1 5260 157 PROGRESSIVE OSSEOUS HETEROPLASIA, AS AN ISOLATED ENTITY OR OVERLAPPING WITH ALBRIGHT HEREDITARY OSTEODYSTROPHY. INTRODUCTION: PROGRESSIVE OSSEOUS HETEROPLASIA (POH) IS A CONDITION OF INVASIVE HETEROTOPIC OSSIFICATION. REPORTS OF PATIENTS WITH MILD POH WITH ALBRIGHT HEREDITARY OSTEODYSTROPHY (AHO), SPECIFICALLY PSEUDOHYPOPARATHYROIDISM TYPE IA (PHP IA) WITH HORMONAL RESISTANCE, SUGGEST THE POSSIBILITY OF A COMMON MOLECULAR BASIS. GNAS HAS BEEN IMPLICATED TO ACCOUNT FOR OVERLAPPING FEATURES OF POH AND PHP IA. CASE 1: A 4-YEAR-OLD BOY WITH OBESITY, SPEECH DELAY, AND EXPANDING SUBCUTANEOUS MASSES ON BUTTOCK/FOREARM. PHYSICAL EXAM REVEALED ROUND FACIES AND BRACHYDACTYLY. BLOOD TESTS SHOWED NORMAL CA, P, MG, 25-OH VITAMIN D LEVELS BUT ELEVATED PARATHYROID HORMONE (PTH) AND THYROID-STIMULATING HORMONE (TSH). ABDOMINAL COMPUTED TOMOGRAPHY (CT) SHOWED AREAS WITH CALCIFICATIONS IN THE SUBCUTANEOUS TISSUE, FAT, AND MUSCLE. PATHOLOGY OF EXCISED TISSUE REVEALED OSSIFICATIONS. GENOMIC STUDY REVEALED NO GNAS MUTATION. HE HAD POH AND PHP IA. CASE 2: A 3-YEAR-OLD BOY WITH PAINFUL OSSIFICATIONS IN THE LEFT LOWER EXTREMITY. LAB TESTS WERE NOTABLE FOR ELEVATED PTH AND HIGH-NORMAL TSH. THE CT-SCAN SHOWED SUBCUTANEOUS/INTRAMUSCULAR CALCIFICATIONS. GENETIC TESTING SHOWED GNAS MUTATION IN EXON 12 [C.1024C>T (R342X)]. PATIENT HAD POH AND PHP IA. CASE 3: A 9-YEAR-OLD BOY WITH KNEE PAIN AND SUBCUTANEOUS OSSIFICATIONS IN BACK AND UPPER/LOWER EXTREMITY, CAUSING SIGNIFICANTLY LIMITED JOINT MOBILITY. LAB TESTS WERE NORMAL. THE CT-SCAN SHOWED AREAS CORRESPONDING TO SUBCUTANEOUS/INTRAMUSCULAR OSSIFICATIONS THROUGHOUT TORSO AND EXTREMITIES, CONSISTENT WITH POH. THERE WAS NO GNAS MUTATION. CONCLUSIONS: PATIENTS WITH HETEROTOPIC OSSIFICATIONS PRESENT WITH A WIDE SPECTRUM OF DISEASE. ALTHOUGH GNAS-BASED MUTATIONS HAVE BEEN POSTULATED TO ACCOUNT FOR OVERLAPPING FEATURES OF AHO AND POH, NORMAL DNA STUDIES IN CERTAIN PATIENTS WITH POH/AHO SUGGEST THAT THERE MAY EXIST OTHER MOLECULAR/EPIGENETIC MECHANISMS EXPLAINING THEIR OVERLAPPING FEATURES. 2015 2 4706 25 NMP4/CIZ CLOSES THE PARATHYROID HORMONE ANABOLIC WINDOW. CHRONIC DEGENERATIVE DISEASES ARE INCREASING WITH THE AGING U.S. POPULATION. ONE CONSEQUENCE OF THIS PHENOMENON IS THE NEED FOR LONG-TERM OSTEOPOROSIS THERAPIES. PARATHYROID HORMONE (PTH), THE ONLY FDA-APPROVED TREATMENT THAT ADDS BONE TO THE AGED SKELETON, LOSES ITS POTENCY WITHIN TWO YEARS OF INITIAL TREATMENT BUT THE MECHANISM REGULATING ITS LIMITED "ANABOLIC WINDOW" IS UNKNOWN. WE HAVE DISCOVERED THAT DISABLING THE NUCLEOCYTOPLASMIC SHUTTLING TRANSCRIPTION FACTOR NUCLEAR MATRIX PROTEIN 4/CAS INTERACTING ZINC FINGER PROTEIN (NMP4/CIZ) IN MICE EXTENDS THE PTH BONE-FORMING CAPACITY. NMP4 WAS DISCOVERED DURING OUR SEARCH FOR NUCLEAR MATRIX TRANSCRIPTION FACTORS THAT COUPLE THIS HORMONE'S IMPACT ON OSTEOBLAST CYTOSKELETAL AND NUCLEAR ORGANIZATION WITH ITS ANABOLIC CAPACITY. CIZ WAS INDEPENDENTLY DISCOVERED AS A PROTEIN THAT ASSOCIATES WITH THE FOCAL ADHESION-ASSOCIATED MECHANOSENSOR P130CAS. THE NMP4/CIZ-KNOCKOUT (KO) SKELETAL PHENOTYPE EXHIBITS A MODESTLY ENHANCED BONE MINERAL DENSITY BUT MANIFESTS AN EXAGGERATED RESPONSE TO BOTH PTH AND TO BMP2 AND IS RESISTANT TO DISUSE-INDUCED BONE LOSS. THE CELLULAR BASIS OF THE GLOBAL NMP4/CIZ-KO SKELETAL PHENOTYPE REMAINS TO BE ELUCIDATED BUT MAY INVOLVE AN EXPANSION OF THE BONE MARROW OSTEOPROGENITOR POPULATION ALONG WITH MODESTLY ENHANCED OSTEOBLAST AND OSTEOCLAST ACTIVITIES SUPPORTING ANABOLIC BONE TURNOVER. AS A SHUTTLING CYS(2)HIS(2) ZINC FINGER PROTEIN, NMP4/CIZ ACTS AS A REPRESSIVE TRANSCRIPTION FACTOR PERHAPS ASSOCIATED WITH EPIGENETIC REMODELING COMPLEXES, BUT THE FUNCTIONAL SIGNIFICANCE OF ITS INTERACTION WITH P130CAS IS NOT KNOWN. DESPITE NUMEROUS REMAINING QUESTIONS, NMP4/CIZ PROVIDES INSIGHTS INTO HOW THE ANABOLIC WINDOW IS REGULATED, AND ITSELF MAY PROVIDE AN ADJUVANT THERAPY TARGET FOR THE TREATMENT OF OSTEOPOROSIS BY EXTENDING PTH ANABOLIC EFFICACY. 2012 3 2761 23 EXPRESSION OF TESTIS-SPECIFIC GENES, TEX101 AND ODF4, IN CHRONIC MYELOID LEUKEMIA AND EVALUATION OF TEX101 IMMUNOGENICITY. BACKGROUND AND OBJECTIVES: CANCER-TESTIS (CT) ANTIGENS ARE A GROUP OF ANTIGENS WITH A RESTRICTED EXPRESSION IN NORMAL TISSUES, EXCEPT TESTIS, AND THEY HAVE ABERRANT EXPRESSION IN DIFFERENT TUMORS. THIS PATTERN OF EXPRESSION HAS MADE THEM PROMISING TARGETS FOR IMMUNOTHERAPY AND CANCER DETECTION. OUR AIM WAS TO FIND NEW MEMBERS OF THIS GROUP THAT MIGHT BE USEFUL AS MARKERS IN THE DETECTION OF CANCER AND IMMUNOTHERAPY. DESIGN AND SETTING: A DESCRIPTIVE STUDY CONDUCTED IN REFERRAL CENTERS OF TEHRAN UNIVERSITY OF MEDICAL SCIENCE FROM JANUARY 2008 TO JANUARY 2009. PATIENTS AND METHODS: WE ANALYZED THE EXPRESSION OF TWO TESTIS-SPECIFIC GENES NAMED ODF4 (OUTER DENSE FIBER OF SPERM TAILS 4) AND TEX101 (TESTIS EXPRESSED 101) IN 20 CHRONIC MYELOID LEUKEMIA (CML) AND 20 NORMAL SAMPLES BY REVERSE TRANSCRIPTION-POLYMERASE CHAIN REACTION AND SEQUENCING. IMMUNOGENICITY OF TEX101 WAS EVALUATED BY MEANS OF ENZYME-LINKED IMMUNOSORBENT ASSAY. RESULTS: THESE TWO GENES WERE EXPRESSED IN 30% OF CML PATIENTS BUT NOT IN ANY OF THE HEALTHY DONORS. HUMORAL RESPONSE AGAINST TEX101 WAS NOT DETECTED IN ANY SAMPLES. CONCLUSIONS: TEX101 AND ODF4 ARE CT GENES USEFUL FOR DETECTION OF CML. UNLIKE MANY CT GENES, OVEREXPRESSION OF TEX101 WAS NOT SHOWN TO INDUCE IMMUNOLOGIC RESPONSES IN THESE SAMPLES. ACCORDING TO THE PREVIOUS STUDIES, OVEREXPRESSION OF TEX101 LEADS TO SUPPRESSION OF CANCER INVASION AND METASTASIS; THUS, THE INDUCTION OF THE EXPRESSION OF TEX101 IN CANCER BY EPIGENETIC MECHANISMS MAY BE A TREATMENT STRATEGY. 2012 4 6835 21 [INFLUENCE OF AGE OF PATIENTS WITH BRONCHOPULMONARY PATHOLOGY ON LOW-MOLECULAR DNA CONCENTRATION IN BLOOD PLASMA.]. THE AIM OF THE WORK WAS TO DETERMINE THE CONCENTRATION OF LOW-MOLECULAR-WEIGHT PLASMA DNA (LMDNA) IN PATIENTS WITH COPD AND CHRONIC NON-OBSTRUCTIVE BRONCHITIS (CNONB) OF TWO AGE GROUPS - 34-59 AND 60-80 YEARS. THE LEVELS OF LMDNA IN HEALTHY DONORS, PATIENTS WITH CNONB, HEALTHY RELATIVES OF PATIENTS WITH COPD DID NOT DIFFER, WHILE THE CONCENTRATION OF LMDNA IN PATIENTS WITH COPD WAS SIGNIFICANTLY LOWER. IN COPD PATIENTS AGED 34-59 YEARS, THE LEVEL OF LMDNA WAS REDUCED BY MORE THAN 7 TIMES, AND IN COPD PATIENTS WHO SURVIVED TO 60-80 YEARS, IT WAS 3 TIMES LOWER COMPARED TO THE VALUE OF THIS BIOCHEMICAL INDICATOR IN HEALTHY DONORS OF THE SAME AGE. THE REDUCTION OF LMDNA REFLECTED A REDUCED SYSTEMIC APOPTOTIC ACTIVITY IN THE BODY OF PATIENTS WITH COPD. A SIGNIFICANT DIFFERENCE IN THE CONCENTRATION OF LMDNA IN PATIENTS WITH COPD AND CNONB IN REMISSION CAN BE USED FOR DIFFERENTIAL DIAGNOSIS OF THE DEVELOPMENT OF THESE PATHOLOGICAL PROCESSES. AN INCREASE IN THE LOW LEVEL OF LMDNA IN COPD PATIENTS DURING AGING MAY INDICATE THE INVOLVEMENT OF EPIGENETIC MECHANISMS IN LIFE EXTENSION. 2022 5 6603 23 TWO SISTERS WITH FAMILIAL MEDITERRANEAN FEVER: LACK OF CORRELATION BETWEEN GENOTYPE AND PHENOTYPE? FAMILIAL MEDITERRANEAN FEVER (FMF) IS AN AUTOSOMAL RECESSIVE DISORDER CHARACTERIZED BY ATTACKS OF FEVER AND SEROSITIS. THE MOST IMPORTANT COMPLICATION OF FMF IS RENAL AMYLOIDOSIS, WHICH DETERMINES THE PROGNOSIS. THE GENE CODING THE DISEASE (MEFV) IS IDENTIFIED ON THE 16TH CHROMOSOME. THE MOST COMMON MEFV MUTATIONS ARE M694V, M680I, V726A AND M694I LOCATED ON EXON 10 AND E148Q LOCATED ON EXON 2. UNFORTUNATELY, GENOTYPE-PHENOTYPE CORRELATION IS NOT WELL ESTABLISHED AND THERE ARE UNEXPLAINED ETHNIC DIFFERENCES IN AMYLOIDOSIS RATES. WE REPORT TWO SISTERS WITH A COMMON GENOTYPE (M694V/M694V) PRESENTING WITH DIFFERENT PHENOTYPIC CHARACTERISTICS: ONE COMPLAINING OF INTERMITTENT ABDOMINAL PAIN, ARTHRITIS AND FEVER, WHILE THE OTHER WAS SUFFERING FROM INTERMITTENT PLEURITIS AND FEVER DURING ATTACKS. THE OBSERVATION OF DIFFERENT PHENOTYPIC PRESENTATIONS WITH A COMMON GENOTYPE IN TWO FAMILY MEMBERS SHOWS THAT DIFFERENT PHENOTYPES CANNOT BE EXPLAINED BY PARTICULAR MUTATIONS. TO UNDERSTAND THE CORRELATION BETWEEN GENOTYPIC AND PHENOTYPIC FMF VARIANTS THE EXISTENCE OF COMPLEX ALLELES, MODIFIER LOCI, GENETIC HETEROGENEITY AND POSSIBLE EPIGENETIC FACTORS SHOULD BE STUDIED EXTENSIVELY. 2006 6 2696 25 EWING SARCOMA. EWING SARCOMA IS THE SECOND MOST FREQUENT BONE TUMOUR OF CHILDHOOD AND ADOLESCENCE THAT CAN ALSO ARISE IN SOFT TISSUE. EWING SARCOMA IS A HIGHLY AGGRESSIVE CANCER, WITH A SURVIVAL OF 70-80% FOR PATIENTS WITH STANDARD-RISK AND LOCALIZED DISEASE AND ~30% FOR THOSE WITH METASTATIC DISEASE. TREATMENT COMPRISES LOCAL SURGERY, RADIOTHERAPY AND POLYCHEMOTHERAPY, WHICH ARE ASSOCIATED WITH ACUTE AND CHRONIC ADVERSE EFFECTS THAT MAY COMPROMISE QUALITY OF LIFE IN SURVIVORS. HISTOLOGICALLY, EWING SARCOMAS ARE COMPOSED OF SMALL ROUND CELLS EXPRESSING HIGH LEVELS OF CD99. GENETICALLY, THEY ARE CHARACTERIZED BY BALANCED CHROMOSOMAL TRANSLOCATIONS IN WHICH A MEMBER OF THE FET GENE FAMILY IS FUSED WITH AN ETS TRANSCRIPTION FACTOR, WITH THE MOST COMMON FUSION BEING EWSR1-FLI1 (85% OF CASES). EWING SARCOMA BREAKPOINT REGION 1 PROTEIN (EWSR1)-FRIEND LEUKAEMIA INTEGRATION 1 TRANSCRIPTION FACTOR (FLI1) IS A TUMOUR-SPECIFIC CHIMERIC TRANSCRIPTION FACTOR (EWSR1-FLI1) WITH NEOMORPHIC EFFECTS THAT MASSIVELY REWIRES THE TRANSCRIPTOME. ADDITIONALLY, EWSR1-FLI1 REPROGRAMMES THE EPIGENOME BY INDUCING DE NOVO ENHANCERS AT GGAA MICROSATELLITES AND BY ALTERING THE STATE OF GENE REGULATORY ELEMENTS, CREATING A UNIQUE EPIGENETIC SIGNATURE. ADDITIONAL MUTATIONS AT DIAGNOSIS ARE RARE AND MAINLY INVOLVE STAG2, TP53 AND CDKN2A DELETIONS. EMERGING STUDIES ON THE MOLECULAR MECHANISMS OF EWING SARCOMA HOLD PROMISE FOR IMPROVEMENTS IN EARLY DETECTION, DISEASE MONITORING, LOWER TREATMENT-RELATED TOXICITY, OVERALL SURVIVAL AND QUALITY OF LIFE. 2018 7 2896 24 GASTRIC ENTEROCHROMAFFIN-LIKE CELL HYPERPLASIA AND NEOPLASIA IN THE RAT: AN INDIRECT EFFECT OF THE HISTAMINE H2-RECEPTOR ANTAGONIST, BL-6341. ORAL ADMINISTRATION OF BL-6341 HYDROCHLORIDE, A LONG-ACTING HISTAMINE H2-RECEPTOR ANTAGONIST, TO RATS FOR 2 YEARS AT DOSES OF 10, 55 OR 300 MG/KG/DAY RESULTED IN SEVERAL CHANGES IN THE FUNDIC (OXYNTIC) MUCOSA OF THE GLANDULAR STOMACH. THE MOST SIGNIFICANT ALTERATION WAS A PROLIFERATION OF ARGYROPHIL ENDOCRINE CELLS THAT WAS DEMONSTRATED TO BE ENTEROCHROMAFFIN-LIKE (ECL) CELLS. THE ECL CELL PROLIFERATION CONSISTED OF A CONTINUUM OF CHANGES INVOLVING DIFFUSE HYPERPLASIA, FOCAL ADENOMATOUS HYPERPLASIA, AND CARCINOID TUMOR FORMATION AT THE HIGHEST DOSE LEVEL OF 300 MG/KG. AT 55 MG/KG ONLY ECL CELL HYPERPLASIA OCCURRED, AND AT THE LOW DOSE OF 10 MG/KG THERE WERE NO REMARKABLE PROLIFERATIVE CHANGES. THE REFERENCE COMPOUND, CIMETIDINE (950 MG/KG), PRODUCED A DEGREE OF ECL CELL PROLIFERATION THAT WAS SLIGHTLY LESS, BUT NOT SIGNIFICANTLY DIFFERENT THAN, THAT OBSERVED WITH 55 MG/KG OF BL-6341. DOSE-RELATED ELEVATIONS OF SERUM GASTRIN WERE OBSERVED WITH BL-6341, WHILE CIMETIDINE PRODUCED HYPERGASTRINEMIA THAT WAS GENERALLY INTERMEDIATE BETWEEN THAT PRODUCED BY THE MIDDLE AND LOW DOSES OF BL-6341. THE HYPERGASTRINEMIA RESULTED FROM THE PHARMACOLOGIC INHIBITION OF ACID SECRETION, WHICH IS THE NEGATIVE FEEDBACK MECHANISM CONTROLLING THE PRODUCTION OF GASTRIN. ONLY THE 300 MG/KG DOSE OF BL-6341 PRODUCED A SIGNIFICANT, SUSTAINED (24 HOURS) HYPERGASTRINEMIA AND CARCINOID TUMORS. THE CHRONIC, SUSTAINED HYPERGASTRINEMIA WAS CONSIDERED TO BE THE PRIMARY CAUSE OF THE ECL CELL CARCINOID NEOPLASIA. ALL GENETIC TOXICOLOGY TESTS PERFORMED WITH BL-6341 WERE NEGATIVE. IT WAS CONCLUDED THAT THE DEMONSTRATED HYPERGASTRINEMIA REPRESENTS AN INDIRECT, HORMONAL, EPIGENETIC MECHANISM OF TUMORIGENESIS. 1988 8 645 20 BIRTH DEFECTS IN GAZA: PREVALENCE, TYPES, FAMILIARITY AND CORRELATION WITH ENVIRONMENTAL FACTORS. THIS IS THE FIRST REPORT OF REGISTRATION AT BIRTH, AND OF INCIDENCE OF MAJOR STRUCTURAL BIRTH DEFECTS (BD) OBTAINED IN GAZA AT AL SHIFA HOSPITAL, WHERE 28% OF TOTAL BIRTHS IN GAZA STRIP OCCUR. DOCTORS REGISTERED 4,027 DELIVERIES, WITH A PROTOCOL COMPREHENSIVE OF CLINICAL, DEMOGRAPHIC, KIN AND ENVIRONMENTAL QUESTIONS. PREVALENCE OF BD IS 14/1,000, WITHOUT ASSOCIATION WITH INTERMARRIAGE OR GENDER OF THE CHILD. PREVALENCE OF LATE MISCARRIAGES AND STILL BIRTHS ARE RESPECTIVELY 23.3/1,000 AND 7.4/1,000, AND OF PREMATURE BIRTHS 19.6/1,000. COUPLES WITH A BD CHILD HAVE ABOUT 10 TIMES HIGHER FREQUENCY OF RECURRENCE OF A BD IN THEIR PROGENY THAN THOSE WITH NORMAL CHILDREN, BUT NONE OF THEIR 694 SIBLINGS AND ONLY 10/1,000 OF THEIR 1,423 PROGENY HAD BD, SIMILAR TO THE FREQUENCY IN GENERAL POPULATION. THESE DATA SUGGEST OCCURRENCE OF NOVEL GENETIC AND EPIGENETIC EVENTS IN DETERMINATION OF BD. CHILDREN WITH BD WERE BORN WITH HIGHER FREQUENCY (P < 0 001) IN FAMILIES WHERE ONE OR BOTH PARENTS WERE UNDER "WHITE PHOSPHORUS" ATTACK, THAT IN THE GENERAL POPULATION. BOMBING OF THE FAMILY HOME AND REMOVAL OF THE RUBBLE WERE ALSO FREQUENTLY REPORTED BY COUPLES WITH BD OCCURRENCE. THESE DATA SUGGESTS A CAUSATIVE/FAVORING ROLE OF ACUTE EXPOSURE OF PARENTS TO THE WEAPONS-ASSOCIATED CONTAMINANTS, AND/OR OF THEIR CHRONIC EXPOSURE FROM THEIR PERSISTENCE IN THE ENVIRONMENT ON THE EMBRYONIC DEVELOPMENT OF THEIR CHILDREN. 2012 9 2974 23 GENETIC AND METHYLATION STATUS OF CDKN2A (P14(ARF)/P16(INK4A)) AND TP53 GENES IN RECURRENT RESPIRATORY PAPILLOMATOSIS. RECURRENT RESPIRATORY PAPILLOMATOSIS (RRP) IS A RARE AND CHRONIC DISEASE AFFECTING THE UPPER AIRWAY WITH PAPILLOMATOUS LESIONS CAUSED BY THE HUMAN PAPILLOMAVIRUS (HPV) INFECTION, ESPECIALLY HPV-6 AND/OR HPV-11 TYPES. LITTLE IS KNOWN ABOUT THE GENETIC AND EPIGENETIC DRIVERS IN RRP PATHOPHYSIOLOGY. FOR THIS PURPOSE, WE ANALYZED 27 PAPILLOMATOUS LESIONS FROM PATIENTS WITH RRP TO EVALUATE SOMATIC MUTATIONS AND METHYLATION STATUS IN CDKN2A (P14(ARF)/P16(INK4A)) AND TP53, WHICH ARE KEY TUMOR SUPPRESSOR GENES FOR THE CELL CYCLE CONTROL. SANGER SEQUENCING ANALYSIS REVEALED ONE SOMATIC MUTATION IN TP53 (C.733_734INSA) AND FOUR MUTATIONS IN CDKN2A (C.-30G > T, C.29_30INSA, C.69DELT, AND C.300C > A). THESE MUTATIONS WERE OBSERVED IN 10 PATIENTS, 6 OF WHICH CARRIED DOUBLE MUTATION. FURTHERMORE, 50% (5/10) OF THESE PATIENTS CARRYING SOMATIC MUTATIONS HAD RRP SEVERITY, REPRESENTING 62.5% (5/8) OF THE SEVERITY CASES IN THIS STUDY, ALBEIT NO SIGNIFICANT ASSOCIATION WAS FOUND BETWEEN SOMATIC MUTATIONS AND DISEASE SEVERITY. METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION ASSAYS REVEALED P14(ARF) PROMOTER HYPERMETHYLATION IN 100% OF CASES, FOLLOWED BY TP53 (96.3%) AND P16(INK4A) (55.6%), SUGGESTING THE INFLUENCE OF HPV IN THE DNA METHYLATION MACHINERY. IN CONCLUSION, SOMATIC MUTATIONS WERE NOT COMMON EVENTS IDENTIFIED IN PATIENTS WITH RRP. HOWEVER, EPIGENETIC MODULATION BY HIGH METHYLATION RATES, PARTICULARLY FOR THE P14(ARF)/TP53 PATHWAY, SEEMS TO BE IN THE COURSE OF RRP DEVELOPMENT. 2022 10 6636 41 UNRAVELING A NEW PLAYER IN MULTIPLE SCLEROSIS PATHOGENESIS: THE RNA-BINDING PROTEIN HUR. BACKGROUND: ELAV-LIKE PROTEINS ARE A SMALL FAMILY OF RNA-BINDING PROTEINS THAT ARE FUNDAMENTAL PLAYERS IN POST-TRANSCRIPTIONAL MECHANISMS AND ARE INVOLVED IN THE PATHOGENESIS OF NEUROLOGIC AND PSYCHIATRIC DISORDERS. HUR, THE UBIQUITOUSLY EXPRESSED MEMBER OF THE FAMILY, IS ALSO IMPLICATED IN SUSTAINING INFLAMMATION AND INFLAMMATORY DISEASES, SUPPORTING THE PRODUCTION OF PRO-INFLAMMATORY CYTOKINES. INFLAMMATION PLAYS A CENTRAL ROLE IN MULTIPLE SCLEROSIS (MS), WHICH REPRESENTS THE MOST COMMON CAUSE OF PERMANENT PHYSICAL DISABILITY IN YOUNG ADULTS. MS IS A CHRONIC AUTOIMMUNE DISEASE AFFECTING THE CENTRAL NERVOUS SYSTEM, WITH A COMPLEX AETIOLOGY INVOLVING GENETIC, ENVIRONMENTAL AND EPIGENETIC FACTORS. NO DATA ARE AVAILABLE ON THE POTENTIAL ENTANGLEMENT OF HUR IN MS PATHOGENESIS IN PATIENTS. IN THE PRESENT WORK, WE AIMED AT EXPLORING HUR PROTEIN LEVELS IN PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMCS) FROM MS PATIENTS, COMPARED TO HEALTHY CONTROLS. TO FURTHER ELUCIDATE THE POSSIBLE INVOLVEMENT OF HUR IN MS, WE ALSO INVESTIGATED THE RELATIONSHIP BETWEEN THIS SPECIFIC RNA-BINDING PROTEIN AND HSP70-2 PROTEIN, ALSO CONSIDERING THE HSP70-2 RS1061581 POLYMORPHISM, GIVEN THAT HSP70-2 MRNA HAS BEEN REPORTED AS A HUR TARGET AND THIS SPECIFIC POLYMORPHISM TO BE ASSOCIATED WITH MS RISK. METHODS: ALLELES AND GENOTYPES FOR HSP70-2 RS1061581 POLYMORPHISM WERE ASSESSED, BY USING A POLYMERASE CHAIN REACTION-RESTRICTION FRAGMENT LENGTH POLYMORPHISM, FOLLOWED BY DIGESTION WITH RESTRICTION ENZYME, IN MS PATIENTS AND HEALTHY CONTROLS. PBMCS FROM A SUBGROUP OF PATIENTS AND CONTROLS WERE USED TO EVALUATE HUR AND HSP70-2 PROTEIN CONTENT BY WESTERN BLOT. RESULTS: PBMCS FROM 52 MS PATIENTS HAD A LOWER HUR AND HIGHER HSP70-2 PROTEIN CONTENT COMPARED TO 43 HEALTHY CONTROLS. AN INCREASE OF 100 UNITS OF HUR SIGNIFICANTLY DECREASED THE RISK OF DEVELOPING MS BY 9.8% (OR: 0.902, 95% CI: 0.83-0.98), CONTROLLING FOR HSP70-2 PROTEIN EXPRESSION, HSP70-2 RS1061581 GENOTYPE, AGE AND SEX. MOREOVER, HOLDING HUR LEVELS, AN INCREASE OF 100 UNITS OF HSP70-2 PROTEIN SIGNIFICANTLY INCREASED THE MS RISK BY 18.1% (OR: 1.181, 95% CI: 1.03-1.36) AND THE GENETIC SUSCEPTIBILITY OF DEVELOPING MS FOR HSP70-2 RS1061581 GG CARRIERS IS CONFIRMED. OF INTEREST, MS PATIENTS WITH A MODERATE TO SEVERE FORM OF MS (MSSS >/= 3) SHOWED A TREND TOWARDS A REDUCTION OF HUR PROTEIN LEVELS COMPARED TO PATIENTS WITH MILD DISEASE SEVERITY (MSSS < 3). CONCLUSIONS: HUR PROTEIN LEVELS ARE REDUCED IN MS PATIENTS COMPARED TO HEALTHY SUBJECTS, AND THE PROTEIN AMOUNT MAY CONTINUE TO DECLINE WITH DISEASE PROGRESSION, SUGGESTING A PUTATIVE ROLE OF THIS RNA-BINDING PROTEIN. MOREOVER, OUR RESULTS SUGGEST THAT MS PATHOLOGY MAY HAVE DISRUPTED THE LINK BETWEEN HUR AND ITS TARGET TRANSCRIPT HSP70-2. IT WILL BE IMPORTANT TO FURTHER EXPLORE THE EXACT ROLE OF HUR IN MS, CONSIDERING THE COMPLEX INTERPLAY WITH OTHER RNA-BINDING FACTORS AND TARGET MRNAS. 2020 11 820 31 CHARACTERIZATION OF A PORTUGUESE FAMILY WITH CHARCOT-MARIE-TOOTH DISEASE TYPE 1E DUE TO A NOVEL POINT MUTATION IN THE PMP22 GENE. INTRODUCTION: POINT MUTATIONS IN THE PERIPHERAL MYELIN PROTEIN 22 (PMP22) GENE COMPRISE LESS THAN 5% OF THE CHARCOT-MARIE-TOOTH (CMT) TYPE 1 CASES, AND INDIVIDUALIZE EITHER THE CMT 1E SUBTYPE, OR HEREDITARY NEUROPATHY WITH LIABILITY TO PRESSURE PALSY. THE PHENOTYPE OF CMT 1E PRESENTS WITH A SEVERE EARLY-ONSET POLYNEUROPATHY ASSOCIATED WITH DEAFNESS, ALTHOUGH THE CLINICAL SPECTRUM IS BROAD. CASE REPORT: WE DESCRIBE A NOVEL PMP22 GENE POINT MUTATION (C.84G>T;P.(TRP28CYS)) IN THREE PATIENTS OF A PORTUGUESE FAMILY WITH VARIABLE PHENOTYPES, RANGING FROM ASYMPTOMATIC TO MILD COMPLAINTS OF DISTAL LIMB NUMBNESS AND GAIT DIFFICULTIES, WITH THE AGE OF ONSET OF SYMPTOMS RANGING FROM MID-TWENTIES TO LATE-SIXTIES, AND NO ASSOCIATED DISABILITY. IN ALL AFFECTED PATIENTS, THERE WAS EVIDENCE OF DIFFUSE DEMYELINATING SENSORIMOTOR POLYNEUROPATHY. HEARING LOSS DOES NOT SEEM TO BE ASSOCIATED WITH THIS VARIANT, ALBEIT NEUROPATHIC PAIN WAS REPORTED. CONCLUSIONS: THESE FINDINGS SUGGEST THAT THIS PARTICULAR POINT MUTATION IN THE PMP22 GENE IS ASSOCIATED WITH A MILD PHENOTYPE, FURTHER EMPHASIZING THAT THERE ARE STILL UNKNOWN MECHANISMS (GENETIC AND/OR EPIGENETIC) THAT MAY PLAY A ROLE IN THE CLINICAL SPECTRUM OF CMT1E PATIENTS. NEXT GENERATION SEQUENCING PANELS INCLUDING COMMONLY MUTATED GENES IN CMT SHOULD BE CONSIDERED IN CMT1 CASES NEGATIVE FOR PMP22 GENE DUPLICATION. 2021 12 5356 23 REAC-INDUCED ENDOGENOUS BIOELECTRIC CURRENTS IN THE TREATMENT OF VENOUS ULCERS: A THREE-ARM RANDOMIZED CONTROLLED PROSPECTIVE STUDY. INTRODUCTION: ENDOGENOUS BIOELECTRIC FIELDS (EBFS) PLAY A FUNDAMENTAL ROLE IN PROMOTING REPAIR AND REGENERATION PROCESSES, INCLUDING IN LEG VENOUS ULCERS (LVUS). UNFORTUNATELY, THE MECHANISM UNDERLYING THE PRODUCTION OF EBFS IS EASILY ALTERED BY INFECTIOUS, TRAUMATIC, AND EPIGENETIC FACTORS. THIS ALTERATION IS ONE OF THE DETERMINING FACTORS FOR THE CHRONICITY OF LVUS. THIS STUDY INVESTIGATES HOW RADIOELECTRIC ASYMMETRIC CONVEYER (REAC) TECHNOLOGY TREATMENTS, SPECIFICALLY DESIGNED TO OPTIMIZE EBFS, AND IN PARTICULAR TISSUE OPTIMIZATION-REPARATIVE (TO-RPR) TREATMENT, CAN IMPROVE THE RESULTS OF STANDARD DRESSING WITH AND WITHOUT ELASTIC COMPRESSION IN LVU PATIENTS. METHODS: A TOTAL OF 30 PATIENTS WERE ENROLLED (12 MALES AND 18 FEMALES) AND RANDOMIZED INTO THREE GROUPS. ALL PATIENTS COMPLETED THE STUDY. GROUP A WAS TREATED WITH STANDARD DRESSING, ELASTIC COMPRESSION, AND REAC TO-RPR TREATMENT; GROUP B WAS TREATED WITH STANDARD DRESSING AND REAC TO-RPR TREATMENT; AND GROUP C WAS TREATED WITH STANDARD DRESSING AND ELASTIC COMPRESSION. RESULTS: THE RESULTS SHOW THAT THE COMBINATION OF REAC TREATMENT AND STANDARD DRESSING ASSOCIATED WITH ELASTIC COMPRESSION HAS THE GREATEST THERAPEUTIC EFFICACY IN PROMOTING THE HEALING PROCESS FOR ULCERS, REDUCING PERCEIVED PAIN, AND IMPROVING THE QUALITY OF LIFE OF THE PATIENTS TREATED. CONCLUSIONS: FURTHER STUDIES WILL BE USEFUL TO INVESTIGATE THESE PROSPECTIVE RESULTS. 2020 13 1448 29 DIPEPTIDYL PEPTIDASE-4 INHIBITION AND NARROW-BAND ULTRAVIOLET-B LIGHT IN PSORIASIS (DINUP): STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL. BACKGROUND: MODERATE TO SEVERE PSORIASIS IS A SYSTEMIC INFLAMMATORY DISEASE ASSOCIATED WITH INSULIN RESISTANCE, OBESITY AND TYPE 2 DIABETES (T2DM). SITAGLIPTIN IS A DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITOR THAT IMPROVES GLYCAEMIA AND HAS A MARKETING AUTHORISATION FOR THE TREATMENT OF T2DM. NON-IMMUNOSUPPRESSIVE THERAPIES THAT ARE EFFECTIVE FOR PSORIASIS AND ITS ASSOCIATED COMORBIDITIES WOULD BE A SIGNIFICANT ADVANCE IN THE TREATMENT OF THIS CHRONIC DISEASE. METHODS/DESIGN: THIS IS A SINGLE CENTRE, 39-WEEK, PROSPECTIVE, RANDOMISED, OPEN LABEL, CLINICAL TRIAL OF ORAL SITAGLIPTIN (JANUVIA((R))) IN PSORIASIS PATIENTS WHO ARE DUE TO UNDERGO A COURSE OF NARROW-BAND ULTRAVIOLET-B (NB-UVB) PHOTOTHERAPY. WE PLAN TO ENROL 120 PARTICIPANTS AND ALLOCATE PARTICIPANTS ON A RANDOM AND 1:1 BASIS TO RECEIVE SITAGLIPTIN 100 MG DAILY FOR 24 WEEKS COMBINED WITH NB-UVB OR NB-UVB MONOTHERAPY. PARTICIPANTS WILL BE FOLLOWED UP FOR 12 WEEKS AFTER SITAGLIPTIN THERAPY IS DISCONTINUED. THE PRIMARY ENDPOINT IS THE CHANGE IN PSORIASIS AREA AND SEVERITY INDEX (PASI) 24 WEEKS AFTER TREATMENT INITIATION. SECONDARY ENDPOINTS INCLUDE CUMULATIVE NB-UVB DOSE, NUMBER OF NB-UVB TREATMENTS REQUIRED TO CLEAR PSORIASIS, PROPORTIONS OF PARTICIPANTS WHO ACHIEVE PASI-50 (50 % REDUCTION IN PASI FROM BASELINE), PASI-75, PASI-90 AND THE PROPORTION OF PARTICIPANTS WHO RELAPSE IN EACH GROUP. WE WILL ALSO ANALYSE CHANGES IN CARDIOVASCULAR DISEASE RISK FACTORS, SERUM CYTOKINE AND HORMONE LEVELS AND PERIPHERAL BLOOD MONONUCLEAR EXPRESSION OF IMMUNE PROTEINS AT 24 AND 36 WEEKS. A SUBGROUP OF PARTICIPANTS WILL HAVE SKIN BIOPSIES TAKEN AND ANALYSED FOR SKIN LEVELS AND EXPRESSION OF IMMUNE CELLS, RECEPTORS, HORMONES AND IMMUNE PROTEINS. THE GENETIC OR EPIGENETIC PROFILE THAT PREDICTS BEST RESPONSE TO DPP-4 INHIBITOR THERAPY WILL BE ANALYSED. THE SAFETY ENDPOINTS INCLUDE THE RATE AND SEVERITY OF ADVERSE EVENTS. DISCUSSION: THIS IS THE FIRST RANDOMISED CLINICAL TRIAL ASSESSING DIPEPTIDYL PEPTIDASE-4 INHIBITION THERAPY IN PSORIASIS. WE HYPOTHESISE THAT SITAGLIPTIN THERAPY IN COMBINATION WITH NB-UVB IMPROVES PSORIASIS SEVERITY COMPARED TO NB-UVB MONOTHERAPY. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER NCT02347501 (DATE OF REGISTRATION: 27 JANUARY 2015). 2016 14 2877 17 FUNCTIONAL STATE OF NEUTROPHIC GRANULOCYTES' GENOME OF THE PERIPHERAL BLOOD IN PATIENTS WITH CHRONIC HEPATITIS C WITH CONCOMITANT DIABETES MELLITUS TYPE II. OBJECTIVE: THE AIM: TO DETERMINE CHANGES OF FSG OF NEUTROPHILIC GRANULOCYTES OF PERIPHERAL BLOOD (NGPB) OF PATIENTS WITH CHC WITH CONCOMITANT DM-2. PATIENTS AND METHODS: MATERIALS AND METHODS: WE'VE EXAMINED 180 PATIENTS WITH CHC: 160 WITH CONCOMITANT DIABETES MELLITUS AND 20 ONES WITHOUT IT. THE NGPB GENOME WAS STUDIED USING CYTOGENETIC METHOD. THERE WERE ANALYZED 100 INTERPHASE NGPB NUCLEI IN THE PREPARATION, STRUCTURAL CHARACTERISTICS WERE EVALUATED ACCORDING TO INDICES: CHROMATIZATION (IC), NUCLEOLAR (IN), PATHOLOGICALLY ALTERED NUCLEI (PAN), MICRONUCLEI (MNI). RESULTS: RESULTS: VIOLATIONS OF FSG OF NGPBWERE FOUND ACCORDING TO ALL INDICES IN PATIENTS WITH CHC, THEY WERE MORE PRONOUNCED IN PATIENTS WITH CONCOMITANT DM-2. CONCLUSION: CONCLUSIONS: FSG NGPB IS MORE DISORDERED IN CHC WITH CONCOMITANT DM-2. THE REDUCTION OF IC IN CHC WITH CONCOMITANT DM-2 IS MORE PRONOUNCED IN MEN. REDUCTION OF IN IN PATIENTS WITH CHC WITH AND WITHOUT DM-2 IS A MARKER OF VIOLATIONS OF THE SECOND STAGE OF REALIZATION OF HEREDITARY INFORMATION. THE TENDENCY TO CHANGE THE COMPONENTS OF THE CYTOGENETIC STATUS OF ALL EXAMINED PATIENTS DUE TO THE FREQUENCY OF MNI WAS DETERMINED. 2020 15 4986 34 PATIENT-REPORTED SYMPTOM OUTCOMES AND MICROSATELLITE INSTABILITY IN PATIENTS WITH METASTATIC COLORECTAL CANCER. BACKGROUND: THE SURVIVAL OF PATIENTS WITH METASTATIC COLORECTAL CANCER (MCRC) IS INFLUENCED BY THE GENETIC AND EPIGENETIC CHANGES THAT MIGHT INFLUENCE THE PATIENT EXPERIENCE OF SYMPTOM BURDEN. UNDERSTANDING THE ASSOCIATION OF MOLECULAR CHANGES WITH THE SYMPTOM BURDEN COULD HELP CLINICIANS GAIN INSIGHT INTO THE MOLECULAR BASIS OF SYMPTOM BURDEN AND IMPROVE TREATMENT TOLERANCE. TO DATE, NO STUDIES HAVE COMPARED THE PATIENT-REPORTED SYMPTOM BURDEN WITH THESE MOLECULAR SUBSETS AMONG PATIENTS WITH MCRC. PATIENTS AND METHODS: WE RECRUITED PATIENTS WITH MCRC THAT WAS REFRACTORY TO >/= 1 LINE OF THERAPY WHO HAD BEEN ENROLLED IN THE ASSESSMENT OF TARGETED THERAPIES AGAINST COLORECTAL CANCER TRIAL AT THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER. ALL PATIENTS COMPLETED A BASELINE GASTROINTESTINAL SYMPTOM INVENTORY (MD ANDERSON SYMPTOM INVENTORY, GASTROINTESTINAL). THE SYMPTOM BURDEN ACROSS KEY DEMOGRAPHIC VARIABLES AND MOLECULAR CHANGES, INCLUDING CRC-ASSOCIATED MUTATIONS, MICROSATELLITE INSTABILITY (MSI) STATUS, AND THE CPG ISLAND METHYLATOR PHENOTYPE (CIMP) WERE COMPARED USING CHI(2) TESTS. ASSOCIATION OF THE SYMPTOM BURDEN WITH OVERALL SURVIVAL WAS EXAMINED USING COX REGRESSION MODELS. RESULTS: PATIENTS WITH AN MSI-HIGH (MSI-H) PHENOTYPE REPORTED GREATER PAIN (ODDS RATIO [OR], 3.06; 95% CONFIDENCE INTERVAL [CI], 1.61-5.84), FATIGUE (OR, 2.78; 95% CI, 1.41-5.49), SLEEP (OR, 2.52; 95% CI, 1.32-4.08); AND DROWSINESS (OR, 2.51; 95% CI, 1.32-4.78) COMPARED WITH MICROSATELLITE STABLE PATIENTS. PATIENTS WITH AN MSI-H PHENOTYPE ALSO HAD GREATER ODDS OF OVERALL SYMPTOM BURDEN (OR, 2.48; 95% CI, 1.29-4.74) COMPARED WITH MICROSATELLITE STABLE PATIENTS. THE CIMP-HIGH PATIENTS EXPERIENCED GREATER ODDS OF PAIN COMPARED WITH THE CIMP-NEGATIVE PATIENTS (OR, 1.72; 95% CI, 1.06-2.80). A GREATER OVERALL SYMPTOM BURDEN WAS ASSOCIATED WITH POOR OVERALL SURVIVAL (HAZARD RATIO, 1.42; 95% CI, 0.98-2.06]), ALTHOUGH THE DIFFERENCE WAS NOT SIGNIFICANT (P = .06). CONCLUSION: CORRELATION OF MSI-H-ASSOCIATED TUMOR FEATURES WITH THE SYMPTOM BURDEN COULD HELP PROVIDE A BETTER UNDERSTANDING OF UNDERLYING MECHANISMS ASSOCIATED WITH OUR FINDINGS. 2020 16 6465 22 TISSUE REMODELING IN ADULT VERNAL KERATOCONJUNCTIVITIS. OUR AIM IS TO DESCRIBE LOCAL TISSUE REMODELING IN A COHORT OF ADULT VKC PATIENTS. MALE PATIENTS DIAGNOSED WITH ACTIVE VKC WERE ENROLLED IN AN OPEN PILOT STUDY INTO TWO GROUPS ACCORDING DISEASE ONSET: CHILDHOOD CLASSIC VKC AND ADULT VKC. VISUAL ACUITY AND OCULAR SURFACE CLINICAL EXAMINATION FOCUSING ON CHRONIC INFLAMMATORY SEQUELAE AND IMPRESSION CYTOLOGY WERE PERFORMED IN ALL ENROLLED SUBJECTS. CONJUNCTIVAL IMPRINTS WERE PROCESSED FOR MOLECULAR, BIOCHEMICAL AND IMMUNOFLUORESCENT ANALYSIS FOR TISSUE REMODELING (TGFBETA1,2,3 AND ALPHASMA) AND EPIGENETIC (DNMT3A, KEAP1; NRF2) MARKERS AS WELL AS ANDROGEN RECEPTORS WERE INVESTIGATED AND COMPARED BETWEEN GROUPS. CLINICAL ASSESSMENT SHOWED INCREASED CONJUNCTIVAL SCARRING IN ADULT VKC COMPARED TO CLASSIC VKC. IMMUNOREACTIVITY FOR ALPHASMA AND EXPRESSION OF TGFBETA WERE HIGHER IN ADULT VKC GROUP. SIGNIFICANTLY HIGHER LEVELS OF TGFBETA3 (3.44 +/- 1.66; P < 0.05) WERE DETECTED IN ADULT VKC COMPARED TO CHILDHOOD VKC, ASSOCIATED WITH AN INCREASING TREND OF TGFBETA1 (1.58 +/- 0.25) AND TGFBETA2 (1.65 +/- 0.20) ISOFORMS LEVELS. MOLECULAR ANALYSIS SHOWED A RELATIVE INCREASE IN TISSUE REMODELING/FIBROGENIC TRANSCRIPTS (TGFBETA ISOFORMS AND ALPHASMA) ASSOCIATED TO A SIGNIFICANT INCREASE OF SELECTIVE EPIGENETIC TARGETS (DNMT3, NRF2 AND KEAP1) IN ADULT VKC PHENOTYPE. INCREASED LOCAL CONJUNCTIVAL ANDROGEN RECEPTORS WAS DETECTED IN PATIENTS WITH ADULT VARIANTS COMPARED TO CLASSIC CHILDHOOD VKC AND HEALTHY SUBJECTS. FINALLY, A DIRECT CORRELATION BETWEEN TGFBETA AND ANDROGEN RECEPTOR EXPRESSION WAS ALSO DETECTED. A PRO-FIBROTIC CLINICAL AND BIOMOLECULAR TRAIT WAS UNVEILED IN ADULT VARIANT OF VKC, WHICH CAUSES OCULAR SURFACE DISEASE AND VISUAL IMPAIRMENT. 2022 17 2674 31 ETHOSUXIMIDE REDUCES EPILEPTOGENESIS AND BEHAVIORAL COMORBIDITY IN THE GAERS MODEL OF GENETIC GENERALIZED EPILEPSY. PURPOSE: ETHOSUXIMIDE (ESX) IS A DRUG OF CHOICE FOR THE SYMPTOMATIC TREATMENT OF ABSENCE SEIZURES. CHRONIC TREATMENT WITH ESX HAS BEEN REPORTED TO HAVE DISEASE-MODIFYING ANTIEPILEPTOGENIC ACTIVITY IN THE WAG/RIJ RAT MODEL OF GENETIC GENERALIZED EPILEPSY (GGE) WITH ABSENCE SEIZURES. HERE WE EXAMINED WHETHER CHRONIC TREATMENT WITH ESX (1) POSSESSES ANTIEPILEPTOGENIC EFFECTS IN THE GENETIC ABSENCE EPILEPSY RATS FROM STRASBOURG (GAERS) MODEL OF GGE, (2) IS ASSOCIATED WITH A MITIGATION OF BEHAVIORAL COMORBIDITIES, AND (3) INFLUENCES GENE EXPRESSION IN THE SOMATOSENSORY CORTEX REGION WHERE SEIZURES ARE THOUGHT TO ORIGINATE. METHODS: GAERS AND NONEPILEPTIC CONTROL (NEC) RATS WERE CHRONICALLY TREATED WITH ESX (IN DRINKING WATER) OR CONTROL (TAP WATER) FROM 3 TO 22 WEEKS OF AGE. SUBSEQUENTLY, ALL ANIMALS RECEIVED TAP WATER ONLY FOR ANOTHER 12 WEEKS TO ASSESS ENDURING EFFECTS OF TREATMENT. SEIZURE FREQUENCY AND ANXIETY-LIKE BEHAVIORS WERE SERIALLY ASSESSED THROUGHOUT THE EXPERIMENTAL PARADIGM. TREATMENT EFFECTS ON THE EXPRESSION OF KEY COMPONENTS OF THE EPIGENETIC MOLECULAR MACHINERY, THE DNA METHYLTRANSFERASE ENZYMES, WERE ASSESSED USING QUANTITATIVE POLYMERASE CHAIN REACTION (QPCR). KEY FINDINGS: ESX TREATMENT SIGNIFICANTLY REDUCED SEIZURES IN GAERS DURING THE TREATMENT PHASE, AND THIS EFFECT WAS MAINTAINED DURING THE 12-WEEK POSTTREATMENT PHASE (P < 0.05). FURTHERMORE, THE ANXIETY-LIKE BEHAVIORS PRESENT IN GAERS WERE REDUCED BY ESX TREATMENT (P < 0.05). MOLECULAR ANALYSIS REVEALED THAT ESX TREATMENT WAS ASSOCIATED WITH INCREASED EXPRESSION OF DNA METHYLTRANSFERASE ENZYME MESSENGER RNA (MRNA) IN CORTEX. SIGNIFICANCE: CHRONIC ESX TREATMENT HAS DISEASE-MODIFYING EFFECTS IN THE GAERS MODEL OF GGE, WITH ANTIEPILEPTOGENIC EFFECTS AGAINST ABSENCE SEIZURES AND MITIGATION OF BEHAVIORAL COMORBIDITIES. THE CELLULAR MECHANISM FOR THESE EFFECTS MAY INVOLVE EPIGENETIC MODIFICATIONS. 2013 18 1265 36 CYSTINURIA POORLY RESPONDING TO TREATMENT - THE RISK OF CHRONIC KIDNEY DISEASE. CYSTINURIA IS THE GENETIC CONDITION FOR THE INCREASED EXCRETION OF CYSTINE IN THE URINE. PATIENTS MAINLY SUFFER FROM AFFLICTIONS RELATED TO THE PRESENCE AND PASSAGE OF KIDNEY STONES. THE CURRENTLY AVAILABLE TREATMENT METHODS INCLUDE CONSERVATIVE TREATMENT BASED ON INCREASED FLUID INTAKE, APPROPRIATE DIET, MEDICATIONS AND UROLOGICAL PROCEDURES. THE CAUSAL TREATMENT HAS NOT YET BEEN INVENTED. A CASE REPORT: A PATIENT CASE WAS DESCRIBED WHOSE FIRST SYMPTOMATIC KIDNEY STONES APPEARED AFTER THE SECOND YEAR OF LIFE. URINARY CYSTINE EXCRETION WAS SIGNIFICANTLY INCREASED - 25,431 MUMOL/1G CREATININE (NORM: 167-333 MUMOL/1G CREATININE), WHICH WAS ALSO SHOWN, BUT LOWER, IN BOTH PARENTS OF THE PATIENT. DESPITE THE EARLY INITIATION OF THERAPY INCLUDING LOW SODIUM DIET, ABUNDANT HYDRATION, ALKALIZATION, CAPTOPRIL AND COMPLIANCE WITH STRINGENT RESTRICTIONS, THE LEVEL OF URINARY CYSTINE EXCRETION WAS STILL NOT WITHIN THE NORMAL RANGE. THERE HAVE BEEN MANY MODIFICATIONS TO THE THERAPY AND DOSE INCREASES OF DRUGS, BUT WITHOUT VISIBLE RESULTS. THE PATIENT UNDERWENT SEVERAL UROLOGICAL PROCEDURES, INCLUDING: ESWL (EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY), URSL (URETEROSCOPIC LITHOTRIPSY), PCNL (PERCUTANEOUS NEPHROLITHOTOMY) AND OPEN SURGERY TO REMOVE CYSTINE DEPOSITS THAT WERE STILL PRODUCED IN THE KIDNEYS. IN ADDITION, FOR MANY YEARS THE DISEASE WAS COMPLICATED BY RECURRENT URINARY TRACT INFECTIONS, UNDERWEIGHT AND LESIONS LIKE EPITHELIAL METAPLASIA IN THE BLADDER. RENAL PARAMETERS WERE REPEATEDLY EXAMINED. ELEVATED RESULTS SUCH AS: SERUM CREATININE 0.9 MG/DL, CYSTATIN C CONCENTRATION 1.10 MG/L, ALBUMIN-CREATININE INDEX 0.197, CREATININE CLEARANCE 50.7 ML/MIN /1.73 M2 AND EGFR 73 ML/MIN/1.73 M2 ALLOWED FOR THE DIAGNOSIS OF CHRONIC KIDNEY DISEASE BEFORE THE AGE OF 18. AFTER MANY YEARS OF CONSERVATIVE TREATMENT, ONLY THE INTRODUCTION OF THIOPRONINE, STILL LITTLE KNOWN IN POLAND, REDUCED THE LEVEL OF CYSTINE EXCRETED IN THE URINE. THE INCLUSION OF THE DRUG REDUCED THE TENDENCY TO PRODUCE KIDNEY STONES, WHICH ALLOWED TO INHIBIT THE PROGRESSION OF RENAL FAILURE. CONCLUSIONS: DESPITE MANY YEARS OF RESEARCH AND MODERN DRUGS, CYSTINURIA IS STILL A DISEASE WITH WHICH PATIENTS ARE ASSOCIATED FOR THE REST OF THEIR LIVES. THE ONGOING RESEARCH, ALONG WITH ATTEMPTS TO UNDERSTAND THE GENETIC AND EPIGENETIC MECHANISMS RESPONSIBLE FOR THE EMERGENCE OF MUTATIONS IN THE MAIN GENES CAUSING THE DISEASE AND THE COURSE OF THE DISEASE, GIVES HOPE FOR FINDING A METHOD OF CAUSAL TREATMENT FOR CYSTINURIA. 2021 19 5353 23 RE-EVALUATION OF POLIHEXANIDE USE IN WOUND ANTISEPSIS IN ORDER TO CLARIFY AMBIGUITIES OF TWO ANIMAL STUDIES. OBJECTIVE: DUE TO CLASSIFICATION OF THE AGENT POLIHEXANIDE (PHMB) IN CATEGORY 2 'MAY CAUSE CANCER' BY THE COMMITTEE FOR RISK ASSESSMENT OF THE EUROPEAN CHEMICALS AGENCY IN 2011, THE USERS OF WOUND ANTISEPTICS MAY BE HIGHLY CONFUSED. IN 2017, THIS STATEMENT WAS UPDATED, DEFINING PHMB UP TO 0.1% AS A PRESERVATIVE SAFE IN ALL COSMETIC PRODUCTS. IN THE INTEREST OF PATIENT SAFETY, A SCIENTIFIC CLARIFICATION OF THE POTENTIAL CARCINOGENICITY OF PHMB IS NECESSARY. METHODS: A MULTIDISCIPLINARY TEAM (MDT) OF MICROBIOLOGISTS, SURGEONS, DERMATOLOGISTS AND BIOCHEMISTS CONDUCTED A BENEFIT-RISK ASSESSMENT TO CLARIFY THE HAZARD OF ANTISEPTIC USE OF PHMB. RESULTS: IN TWO ANIMAL STUDIES, FROM WHICH THE ASSESSMENT OF A CARCINOGENIC RISK WAS DERIVED, PHMB WAS ADMINISTERED ORALLY OVER TWO YEARS IN EXTREMELY HIGH CONCENTRATIONS FAR ABOVE THE NO(A)EL (NO-OBSERVED-(ADVERSE-) EFFECT LEVEL) IN RATS AND MICE. FEEDING IN THE NO(A)EL RANGE RESULTED IN NO ABNORMAL EFFECTS. IN ONE MALE IN THE HIGHEST DOSE GROUP OF 4000PPM PHMB, AN ADENOCARCINOMA WAS FOUND, WHICH THE AUTHOR ATTRIBUTED TO CHRONIC INFLAMMATION OF THE COLON WITH SYSTEMIC ATYPICAL EXPOSURE. THE INCREASING INCIDENCE OF HEMANGIOSARCOMAS HIGHLY PROBABLY RESULTED FROM INCREASED ENDOTHELIAL PROLIFERATION, TRIGGERED BY THE EXCEEDINGLY HIGH DOSAGE FED, BECAUSE PHMB IS NOT GENOTOXIC AND THERE IS NO EVIDENCE FOR EPIGENETIC EFFECTS. DISCUSSION: IT IS WELL KNOWN THAT PHMB IS NOT ABSORBED WHEN APPLIED TOPICALLY. CONSIDERING THE ABSENCE OF GENOTOXICITY AND EPIGENETIC EFFECTS TOGETHER WITH THE INTERPRETATION OF THE ANIMAL STUDIES, IT IS THE CONSENSUS OF THE MULTIDISCIPLINARY EXPERTS THAT A CARCINOGENIC RISK FROM PHMB-USE FOR WOUND ANTISEPSIS CAN BE RULED OUT. CONCLUSION: ON THIS BASIS AND CONSIDERING THEIR EFFECTIVENESS, TOLERABILITY AND CLINICAL EVIDENCE, THE INDICATIONS FOR PHMB BASED WOUND ANTISEPTICS ARE JUSTIFIED. 2019 20 1622 26 DNA METHYLTRANSFERASES IN MALAR MELASMA AND THEIR MODIFICATION BY SUNSCREEN IN COMBINATION WITH 4% NIACINAMIDE, 0.05% RETINOIC ACID, OR PLACEBO. BACKGROUND: MALAR MELASMA HAS A CHRONIC AND RECURRENT CHARACTER THAT MAY BE RELATED TO EPIGENETIC CHANGES. OBJECTIVE: TO RECOGNIZE THE EXPRESSION AND DNA METHYLATION OF DNA METHYLTRANSFERASES (DNMTS) IN MALAR MELASMA AND PERILESIONAL SKIN, AS WELL AS THE CHANGES IN DNMTS AFTER THEIR TREATMENT WITH SUNSCREEN IN COMBINATION WITH 4% NIACINAMIDE, 0.05% RETINOIC ACID, OR PLACEBO. METHODS: THIRTY FEMALE PATIENTS WERE CLINICALLY EVALUATED FOR THE EXPRESSION OF DNMT1 AND DNMT3B USING REAL-TIME PCR AND IMMUNOFLUORESCENCE. THESE INITIAL RESULTS WERE COMPARED TO RESULTS AFTER EIGHT WEEKS OF TREATMENT WITH SUNSCREEN IN COMBINATION WITH NIACINAMIDE, RETINOIC ACID, OR PLACEBO. RESULTS: THE RELATIVE EXPRESSION OF DNMT1 WAS SIGNIFICANTLY ELEVATED IN MELASMA COMPARED WITH UNAFFECTED SKIN IN ALL SUBJECTS, INDICATING DNA HYPERMETHYLATION. AFTER TREATMENT, IT WAS DECREASED IN ALL GROUPS: NIACINAMIDE (7 VERSUS 1; P<0.01), RETINOIC ACID (7 VERSUS 2; P<0.05), AND PLACEBO (7 VERSUS 3; P<0.05), WHICH CORRELATES WITH CLINICAL IMPROVEMENT. DNMT3B WAS NOT OVEREXPRESSED IN LESIONAL SKIN BUT REDUCED IN ALL GROUPS. CONCLUSIONS: WE FOUND DNA HYPERMETHYLATION IN MELASMA LESIONS. ENVIRONMENTAL FACTORS SUCH AS SOLAR RADIATION MAY INDUCE CELLULAR CHANGES THAT TRIGGER HYPERPIGMENTATION THROUGH THE ACTIVATION OF PATHWAYS REGULATED BY EPIGENETIC MODIFICATIONS. HOWEVER, LIMITING OR DECREASING DNA METHYLATION THROUGH SUNSCREEN, NIACINAMIDE, AND RETINOIC ACID TREATMENTS THAT PROVIDE PHOTOPROTECTION AND GENETIC TRANSCRIPTION CAN COUNTERACT THIS. 2019