFECTS SUCH AS DNA METHYLATION CAN BE PASSED TO SUCCESSIVE GENERATIONS. ENVIRONMENTAL TOXINS, INCLUDING ENDOCRINE DISRUPTORS, MAY INDUCE GREATER RISK OF CHRONIC DISEASE, EVEN AT LOW EXPOSURE LEVELS, IF THEY AFFECT SUCH NORMAL DEVELOPMENTAL EPIGENETIC PROCESSES. APPROPRIATE INTERVENTIONS MAY HAVE LONG-TERM MULTIGENERATIONAL EFFECTS TO REDUCE THE RISK OF CHRONIC DISEASE. 2008 5 1895 35 ENDOTHELIAL DYSFUNCTION IN INDIVIDUALS BORN AFTER FETAL GROWTH RESTRICTION: CARDIOVASCULAR AND RENAL CONSEQUENCES AND PREVENTIVE APPROACHES. INDIVIDUALS BORN AFTER INTRAUTERINE GROWTH RESTRICTION (IUGR) HAVE AN INCREASED RISK OF PERINATAL MORBIDITY/MORTALITY, AND THOSE WHO SURVIVE FACE LONG-TERM CONSEQUENCES SUCH AS CARDIOVASCULAR-RELATED DISEASES, INCLUDING SYSTEMIC HYPERTENSION, ATHEROSCLEROSIS, CORONARY HEART DISEASE AND CHRONIC KIDNEY DISEASE. IN ADDITION TO THE DEMONSTRATED LONG-TERM EFFECTS OF DECREASED NEPHRON ENDOWMENT AND HYPERACTIVITY OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS, INDIVIDUALS BORN AFTER IUGR ALSO EXHIBIT EARLY ALTERATIONS IN VASCULAR STRUCTURE AND FUNCTION, WHICH HAVE BEEN IDENTIFIED AS KEY FACTORS OF THE DEVELOPMENT OF CARDIOVASCULAR-RELATED DISEASES. THE ENDOTHELIUM PLAYS A MAJOR ROLE IN MAINTAINING VASCULAR FUNCTION AND HOMEOSTASIS. THEREFORE, IT IS NOT SURPRISING THAT IMPAIRED ENDOTHELIAL FUNCTION CAN LEAD TO THE LONG-TERM DEVELOPMENT OF VASCULAR-RELATED DISEASES. ENDOTHELIAL DYSFUNCTION, PARTICULARLY IMPAIRED ENDOTHELIUM-DEPENDENT VASODILATION AND VASCULAR REMODELING, INVOLVES DECREASED NITRIC OXIDE (NO) BIOAVAILABILITY, IMPAIRED ENDOTHELIAL NO SYNTHASE FUNCTIONALITY, INCREASED OXIDATIVE STRESS, ENDOTHELIAL PROGENITOR CELLS DYSFUNCTION AND ACCELERATED VASCULAR SENESCENCE. PREVENTIVE APPROACHES SUCH AS BREASTFEEDING, SUPPLEMENTATION WITH FOLATE, VITAMINS, ANTIOXIDANTS, L-CITRULLINE, L-ARGININE AND TREATMENT WITH NO MODULATORS REPRESENT PROMISING STRATEGIES FOR IMPROVING ENDOTHELIAL FUNCTION, MITIGATING LONG-TERM OUTCOMES AND POSSIBLY PREVENTING IUGR OF VASCULAR ORIGIN. MOREOVER, THE IDENTIFICATION OF EARLY BIOMARKERS OF ENDOTHELIAL DYSFUNCTION, ESPECIALLY EPIGENETIC BIOMARKERS, COULD ALLOW EARLY SCREENING AND FOLLOW-UP OF INDIVIDUALS AT RISK OF DEVELOPING CARDIOVASCULAR AND RENAL DISEASES, THUS CONTRIBUTING TO THE DEVELOPMENT OF PREVENTIVE AND THERAPEUTIC STRATEGIES TO AVERT THE LONG-TERM EFFECTS OF ENDOTHELIAL DYSFUNCTION IN INFANTS BORN AFTER IUGR. 2017 6 4978 29 PATHOPHYSIOLOGY AND NEW ADVANCES IN PULMONARY HYPERTENSION. PULMONARY HYPERTENSION IS A PROGRESSIVE AND OFTEN FATAL CARDIOPULMONARY CONDITION CHARACTERISED BY INCREASED PULMONARY ARTERIAL PRESSURE, STRUCTURAL CHANGES IN THE PULMONARY CIRCULATION, AND THE FORMATION OF VASO-OCCLUSIVE LESIONS. THESE CHANGES LEAD TO INCREASED RIGHT VENTRICULAR AFTERLOAD, WHICH OFTEN PROGRESSES TO MALADAPTIVE RIGHT VENTRICULAR REMODELLING AND EVENTUALLY DEATH. PULMONARY ARTERIAL HYPERTENSION REPRESENTS ONE OF THE MOST SEVERE AND BEST STUDIED TYPES OF PULMONARY HYPERTENSION AND IS CONSISTENTLY TARGETED BY DRUG TREATMENTS. THE UNDERLYING MOLECULAR PATHOGENESIS OF PULMONARY HYPERTENSION IS A COMPLEX AND MULTIFACTORIAL PROCESS, BUT CAN BE CHARACTERISED BY SEVERAL HALLMARKS: INFLAMMATION, IMPAIRED ANGIOGENESIS, METABOLIC ALTERATIONS, GENETIC OR EPIGENETIC ABNORMALITIES, INFLUENCE OF SEX AND SEX HORMONES, AND ABNORMALITIES IN THE RIGHT VENTRICLE. CURRENT TREATMENTS FOR PULMONARY ARTERIAL HYPERTENSION AND SOME OTHER TYPES OF PULMONARY HYPERTENSION TARGET PATHWAYS INVOLVED IN THE CONTROL OF PULMONARY VASCULAR TONE AND PROLIFERATION; HOWEVER, THESE TREATMENTS HAVE LIMITED EFFICACY ON PATIENT OUTCOMES. THIS REVIEW DESCRIBES KEY FEATURES OF PULMONARY HYPERTENSION, DISCUSSES CURRENT AND EMERGING THERAPEUTIC INTERVENTIONS, AND POINTS TO FUTURE DIRECTIONS FOR RESEARCH AND PATIENT CARE. BECAUSE MOST PROGRESS IN THE SPECIALTY HAS BEEN MADE IN PULMONARY ARTERIAL HYPERTENSION, THIS REVIEW FOCUSES ON THIS TYPE OF PULMONARY HYPERTENSION. THE REVIEW HIGHLIGHTS KEY PATHOPHYSIOLOGICAL CONCEPTS AND EMERGING THERAPEUTIC DIRECTIONS, TARGETING INFLAMMATION, CELLULAR METABOLISM, GENETICS AND EPIGENETICS, SEX HORMONE SIGNALLING, BONE MORPHOGENETIC PROTEIN SIGNALLING, AND INHIBITION OF TYROSINE KINASE RECEPTORS. 2023 7 3814 23 INTRAUTERINE HYPOXIA AND EPIGENETIC PROGRAMMING IN LUNG DEVELOPMENT AND DISEASE. CLINICALLY, INTRAUTERINE HYPOXIA IS THE FOREMOST CAUSE OF PERINATAL MORBIDITY AND DEVELOPMENTAL PLASTICITY IN THE FETUS AND NEWBORN INFANT. UNDER HYPOXIA, DEVIATIONS OCCUR IN THE LUNG CELL EPIGENOME. EPIGENETIC MECHANISMS (E.G., DNA METHYLATION, HISTONE MODIFICATION, AND MIRNA EXPRESSION) CONTROL PHENOTYPIC PROGRAMMING AND ARE ASSOCIATED WITH PHYSIOLOGICAL RESPONSES AND THE RISK OF DEVELOPMENTAL DISORDERS, SUCH AS BRONCHOPULMONARY DYSPLASIA. THIS DEVELOPMENTAL DISORDER IS THE MOST FREQUENT CHRONIC PULMONARY COMPLICATION IN PRETERM LABOR. THE PATHOGENESIS OF THIS DISEASE INVOLVES MANY FACTORS, INCLUDING ABERRANT OXYGEN CONDITIONS AND MECHANICAL VENTILATION-MEDIATED LUNG INJURY, INFECTION/INFLAMMATION, AND EPIGENETIC/GENETIC RISK FACTORS. THIS REVIEW IS FOCUSED ON VARIOUS ASPECTS RELATED TO INTRAUTERINE HYPOXIA AND EPIGENETIC PROGRAMMING IN LUNG DEVELOPMENT AND DISEASE, SUMMARIZES OUR CURRENT KNOWLEDGE OF HYPOXIA-INDUCED EPIGENETIC PROGRAMMING AND DISCUSSES POTENTIAL THERAPEUTIC INTERVENTIONS FOR LUNG DISEASE. 2021 8 5048 43 PHARMACOLOGICAL APPROACHES IN EITHER INTERMITTENT OR PERMANENT HYPOXIA: A TALE OF TWO EXPOSURES. HYPOXIA INDUCES SEVERAL RESPONSES AT CARDIOVASCULAR, PULMONARY AND REPRODUCTIVE LEVELS, WHICH MAY LEAD TO CHRONIC DISEASES. THIS IS RELEVANT IN HUMAN POPULATIONS EXPOSED TO HIGH ALTITUDE (HA), IN EITHER CHRONIC CONTINUOUS (PERMANENT INHABITANTS) OR INTERMITTENT FASHION (HA WORKERS, TOURISTS AND MOUNTAINEERS). IN CHILE, IT IS ESTIMATED THAT 1.000.000 PEOPLE LIVE AT HIGHLANDS AND MORE THAN 55.000 WORK IN HA SHIFTS. INITIAL RESPONSES TO HYPOXIA ARE COMPENSATORY AND INDUCE ACTIVATION OF CARDIOPROTECTIVE MECHANISMS, SUCH AS THOSE SEEN UNDER INTERMITTENT HYPOBARIC (IH) HYPOXIA, EVENTS THAT COULD MEDIATE PRECONDITIONING. HOWEVER, WHENEVER HYPOXIA IS PROLONGED, THE CHRONIC ACTIVATION OF CELLULAR RESPONSES INDUCES LONG-LASTING MODIFICATIONS THAT MAY RESULT IN ACCLIMATIZATION OR PRODUCE MALADAPTIVE CHANGES WITH INCREASE IN CARDIOVASCULAR RISK. HA EXPOSURE DURING PREGNANCY INDUCES HYPOXIA AND OXIDATIVE STRESS, WHICH IN TURN MAY PROMOTE CELLULAR RESPONSES AND EPIGENETIC MODIFICATIONS RESULTING IN SEVERE IMPAIRMENT IN GROWTH AND DEVELOPMENT. SADLY, THIS CONDITION IS ACCOMPANIED WITH AN INCREASED FETAL AND NEONATAL MORBI-MORTALITY. FURTHER, DEVELOPMENTAL HYPOXIA MAY PROGRAM CARDIO-PULMONARY CIRCULATIONS LATER IN POSTNATAL LIFE, ENDING IN VASCULAR STRUCTURAL AND FUNCTIONAL ALTERATIONS WITH AUGMENTED RISK ON PULMONARY AND CARDIOVASCULAR FAILURE. ADDITIONALLY, PERMANENT HA INHABITANTS HAVE AUGMENTED RISK AND PREVALENCE OF CHRONIC HYPOXIC PULMONARY HYPERTENSION, RIGHT VENTRICULAR HYPERTROPHY AND CARDIOPULMONARY REMODELING. SIMILAR RESPONSES ARE SEEN IN ADULTS THAT ARE INTERMITTENTLY EXPOSED TO CHRONIC HYPOXIA (CH) SUCH AS SHIFT WORKERS IN HA AREAS. THE MECHANISMS INVOLVED DETERMINING THE IMMEDIATE, SHORT AND LONG-LASTING EFFECTS ARE STILL UNCLEAR. FOR SEVERAL YEARS, THE STUDY OF THE RESPONSES TO HYPOXIC INSULTS AND PHARMACOLOGICAL TARGETS HAS BEEN THE MOTIVATION OF OUR GROUP. THIS REVIEW DESCRIBES SOME OF THE MECHANISMS UNDERLYING HYPOXIC RESPONSES AND POTENTIAL THERAPEUTIC APPROACHES WITH ANTIOXIDANTS SUCH AS MELATONIN, ASCORBATE, OMEGA 3 (OMEGA3) OR COMPOUNDS THAT INCREASE THE NITRIC OXIDE (NO) BIOAVAILABILITY. 2015 9 1982 32 EPIGENETIC ALTERATIONS IN PEDIATRIC SLEEP APNEA. PEDIATRIC OBSTRUCTIVE SLEEP APNEA HAS SIGNIFICANT NEGATIVE EFFECTS ON HEALTH AND BEHAVIOR IN CHILDHOOD INCLUDING DEPRESSION, FAILURE TO THRIVE, NEUROCOGNITIVE IMPAIRMENT, AND BEHAVIORAL ISSUES. IT IS STRONGLY ASSOCIATED WITH AN INCREASED RISK FOR CHRONIC ADULT DISEASE SUCH AS OBESITY AND DIABETES, ACCELERATED ATHEROSCLEROSIS, AND ENDOTHELIAL DYSFUNCTION. ACCUMULATING EVIDENCE SUGGESTS THAT ADULT-ONSET NON-COMMUNICABLE DISEASES MAY ORIGINATE FROM EARLY LIFE THROUGH A PROCESS BY WHICH AN INSULT APPLIED AT A CRITICAL DEVELOPMENTAL WINDOW CAUSES LONG-TERM EFFECTS ON THE STRUCTURE OR FUNCTION OF AN ORGANISM. IN RECENT YEARS, THERE HAS BEEN INCREASED INTEREST IN THE ROLE OF EPIGENETIC MECHANISMS IN THE PATHOGENESIS OF ADULT DISEASE SUSCEPTIBILITY. EPIGENETIC MECHANISMS THAT INFLUENCE ADAPTIVE VARIABILITY INCLUDE HISTONE MODIFICATIONS, NON-CODING RNAS, AND DNA METHYLATION. THIS REVIEW WILL HIGHLIGHT WHAT IS CURRENTLY KNOWN ABOUT THE PHENOTYPIC ASSOCIATIONS OF EPIGENETIC MODIFICATIONS IN PEDIATRIC OBSTRUCTIVE SLEEP APNEA AND WILL EMPHASIZE THE IMPORTANCE OF EPIGENETIC CHANGES AS BOTH MODULATORS OF CHRONIC DISEASE AND POTENTIAL THERAPEUTIC TARGETS. 2021 10 2687 37 EVIDENCE OF EPIGENETIC ALTERATIONS IN THROMBOSIS AND COAGULATION: A SYSTEMATIC REVIEW. THROMBOSIS IN THE CONTEXT OF CARDIOVASCULAR DISEASE (CVD) AFFECTS MAINLY THE BLOOD VESSELS SUPPLYING THE HEART, BRAIN AND PERIPHERIES AND IT IS THE LEADING CAUSE OF DEATH WORLDWIDE. THE PATHOPHYSIOLOGICAL THROMBOTIC MECHANISMS ARE LARGELY UNKNOWN. HERITABILITY CONTRIBUTES TO A 30% OF THE INCIDENCE OF CVD. THE REMAINING VARIATION CAN BE EXPLAINED BY LIFE STYLE FACTORS SUCH AS SMOKING, DIETARY AND EXERCISE HABITS, ENVIRONMENTAL EXPOSURE TO TOXINS, AND DRUG USAGE AND OTHER COMORBIDITIES. EPIGENETIC VARIATION CAN BE ACQUIRED OR INHERITED AND CONSTITUTES AN INTERACTION BETWEEN GENES AND THE ENVIRONMENT. EPIGENETICS HAVE BEEN IMPLICATED IN ATHEROSCLEROSIS, ISCHEMIA/REPERFUSION DAMAGE AND THE CARDIOVASCULAR RESPONSE TO HYPOXIA. EPIGENETIC REGULATORS OF GENE EXPRESSION ARE MAINLY THE METHYLATION OF CPG ISLANDS, HISTONE POST TRANSLATIONAL MODIFICATIONS (PTMS) AND MICRORNAS (MIRNAS). THESE EPIGENETIC REGULATORS CONTROL GENE EXPRESSION EITHER THROUGH ACTIVATION OR SILENCING. EPIGENETIC CONTROL IS MOSTLY DYNAMIC AND CAN POTENTIALLY BE MANIPULATED TO PREVENT OR REVERSE THE UNCONTROLLED EXPRESSION OF GENES, A TRAIT THAT RENDERS THEM PUTATIVE THERAPEUTIC TARGETS. IN THE CURRENT REVIEW, WE SYSTEMATICALLY STUDIED AND PRESENT AVAILABLE DATA ON EPIGENETIC ALTERATIONS IMPLICATED IN THROMBOSIS DERIVED FROM HUMAN STUDIES. EVIDENCE OF EPIGENETIC ALTERATIONS IS OBSERVED IN SEVERAL THROMBOTIC DISEASES SUCH AS CORONARY ARTERY DISEASE AND CEREBROVASCULAR DISEASE, PREECLAMPSIA AND ANTIPHOSPHOLIPID SYNDROME. DIFFERENTIAL CPG METHYLATION AND SPECIFIC HISTONE PTMS THAT CONTROL TRANSCRIPTION OF PROTHROMBOTIC AND PROINFLAMMATORY GENES HAVE ALSO BEEN ASSOCIATED WITH PREDISPOSING FACTORS OF THROMBOSIS AND CVD, SUCH US SMOKING, AIR POLLUTION, HYPERTRIGLYCERIDEMIA, OCCUPATIONAL EXPOSURE TO PARTICULATE MATTER AND COMORBIDITIES INCLUDING CANCER, CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CHRONIC KIDNEY DISEASE. THESE CLINICAL OBSERVATIONS ARE FURTHER SUPPORTED BY IN VITRO EXPERIMENTS AND INDICATE THAT EPIGENETIC REGULATION AFFECTS THE PATHOPHYSIOLOGY OF THROMBOTIC DISORDERS WITH POTENTIAL DIAGNOSTIC OR THERAPEUTIC UTILITY. 2019 11 6192 32 THE IMPACT OF NUTRITIONAL INSULTS DURING FETAL LIFE ON BLOOD PRESSURE. NUMEROUS EPIDEMIOLOGICAL AND EXPERIMENTAL STUDIES PROVIDE COMPELLING EVIDENCE THAT NUTRITIONAL INSULTS THAT IMPACT FETAL GROWTH PROGRAM A MARKED INCREASE IN BLOOD PRESSURE IN LATER LIFE. SEX AND AGE ALSO INFLUENCE THE DEVELOPMENTAL PROGRAMMING OF HYPERTENSION; YET THE EXACT MECHANISMS THAT PERMANENTLY CHANGE THE STRUCTURE, PHYSIOLOGY, AND ENDOCRINE HEALTH OF AN INDIVIDUAL ACROSS THEIR LIFESPAN FOLLOWING EXPOSURE TO A NUTRITIONAL INSULT ARE NOT ENTIRELY CLEAR. FETAL EXPOSURE TO MATERNAL GLUCOCORTICOIDS IS POSTULATED AS AN INITIATING EVENT. IN ADDITION, INAPPROPRIATE SUPPRESSION OR ACTIVATION OF THE RENIN ANGIOTENSIN SYSTEM (RAS) AND/OR ACTIVATION OF THE SYMPATHETIC NERVOUS SYSTEM (SNS) LEADING TO MARKED INCREASES IN OXIDATIVE STRESS AND ENDOTHELIN PRODUCTION ARE IMPLICATED IN THE ETIOLOGY OF HYPERTENSION THAT HAS ITS ORIGINS IN FETAL LIFE. THE RISK OF HYPERTENSION AND CHRONIC DISEASE IN ONE GENERATION IS TRANSMITTED TO THE NEXT IN THE ABSENCE OF AN ADDITIONAL PRENATAL INSULT IMPLICATING EPIGENETIC PROCESSES. YET, FURTHER STUDIES ARE NEEDED TO FULLY ELUCIDATE THE MECHANISMS THAT CONTRIBUTE TO HYPERTENSION PROGRAMMED IN RESPONSE TO NUTRITIONAL INSULTS DURING EARLY LIFE IN ORDER TO IMPROVE THE CARDIOVASCULAR HEALTH OF AN INDIVIDUAL ACROSS THEIR LIFESPAN. 2015 12 6183 22 THE IMPACT OF ENVIRONMENTAL FACTORS IN INFLUENCING EPIGENETICS RELATED TO OXIDATIVE STATES IN THE CARDIOVASCULAR SYSTEM. OXIDATIVE STATES EXERT A SIGNIFICANT INFLUENCE ON A WIDE RANGE OF BIOLOGICAL AND MOLECULAR PROCESSES AND FUNCTIONS. WHEN THEIR BALANCE IS SHIFTED TOWARDS ENHANCED AMOUNTS OF FREE RADICALS, PATHOLOGICAL PHENOMENA CAN OCCUR, AS THE GENERATION OF REACTIVE OXYGEN SPECIES (ROS) IN TISSUE MICROENVIRONMENT OR IN THE SYSTEMIC CIRCULATION CAN BE DETRIMENTAL. EPIDEMIC CHRONIC DISEASES OF WESTERN SOCIETIES, SUCH AS CARDIOVASCULAR DISEASE, OBESITY, AND DIABETES CORRELATE WITH THE IMBALANCE OF REDOX HOMEOSTASIS. CURRENT ADVANCES IN OUR UNDERSTANDING OF EPIGENETICS HAVE REVEALED A PARALLEL SCENARIO SHOWING THE INFLUENCE OF OXIDATIVE STRESS AS A MAJOR REGULATOR OF EPIGENETIC GENE REGULATION VIA MODIFICATION OF DNA METHYLATION, HISTONES, AND MICRORNAS. THIS HAS PROVIDED BOTH THE BIOLOGICAL LINK AND A POTENTIAL MOLECULAR EXPLANATION BETWEEN OXIDATIVE STRESS AND CARDIOVASCULAR/METABOLIC PHENOMENA. ACCORDINGLY, IN THIS REVIEW, WE WILL PROVIDE CURRENT INSIGHTS ON THE PHYSIOLOGICAL AND PATHOLOGICAL IMPACT OF CHANGES IN OXIDATIVE STATES ON CARDIOVASCULAR DISORDERS, BY SPECIFICALLY FOCUSING ON THE INFLUENCE OF EPIGENETIC REGULATION. A SPECIAL EMPHASIS WILL HIGHLIGHT THE EFFECT ON EPIGENETIC REGULATION OF HUMAN'S CURRENT LIFE HABITS, EXTERNAL AND ENVIRONMENTAL FACTORS, INCLUDING FOOD INTAKE, TOBACCO, AIR POLLUTION, AND ANTIOXIDANT-BASED APPROACHES. ADDITIONALLY, THE STRATEGY TO QUANTIFY OXIDATIVE STATES IN HUMANS IN ORDER TO DETERMINE WHICH BIOLOGICAL MARKER COULD BEST MATCH A SUBJECT'S PROFILE WILL BE DISCUSSED. 2017 13 3771 38 INTER- AND TRANSGENERATIONAL EPIGENETIC INHERITANCE: EVIDENCE IN ASTHMA AND COPD? EVIDENCE IS NOW EMERGING THAT EARLY LIFE ENVIRONMENT CAN HAVE LIFELONG EFFECTS ON METABOLIC, CARDIOVASCULAR, AND PULMONARY FUNCTION IN OFFSPRING, A CONCEPT ALSO KNOWN AS FETAL OR DEVELOPMENTAL PROGRAMMING. IN MAMMALS, DEVELOPMENTAL PROGRAMMING IS THOUGHT TO OCCUR MAINLY VIA EPIGENETIC MECHANISMS, WHICH INCLUDE DNA METHYLATION, HISTONE MODIFICATIONS, AND EXPRESSION OF NON-CODING RNAS. THE EFFECTS OF DEVELOPMENTAL PROGRAMMING CAN BE INDUCED BY THE INTRAUTERINE ENVIRONMENT, LEADING TO INTERGENERATIONAL EPIGENETIC EFFECTS FROM ONE GENERATION TO THE NEXT. TRANSGENERATIONAL EPIGENETIC INHERITANCE MAY BE CONSIDERED WHEN DEVELOPMENTAL PROGRAMMING IS TRANSMITTED ACROSS GENERATIONS THAT WERE NOT EXPOSED TO THE INITIAL ENVIRONMENT WHICH TRIGGERED THE CHANGE. SO FAR, INTER- AND TRANSGENERATIONAL PROGRAMMING HAS BEEN MAINLY DESCRIBED FOR CARDIOVASCULAR AND METABOLIC DISEASE RISK. IN THIS REVIEW, WE DISCUSS AVAILABLE EVIDENCE THAT EPIGENETIC INHERITANCE ALSO OCCURS IN RESPIRATORY DISEASES, USING ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AS EXAMPLES. WHILE MULTIPLE EPIDEMIOLOGICAL AS WELL AS ANIMAL STUDIES DEMONSTRATE EFFECTS OF 'TOXIC' INTRAUTERINE EXPOSURE ON VARIOUS ASTHMA-RELATED PHENOTYPES IN THE OFFSPRING, ONLY FEW STUDIES LINK EPIGENETIC MARKS TO THE OBSERVED PHENOTYPES. AS EPIGENETIC MARKS MAY DISTINGUISH INDIVIDUALS MOST AT RISK OF LATER DISEASE AT EARLY AGE, IT WILL ENABLE EARLY INTERVENTION STRATEGIES TO REDUCE SUCH RISKS. TO ACHIEVE THIS GOAL FURTHER, WELL DESIGNED EXPERIMENTAL AND HUMAN STUDIES ARE NEEDED. 2015 14 2062 27 EPIGENETIC CONTROL OF HYPERTENSION BY DNA METHYLATION: A REAL POSSIBILITY. HYPERTENSION IS A COMMON CHRONIC DISEASE THAT PARTICULARLY AFFECTS THE ELDERLY AND CAN TRIGGER SEVERAL CARDIOVASCULAR CONDITIONS. ALTHOUGH THE TREATMENT OF HYPERTENSION HAS EVOLVED IN RECENT DECADES, MANY HYPERTENSIVE PATIENTS STILL DO NOT HAVE PROPERLY CONTROLLED BLOOD PRESSURE. ACCUMULATING EVIDENCE SUPPORTS THE HYPOTHESIS THAT DNA METHYLATION PLAYS AN IMPORTANT ROLE IN REGULATING GENE EXPRESSION, ALTERING THE PHENOTYPE AND FUNCTION OF THE CARDIOVASCULAR SYSTEM. THE PRESENT REVIEW HIGHLIGHTS RECENT ADVANCES IN RESEARCH ON DNA METHYLATION IN THE DEVELOPMENT OF HYPERTENSION. SEVERAL PRECLINICAL AND CLINICAL EVIDENCE SHOW THAT METHYLATION OF DIFFERENT TARGETS APPEARS TO BE INVOLVED IN HYPERTENSION. STUDIES OF THE INVOLVEMENT OF DNA METHYLATION HAVE GREATLY IMPROVED OUR UNDERSTANDING OF HYPERTENSION, BUT ITS USE AS A VALID THERAPEUTIC TARGET IS STILL UNKNOWN. FURTHER STUDIES COULD HELP TO BRING TO LIGHT THE TRUTH ABOUT GENE THERAPY IN HYPERTENSION. 2021 15 3848 26 IS EPIGENETICS AN IMPORTANT LINK BETWEEN EARLY LIFE EVENTS AND ADULT DISEASE? BACKGROUND: EPIGENETIC MECHANISMS PROVIDE ONE POTENTIAL EXPLANATION FOR HOW ENVIRONMENTAL INFLUENCES IN EARLY LIFE CAUSE LONG-TERM CHANGES IN CHRONIC DISEASE SUSCEPTIBILITY. WHEREAS EPIGENETIC DYSREGULATION IS INCREASINGLY IMPLICATED IN VARIOUS RARE DEVELOPMENTAL SYNDROMES AND CANCER, THE ROLE OF EPIGENETICS IN COMPLEX CHRONIC DISEASES, SUCH AS CARDIOVASCULAR DISEASE, TYPE 2 DIABETES AND OBESITY, REMAINS LARGELY UNCHARACTERIZED. EXTENSIVE WORK IN ANIMAL MODELS IS REQUIRED TO DEVELOP SPECIFIC HYPOTHESES THAT CAN BE PRACTICABLY TESTED IN HUMANS. ANIMAL MODELS: WE HAVE DEVELOPED A MOUSE MODEL SHOWING THAT METHYL DONOR SUPPLEMENTATION PREVENTS TRANSGENERATIONAL AMPLIFICATION OF OBESITY, SUGGESTING A ROLE FOR DNA METHYLATION IN THE DEVELOPMENTAL ESTABLISHMENT OF BODY WEIGHT REGULATION. CONCLUSIONS: COUPLING SUCH MODELS WITH RECENTLY DEVELOPED EPIGENOMIC TECHNOLOGIES SHOULD ULTIMATELY ENABLE US TO DETERMINE IF EPIGENETICS IS AN IMPORTANT LINK BETWEEN EARLY LIFE EVENTS AND ADULT DISEASE. 2009 16 5471 26 RESPIRATORY MUSCLE SENESCENCE IN AGEING AND CHRONIC LUNG DISEASES. AGEING IS A PROGRESSIVE CONDITION THAT USUALLY LEADS TO THE LOSS OF PHYSIOLOGICAL PROPERTIES. THIS PROCESS IS ALSO PRESENT IN RESPIRATORY MUSCLES, WHICH ARE AFFECTED BY BOTH SENESCENT CHANGES OCCURRING IN THE WHOLE ORGANISM AND THOSE THAT ARE MORE SPECIFIC FOR MUSCLES. THE MECHANISMS OF THE LATTER CHANGES INCLUDE OXIDATIVE STRESS, DECREASE IN NEUROTROPHIC FACTORS AND DNA ABNORMALITIES. AGEING NORMALLY COEXISTS WITH COMORBIDITIES, INCLUDING RESPIRATORY DISEASES, WHICH FURTHER DETERIORATE THE STRUCTURE AND FUNCTION OF RESPIRATORY MUSCLES. IN THIS CONTEXT, CHANGES INTRINSIC TO AGEING BECOME ENHANCED BY MORE SPECIFIC FACTORS SUCH AS THE IMPAIRMENT IN LUNG MECHANICS AND GAS EXCHANGE, EXACERBATIONS AND HYPOXIA. HYPOXIA IN PARTICULAR HAS A DIRECT EFFECT ON MUSCLES, MAINLY THROUGH THE EXPRESSION OF INDUCIBLE FACTORS (HYPOXIC-INDUCIBLE FACTOR), AND CAN RESULT IN OXIDATIVE STRESS AND CHANGES IN DNA, DECREASE IN MITOCHONDRIAL BIOGENESIS AND DEFECTS IN THE TISSUE REPAIR MECHANISMS. INTENSE EXERCISE CAN ALSO CAUSE DAMAGE IN RESPIRATORY MUSCLES OF ELDERLY RESPIRATORY PATIENTS, BUT THIS CAN BE FOLLOWED BY TISSUE REPAIR AND REMODELLING. HOWEVER, AGEING INTERFERES WITH MUSCLE REPAIR BY TAMPERING WITH THE FUNCTION OF SATELLITE CELLS, MAINLY DUE TO OXIDATIVE STRESS, DNA DAMAGE AND EPIGENETIC MECHANISMS. IN ADDITION TO THE NORMAL PROCESS OF AGEING, STRESS-INDUCED PREMATURE SENESCENCE CAN ALSO OCCUR, INVOLVING CHANGES IN THE EXPRESSION OF MULTIPLE GENES BUT WITHOUT MODIFICATIONS IN TELOMERE LENGTH. 2020 17 754 35 CARDIOVASCULAR ADAPTATIONS TO PARTICLE INHALATION EXPOSURE: MOLECULAR MECHANISMS OF THE TOXICOLOGY. AMBIENT AIR, OCCUPATIONAL SETTINGS, AND THE USE AND DISTRIBUTION OF CONSUMER PRODUCTS ALL SERVE AS CONDUITS FOR TOXICANT EXPOSURE THROUGH INHALATION. WHILE THE PULMONARY SYSTEM REMAINS A PRIMARY TARGET FOLLOWING INHALATION EXPOSURE, CARDIOVASCULAR IMPLICATIONS ARE EXCEPTIONALLY CULPABLE FOR INCREASED MORBIDITY AND MORTALITY. THE EPIDEMIOLOGICAL EVIDENCE FOR CARDIOVASCULAR DYSFUNCTION RESULTING FROM ACUTE OR CHRONIC INHALATION EXPOSURE TO PARTICULATE MATTER HAS BEEN WELL DOCUMENTED, BUT THE MECHANISMS DRIVING THE RESULTING DISTURBANCES REMAIN ELUSIVE. IN THE CURRENT REVIEW, WE AIM TO SUMMARIZE THE CELLULAR AND MOLECULAR MECHANISMS THAT ARE DIRECTLY LINKED TO CARDIOVASCULAR HEALTH FOLLOWING EXPOSURE TO A VARIETY OF INHALED TOXICANTS. THE PURPOSE OF THIS REVIEW IS TO PROVIDE A COMPREHENSIVE OVERVIEW OF THE BIOCHEMICAL CHANGES IN THE CARDIOVASCULAR SYSTEM FOLLOWING PARTICLE INHALATION EXPOSURE AND TO HIGHLIGHT POTENTIAL BIOMARKERS THAT EXIST ACROSS MULTIPLE EXPOSURE PARADIGMS. WE ATTEMPT TO INTEGRATE THESE MOLECULAR SIGNATURES IN AN EFFORT TO PROVIDE DIRECTION FOR FUTURE INVESTIGATIONS. THIS REVIEW ALSO CHARACTERIZES HOW MOLECULAR RESPONSES ARE MODIFIED IN AT-RISK POPULATIONS, SPECIFICALLY THE IMPACT OF ENVIRONMENTAL EXPOSURE DURING CRITICAL WINDOWS OF DEVELOPMENT. MATERNAL EXPOSURE TO PARTICULATE MATTER DURING GESTATION CAN LEAD TO FETAL EPIGENETIC REPROGRAMMING, RESULTING IN LONG-TERM DEFICITS TO THE CARDIOVASCULAR SYSTEM. IN BOTH DIRECT AND INDIRECT (GESTATIONAL) EXPOSURES, CONNECTING THE BIOCHEMICAL MECHANISMS WITH FUNCTIONAL DEFICITS OUTLINES PATHWAYS THAT CAN BE TARGETED FOR FUTURE THERAPEUTIC INTERVENTION. ULTIMATELY, FUTURE INVESTIGATIONS INTEGRATING "OMICS"-BASED APPROACHES WILL BETTER ELUCIDATE THE MECHANISMS THAT ARE ALTERED BY XENOBIOTIC INHALATION EXPOSURE, IDENTIFY BIOMARKERS, AND GUIDE IN CLINICAL DECISION MAKING. 2020 18 4974 26 PATHOPHYSIOLOGICAL MECHANISMS LEADING TO MUSCLE LOSS IN CHRONIC KIDNEY DISEASE. LOSS OF MUSCLE PROTEINS IS A DELETERIOUS CONSEQUENCE OF CHRONIC KIDNEY DISEASE (CKD) THAT CAUSES A DECREASE IN MUSCLE STRENGTH AND FUNCTION, AND CAN LEAD TO A REDUCTION IN QUALITY OF LIFE AND INCREASED RISK OF MORBIDITY AND MORTALITY. THE EFFECTIVENESS OF CURRENT TREATMENT STRATEGIES IN PREVENTING OR REVERSING MUSCLE PROTEIN LOSSES IS LIMITED. THE LIMITATIONS LARGELY STEM FROM THE SYSTEMIC NATURE OF DISEASES SUCH AS CKD, WHICH STIMULATE SKELETAL MUSCLE PROTEIN DEGRADATION PATHWAYS WHILE SIMULTANEOUSLY ACTIVATING MECHANISMS THAT IMPAIR MUSCLE PROTEIN SYNTHESIS AND REPAIR. STIMULI THAT INITIATE MUSCLE PROTEIN LOSS INCLUDE METABOLIC ACIDOSIS, INSULIN AND IGF1 RESISTANCE, CHANGES IN HORMONES, CYTOKINES, INFLAMMATORY PROCESSES AND DECREASED APPETITE. A GROWING BODY OF EVIDENCE SUGGESTS THAT SIGNALLING MOLECULES SECRETED FROM MUSCLE CAN ENTER THE CIRCULATION AND SUBSEQUENTLY INTERACT WITH RECIPIENT ORGANS, INCLUDING THE KIDNEYS, WHILE CONVERSELY, PATHOLOGICAL EVENTS IN THE KIDNEY CAN ADVERSELY INFLUENCE PROTEIN METABOLISM IN SKELETAL MUSCLE, DEMONSTRATING THE EXISTENCE OF CROSSTALK BETWEEN KIDNEY AND MUSCLE. TOGETHER, THESE SIGNALS, WHETHER DIRECT OR INDIRECT, INDUCE CHANGES IN THE LEVELS OF REGULATORY AND EFFECTOR PROTEINS VIA ALTERATIONS IN MRNAS, MICRORNAS AND CHROMATIN EPIGENETIC RESPONSES. ADVANCES IN OUR UNDERSTANDING OF THE SIGNALS AND PROCESSES THAT MEDIATE MUSCLE LOSS IN CKD AND OTHER MUSCLE WASTING CONDITIONS WILL SUPPORT THE FUTURE DEVELOPMENT OF THERAPEUTIC STRATEGIES TO REDUCE MUSCLE LOSS. 2022 19 5647 36 SEX DIFFERENCES IN FETAL KIDNEY REPROGRAMMING: THE CASE IN THE RENIN-ANGIOTENSIN SYSTEM. DURING THE EARLY STAGES OF THE DEVELOPMENT OF THE LIVING MULTIORGAN SYSTEMS, GENOME MODIFICATIONS OTHER THAN SEQUENCE VARIATION OCCUR THAT GUIDE CELL DIFFERENTIATION AND ORGANOGENESIS. THESE MODIFICATIONS ARE KNOWN TO OPERATE AS A FETAL PROGRAMMING CODE DURING THIS PERIOD, AND RECENT RESEARCH INDICATES THAT THERE ARE SOME TISSUE-SPECIFIC CODES IN ORGANOGENESIS WHOSE EFFECTS MAY PERSIST AFTER BIRTH UNTIL ADULTHOOD. CONSEQUENTLY, THE EVENTS THAT DISRUPT THE PRE-ESTABLISHED EPIGENETIC PATTERN COULD INDUCE SHIFTS IN ORGAN PHYSIOLOGY, WITH IMPLICATIONS ON HEALTH FROM BIRTH OR LATER IN ADULT LIFE. CHRONIC KIDNEY DISEASE (CKD) IS ONE OF THE MAIN CAUSES OF MORTALITY WORLDWIDE; ITS ETIOLOGY IS MULTIFACTORIAL, BUT DIABETES, OBESITY, AND HYPERTENSION ARE THE MAIN CAUSES OF CKD IN ADULTS, ALTHOUGH THERE ARE OTHER RISK FACTORS THAT ARE MAINLY ASSOCIATED WITH AN INDIVIDUAL'S LIFESTYLE. RECENT STUDIES SUGGEST THAT FETAL REPROGRAMMING IN THE DEVELOPING KIDNEY COULD BE IMPLICATED IN THE SUSCEPTIBILITY TO KIDNEY DISEASE IN BOTH CHILDHOOD AND ADULTHOOD. SOME EPIGENETIC MODIFICATIONS, SUCH AS GENOME METHYLATION STATUS, DYSREGULATION OF MIRNA, AND HISTONE CODING ALTERATIONS IN GENES RELATED TO THE REGULATION OF THE RENIN-ANGIOTENSIN AXIS, A COMMON DENOMINATOR IN CKD, MAY HAVE ORIGINATED DURING FETAL DEVELOPMENT. THIS REVIEW FOCUSES ON EPIGENETIC CHANGES DURING NEPHROGENESIS AND THEIR REPERCUSSIONS ON KIDNEY HEALTH AND DISEASE. IN ADDITION, THE FOCUS IS ON THE INFLUENCE OF ENVIRONMENTAL FACTORS DURING PREGNANCY, SUCH AS MATERNAL METABOLIC DISEASES AND DIETARY AND METABOLIC CONDITIONS, AS WELL AS SOME SEX DIFFERENCES IN FETAL KIDNEY REPROGRAMMING DURING WHICH DYSREGULATION OF THE RENIN-ANGIOTENSIN SYSTEM IS INVOLVED. 2023 20 4542 29 MURINE MODELS OF SLEEP APNEA: FUNCTIONAL IMPLICATIONS OF ALTERED MACROPHAGE POLARITY AND EPIGENETIC MODIFICATIONS IN ADIPOSE AND VASCULAR TISSUES. OBSTRUCTIVE SLEEP APNEA (OSA) IS A HIGHLY PREVALENT DISEASE ACROSS THE LIFESPAN, IS CHARACTERIZED BY CHRONIC INTERMITTENT HYPOXIA AND SLEEP FRAGMENTATION, AND HAS BEEN INDEPENDENTLY ASSOCIATED WITH SUBSTANTIAL CARDIOMETABOLIC MORBIDITY. HOWEVER, THE REVERSIBILITY OF END-ORGAN MORBIDITY WITH TREATMENT IS NOT ALWAYS APPARENT, SUGGESTING THAT BOTH TISSUE REMODELING AND EPIGENETIC MECHANISMS MAY BE OPERATIONALLY INVOLVED. HERE, WE REVIEW THE CUMULATIVE EVIDENCE FOCUSED AROUND MURINE MODELS OF OSA TO ILLUSTRATE THE TEMPORAL DEPENDENCIES OF CARDIOMETABOLIC DYSFUNCTION AND ITS REVERSIBILITY, AND MORE PARTICULARLY TO DISCUSS THE CRITICAL CONTRIBUTIONS OF TISSUE MACROPHAGES TO ADIPOSE TISSUE INSULIN RESISTANCE AND VASCULAR ATHEROGENESIS. IN ADDITION, WE DESCRIBE INITIAL FINDINGS POTENTIALLY IMPLICATING EPIGENETIC ALTERATIONS IN BOTH THE EMERGENCE OF THE CARDIOMETABOLIC MORBIDITY OF OSA, AND IN ITS REVERSIBILITY WITH TREATMENT. WE ANTICIPATE THAT IMPROVED UNDERSTANDING OF MACROPHAGE BIOLOGY AND EPIGENETICS IN THE CONTEXT OF INTERMITTENT HYPOXIA AND SLEEP FRAGMENTATION WILL LEAD TO DISCOVERY OF NOVEL THERAPEUTIC TARGETS AND IMPROVED CARDIOVASCULAR AND METABOLIC OUTCOMES IN OSA. 2018