1 6536 89 TRANSCRIPTIONAL REGULATION OF TYPE-2 METABOTROPIC GLUTAMATE RECEPTORS: AN EPIGENETIC PATH TO NOVEL TREATMENTS FOR CHRONIC PAIN. ACTIVATION OF METABOTROPIC GLUTAMATE 2 (MGLU2) RECEPTORS INHIBITS PAIN TRANSMISSION AT THE SYNAPSES BETWEEN PRIMARY AFFERENT FIBERS AND NEURONS IN THE DORSAL HORN OF THE SPINAL CORD. IN ADDITION, MGLU2 RECEPTORS ARE FOUND IN PERIPHERAL NOCICEPTORS, AND IN PAIN-REGULATORY CENTERS OF THE BRAIN STEM AND FOREBRAIN. MGLU2 RECEPTOR AGONISTS PRODUCE ANALGESIA IN MODELS OF INFLAMMATORY AND NEUROPATHIC PAIN, BUT THEIR USE IS LIMITED BY THE DEVELOPMENT OF TOLERANCE. A NEW THERAPEUTIC STRATEGY COULD BE BASED ON THE TRANSCRIPTIONAL REGULATION OF MGLU2 RECEPTORS VIA THE ACETYLATION-PROMOTED ACTIVATION OF THE P65/RELA TRANSCRIPTION FACTOR. "EPIGENETIC" DRUGS THAT INCREASE MGLU2 RECEPTOR EXPRESSION, INCLUDING L-ACETYLCARNITINE AND INHIBITORS OF HISTONE DEACETYLASES, HAVE A DIFFERENT ANALGESIC PROFILE WITH NO TOLERANCE TO THE THERAPEUTIC EFFECT AFTER REPEATED DOSING. 2010 2 3319 32 HISTONE ACETYLATION AND HISTONE DEACETYLATION IN NEUROPATHIC PAIN: AN UNRESOLVED PUZZLE? CHRONIC PAIN IS BROADLY CLASSIFIED INTO SOMATIC, VISCERAL OR NEUROPATHIC PAIN DEPENDING UPON THE LOCATION AND EXTENT OF PAIN PERCEPTION. EVIDENCES FROM DIFFERENT ANIMAL STUDIES SUGGEST THAT INFLAMMATORY OR NEUROPATHIC PAIN IS ASSOCIATED WITH ALTERED ACETYLATION AND DEACETYLATION OF HISTONE PROTEINS, WHICH RESULT IN ABNORMAL TRANSCRIPTION OF NOCICEPTIVE PROCESSING GENES. THERE HAVE BEEN A NUMBER OF STUDIES INDICATING THAT NERVE INJURY UP-REGULATES HISTONE DEACETYLASE ENZYMES, WHICH LEADS TO INCREASED HISTONE DEACETYLATION AND INDUCE CHRONIC PAIN. TREATMENT WITH HISTONE DEACETYLASE INHIBITORS RELIEVES PAIN BY NORMALIZING NERVE INJURY-INDUCED DOWN REGULATION OF METABOTROPIC GLUTAMATE RECEPTORS, GLUTAMATE TRANSPORTERS, GLUTAMIC ACID DECARBOXYLASE 65, NEURON RESTRICTIVE SILENCER FACTOR AND SERUM AND GLUCOCORTICOID INDUCIBLE KINASE 1. ON THE OTHER HAND, A FEW STUDIES REFER TO INCREASED EXPRESSION OF HISTONE ACETYLASE ENZYMES IN RESPONSE TO NERVE INJURY THAT PROMOTES HISTONE ACETYLATION LEADING TO PAIN INDUCTION. TREATMENT WITH HISTONE ACETYL TRANSFERASE INHIBITORS HAVE BEEN REPORTED TO RELIEVE CHRONIC PAIN BY BLOCKING THE UP-REGULATION OF CHEMOKINES AND CYCLOOXYGENASE-2, THE CRITICAL FACTORS ASSOCIATED WITH HISTONE ACETYLATION-INDUCED PAIN. THE PRESENT REVIEW DESCRIBES THE DUAL ROLE OF HISTONE ACETYLATION/DEACETYLATION IN DEVELOPMENT OR ATTENUATION OF NEUROPATHIC PAIN ALONG WITH THE UNDERLYING MECHANISMS. 2017 3 3191 41 HDAC AND HAT INHIBITORS DIFFERENTLY AFFECT ANALGESIA MEDIATED BY GROUP II METABOTROPIC GLUTAMATE RECEPTORS. BACKGROUND: HISTONE DEACETYLASES (HDACS) AND HISTONE ACETYLTRANSFERASES (HATS) ARE KEY PLAYERS IN EPIGENETIC REGULATION OF GENE EXPRESSION. ANALGESIC ACTIVITY BY HDAC INHIBITORS HAS BEEN REPORTED IN DIFFERENT PAIN MODELS INCLUDING INFLAMMATORY AND NEUROPATHIC PAIN. THESE DRUGS INTERFERE WITH GENE EXPRESSION THROUGH DIFFERENT MECHANISMS INCLUDING CHROMATIN REMODELING AND/OR ACTIVATION OF TRANSCRIPTION FACTORS. AMONG OTHER TARGETS, HDAC INHIBITORS REGULATE METABOTROPIC GLUTAMATE RECEPTORS TYPE 2 (MGLU2) EXPRESSION IN CENTRAL AND PERIPHERAL CENTRAL NERVOUS SYSTEM. HOWEVER WHETHER INHIBITION OF HAT ACTIVITY ALSO REGULATES MGLU2 EXPRESSION HAS NOT BEEN REPORTED. FINDINGS: HERE WE REPORT THAT CURCUMIN (CUR), A NATURALLY OCCURRING COMPOUND ENDOWED WITH P300/CREB-BINDING PROTEIN HAT INHIBITORY ACTIVITY, IS ABLE TO INDUCE A DRASTIC DOWN-REGULATION OF THE MGLU2 RECEPTOR IN THE MOUSE SPINAL CORD AFTER SYSTEMIC ADMINISTRATION TOGETHER WITH A MARKED HYPOACETYLATION OF HISTONES H3 AND H4 IN DORSAL ROOT GANGLIA (DRG). FURTHERMORE, THE ANALGESIC ACTIVITY OF THE MGLU2/3 AGONIST, LY379268 IS LOST AFTER A 3-DAY TREATMENT WITH CUR. CONVERSELY THE ANALGESIC ACTIVITY OF LY379268 IS POTENTIATED IN MICE PRETREATED FOR 5 CONSECUTIVE DAYS WITH THE HDAC INHIBITOR, SUBEROYLANILIDE HYDROXAMIC ACID (SAHA), KNOWN TO INDUCE MGLU2-UPREGULATION. CONCLUSIONS: OUR RESULTS DEMONSTRATE THAT SYSTEMICALLY INJECTED CUR IS ABLE TO INHIBIT H3 AND H4 ACETYLATION IN THE DRG AND TO DOWN-REGULATE MGLU2 RECEPTORS IN THE SPINAL CORD. WE ALSO DEMONSTRATE THAT LONG TERM MODIFICATION OF THE MGLU2 EXPRESSION AFFECTS THE ANALGESIC PROPERTIES OF THE ORTHOSTERIC MGLU2/3 AGONIST, LY379268. THESE DATA OPEN UP THE POSSIBILITY THAT EPIGENETIC MODULATORS MIGHT BE GIVEN IN COMBINATION WITH "TRADITIONAL" DRUGS IN A CONTEXT OF A MULTI TARGET APPROACH FOR A BETTER ANALGESIC EFFICACY. 2014 4 2249 43 EPIGENETIC MODULATION OF MGLU2 RECEPTORS BY HISTONE DEACETYLASE INHIBITORS IN THE TREATMENT OF INFLAMMATORY PAIN. KNOWING THAT EXPRESSION OF METABOTROPIC GLUTAMATE 2 (MGLU2) RECEPTORS IN THE DORSAL ROOT GANGLIA IS REGULATED BY ACETYLATION MECHANISMS, WE EXAMINED THE EFFECT OF TWO SELECTIVE AND CHEMICALLY UNRELATED HISTONE DEACETYLASE (HDAC) INHIBITORS, N-(2-AMINOPHENYL)-4-[N-(PYRIDINE-3-YLMETHOXY-CARBONYL)AMINOMETHYL]BENZAMIDE (MS-275) AND SUBEROYLANILIDE HYDROAMIC ACID (SAHA), IN A MOUSE MODEL OF PERSISTENT INFLAMMATORY PAIN. ALTHOUGH A SINGLE SUBCUTANEOUS INJECTION OF MS-275 (3 MG/KG) OR SAHA (5-50 MG/KG) WAS INEFFECTIVE, A 5-DAY TREATMENT WITH EITHER OF THE TWO HDAC INHIBITORS SUBSTANTIALLY REDUCED THE NOCICEPTIVE RESPONSE IN THE SECOND PHASE OF THE FORMALIN TEST, WHICH REFLECTS THE DEVELOPMENT OF CENTRAL SENSITIZATION IN THE DORSAL HORN OF THE SPINAL CORD. ANALGESIA WAS ABROGATED BY A SINGLE INJECTION OF THE MGLU2/3 RECEPTOR ANTAGONIST (ALPHAS)-ALPHA-AMINO-ALPHA-[(1S,2S)-2-CARBOXYCYCLOPROPYL]-9H-XANTINE-9-PROPANOIC ACID (LY341495; 1 MG/KG, I.P.), WHICH WAS INACTIVE PER SE. BOTH MS-275 AND SAHA UP-REGULATED THE EXPRESSION OF MGLU2 RECEPTORS IN THE DORSAL ROOT GANGLION (DRG) AND SPINAL CORD UNDER CONDITIONS IN WHICH THEY CAUSED ANALGESIA, WITHOUT CHANGING THE EXPRESSION OF MGLU1A, MGLU4, OR MGLU5 RECEPTORS. INDUCTION OF DRG MGLU2 RECEPTORS IN RESPONSE TO SAHA WAS ASSOCIATED WITH INCREASED ACETYLATION OF P65/RELA ON LYSINE 310, A PROCESS THAT ENHANCES THE TRANSCRIPTIONAL ACTIVITY OF P65/RELA AT NUCLEAR FACTOR-KAPPAB-REGULATED GENES. TRANSCRIPTION OF THE MGLU2 RECEPTOR GENE IS KNOWN TO BE ACTIVATED BY P65/RELA IN DRG NEURONS. WE CONCLUDE THAT HDAC INHIBITION PRODUCES ANALGESIA BY UP-REGULATING MGLU2 RECEPTOR EXPRESSION IN THE DRG, AN EFFECT THAT RESULTS FROM THE AMPLIFICATION OF NF-KAPPAB TRANSCRIPTIONAL ACTIVITY. THESE DATA PROVIDE THE FIRST EVIDENCE THAT HDAC INHIBITORS CAUSE ANALGESIA AND SUGGEST THAT HDACS ARE POTENTIAL TARGETS FOR THE EPIGENETIC TREATMENT OF PAIN. 2009 5 3202 32 HDAC2 REGULATES ATYPICAL ANTIPSYCHOTIC RESPONSES THROUGH THE MODULATION OF MGLU2 PROMOTER ACTIVITY. HISTONE DEACETYLASES (HDACS) COMPACT CHROMATIN STRUCTURE AND REPRESS GENE TRANSCRIPTION. IN SCHIZOPHRENIA, CLINICAL STUDIES DEMONSTRATE THAT HDAC INHIBITORS ARE EFFICACIOUS WHEN GIVEN IN COMBINATION WITH ATYPICAL ANTIPSYCHOTICS. HOWEVER, THE MOLECULAR MECHANISM THAT INTEGRATES A BETTER RESPONSE TO ANTIPSYCHOTICS WITH CHANGES IN CHROMATIN STRUCTURE REMAINS UNKNOWN. HERE WE FOUND THAT CHRONIC ATYPICAL ANTIPSYCHOTICS DOWNREGULATED THE TRANSCRIPTION OF METABOTROPIC GLUTAMATE 2 RECEPTOR (MGLU2, ALSO KNOWN AS GRM2), AN EFFECT THAT WAS ASSOCIATED WITH DECREASED HISTONE ACETYLATION AT ITS PROMOTER IN MOUSE AND HUMAN FRONTAL CORTEX. THIS EPIGENETIC CHANGE OCCURRED IN CONCERT WITH A SEROTONIN 5-HT(2A) RECEPTOR-DEPENDENT UPREGULATION AND INCREASED BINDING OF HDAC2 TO THE MGLU2 PROMOTER. VIRALLY MEDIATED OVEREXPRESSION OF HDAC2 IN FRONTAL CORTEX DECREASED MGLU2 TRANSCRIPTION AND ITS ELECTROPHYSIOLOGICAL PROPERTIES, THEREBY INCREASING PSYCHOSIS-LIKE BEHAVIOR. CONVERSELY, HDAC INHIBITORS PREVENTED THE REPRESSIVE HISTONE MODIFICATIONS INDUCED AT THE MGLU2 PROMOTER BY ATYPICAL ANTIPSYCHOTICS, AND AUGMENTED THEIR THERAPEUTIC-LIKE EFFECTS. THESE OBSERVATIONS SUPPORT THE VIEW OF HDAC2 AS A PROMISING NEW TARGET FOR SCHIZOPHRENIA TREATMENT. 2012 6 3194 36 HDAC INHIBITORS ATTENUATE THE DEVELOPMENT OF HYPERSENSITIVITY IN MODELS OF NEUROPATHIC PAIN. HISTONE DEACETYLASE INHIBITORS (HDACIS) INTERFERE WITH THE EPIGENETIC PROCESS OF HISTONE ACETYLATION AND ARE KNOWN TO HAVE ANALGESIC PROPERTIES IN MODELS OF CHRONIC INFLAMMATORY PAIN. THE AIM OF THIS STUDY WAS TO DETERMINE WHETHER THESE COMPOUNDS COULD ALSO AFFECT NEUROPATHIC PAIN. DIFFERENT CLASS I HDACIS WERE DELIVERED INTRATHECALLY INTO RAT SPINAL CORD IN MODELS OF TRAUMATIC NERVE INJURY AND ANTIRETROVIRAL DRUG-INDUCED PERIPHERAL NEUROPATHY (STAVUDINE, D4T). MECHANICAL AND THERMAL HYPERSENSITIVITY WAS ATTENUATED BY 40% TO 50% AS A RESULT OF HDACI TREATMENT, BUT ONLY IF STARTED BEFORE ANY INSULT. THE DRUGS GLOBALLY INCREASED HISTONE ACETYLATION IN THE SPINAL CORD, BUT APPEARED TO HAVE NO MEASURABLE EFFECTS IN RELEVANT DORSAL ROOT GANGLIA IN THIS TREATMENT PARADIGM, SUGGESTING THAT ANY POTENTIAL MECHANISM SHOULD BE SOUGHT IN THE CENTRAL NERVOUS SYSTEM. MICROARRAY ANALYSIS OF DORSAL CORD RNA REVEALED THE SIGNATURE OF THE SPECIFIC COMPOUND USED (MS-275) AND SUGGESTED THAT ITS MAIN EFFECT WAS MEDIATED THROUGH HDAC1. TAKEN TOGETHER, THESE DATA SUPPORT A ROLE FOR HISTONE ACETYLATION IN THE EMERGENCE OF NEUROPATHIC PAIN. 2013 7 6138 33 THE ETIOLOGICAL CHANGES OF ACETYLATION IN PERIPHERAL NERVE INJURY-INDUCED NEUROPATHIC HYPERSENSITIVITY. NEUROPATHIC PAIN IS A COMMON CHRONIC PAIN CONDITION WITH MECHANISMS FAR CLEARLY BEEN ELUCIDATED. MOUNTING PRECLINICAL AND CLINICAL STUDIES HAVE SHOWN NEUROPATHIC PAIN IS HIGHLY ASSOCIATED WITH HISTONE ACETYLATION MODIFICATION, WHICH FOLLOWS EXPRESSION REGULATION OF VARIOUS PAIN-RELATED MOLECULES SUCH AS MGLUR1/5, GLUTAMATE ASPARTATE TRANSPORTER, GLUTAMATE TRANSPORTER-1, GAD65, NA(V)1.8, KV4.3, MU-OPIOID RECEPTOR, BRAIN-DERIVED NEUROTROPHIC FACTOR, AND CERTAIN CHEMOKINES. AS TWO TYPES OF PIVOTAL ENZYMES INVOLVED IN HISTONE ACETYLATION, HISTONE DEACETYLASES INDUCE HISTONE DEACETYLATION TO SILENCE GENE EXPRESSION; IN CONTRAST, HISTONE ACETYL TRANSFERASES FACILITATE HISTONE ACETYLATION TO POTENTIATE GENE TRANSCRIPTION. ACCORDINGLY, UPREGULATION OR BLOCKADE OF ACETYLATION MAY BE A PROMISING INTERVENTION DIRECTION FOR NEUROPATHIC PAIN TREATMENT. IN FACT, NUMEROUS ANIMAL STUDIES HAVE SUGGESTED VARIOUS HISTONE DEACETYLASE INHIBITORS, SIRT (CLASS III HISTONE DEACETYLASES) ACTIVATORS, AND HISTONE ACETYL TRANSFERASES INHIBITORS ARE EFFECTIVE IN NEUROPATHIC PAIN TREATMENT VIA TARGETING SPECIFIC EPIGENETIC SITES. IN THIS REVIEW, WE SUMMARIZE THE CHARACTERISTICS OF THE MOLECULES AND MECHANISMS OF NEUROPATHY-RELATED ACETYLATION, AS WELL AS THE ACETYLATION UPREGULATION AND BLOCKADE FOR NEUROPATHIC PAIN THERAPY. FINALLY, WE WILL DISCUSS THE CURRENT DRUG ADVANCES FOCUSING ON NEUROPATHY-RELATED ACETYLATION ALONG WITH THE UNDERLYING TREATMENT MECHANISMS. 2018 8 189 34 ACETYL-L-CARNITINE IN CHRONIC PAIN: A NARRATIVE REVIEW. ACETYL-L-CARNITINE (ALC) IS AN ENDOGENOUS MOLECULE THAT NOT ONLY PLAYS A ROLE IN ENERGY METABOLISM, BUT ALSO HAS ANTIOXIDANT PROPERTIES, PROTECTS FROM OXIDATIVE STRESS, MODULATES BRAIN NEUROTRANSMITTERS SUCH AS ACETYLCHOLINE, SEROTONIN AND DOPAMINE, AND ACTS ON NEUROTROPHIC FACTORS SUCH AS NERVE GROWTH FACTOR (NGF) AND METABOTROPIC GLUTAMATE (MGLU) RECEPTORS BY MEANS OF EPIGENETIC MECHANISMS. IMPORTANTLY, IT INDUCES MGLU2 EXPRESSION AT NERVE TERMINALS, THUS GIVING RISE TO ANALGESIA AND PREVENTING SPINAL SENSITISATION. IT HAS ALSO BEEN FOUND TO HAVE EVEN LONG-TERM NEUROTROPHIC AND ANALGESIC ACTIVITY IN EXPERIMENTAL MODELS OF CHRONIC INFLAMMATORY AND NEUROPATHIC PAIN. THE AIM OF THIS NARRATIVE REVIEW IS TO SUMMARISE THE CURRENT EVIDENCE REGARDING THE USE OF ALC IN PATIENTS WITH CHRONIC PAIN, AND COGNITIVE AND MOOD DISORDERS, AND INVESTIGATE THE RATIONALE UNDERLYING ITS USE IN PATIENTS WITH FIBROMYALGIA SYNDROME, WHICH IS CHARACTERISED BY NOCIPLASTIC CHANGES THAT INCREASE THE SENSITIVITY OF THE NERVOUS SYSTEM TO PAIN. 2021 9 2179 32 EPIGENETIC MECHANISMS OF NEURAL PLASTICITY IN CHRONIC NEUROPATHIC PAIN. NEUROPATHIC PAIN IS A CHALLENGING CLINICAL PROBLEM AND REMAINS DIFFICULT TO TREAT. ALTERED GENE EXPRESSION IN PERIPHERAL SENSORY NERVES AND NEURONS DUE TO NERVE INJURY IS WELL DOCUMENTED AND CONTRIBUTES CRITICALLY TO THE SYNAPTIC PLASTICITY IN THE SPINAL CORD AND THE INITIATION AND MAINTENANCE OF CHRONIC PAIN. HOWEVER, OUR UNDERSTANDING OF THE EPIGENETIC MECHANISMS REGULATING THE TRANSCRIPTION OF PRO-NOCICEPTIVE (E.G., NMDA RECEPTORS AND ALPHA2DELTA-1) AND ANTINOCICEPTIVE (E.G., POTASSIUM CHANNELS AND OPIOID AND CANNABINOID RECEPTORS) GENES ARE STILL LIMITED. IN THIS REVIEW, WE SUMMARIZE RECENT STUDIES DETERMINING THE ROLES OF HISTONE MODIFICATIONS (INCLUDING METHYLATION, ACETYLATION, AND UBIQUITINATION), DNA METHYLATION, AND NONCODING RNAS IN NEUROPATHIC PAIN DEVELOPMENT. WE REVIEW THE EPIGENETIC WRITER, READER, AND ERASER PROTEINS THAT PARTICIPATE IN THE TRANSCRIPTIONAL CONTROL OF THE EXPRESSION OF KEY ION CHANNELS AND NEUROTRANSMITTER RECEPTORS IN THE DORSAL ROOT GANGLION AFTER TRAUMATIC NERVE INJURY, WHICH IS COMMONLY USED AS A PRECLINICAL MODEL OF NEUROPATHIC PAIN. A BETTER UNDERSTANDING OF EPIGENETIC REPROGRAMMING INVOLVED IN THE TRANSITION FROM ACUTE TO CHRONIC PAIN COULD LEAD TO THE DEVELOPMENT OF NEW TREATMENTS FOR NEUROPATHIC PAIN. 2022 10 191 28 ACETYL-L-CARNITINE: FROM A BIOLOGICAL CURIOSITY TO A DRUG FOR THE PERIPHERAL NERVOUS SYSTEM AND BEYOND. ACETYL-L-CARNITINE (ALC) IS A MOLECULE DERIVED FROM ACETYLATION OF CARNITINE IN THE MITOCHONDRIA. CARNITINE ACETYLATION ENABLES THE FUNCTION OF COA AND FACILITATES ELIMINATION OF OXIDATIVE PRODUCTS. BEYOND THIS METABOLIC ACTIVITY, ALC PROVIDES ACETYL GROUPS FOR ACETYLCHOLINE SYNTHESIS, EXERTS A CHOLINERGIC EFFECT AND OPTIMIZES THE BALANCE OF ENERGY PROCESSES. ACETYLCARNITINE SUPPLEMENTATION INDUCES NEUROPROTECTIVE, NEUROTROPHIC AND ANALGESIC EFFECTS IN THE PERIPHERAL NERVOUS SYSTEM. IN THE RECENT STUDIES, ALC, BY ACTING AS A DONOR OF ACETYL GROUPS TO NF-KB P65/RELA, ENHANCED THE TRANSCRIPTION OF THE GRM2 GENE ENCODING THE MGLU2 RECEPTORS, INDUCING LONG-TERM UPREGULATION OF THE MGLUR2, EVIDENCING THEREFORE THAT ITS LONG-TERM ANALGESIC EFFECTS ARE DEPENDENT ON EPIGENETIC MODIFICATIONS. SEVERAL STUDIES, INCLUDING DOUBLE-BLIND, PLACEBO-CONTROLLED, PARALLEL GROUP STUDIES AND FEW OPEN STUDIES SHOWED THE EFFECT OF ALC IN DISEASES CHARACTERIZED BY NEUROPATHIES AND NEUROPATHIC PAIN: THE STUDIES INCLUDED DIABETIC NEUROPATHY, HIV AND ANTIRETROVIRAL THERAPY-INDUCED NEUROPATHIES, NEUROPATHIES DUE TO COMPRESSION AND CHEMOTHERAPEUTIC AGENTS. DOUBLE-BLINDED STUDIES INVOLVED 1773 PATIENTS. STATISTICAL EVALUATIONS EVIDENCED REDUCTION OF PAIN, IMPROVEMENTS OF NERVE FUNCTION AND TROPHISM. IN CONCLUSION, ALC REPRESENTS A CONSISTENT THERAPEUTIC OPTION FOR PERIPHERAL NEUROPATHIES, AND ITS COMPLEX EFFECTS, NEUROTROPHIC AND ANALGESIC, BASED ON EPIGENETIC MECHANISM, OPEN NEW PATHWAYS IN THE STUDY OF PERIPHERAL NERVE DISEASE MANAGEMENT. 2013 11 4619 33 NERVE TRAUMA-CAUSED DOWNREGULATION OF OPIOID RECEPTORS IN PRIMARY AFFERENT NEURONS: MOLECULAR MECHANISMS AND POTENTIAL MANAGEMENTS. NEUROPATHIC PAIN IS THE MOST COMMON CLINICAL DISORDER DESTROYING THE QUALITY OF PATIENT LIFE AND LEADING TO A MARKED ECONOMIC AND SOCIAL BURDEN. OPIOIDS ARE STILL LAST OPTION FOR PHARMACOLOGICAL TREATMENT OF THIS DISORDER, BUT THEIR ANTINOCICEPTIVE EFFECTS ARE LIMITED IN PART DUE TO THE DOWNREGULATION OF OPIOID RECEPTORS IN THE PRIMARY AFFERENT NEURONS AFTER PERIPHERAL NERVE TRAUMA. HOW THIS DOWNREGULATION OCCURS IS NOT COMPLETELY UNDERSTOOD, BUT RECENT STUDIES HAVE DEMONSTRATED THAT PERIPHERAL NERVE TRAUMA DRIVES THE ALTERATIONS IN EPIGENETIC MODIFICATIONS (INCLUDING DNA METHYLATION, HISTONE METHYLATION AND MCIRORNAS), EXPRESSION OF TRANSCRIPTION FACTORS, POST-TRANSCRIPTIONAL MODIFICATIONS (E.G., RNA METHYLATION) AND PROTEIN TRANSLATION INITIATION IN THE NEURONS OF NERVE TRAUMA-RELATED DORSAL ROOT GANGLION (DRG) AND THAT THESE ALTERNATIONS MAY BE ASSOCIATED WITH NERVE TRAUMA-CAUSED DOWNREGULATION OF DRG OPIOID RECEPTORS. THIS REVIEW PRESENTS HOW OPIOID RECEPTORS ARE DOWNREGULATED IN THE DRG AFTER PERIPHERAL NERVE TRAUMA, SPECIFICALLY FOCUSING ON DISTINCT MOLECULAR MECHANISMS UNDERLYING TRANSCRIPTIONAL AND TRANSLATIONAL PROCESSES. THIS REVIEW ALSO DISCUSSES HOW THIS DOWNREGULATION CONTRIBUTES TO THE INDUCTION AND MAINTENANCE OF NEUROPATHIC PAIN. A DEEPER UNDERSTANDING OF THESE MOLECULAR MECHANISMS LIKELY PROVIDES A NOVEL AVENUE FOR PREVENTION AND/OR TREATMENT OF NEUROPATHIC PAIN. 2021 12 6139 27 THE ETIOLOGICAL CONTRIBUTION OF GABAERGIC PLASTICITY TO THE PATHOGENESIS OF NEUROPATHIC PAIN. NEUROPATHIC PAIN DEVELOPING AFTER PERIPHERAL OR CENTRAL NERVE INJURY IS THE RESULT OF PATHOLOGICAL CHANGES GENERATED THROUGH COMPLEX MECHANISMS. DISRUPTION IN THE HOMEOSTASIS OF EXCITATORY AND INHIBITORY NEURONS WITHIN THE CENTRAL NERVOUS SYSTEM IS A CRUCIAL FACTOR IN THE FORMATION OF HYPERALGESIA OR ALLODYNIA OCCURRING WITH NEUROPATHIC PAIN. THE CENTRAL GABAERGIC PATHWAY HAS RECEIVED ATTENTION FOR ITS EXTENSIVE DISTRIBUTION AND FUNCTION IN NEURAL CIRCUITS, INCLUDING THE GENERATION AND DEVELOPMENT OF NEUROPATHIC PAIN. GABAERGIC INHIBITORY CHANGES THAT OCCUR IN THE INTERNEURONS ALONG DESCENDING MODULATORY AND NOCICEPTIVE PATHWAYS IN THE CENTRAL NERVOUS SYSTEM ARE BELIEVED TO GENERATE NEURONAL PLASTICITY, SUCH AS SYNAPTIC PLASTICITY OR FUNCTIONAL PLASTICITY OF THE RELATED GENES OR PROTEINS, THAT IS THE FOUNDATION OF PERSISTENT NEUROPATHIC PAIN. THE PRIMARY GABAERGIC PLASTICITY OBSERVED IN NEUROPATHIC PAIN INCLUDES GABAERGIC SYNAPSE HOMO- AND HETEROSYNAPTIC PLASTICITY, DECREASED SYNTHESIS OF GABA, DOWN-EXPRESSION OF GLUTAMIC ACID DECARBOXYLASE AND GABA TRANSPORTER, ABNORMAL EXPRESSION OF NKCC1 OR KCC2, AND DISTURBED FUNCTION OF GABA RECEPTORS. IN THIS REVIEW, WE DESCRIBE POSSIBLE MECHANISMS ASSOCIATED WITH GABAERGIC PLASTICITY, SUCH AS CENTRAL SENSITIZATION AND GABAERGIC INTERNEURON APOPTOSIS, AND THE EPIGENETIC ETIOLOGIES OF GABAERGIC PLASTICITY IN NEUROPATHIC PAIN. MOREOVER, WE SUMMARIZE POTENTIAL THERAPEUTIC TARGETS OF GABAERGIC PLASTICITY THAT MAY ALLOW FOR SUCCESSFUL RELIEF OF HYPERALGESIA FROM NERVE INJURY. FINALLY, WE COMPARE THE EFFECTS OF THE GABAERGIC SYSTEM IN NEUROPATHIC PAIN TO OTHER TYPES OF CHRONIC PAIN TO UNDERSTAND THE CONTRIBUTION OF GABAERGIC PLASTICITY TO NEUROPATHIC PAIN. 2019 13 3892 36 L-ACETYLCARNITINE CAUSES RAPID ANTIDEPRESSANT EFFECTS THROUGH THE EPIGENETIC INDUCTION OF MGLU2 RECEPTORS. EPIGENETIC MECHANISMS ARE INVOLVED IN THE PATHOPHYSIOLOGY OF DEPRESSIVE DISORDERS AND ARE UNIQUE POTENTIAL TARGETS FOR THERAPEUTIC INTERVENTION. THE ACETYLATING AGENT L-ACETYLCARNITINE (LAC), A WELL-TOLERATED DRUG, BEHAVES AS AN ANTIDEPRESSANT BY THE EPIGENETIC REGULATION OF TYPE 2 METABOTROPIC GLUTAMATE (MGLU2) RECEPTORS. IT CAUSED A RAPID AND LONG-LASTING ANTIDEPRESSANT EFFECT IN FLINDERS SENSITIVE LINE RATS AND IN MICE EXPOSED TO CHRONIC UNPREDICTABLE STRESS, WHICH, RESPECTIVELY, MODEL GENETIC AND ENVIRONMENTALLY INDUCED DEPRESSION. IN BOTH MODELS, LAC INCREASED LEVELS OF ACETYLATED H3K27 BOUND TO THE GRM2 PROMOTER AND ALSO INCREASED ACETYLATION OF NF-KB-P65 SUBUNIT, THEREBY ENHANCING THE TRANSCRIPTION OF GRM2 GENE ENCODING FOR THE MGLU2 RECEPTOR IN HIPPOCAMPUS AND PREFRONTAL CORTEX. IMPORTANTLY, LAC REDUCED THE IMMOBILITY TIME IN THE FORCED SWIM TEST AND INCREASED SUCROSE PREFERENCE AS EARLY AS 3 D OF TREATMENT, WHEREAS 14 D OF TREATMENT WERE NEEDED FOR THE ANTIDEPRESSANT EFFECT OF CHLORIMIPRAMINE. MOREOVER, THERE WAS NO TOLERANCE TO THE ACTION OF LAC, AND THE ANTIDEPRESSANT EFFECT WAS STILL SEEN 2 WK AFTER DRUG WITHDRAWAL. CONVERSELY, NF-KB INHIBITION PREVENTED THE INCREASE IN MGLU2 EXPRESSION INDUCED BY LAC, WHEREAS THE USE OF A HISTONE DEACETYLASE INHIBITOR SUPPORTED THE EPIGENETIC CONTROL OF MGLU2 EXPRESSION. FINALLY, LAC HAD NO EFFECT ON MGLU2 KNOCKOUT MICE EXPOSED TO CHRONIC UNPREDICTABLE STRESS, AND A SINGLE INJECTION OF THE MGLU2/3 RECEPTOR ANTAGONIST LY341495 PARTIALLY BLOCKED LAC ACTION. THE RAPID AND LONG-LASTING ANTIDEPRESSANT ACTION OF LAC STRONGLY SUGGESTS A UNIQUE APPROACH TO EXAMINE THE EPIGENETIC HYPOTHESIS OF DEPRESSIVE DISORDERS IN HUMANS, PAVING THE WAY FOR MORE EFFICIENT ANTIDEPRESSANTS WITH FASTER ONSET OF ACTION. 2013 14 400 36 ANALGESIA INDUCED BY THE EPIGENETIC DRUG, L-ACETYLCARNITINE, OUTLASTS THE END OF TREATMENT IN MOUSE MODELS OF CHRONIC INFLAMMATORY AND NEUROPATHIC PAIN. BACKGROUND L-ACETYLCARNITINE, A DRUG MARKETED FOR THE TREATMENT OF CHRONIC PAIN, CAUSES ANALGESIA BY EPIGENETICALLY UP-REGULATING TYPE-2 METABOTROPIC GLUTAMATE (MGLU2) RECEPTORS IN THE SPINAL CORD. BECAUSE THE EPIGENETIC MECHANISMS ARE TYPICALLY LONG-LASTING, WE HYPOTHESIZED THAT ANALGESIA COULD OUTLAST THE DURATION OF L-ACETYLCARNITINE TREATMENT IN MODELS OF INFLAMMATORY AND NEUROPATHIC PAIN. RESULTS A SEVEN-DAY TREATMENT WITH L-ACETYLCARNITINE (100 MG/KG, ONCE A DAY, I.P.) PRODUCED AN ANTIALLODYNIC EFFECT IN THE COMPLETE FREUND ADJUVANT MOUSE MODEL OF CHRONIC INFLAMMATORY PAIN. L-ACETYLCARNITINE-INDUCED ANALGESIA PERSISTED FOR AT LEAST 14 DAYS AFTER DRUG WITHDRAWAL. IN CONTRAST, THE ANALGESIC EFFECT OF PREGABALIN, AMITRYPTILINE, CEFTRIAXONE, AND N-ACETYLCYSTEINE DISAPPEARED SEVEN DAYS AFTER DRUG WITHDRAWAL. L-ACETYLCARNITINE TREATMENT ENHANCED MGLU2/3 RECEPTOR PROTEIN LEVELS IN THE DORSAL REGION OF THE SPINAL CORD. THIS EFFECT ALSO PERSISTED FOR TWO WEEKS AFTER DRUG WITHDRAWAL AND WAS ASSOCIATED WITH INCREASED LEVELS OF ACETYLATED HISTONE H3 BOUND TO THE GRM2 GENE PROMOTER IN THE DORSAL ROOT GANGLIA. A LONG-LASTING ANALGESIC EFFECT OF L-ACETYLCARNITINE WAS ALSO OBSERVED IN MICE SUBJECTED TO CHRONIC CONSTRICTION INJURY OF THE SCIATIC NERVE. IN THESE ANIMALS, A 14-DAY TREATMENT WITH PREGABALIN, AMITRYPTILINE, TRAMADOL, OR L-ACETYLCARNITINE PRODUCED A SIGNIFICANT ANTIALLODYNIC EFFECT, WITH PREGABALIN DISPLAYING THE GREATEST EFFICACY. IN MICE TREATED WITH PREGABALIN, TRAMADOL OR L-ACETYLCARNITINE THE ANALGESIC EFFECT WAS STILL VISIBLE 15 DAYS AFTER THE END OF DRUG TREATMENT. HOWEVER, ONLY IN MICE TREATED WITH L-ACETYLCARNITINE ANALGESIA PERSISTED 37 DAYS AFTER DRUG WITHDRAWAL. THIS EFFECT WAS ASSOCIATED WITH AN INCREASE IN MGLU2/3 RECEPTOR PROTEIN LEVELS IN THE DORSAL HORNS OF THE SPINAL CORD. CONCLUSIONS OUR FINDINGS SUGGEST THAT L-ACETYLCARNITINE HAS THE UNIQUE PROPERTY TO CAUSE A LONG-LASTING ANALGESIC EFFECT THAT MIGHT REDUCE RELAPSES IN PATIENTS SUFFERING FROM CHRONIC PAIN. 2017 15 1003 35 CHRONIC TREATMENT WITH FLUOXETINE INDUCES SEX-DEPENDENT ANALGESIC EFFECTS AND MODULATES HDAC2 AND MGLU2 EXPRESSION IN FEMALE MICE. GENDER AND SEX DIFFERENCES IN PAIN RECOGNITION AND DRUG RESPONSES HAVE BEEN REPORTED IN CLINICAL TRIALS AND EXPERIMENTAL MODELS OF PAIN. AMONG ANTIDEPRESSANTS, CONTRADICTORY RESULTS HAVE BEEN OBSERVED IN PATIENTS TREATED WITH SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS). THIS STUDY EVALUATED SEX DIFFERENCES IN RESPONSE TO THE SSRI FLUOXETINE AFTER CHRONIC ADMINISTRATION IN THE MOUSE FORMALIN TEST. ADULT MALE AND FEMALE CD1 MICE WERE INTRAPERITONEALLY INJECTED WITH FLUOXETINE (10 MG/KG) FOR 21 DAYS AND SUBJECTED TO PAIN ASSESSMENT. FLUOXETINE TREATMENT REDUCED THE SECOND PHASE OF THE FORMALIN TEST ONLY IN FEMALE MICE WITHOUT PRODUCING BEHAVIORAL CHANGES IN MALES. WE ALSO OBSERVED THAT FLUOXETINE WAS ABLE TO SPECIFICALLY INCREASE THE EXPRESSION OF METABOTROPIC GLUTAMATE RECEPTOR TYPE-2 (MGLU2) IN FEMALES. ALSO A REDUCED EXPRESSION OF THE EPIGENETIC MODIFYING ENZYME, HISTONE DEACETYLASE 2 (HDAC2), IN DORSAL ROOT GANGLIA (DRG) AND DORSAL HORN (DH) TOGETHER WITH AN INCREASE HISTONE 3 ACETYLATION (H3) LEVEL WAS OBSERVED IN FEMALES BUT NOT IN MALES. WITH THIS STUDY WE PROVIDE EVIDENCE THAT FLUOXETINE INDUCES SEX SPECIFIC CHANGES IN HDAC2 AND MGLU2 EXPRESSION IN THE DH OF THE SPINAL CORD AND IN DRGS AND SUGGESTS A MOLECULAR EXPLANATION FOR THE ANALGESIC EFFECTS IN FEMALE MICE. 2017 16 2214 39 EPIGENETIC MODIFICATIONS ASSOCIATED TO NEUROINFLAMMATION AND NEUROPATHIC PAIN AFTER NEURAL TRAUMA. ACCUMULATING EVIDENCE SUGGESTS THAT EPIGENETIC ALTERATIONS LIE BEHIND THE INDUCTION AND MAINTENANCE OF NEUROPATHIC PAIN. NEUROPATHIC PAIN IS USUALLY A CHRONIC CONDITION CAUSED BY A LESION, OR PATHOLOGICAL CHANGE, WITHIN THE NERVOUS SYSTEM. NEUROPATHIC PAIN APPEARS FREQUENTLY AFTER NERVE AND SPINAL CORD INJURIES OR DISEASES, PRODUCING A DEBILITATION OF THE PATIENT AND A DECREASE OF THE QUALITY OF LIFE. AT THE CELLULAR LEVEL, NEUROPATHIC PAIN IS THE RESULT OF NEURONAL PLASTICITY SHAPED BY AN INCREASE IN THE SENSITIVITY AND EXCITABILITY OF SENSORY NEURONS OF THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM. ONE OF THE MECHANISMS THOUGHT TO CONTRIBUTE TO HYPEREXCITABILITY AND THEREFORE TO THE ONTOGENY OF NEUROPATHIC PAIN IS THE ALTERED EXPRESSION, TRAFFICKING, AND FUNCTIONING OF RECEPTORS AND ION CHANNELS EXPRESSED BY PRIMARY SENSORY NEURONS. BESIDES, NEURONAL AND GLIAL CELLS, SUCH AS MICROGLIA AND ASTROCYTES, TOGETHER WITH BLOOD BORNE MACROPHAGES, PLAY A CRITICAL ROLE IN THE INDUCTION AND MAINTENANCE OF NEUROPATHIC PAIN BY RELEASING POWERFUL NEUROMODULATORS SUCH AS PRO-INFLAMMATORY CYTOKINES AND CHEMOKINES, WHICH ENHANCE NEURONAL EXCITABILITY. ALTERED GENE EXPRESSION OF NEURONAL RECEPTORS, ION CHANNELS, AND PRO-INFLAMMATORY CYTOKINES AND CHEMOKINES, HAVE BEEN ASSOCIATED TO EPIGENETIC ADAPTATIONS OF THE INJURED TISSUE. WITHIN THIS REVIEW, WE DISCUSS THE INVOLVEMENT OF THESE EPIGENETIC CHANGES, INCLUDING HISTONE MODIFICATIONS, DNA METHYLATION, NON-CODING RNAS, AND ALTERATION OF CHROMATIN MODIFIERS, THAT HAVE BEEN SHOWN TO TRIGGER MODIFICATION OF NOCICEPTION AFTER NEURAL LESIONS. IN PARTICULAR, THE FUNCTION ON THESE PROCESSES OF EZH2, JMJD3, MECP2, SEVERAL HISTONE DEACETYLASES (HDACS) AND HISTONE ACETYL TRANSFERASES (HATS), G9A, DNMT, REST AND DIVERSE NON-CODING RNAS, ARE DESCRIBED. DESPITE THE EFFORT ON DEVELOPING NEW THERAPIES, CURRENT TREATMENTS HAVE ONLY PRODUCED LIMITED RELIEF OF THIS PAIN IN A PORTION OF PATIENTS. THUS, THE PRESENT REVIEW AIMS TO CONTRIBUTE TO FIND NOVEL TARGETS FOR CHRONIC NEUROPATHIC PAIN TREATMENT. 2018 17 881 37 CHRONIC CLOZAPINE TREATMENT RESTRAINS VIA HDAC2 THE PERFORMANCE OF MGLU2 RECEPTOR AGONISM IN A RODENT MODEL OF ANTIPSYCHOTIC ACTIVITY. PRECLINICAL FINDINGS IN RODENT MODELS POINTED TOWARD ACTIVATION OF METABOTROPIC GLUTAMATE 2/3 (MGLU2/3) RECEPTORS AS A NEW PHARMACOLOGICAL APPROACH TO TREAT PSYCHOSIS. HOWEVER, MORE RECENT STUDIES FAILED TO SHOW CLINICAL EFFICACY OF MGLU2/3 RECEPTOR AGONISM IN SCHIZOPHRENIA PATIENTS. WE PREVIOUSLY PROPOSED THAT LONG-TERM ANTIPSYCHOTIC MEDICATION RESTRICTED THE THERAPEUTIC EFFECTS OF THESE GLUTAMATERGIC AGENTS. HOWEVER, LITTLE IS KNOWN ABOUT THE MOLECULAR MECHANISM UNDERLYING THE POTENTIAL REPERCUSSION OF PREVIOUS ANTIPSYCHOTIC EXPOSURE ON THE THERAPEUTIC PERFORMANCE OF MGLU2/3 RECEPTOR AGONISTS. HERE WE SHOW THAT THIS MALADAPTIVE EFFECT OF ANTIPSYCHOTIC TREATMENT IS MEDIATED MOSTLY VIA HISTONE DEACETYLASE 2 (HDAC2). CHRONIC TREATMENT WITH THE ANTIPSYCHOTIC CLOZAPINE LED TO A DECREASE IN MOUSE FRONTAL CORTEX MGLU2 MRNA, AN EFFECT THAT REQUIRED EXPRESSION OF BOTH HDAC2 AND THE SEROTONIN 5-HT(2A) RECEPTOR. THIS TRANSCRIPTIONAL ALTERATION OCCURRED IN ASSOCIATION WITH HDAC2-DEPENDENT REPRESSIVE HISTONE MODIFICATIONS AT THE MGLU2 PROMOTER. WE FOUND THAT CHRONIC CLOZAPINE TREATMENT DECREASED VIA HDAC2 THE CAPABILITIES OF THE MGLU2/3 RECEPTOR AGONIST LY379268 TO ACTIVATE G-PROTEINS IN THE FRONTAL CORTEX OF MICE. CHRONIC CLOZAPINE TREATMENT BLUNTED THE ANTIPSYCHOTIC-RELATED BEHAVIORAL EFFECTS OF LY379268, AN EFFECT THAT WAS NOT OBSERVED IN HDAC2 KNOCKOUT MICE. MORE IMPORTANTLY, CO-ADMINISTRATION OF THE CLASS I AND II HDAC INHIBITOR SAHA (VORINOSTAT) PRESERVED THE ANTIPSYCHOTIC PROFILE OF LY379268 AND FRONTAL CORTEX MGLU2/3 RECEPTOR DENSITY IN WILD-TYPE MICE. THESE FINDINGS RAISE CONCERNS ON THE DESIGN OF PREVIOUS CLINICAL STUDIES WITH MGLU2/3 AGONISTS, PROVIDING THE RATIONALE FOR THE DEVELOPMENT OF HDAC2 INHIBITORS AS A NEW EPIGENETIC-BASED APPROACH TO IMPROVE THE CURRENTLY LIMITED RESPONSE TO TREATMENT WITH GLUTAMATERGIC ANTIPSYCHOTICS. 2019 18 2353 36 EPIGENETIC REGULATION OF OPIOID-INDUCED HYPERALGESIA, DEPENDENCE, AND TOLERANCE IN MICE. REPEATED ADMINISTRATION OF OPIOIDS SUCH AS MORPHINE INDUCES PERSISTENT BEHAVIORAL CHANGES INCLUDING OPIOID-INDUCED HYPERALGESIA (OIH), TOLERANCE, AND PHYSICAL DEPENDENCE. IN THE CURRENT WORK WE EXPLORED HOW THE BALANCE OF HISTONE ACETYLTRANSFERASE (HAT) VERSUS HISTONE DEACETYLASE (HDAC) MIGHT REGULATE THESE MORPHINE-INDUCED CHANGES. NOCICEPTIVE THRESHOLDS, ANALGESIA, AND PHYSICAL DEPENDENCE WERE ASSESSED DURING AND FOR A PERIOD OF SEVERAL WEEKS AFTER MORPHINE EXPOSURE. TO PROBE THE ROLES OF HISTONE ACETYLATION, THE HAT INHIBITOR CURCUMIN OR A SELECTIVE HDAC INHIBITOR SUBEROYLANILIDE HYDROXAMIC ACID (SAHA) WAS ADMINISTERED DAILY TO GROUPS OF ANIMALS. HISTONE ACETYLATION IN SPINAL CORD WAS ASSESSED BY WESTERN BLOT AND IMMUNOHISTOCHEMISTRY. CONCURRENT ADMINISTRATION OF CURCUMIN WITH MORPHINE FOR 4 DAYS SIGNIFICANTLY REDUCED DEVELOPMENT OF OPIOID-INDUCED MECHANICAL ALLODYNIA, THERMAL HYPERALGESIA, TOLERANCE, AND PHYSICAL DEPENDENCE. CONVERSELY, THE HDAC INHIBITOR SAHA ENHANCED THESE RESPONSES. INTERESTINGLY, SAHA TREATMENT AFTER THE TERMINATION OF OPIOID ADMINISTRATION SUSTAINED THESE BEHAVIORAL CHANGES FOR AT LEAST 4 WEEKS. HISTONE H3 ACETYLATION IN THE DORSAL HORN OF THE SPINAL CORD WAS INCREASED AFTER CHRONIC MORPHINE TREATMENT, BUT H4 ACETYLATION WAS UNCHANGED. MOREOVER, WE OBSERVED A DECREASE IN HDAC ACTIVITY IN THE SPINAL CORDS OF MORPHINE-TREATED MICE WHILE OVERALL HAT ACTIVITY WAS UNCHANGED, SUGGESTING A SHIFT TOWARD A STATE OF ENHANCED HISTONE ACETYLATION. PERSPECTIVE: THE CURRENT STUDY INDICATES THAT EPIGENETIC MECHANISMS PLAY A CRUCIAL ROLE IN OPIOID-INDUCED LONG-LASTING NEUROPLASTICITY. THESE RESULTS PROVIDE NEW SIGHT INTO UNDERSTANDING THE MECHANISMS OF OPIOID-INDUCED NEUROPLASTICITY AND SUGGEST NEW STRATEGIES TO LIMIT OPIOID ABUSE POTENTIAL AND INCREASE THE VALUE OF THESE DRUGS AS ANALGESICS. 2013 19 2061 27 EPIGENETIC CONTROL OF HYPERSENSITIVITY IN CHRONIC INFLAMMATORY PAIN BY THE DE NOVO DNA METHYLTRANSFERASE DNMT3A2. CHRONIC PAIN IS A PATHOLOGICAL MANIFESTATION OF NEURONAL PLASTICITY SUPPORTED BY ALTERED GENE TRANSCRIPTION IN SPINAL CORD NEURONS THAT RESULTS IN LONG-LASTING HYPERSENSITIVITY. RECENTLY, THE CONCEPT THAT EPIGENETIC REGULATORS MIGHT BE IMPORTANT IN PATHOLOGICAL PAIN HAS EMERGED, BUT A CLEAR UNDERSTANDING OF THE MOLECULAR PLAYERS INVOLVED IN THE PROCESS IS STILL LACKING. IN THIS STUDY, WE LINKED DNMT3A2, A SYNAPTIC ACTIVITY-REGULATED DE NOVO DNA METHYLTRANSFERASE, TO CHRONIC INFLAMMATORY PAIN. WE OBSERVED THAT DNMT3A2 LEVELS ARE INCREASED IN THE SPINAL CORD OF ADULT MICE FOLLOWING PLANTAR INJECTION OF COMPLETE FREUND'S ADJUVANT, AN IN VIVO MODEL OF CHRONIC INFLAMMATORY PAIN. IN VIVO KNOCKDOWN OF DNMT3A2 EXPRESSION IN DORSAL HORN NEURONS BLUNTED THE INDUCTION OF GENES TRIGGERED BY COMPLETE FREUND'S ADJUVANT INJECTION. AMONG THE GENES WHOSE TRANSCRIPTION WAS FOUND TO BE INFLUENCED BY DNMT3A2 EXPRESSION IN THE SPINAL CORD IS PTGS2, ENCODING FOR COX-2, A PRIME MEDIATOR OF PAIN PROCESSING. LOWERING THE LEVELS OF DNMT3A2 PREVENTED THE ESTABLISHMENT OF LONG-LASTING INFLAMMATORY HYPERSENSITIVITY. THESE RESULTS IDENTIFY DNMT3A2 AS AN IMPORTANT EPIGENETIC REGULATOR NEEDED FOR THE ESTABLISHMENT OF CENTRAL SENSITIZATION. TARGETING EXPRESSION OR FUNCTION OF DNMT3A2 MAY BE SUITABLE FOR THE TREATMENT OF CHRONIC PAIN. 2019 20 2310 30 EPIGENETIC REGULATION OF CHRONIC PAIN. CHRONIC PAIN ARISING FROM PERIPHERAL INFLAMMATION AND TISSUE OR NERVE INJURY IS A COMMON CLINICAL SYMPTOM. ALTHOUGH INTENSIVE RESEARCH ON THE NEUROBIOLOGICAL MECHANISMS OF CHRONIC PAIN HAS BEEN CARRIED OUT DURING PREVIOUS DECADES, THIS DISORDER IS STILL POORLY MANAGED BY CURRENT DRUGS SUCH AS OPIOIDS AND NONSTEROIDAL ANTI-INFLAMMATORY DRUGS. INFLAMMATION, TISSUE INJURY AND/OR NERVE INJURY-INDUCED CHANGES IN GENE EXPRESSION IN SENSORY NEURONS OF THE DORSAL ROOT GANGLION, SPINAL CORD DORSAL HORN AND PAIN-ASSOCIATED BRAIN REGIONS ARE THOUGHT TO PARTICIPATE IN CHRONIC PAIN GENESIS; HOWEVER, HOW THESE CHANGES OCCUR IS STILL ELUSIVE. EPIGENETIC MODIFICATIONS INCLUDING DNA METHYLATION AND COVALENT HISTONE MODIFICATIONS CONTROL GENE EXPRESSION. RECENT STUDIES HAVE SHOWN THAT PERIPHERAL NOXIOUS STIMULATION CHANGES DNA METHYLATION AND HISTONE MODIFICATIONS AND THAT THESE CHANGES MAY BE RELATED TO THE INDUCTION OF PAIN HYPERSENSITIVITY UNDER CHRONIC PAIN CONDITIONS. THIS REVIEW SUMMARIZES THE CURRENT KNOWLEDGE AND PROGRESS IN EPIGENETIC RESEARCH IN CHRONIC PAIN AND DISCUSSES THE POTENTIAL ROLE OF EPIGENETIC MODIFICATIONS AS THERAPEUTIC ANTINOCICEPTIVE TARGETS IN THIS DISORDER. 2015