1 6719 137 VITAMIN D AND SUSCEPTIBILITY OF CHRONIC LUNG DISEASES: ROLE OF EPIGENETICS. VITAMIN D DEFICIENCY IS LINKED TO ACCELERATED DECLINE IN LUNG FUNCTION, INCREASED INFLAMMATION, AND REDUCED IMMUNITY IN CHRONIC LUNG DISEASES. EPIDEMIOLOGICAL STUDIES HAVE SUGGESTED THAT VITAMIN D INSUFFICIENCY IS ASSOCIATED WITH LOW LUNG FUNCTION IN SUSCEPTIBLE SUBJECTS WHO ARE EXPOSED TO HIGHER LEVELS OF ENVIRONMENTAL AGENTS (AIRBORNE PARTICULATES). RECENT STUDIES HAVE HIGHLIGHTED THE ROLE OF VITAMIN D AND VITAMIN D RECEPTOR (VDR) IN REGULATION OF SEVERAL GENES THAT ARE INVOLVED IN INFLAMMATION, IMMUNITY, CELLULAR PROLIFERATION, DIFFERENTIATION, AND APOPTOSIS. VITAMIN D HAS ALSO BEEN IMPLICATED IN REVERSAL OF STEROID RESISTANCE AND AIRWAY REMODELING, WHICH ARE THE HALLMARKS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND SEVERE ASTHMA. VDR PROTEIN LEVEL IS DECREASED IN LUNGS OF PATIENTS WITH COPD. VDR DEFICIENT MICE DEVELOP AN ABNORMAL LUNG PHENOTYPE WITH CHARACTERISTICS OF COPD, SUCH AS AIRSPACE ENLARGEMENT AND DECLINE IN LUNG FUNCTION ASSOCIATED WITH INCREASED LUNG INFLAMMATORY CELLULAR INFLUX, AND IMMUNE-LYMPHOID AGGREGATES FORMATION. DIETARY VITAMIN D MAY REGULATE EPIGENETIC EVENTS, IN PARTICULAR ON GENES WHICH ARE RESPONSIBLE FOR COPD SUSCEPTIBILITY. ACTIVE METABOLITE OF VITAMIN D, 1,25-DIHYDROXYVITAMIN D(3) PLAYS AN ESSENTIAL ROLE IN CELLULAR METABOLISM AND DIFFERENTIATION VIA ITS NUCLEAR RECEPTOR (VDR) THAT COOPERATES WITH SEVERAL OTHER CHROMATIN MODIFICATION ENZYMES (HISTONE ACETYLTRANSFERASES AND HISTONE DEACETYLASES), THEREBY MEDIATING COMPLEX EPIGENETIC EVENTS IN VITAMIN D SIGNALING AND METABOLISM. THIS REVIEW PROVIDES AN UPDATE ON THE CURRENT KNOWLEDGE AND UNDERSTANDING ON VITAMIN D, AND SUSCEPTIBILITY OF CHRONIC LUNG DISEASES IN RELATION TO THE POSSIBLE ROLE OF EPIGENETICS IN ITS MOLECULAR ACTION. UNDERSTANDING THE MOLECULAR EPIGENETIC MECHANISM OF VITAMIN D/VDR WOULD PROVIDE RATIONALE FOR DIETARY VITAMIN D-MEDIATED INTERVENTION IN PREVENTION AND MANAGEMENT OF CHRONIC LUNG DISEASES LINKED WITH VITAMIN D DEFICIENCY. 2011 2 2059 34 EPIGENETIC CONTROL OF GENE EXPRESSION IN THE LUNG. EPIGENETICS IS TRADITIONALLY DEFINED AS THE STUDY OF HERITABLE CHANGES IN GENE EXPRESSION CAUSED BY MECHANISMS OTHER THAN CHANGES IN THE UNDERLYING DNA SEQUENCE. THERE ARE THREE MAIN CLASSES OF EPIGENETIC MARKS--DNA METHYLATION, MODIFICATIONS OF HISTONE TAILS, AND NONCODING RNAS--EACH OF WHICH MAY BE INFLUENCED BY THE ENVIRONMENT, DIET, DISEASES, AND AGEING. IMPORTANTLY, EPIGENETIC MARKS HAVE BEEN SHOWN TO INFLUENCE IMMUNE CELL MATURATION AND ARE ASSOCIATED WITH THE RISK OF DEVELOPING VARIOUS FORMS OF CANCER, INCLUDING LUNG CANCER. MOREOVER, THERE IS EMERGING EVIDENCE THAT THESE EPIGENETIC MARKS AFFECT GENE EXPRESSION IN THE LUNG AND ARE ASSOCIATED WITH BENIGN LUNG DISEASES, SUCH AS ASTHMA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND INTERSTITIAL LUNG DISEASE. TECHNOLOGICAL ADVANCES HAVE MADE IT FEASIBLE TO STUDY EPIGENETIC MARKS IN THE LUNG, AND IT IS ANTICIPATED THAT THIS KNOWLEDGE WILL ENHANCE OUR UNDERSTANDING OF THE DYNAMIC BIOLOGY IN THE LUNG AND LEAD TO THE DEVELOPMENT OF NOVEL DIAGNOSTIC AND THERAPEUTIC APPROACHES FOR OUR PATIENTS WITH LUNG DISEASE. 2011 3 6199 46 THE IMPORTANCE OF EPIGENETICS IN THE DEVELOPMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. IT IS GENERALLY ACCEPTED THAT GENETIC PREDISPOSITION PLAYS A ROLE IN COPD DEVELOPMENT IN SUSCEPTIBLE INDIVIDUALS. THEREFORE, MANY CANDIDATE GENES THAT COULD BE LINKED TO THE DEVELOPMENT OF DISEASE HAVE BEEN EXAMINED IN COPD. HOWEVER, INCONSISTENT RESULTS IN DIFFERENT STUDY POPULATIONS OFTEN LIMIT THIS APPROACH, SUGGESTING THAT NOT ONLY GENETICS, BUT ALSO OTHER FACTORS, MAY BE CONTRIBUTED TO THE SUSCEPTIBILITY TO COPD. EPIGENETIC MECHANISMS CAN AFFECT THE TRANSCRIPTIONAL ACTIVITY OF SPECIFIC GENES, AT DIFFERENT POINTS IN TIME, AND IN DIFFERENT ORGANS. MOREOVER, THESE MECHANISMS CAN HAVE AN EFFECT ON PEOPLE'S HEALTH. RECENTLY, THERE IS EMERGING EVIDENCE SUPPORTING A ROLE OF EPIGENETICS FOR THE REGULATION OF INFLAMMATORY GENES IN DISEASES SUCH AS ASTHMA AND COPD. MOREOVER, RECENT STUDIES SUGGEST THAT THE CURRENTLY USED TREATMENTS INCLUDING CORTICOSTEROIDS MAY WORK THROUGH EPIGENETIC MECHANISMS. EPIGENETIC REGULATION CAN BE REPROGRAMMED, POTENTIALLY AFFECTING THE RISK, AETIOLOGY AND TREATMENT OF VARIOUS DISEASE STATES. THE EPIGENETICALLY INFLUENCED PHENOTYPE COULD BE REVERSED WITH DEMETHYLATING OR DEACETYLATING AGENTS, CONSISTENT WITH EPIGENETIC PLASTICITY. THE POSTNATAL REVERSIBILITY OF THESE METHYLATION OR ACETYLATION EVENTS MAY THEREFORE PROVIDE GOOD OPPORTUNITIES FOR INTERVENTION. THE RECOGNITION OF THE ROLE OF GENETIC AND EPIGENETIC MECHANISMS IN THE DEVELOPMENT OF COPD MAY IDENTIFY NOVEL TARGETS THAT HATCH NEW THERAPIES FOR PATIENTS WITH COPD. 2011 4 3801 37 INTERPLAY OF VITAMIN D AND SIRT1 IN TISSUE-SPECIFIC METABOLISM-POTENTIAL ROLES IN PREVENTION AND TREATMENT OF NON-COMMUNICABLE DISEASES INCLUDING CANCER. THE IMPORTANCE OF THE PREVENTION AND CONTROL OF NON-COMMUNICABLE DISEASES, INCLUDING OBESITY, METABOLIC SYNDROME, TYPE 2 DIABETES, CARDIOVASCULAR DISEASES, AND CANCER, IS INCREASING AS A REQUIREMENT OF THE AGING POPULATION IN DEVELOPED COUNTRIES AND THE SUSTAINABILITY OF HEALTHCARE. SIMILARLY, THE 2013-2030 ACTION PLAN OF THE WHO FOR THE PREVENTION AND CONTROL OF NON-COMMUNICABLE DISEASES SEEKS THESE ACHIEVEMENTS. ADEQUATE LIFESTYLE CHANGES, ALONE OR WITH THE NECESSARY TREATMENTS, COULD REDUCE THE RISK OF MORTALITY OR THE DETERIORATION OF QUALITY OF LIFE. IN OUR RECENT WORK, WE SUMMARIZED THE ROLE OF TWO CENTRAL FACTORS, I.E., APPROPRIATE LEVELS OF VITAMIN D AND SIRT1, WHICH ARE CONNECTED TO ADEQUATE LIFESTYLES WITH BENEFICIAL EFFECTS ON THE PREVENTION AND CONTROL OF NON-COMMUNICABLE DISEASES. BOTH OF THESE FACTORS HAVE RECEIVED INCREASED ATTENTION IN RELATION TO THE COVID-19 PANDEMIC AS THEY BOTH TAKE PART IN REGULATION OF THE MAIN METABOLIC PROCESSES, I.E., LIPID/GLUCOSE/ENERGY HOMEOSTASIS, OXIDATIVE STRESS, REDOX BALANCE, AND CELL FATE, AS WELL AS IN THE HEALTHY REGULATION OF THE IMMUNE SYSTEM. VITAMIN D AND SIRT1 HAVE DIRECT AND INDIRECT INFLUENCE OF THE REGULATION OF TRANSCRIPTION AND EPIGENETIC CHANGES AND ARE RELATED TO CYTOPLASMIC SIGNALING PATHWAYS SUCH AS PLC/DAG/IP3/PKC/MAPK, MEK/ERK, INSULIN/MTOR/CELL GROWTH, PROLIFERATION; LEPTIN/PI3K-AKT-MTORC1, AKT/NFKB/COX-2, NFKB/TNFALPHA, IL-6, IL-8, IL-1BETA, AND AMPK/PGC-1ALPHA/GLUT4, AMONG OTHERS. THROUGH THEIR PROPER REGULATION, THEY MAINTAIN NORMAL BODY WEIGHT, LIPID PROFILE, INSULIN SECRETION AND SENSITIVITY, BALANCE BETWEEN THE PRO- AND ANTI-INFLAMMATORY PROCESSES UNDER NORMAL CONDITIONS AND INFECTIONS, MAINTAIN ENDOTHELIAL HEALTH; BALANCE CELL DIFFERENTIATION, PROLIFERATION, AND FATE; AND BALANCE THE CIRCADIAN RHYTHM OF THE CELLULAR METABOLISM. THE ROLE OF THESE TWO MOLECULES IS INTERCONNECTED IN THE MOLECULAR NETWORK, AND THEY REGULATE EACH OTHER IN SEVERAL LAYERS OF THE HOMEOSTASIS OF ENERGY AND THE CELLULAR METABOLISM. BOTH HAVE A CENTRAL ROLE IN THE MAINTENANCE OF HEALTHY AND BALANCED IMMUNE REGULATION AND REDOX REACTIONS; THEREFORE, THEY COULD CONSTITUTE PROMISING TARGETS EITHER FOR PREVENTION OR AS COMPLEMENTARY THERAPIES TO ACHIEVE A BETTER QUALITY OF LIFE, AT ANY AGE, FOR HEALTHY PEOPLE AND PATIENTS UNDER CHRONIC CONDITIONS. 2023 5 4896 38 OXIDATIVE STRESS IN AIRWAY DISEASES. AIRWAY OXIDATIVE STRESS IS BROADLY DEFINED AS AN IMBALANCE BETWEEN PROOXIDATIVE AND ANTIOXIDATIVE PROCESSES IN THE AIRWAY. GIVEN ITS DIRECT EXPOSURE TO THE ENVIRONMENT, THE LUNG HAS SEVERAL MECHANISMS TO PREVENT AN EXCESSIVE DEGREE OF OXIDATIVE STRESS. BOTH ENZYMATIC AND NONENZYMATIC SYSTEMS CAN BUFFER A WIDE RANGE OF REACTIVE OXIDATIVE SPECIES AND OTHER COMPOUNDS WITH OXIDATIVE POTENTIAL. IN DISEASES LIKE ASTHMA AND CHRONIC OBSTRUCTIVE LUNG DISEASE, AIRWAY OXIDATIVE STRESS CAN OCCUR FROM A NUMBER OF SOURCES, INCLUDING GREATER EXPOSURE TO ENVIRONMENTAL PROOXIDANTS, AIRWAY INFILTRATION OF INFLAMMATORY CELLS, METABOLIC DEREGULATION, AND REDUCED LEVELS OF ANTIOXIDANTS. AIRWAY OXIDATIVE STRESS HAS BEEN ASSOCIATED WITH WORSE DISEASE SEVERITY, REDUCED LUNG FUNCTION, AND EPIGENETIC CHANGES THAT CAN DIMINISH RESPONSE TO STEROIDS. ALTHOUGH OXIDATIVE STRESS HAS BEEN LINKED TO A WIDE RANGE OF ADVERSE BIOLOGICAL EFFECTS, IT HAS ALSO BEEN ASSOCIATED WITH ADAPTIVE RESPONSES AND WITH RESOLUTION OF INFLAMMATION. THEREFORE, MORE THAN BEING AN IMBALANCE WITH A PREDICTABLE THRESHOLD AFTER WHICH DISEASE OR INJURY ENSUES, OXIDATIVE STRESS IS A DYNAMIC AND CONTINUOUS PROCESS. THIS MIGHT EXPLAIN WHY SUPPLEMENTING ANTIOXIDANTS HAS LARGELY FAILED TO IMPROVE DISEASES SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE. HOWEVER, THE THERAPEUTIC POTENTIAL OF ANTIOXIDANTS COULD BE GREATLY IMPROVED BY TAKING AN APPROACH THAT CONSIDERS INDIVIDUAL AND ENVIRONMENTAL RISK FACTORS, INSTEAD OF TREATING OXIDATIVE AIRWAY STRESS BROADLY. 2013 6 2457 32 EPIGENETIC TARGETS FOR THERAPEUTIC APPROACHES IN COPD AND ASTHMA. NUTRIGENOMICS - POSSIBLE OR ILLUSIVE. OXIDATIVE STRESS GENERATED BY CIGARETTE SMOKING, ENVIRONMENTAL POLLUTION, OR OTHER NOXIOUS PARTICLES LEADS TO EPIGENETIC CHANGES IN THE CELLS OF THE RESPIRATORY TRACT. THEY REFLECT CELL ADAPTATION IN RESPONSE TO CHRONIC EXPOSURE TO EXTERNAL FACTORS. ALTHOUGH THERE IS NO CHANGE IN THE GENETIC CODE, EPIGENETIC CHANGES MAY BE HERITABLE AND TRANSLATED FROM ONE GENERATION TO ANOTHER, ACCUMULATING ABNORMALITIES AND RENDERING CELLS INTO ENTIRELY DIFFERENT PHENOTYPE, CAUSING DISEASE. DNA METHYLATION, POST-TRANSLATION HISTONE MODIFICATION, UBIQUITINATION, SUMOYLATION AND MIRNA TRANSCRIPTIONAL REGULATION ARE THE MAJOR PROCESSES THAT ARE RESPONSIBLE FOR THE EPIGENETIC CONTROL OF GENE EXPRESSION. ALL OF THEM ARE REVERSIBLE. THEY CAN BE REGULATED BY TARGETING SPECIFIC ENZYMES/PROTEINS INVOLVED IN THE PROCESS IN ORDER TO MITIGATE INFLAMMATION. CHRONIC RESPIRATORY DISEASES HAVE EPIGENETIC SIGNATURES THAT AFFECT GENE EXPRESSION IN THE LUNG. TARGETING THEM PROVIDES THE DEVELOPMENT OF NOVEL DIAGNOSTIC AND THERAPEUTIC APPROACHES IN RESPIRATORY MEDICINE. NUTRIGENOMICS REVEALS THE BENEFICIAL EFFECT OF NATURAL PHYTOCHEMICALS, AFFECTING KEY STEPS IN THE SIGNALING PATHWAYS OF CHRONIC RESPIRATORY DISEASES. 2019 7 3543 25 IMMUNOLOGY, GENETICS AND MICROBIOTA IN THE COPD PATHOPHYSIOLOGY: POTENTIAL SCOPE FOR PATIENT STRATIFICATION. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS CHARACTERIZED BY SUSTAINED INFLAMMATION OF THE AIRWAYS, LEADING TO DESTRUCTION OF LUNG TISSUE AND DECLINING PULMONARY FUNCTION. ALTHOUGH SMOKING IS THE MOST OBVIOUS RISK FACTOR FOR COPD, ONLY ABOUT 20% OF SMOKERS DEVELOP COPD AND SMOKING CESSATION DOES NOT REVERSE PROGRESSION OF COPD, INDICATING THAT WHILE SMOKING IS AN IMPORTANT CAUSE OR INITIATING FACTOR, IT IS NOT THE ONLY DRIVER OF ONGOING CHRONIC INFLAMMATION AND DISEASE PROGRESSION IN COPD PATIENTS. WE HYPOTHESIZE THAT SMOKING-INDUCED CHANGES IN LUNG MICROBIOTA, EPITHELIAL INTEGRITY AND EPIGENETIC CONTROL OF GENE EXPRESSION RESULT IN AUTOANTIGEN INDUCTION AND PERTURBED IMMUNE REGULATION IN GENETICALLY VUNERABLE INDIVIDUALS. IN OUR VIEW, COPD PATIENTS MAY BE STRATIFIED ACCORDING TO THEIR IMMUNOLOGICAL AND INFLAMMATORY STATUS RELATED TO SPECIFIC CHANGES IN THE LUNG MICROBIOTA (INNATE AND ADAPTIVE IMMUNITY), PRESENCE OF AUTOANTIGENS (ADAPTIVE IMMUNITY: TH1-B-CELL AXIS) AND EPIGENETIC MODIFICATIONS (INFLAMMATION AND STRUCTURAL CHANGES). 2015 8 288 42 AGING AND INDUCED SENESCENCE AS FACTORS IN THE PATHOGENESIS OF LUNG EMPHYSEMA. CLASSICALLY, THE DEVELOPMENT OF EMPHYSEMA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE IS BELIEVED TO INVOLVE INFLAMMATION INDUCED BY CIGARETTE SMOKE AND LEUKOCYTE ACTIVATION, INCLUDING OXIDANT-ANTIOXIDANT AND PROTEASE-ANTIPROTEASE IMBALANCES. WHILE THERE IS SUBSTANTIAL EVIDENCE FOR THIS, ADDITIONAL ASPECTS HAVE BEEN SUGGESTED BY A NUMBER OF CLINICAL AND EXPERIMENTAL OBSERVATIONS. SMOKERS EXHIBIT SIGNS OF PREMATURE AGING, PARTICULARLY OBVIOUS IN THE SKIN. THE LINK BETWEEN AGING AND CHRONIC DISEASE IS WELL-KNOWN, E.G., FOR THE BRAIN AND MUSCULOSKELETAL OR CARDIOVASCULAR SYSTEM, AS WELL AS THE CLINICAL LINK BETWEEN MALNUTRITION AND EMPHYSEMA, AND THE EXPERIMENTAL LINK TO CALORIC RESTRICTION. INTERESTINGLY, THIS INTERVENTION ALSO INCREASES LIFESPAN, IN PARALLEL WITH ALTERATIONS IN METABOLISM, OXIDANT BURDEN AND ENDOCRINE SIGNALING. OF SPECIAL INTEREST IS THE OBSERVATION THAT, EVEN IN THE ABSENCE OF AN INFLAMMATORY ENVIRONMENT, LUNG FIBROBLASTS FROM PATIENTS WITH EMPHYSEMA SHOW PERSISTENT ALTERATIONS, POSSIBLY BASED ON EPIGENETIC MECHANISMS. THE IMPORTANCE OF THESE MECHANISMS FOR CELLULAR REPROGRAMMING AND RESPONSE PATTERNS, INDIVIDUAL RISK PROFILE AND THERAPEUTIC OPTIONS IS BECOMING INCREASINGLY RECOGNIZED. THE SAME APPLIES TO CELLULAR SENESCENCE. RECENT FINDINGS FROM PATIENTS AND EXPERIMENTAL MODELS OPEN NOVEL VIEWS INTO THE ARENA OF GENE-ENVIRONMENT INTERACTIONS, INCLUDING THE ROLE OF SYSTEMIC ALTERATIONS, CELLULAR STRESS, TELOMERES, CDK INHIBITORS SUCH AS P16, P21, PRB, PI3K, MTOR, FOXO TRANSCRIPTION FACTORS, HISTONE MODIFICATIONS, AND SIRTUINS. THIS ARTICLE AIMS TO OUTLINE THIS EMERGING PICTURE AND TO STIMULATE THE IDENTIFICATION OF CHALLENGING QUESTIONS. SUCH INSIGHTS ALSO BEAR IMPLICATIONS FOR THE LONG-TERM COURSE OF THE DISEASE IN RELATION TO EXISTING OR FUTURE THERAPIES AND THE EXPLORATION OF POTENTIAL LUNG REGENERATION. 2008 9 1405 37 DIETARY FACTORS AND EPIGENETIC REGULATION FOR PROSTATE CANCER PREVENTION. THE ROLE OF EPIGENETIC ALTERATIONS IN VARIOUS HUMAN CHRONIC DISEASES HAS GAINED INCREASING ATTENTION AND HAS RESULTED IN A PARADIGM SHIFT IN OUR UNDERSTANDING OF DISEASE SUSCEPTIBILITY. IN THE FIELD OF CANCER RESEARCH, E.G., GENETIC ABNORMALITIES/MUTATIONS HISTORICALLY WERE VIEWED AS PRIMARY UNDERLYING CAUSES; HOWEVER, EPIGENETIC MECHANISMS THAT ALTER GENE EXPRESSION WITHOUT AFFECTING DNA SEQUENCE ARE NOW RECOGNIZED AS BEING OF EQUAL OR GREATER IMPORTANCE FOR ONCOGENESIS. METHYLATION OF DNA, MODIFICATION OF HISTONES, AND INTERFERING MICRORNA (MIRNA) COLLECTIVELY REPRESENT A CADRE OF EPIGENETIC ELEMENTS DYSREGULATED IN CANCER. TARGETING THE EPIGENOME WITH COMPOUNDS THAT MODULATE DNA METHYLATION, HISTONE MARKS, AND MIRNA PROFILES REPRESENTS AN EVOLVING STRATEGY FOR CANCER CHEMOPREVENTION, AND THESE APPROACHES ARE STARTING TO SHOW PROMISE IN HUMAN CLINICAL TRIALS. ESSENTIAL MICRONUTRIENTS SUCH AS FOLATE, VITAMIN B-12, SELENIUM, AND ZINC AS WELL AS THE DIETARY PHYTOCHEMICALS SULFORAPHANE, TEA POLYPHENOLS, CURCUMIN, AND ALLYL SULFUR COMPOUNDS ARE AMONG A GROWING LIST OF AGENTS THAT AFFECT EPIGENETIC EVENTS AS NOVEL MECHANISMS OF CHEMOPREVENTION. TO ILLUSTRATE THESE CONCEPTS, THE CURRENT REVIEW HIGHLIGHTS THE INTERACTIONS AMONG NUTRIENTS, EPIGENETICS, AND PROSTATE CANCER SUSCEPTIBILITY. IN PARTICULAR, WE FOCUS ON EPIGENETIC DYSREGULATION AND THE IMPACT OF SPECIFIC NUTRIENTS AND FOOD COMPONENTS ON DNA METHYLATION AND HISTONE MODIFICATIONS THAT CAN ALTER GENE EXPRESSION AND INFLUENCE PROSTATE CANCER PROGRESSION. 2011 10 6628 33 UNDERSTANDING THE GENETICS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ALPHA1-ANTITRYPSIN DEFICIENCY, AND IMPLICATIONS FOR CLINICAL PRACTICE. CIGARETTE SMOKING AND POOR AIR QUALITY ARE THE GREATEST RISK FACTORS FOR DEVELOPING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), BUT GROWING EVIDENCE INDICATES THAT GENETIC FACTORS ALSO AFFECT PREDISPOSITION TO AND CLINICAL EXPRESSION OF DISEASE. WITH THE EXCEPTION OF ALPHA1-ANTITRYPSIN DEFICIENCY (AATD), A RARE AUTOSOMAL RECESSIVE DISORDER THAT IS PRESENT IN 1-3% OF INDIVIDUALS WITH COPD, NO SINGLE GENE IS ASSOCIATED WITH THE DEVELOPMENT OF OBSTRUCTIVE LUNG DISEASE. INSTEAD, A COMPLEX INTERPLAY OF GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS IS THE BASIS FOR PERSISTENT INFLAMMATORY RESPONSES, ACCELERATED CELL AGING, CELL DEATH, AND FIBROSIS, LEADING TO THE CLINICAL SYMPTOMS OF COPD AND DIFFERENT PHENOTYPIC PRESENTATIONS. IN THIS BRIEF REVIEW, WE DISCUSS CURRENT UNDERSTANDING OF THE GENETICS OF COPD, PATHOGENETICS OF AATD, EPIGENETIC INFLUENCES ON THE DEVELOPMENT OF OBSTRUCTIVE LUNG DISEASE, AND HOW CLASSIFYING COPD BY PHENOTYPE CAN INFLUENCE CLINICAL TREATMENT AND PATIENT OUTCOMES. 2021 11 1259 39 CURRENT VIEWS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATHOGENESIS AND MANAGEMENT. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS A PROGRESSIVE LUNG DYSFUNCTION CAUSED MAINLY BY INHALING TOXIC PARTICLES AND CIGARETTE SMOKING (CS). THE CONTINUOUS EXPOSURE TO RUINOUS MOLECULES CAN LEAD TO ABNORMAL INFLAMMATORY RESPONSES, PERMANENT DAMAGES TO THE RESPIRATORY SYSTEM, AND IRREVERSIBLE PATHOLOGICAL CHANGES. OTHER FACTORS, SUCH AS GENETICS AND AGING, INFLUENCE THE DEVELOPMENT OF COPD. IN THE LAST DECADE, ACCUMULATING EVIDENCE SUGGESTED THAT MITOCHONDRIAL ALTERATION, INCLUDING MITOCHONDRIAL DNA DAMAGE, INCREASED MITOCHONDRIAL REACTIVE OXYGEN SPECIES (ROS), ABNORMAL AUTOPHAGY, AND APOPTOSIS, HAVE BEEN IMPLICATED IN THE PATHOGENESIS OF COPD. THE ALTERATION CAN ALSO EXTEND TO EPIGENETICS, NAMELY DNA METHYLATION, HISTONE MODIFICATION, AND NON-CODING RNA. THIS REVIEW WILL DISCUSS THE RECENT PROGRESSIONS IN COPD PATHOLOGY, PATHOPHYSIOLOGY, AND MOLECULAR PATHWAYS. MORE FOCUS WILL BE SHED ON MITOCHONDRIAL AND EPIGENETIC VARIATIONS RELATED TO COPD DEVELOPMENT AND THE ROLE OF NANOMEDICINE AS A POTENTIAL TOOL FOR THE PREVENTION AND TREATMENT OF THIS DISEASE. 2021 12 2279 39 EPIGENETIC REGULATION IN ALLERGIC DISEASES AND RELATED STUDIES. ASTHMA, A CHRONIC INFLAMMATORY DISORDER OF THE AIRWAY, HAS FEATURES OF BOTH HERITABILITY AS WELL AS ENVIRONMENTAL INFLUENCES WHICH CAN BE INTRODUCED IN UTERO EXPOSURES AND MODIFIED THROUGH AGING, AND THE FEATURES MAY ATTRIBUTE TO EPIGENETIC REGULATION. EPIGENETIC REGULATION EXPLAINS THE ASSOCIATION BETWEEN EARLY PRENATAL MATERNAL SMOKING AND LATER ASTHMA-RELATED OUTCOMES. EPIGENETIC MARKS (DNA METHYLATION, MODIFICATIONS OF HISTONE TAILS OR NONCODING RNAS) WORK WITH OTHER COMPONENTS OF THE CELLULAR REGULATORY MACHINERY TO CONTROL THE LEVELS OF EXPRESSED GENES, AND SEVERAL ALLERGY- AND ASTHMA-RELATED GENES HAVE BEEN FOUND TO BE SUSCEPTIBLE TO EPIGENETIC REGULATION, INCLUDING GENES IMPORTANT TO T-EFFECTOR PATHWAYS (IFN-GAMMA, INTERLEUKIN [IL] 4, IL-13, IL-17) AND T-REGULATORY PATHWAYS (FOXP3). THEREFORE, THE MECHANISM BY WHICH EPIGENETIC REGULATION CONTRIBUTES TO ALLERGIC DISEASES IS A CRITICAL ISSUE. IN THE PAST MOST PUBLISHED EXPERIMENTAL WORK, WITH FEW EXCEPTIONS, HAS ONLY COMPRISED SMALL OBSERVATIONAL STUDIES AND MODELS IN CELL SYSTEMS AND ANIMALS. HOWEVER, VERY RECENTLY EXCITING AND ELEGANT EXPERIMENTAL STUDIES AND NOVEL TRANSLATIONAL RESEARCH WORKS WERE PUBLISHED WITH NEW AND ADVANCED TECHNOLOGIES INVESTIGATING EPIGENETIC MARK ON A GENOMIC SCALE AND COMPREHENSIVE APPROACHES TO DATA ANALYSIS. INTERESTINGLY, A POTENTIAL LINK BETWEEN EXPOSURE TO ENVIRONMENTAL POLLUTANTS AND THE OCCURRENCE OF ALLERGIC DISEASES IS REVEALED RECENTLY, PARTICULAR IN DEVELOPED AND INDUSTRIALIZED COUNTRIES, AND ENDOCRINE DISRUPTING CHEMICALS (EDCS) AS ENVIRONMENTAL HORMONE MAY PLAY A KEY ROLE. THIS REVIEW ADDRESSES THE IMPORTANT QUESTION OF HOW EDCS (NONYLPHENOL, 4 OCTYLPHENOL, AND PHTHALATES) INFLUENCES ON ASTHMA-RELATED GENE EXPRESSION VIA EPIGENETIC REGULATION IN IMMUNE CELLS, AND HOW ANTI-ASTHMATIC AGENTS PROHIBIT EXPRESSION OF INFLAMMATORY GENES VIA EPIGENETIC MODIFICATION. THE DISCOVERY AND VALIDATION OF EPIGENETIC BIOMARKERS LINKING EXPOSURE TO ALLERGIC DISEASES MIGHT LEAD TO BETTER EPIGENOTYPING OF RISK, PROGNOSIS, TREATMENT PREDICTION, AND DEVELOPMENT OF NOVEL THERAPIES. 2014 13 629 33 BIOLOGICAL AND GENETIC MECHANISMS OF COPD, ITS DIAGNOSIS, TREATMENT, AND RELATIONSHIP WITH LUNG CANCER. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS ONE OF THE MOST PREVALENT CHRONIC ADULT DISEASES, WITH SIGNIFICANT WORLDWIDE MORBIDITY AND MORTALITY. ALTHOUGH LONG-TERM TOBACCO SMOKING IS A CRITICAL RISK FACTOR FOR THIS GLOBAL HEALTH PROBLEM, ITS MOLECULAR MECHANISMS REMAIN UNCLEAR. SEVERAL PHENOMENA ARE THOUGHT TO BE INVOLVED IN THE EVOLUTION OF EMPHYSEMA, INCLUDING AIRWAY INFLAMMATION, PROTEINASE/ANTI-PROTEINASE IMBALANCE, OXIDATIVE STRESS, AND GENETIC/EPIGENETIC MODIFICATIONS. FURTHERMORE, COPD IS ONE MAIN RISK FOR LUNG CANCER (LC), THE DEADLIEST FORM OF HUMAN TUMOR; FORMATION AND CHRONIC INFLAMMATION ACCOMPANYING COPD CAN BE A POTENTIAL DRIVER OF MALIGNANCY MATURATION (0.8-1.7% OF COPD CASES DEVELOP CANCER/PER YEAR). RECENTLY, THE DEVELOPMENT OF MORE RESEARCH BASED ON COPD AND LUNG CANCER MOLECULAR ANALYSIS HAS PROVIDED NEW LIGHT FOR UNDERSTANDING THEIR PATHOGENESIS, IMPROVING THE DIAGNOSIS AND TREATMENTS, AND ELUCIDATING MANY CONNECTIONS BETWEEN THESE DISEASES. OUR REVIEW EMPHASIZES THE BIOLOGICAL FACTORS INVOLVED IN COPD AND LUNG CANCER, THE ADVANCES IN THEIR MOLECULAR MECHANISMS' RESEARCH, AND THE STATE OF THE ART OF DIAGNOSIS AND TREATMENTS. THIS WORK COMBINES MANY BIOLOGICAL AND GENETIC ELEMENTS INTO A SINGLE WHOLE AND STRONGLY LINKS COPD WITH LUNG TUMOR FEATURES. 2023 14 1188 39 COPD: A MULTIFACTORIAL SYSTEMIC DISEASE. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) HAS TRADITIONALLY BEEN CONSIDERED A DISEASE OF THE LUNGS SECONDARY TO CIGARETTE SMOKING AND CHARACTERIZED BY AIRFLOW OBSTRUCTION DUE TO ABNORMALITIES OF BOTH AIRWAY (BRONCHITIS) AND LUNG PARENCHYMA (EMPHYSEMA). IT IS NOW WELL KNOWN THAT COPD IS ASSOCIATED WITH SIGNIFICANT SYSTEMIC ABNORMALITIES, SUCH AS RENAL AND HORMONAL ABNORMALITIES, MALNUTRITION, MUSCLE WASTING, OSTEOPOROSIS, AND ANEMIA. HOWEVER, IT IS STILL UNCLEAR WHETHER THEY REPRESENT CONSEQUENCES OF THE PULMONARY DISORDER, OR WHETHER COPD SHOULD BE CONSIDERED AS A SYSTEMIC DISEASE. THESE SYSTEMIC ABNORMALITIES HAVE BEEN ATTRIBUTED TO AN INCREASED LEVEL OF SYSTEMIC INFLAMMATION. CHRONIC INFLAMMATION, HOWEVER, MAY NOT BE THE ONLY CAUSE OF THE SYSTEMIC EFFECTS OF COPD. RECENT DATA FROM HUMANS AND ANIMAL MODELS SUPPORT THE VIEW THAT EMPHYSEMA MAY BE A VASCULAR DISEASE. OTHER STUDIES HAVE HIGHLIGHTED THE ROLE OF REPAIR FAILURE, BONE MARROW ABNORMALITY, GENETIC AND EPIGENETIC FACTORS, IMMUNOLOGICAL DISORDERS AND INFECTIONS AS POTENTIAL CAUSES OF COPD SYSTEMIC MANIFESTATIONS. BASED ON THIS NEW EVIDENCE, IT IS REASONABLE TO CONSIDER COPD, AND EMPHYSEMA IN PARTICULAR, AS 'A DISEASE WITH A SIGNIFICANT SYSTEMIC COMPONENT' IF NOT A 'SYSTEMIC DISEASE' PER SE. THE AIM OF THIS REVIEW IS TO GIVE AN OVERVIEW OF THE MOST RELEVANT AND INNOVATIVE HYPOTHESIS ABOUT THE EXTRAPULMONARY MANIFESTATIONS OF COPD. 2011 15 2474 44 EPIGENETIC UNDERPINNINGS OF INFLAMMATION: CONNECTING THE DOTS BETWEEN PULMONARY DISEASES, LUNG CANCER AND COVID-19. INFLAMMATION IS AN ESSENTIAL COMPONENT OF SEVERAL RESPIRATORY DISEASES, SUCH AS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), ASTHMA AND ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS). IT IS CENTRAL TO LUNG CANCER, THE LEADING CANCER IN TERMS OF ASSOCIATED MORTALITY THAT HAS AFFECTED MILLIONS OF INDIVIDUALS WORLDWIDE. INFLAMMATION AND PULMONARY MANIFESTATIONS ARE ALSO THE MAJOR CAUSES OF COVID-19 RELATED DEATHS. ACUTE HYPERINFLAMMATION PLAYS AN IMPORTANT ROLE IN THE COVID-19 DISEASE PROGRESSION AND SEVERITY, AND DEVELOPMENT OF PROTECTIVE IMMUNITY AGAINST THE VIRUS IS GREATLY SOUGHT. FURTHER, THE SEVERITY OF COVID-19 IS GREATLY ENHANCED IN LUNG CANCER PATIENTS, PROBABLY DUE TO THE GENES SUCH AS ACE2, TMPRSS2, PAI-1 AND FURIN THAT ARE COMMONLY INVOLVED IN CANCER PROGRESSION AS WELL AS SAR-COV-2 INFECTION. THE IMPORTANCE OF INFLAMMATION IN PULMONARY MANIFESTATIONS, CANCER AND COVID-19 CALLS FOR A CLOSER LOOK AT THE UNDERLYING PROCESSES, PARTICULARLY THE ASSOCIATED INCREASE IN IL-6 AND OTHER CYTOKINES, THE DYSREGULATION OF IMMUNE CELLS AND THE COAGULATION PATHWAY. TOWARDS THIS END, SEVERAL REPORTS HAVE IDENTIFIED EPIGENETIC REGULATION OF INFLAMMATION AT DIFFERENT LEVELS. EXPRESSION OF SEVERAL KEY INFLAMMATION-RELATED CYTOKINES, CHEMOKINES AND OTHER GENES IS AFFECTED BY METHYLATION AND ACETYLATION WHILE NON-CODING RNAS, INCLUDING MICRORNAS AS WELL AS LONG NON-CODING RNAS, ALSO AFFECT THE OVERALL INFLAMMATORY RESPONSES. SELECT MIRNAS CAN REGULATE INFLAMMATION IN COVID-19 INFECTION, LUNG CANCER AS WELL AS OTHER INFLAMMATORY LUNG DISEASES, AND CAN SERVE AS EPIGENETIC LINKS THAT CAN BE THERAPEUTICALLY TARGETED. FURTHERMORE, EPIGENETIC CHANGES ALSO MEDIATE THE ENVIRONMENTAL FACTORS-INDUCED INFLAMMATION. THEREFORE, A BETTER UNDERSTANDING OF EPIGENETIC REGULATION OF INFLAMMATION CAN POTENTIALLY HELP DEVELOP NOVEL STRATEGIES TO PREVENT, DIAGNOSE AND TREAT CHRONIC PULMONARY DISEASES, LUNG CANCER AND COVID-19. 2022 16 4901 29 OXIDATIVE, INFLAMMATORY, GENETIC, AND EPIGENETIC BIOMARKERS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISORDER. A LARGE BODY OF EVIDENCE INDICATES THAT CHRONIC OBSTRUCTIVE PULMONARY DISORDER (COPD) IS ACCOMPANIED BY OXIDATIVE STRESS AND INFLAMMATORY AND GENETIC PATHWAYS. EPIDEMIOLOGICAL STUDIES INDICATE THAT COPD IS A MAJOR CAUSE OF MORTALITY AND MORBIDITY IN THE WORLD. RECENT RESEARCH DEVELOPMENT IN COPD FOCUSES ON ACCELERATED AGING AND VARIOUS OXIDATIVE STRESS BIOMARKERS. IT INVOLVES THE CLINICAL MANIFESTATION OF THE DISEASE PROCESS AND MAY ALSO CONTAIN BIOCHEMICAL, IMMUNOLOGICAL, PHYSIOLOGICAL, MORPHOLOGICAL, AND GENETIC ASPECTS THAT ADD TO THE PROGRESSIVENESS OF THE DISEASE. HEREIN, WE SUMMARIZE FINDINGS THAT HIGHLIGHT THE ROLE OF DIMENSIONS OF COPD IN THE INVESTIGATION OF OXIDATIVE STRESS, INFLAMMATORY RESPONSES, GENETIC AND EPIGENETIC STUDIES, AND PHARMACOLOGICAL AND DIETARY ANTIOXIDANT INTERVENTION. 2019 17 3123 44 GETTING AN INSIGHT INTO THE COMPLEXITY OF MAJOR CHRONIC INFLAMMATORY AND DEGENERATIVE DISEASES: A POTENTIAL NEW SYSTEMIC APPROACH TO THEIR TREATMENT. AS THE MODERN SOCIETY IS TROUBLED BY MULTI-FACTORIAL DISEASES, RESEARCH HAS BEEN CONDUCTED ON COMPLEX REALITIES INCLUDING CHRONIC INFLAMMATION, CANCER, OBESITY, HIV INFECTION, METABOLIC SYNDROME AND ITS DETRIMENTAL CARDIOVASCULAR COMPLICATIONS AS WELL AS DEPRESSION AND OTHER BRAIN DISORDERS. DETERIORATION OF CRUCIAL HOMEOSTATIC MECHANISMS IN SUCH DISEASES INVARIABLY RESULTS IN ACTIVATION OF INFLAMMATORY MEDIATORS, CHRONIC INFLAMMATION, LOSS IN IMMUNOLOGICAL FUNCTION, INCREASED SUSCEPTIBILITY TO DISEASES, ALTERATION OF METABOLISM, DECREASE OF ENERGY PRODUCTION AND NEURO-COGNITIVE DECLINE. REGULATION OF GENES EXPRESSION BY EPIGENETIC CODE IS THE DOMINANT MECHANISM FOR THE TRANSDUCTION OF ENVIRONMENTAL INPUTS, SUCH AS STRESS AND INFLAMMATION TO LASTING PHYSIOLOGICAL CHANGES. ACUTE AND CHRONIC STRESS DETERMINES DNA METHYLATION AND HISTONE MODIFICATIONS IN BRAIN REGIONS WHICH MAY CONTRIBUTE TO NEURO-DEGENERATIVE DISORDERS. NUCLEAR GLUCOCORTICOIDS RECEPTOR INTERACTS WITH THE EPIGENOMA RESULTING IN A CORTISOL RESISTANCE STATUS ASSOCIATED WITH A DETERIORATION OF THE METABOLIC AND IMMUNE FUNCTIONS. GONADAL STEROIDS RECEPTORS HAVE A SIMILAR CAPACITY TO PRODUCE EPIGENOMIC REORGANIZATION OF CHROMATINE STRUCTURE. EPIGENOMIC-INDUCED REDUCTION IN IMMUNE CELLS TELOMERES LENGTH HAS BEEN OBSERVED IN MANY DEGENERATIVE DISEASES, INCLUDING ALL TYPES OF CANCER. THE FINAL RESULT OF THESE EPIGENETIC ALTERATIONS IS A SERIOUS DAMAGE TO THE NEURO-ENDOCRINE-IMMUNE-METABOLIC ADAPTIVE SYSTEMS. IN THIS STUDY, WE PROPOSE A TREATMENT WITH STEM CELLS DIFFERENTIATION STAGE FACTORS TAKEN FROM ZEBRAFISH EMBRYOS WHICH ARE ABLE TO REGULATE THE GENES EXPRESSION OF NORMAL AND PATHOLOGICAL STEM CELLS IN A DIFFERENT SPECIFIC WAY. 2015 18 1245 44 CURRENT CONCEPTS ON THE ROLE OF INFLAMMATION IN COPD AND LUNG CANCER. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND LUNG CANCER ARE LEADING CAUSE OF DEATH, AND BOTH ARE ASSOCIATED WITH CIGARETTE SMOKE EXPOSURE. IT HAS BEEN SHOWN THAT 50-70% OF PATIENTS DIAGNOSED WITH LUNG CANCER SUFFER FROM COPD, AND REDUCED LUNG FUNCTION IS AN IMPORTANT EVENT IN LUNG CANCER SUGGESTING AN ASSOCIATION BETWEEN COPD AND LUNG CANCER. HOWEVER, A CAUSAL RELATIONSHIP BETWEEN COPD AND LUNG TUMORIGENESIS IS NOT YET FULLY UNDERSTOOD. RECENT STUDIES HAVE SUGGESTED A CENTRAL ROLE OF CHRONIC INFLAMMATION IN THE PATHOGENESIS OF BOTH THE DISEASES. FOR EXAMPLE, IMMUNE DYSFUNCTION, ABNORMAL ACTIVATION OF NF-KAPPAB, EPITHELIAL-TO-MESENCHYMAL TRANSITION, ALTERED ADHESION SIGNALING PATHWAYS, AND EXTRACELLULAR MATRIX DEGRADATION/ALTERED SIGNALING ARE THE KEY UNDERLYING MECHANISMS IN BOTH COPD AND LUNG CANCER. THESE PARAMETERS ALONG WITH OTHER PROCESSES, SUCH AS CHROMATIN MODIFICATIONS/EPIGENETIC CHANGES, ANGIOGENESIS, AND AUTOPHAGY/APOPTOSIS ARE ALTERED BY CIGARETTE SMOKE, ARE CRUCIAL IN THE DEVELOPMENT OF COPD AND LUNG CANCER. UNDERSTANDING THE CELLULAR AND MOLECULAR MECHANISMS UNDERLYING THESE PROCESSES WILL PROVIDE NOVEL AVENUES FOR HALTING THE CHRONIC INFLAMMATION IN COPD AND DEVISING THERAPEUTIC STRATEGIES AGAINST LUNG CANCER. 2009 19 4026 37 LUNG CANCER AND ITS ASSOCIATION WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: UPDATE ON NEXUS OF EPIGENETICS. PURPOSE OF REVIEW: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND LUNG CANCER ARE THE LEADING CAUSES OF MORBIDITY AND MORTALITY WORLDWIDE. THE CURRENT RESEARCH IS FOCUSED ON IDENTIFYING THE COMMON AND DISPARATE EVENTS INVOLVED IN EPIGENETIC MODIFICATIONS THAT CONCURRENTLY OCCUR DURING THE PATHOGENESIS OF COPD AND LUNG CANCER. THE PURPOSE OF THIS REVIEW IS TO DESCRIBE THE CURRENT KNOWLEDGE AND UNDERSTANDING OF EPIGENETIC MODIFICATIONS IN PATHOGENESIS OF COPD AND LUNG CANCER. RECENT FINDINGS: THIS REVIEW PROVIDES AN UPDATE ON ADVANCES OF HOW EPIGENETIC MODIFICATIONS ARE LINKED TO COPD AND LUNG CANCER, AND THEIR COMMONALITIES AND DISPARITIES. THE KEY EPIGENETIC MODIFICATION ENZYMES (E.G. DNA METHYLTRANSFERASES -- CPG METHYLATION, HISTONE ACETYLASES/DEACETYLASES AND HISTONE METHYLTRANSFERASES/DEMETHYLASES) THAT ARE IDENTIFIED TO PLAY AN IMPORTANT ROLE IN COPD AND LUNG TUMORIGENESIS AND PROGRESSION ARE DESCRIBED IN THIS REVIEW. SUMMARY: DISTINCT DNA METHYLTRANSFERASES AND HISTONE MODIFICATION ENZYMES ARE DIFFERENTIALLY INVOLVED IN PATHOGENESIS OF LUNG CANCER AND COPD, ALTHOUGH SOME OF THE MODIFICATIONS ARE COMMON. UNDERSTANDING THE EPIGENETIC MODIFICATIONS INVOLVED IN PATHOGENESIS OF LUNG CANCER OR COPD WITH RESPECT TO COMMON AND DISPARATE MECHANISMS WILL LEAD TO TARGETING OF EPIGENETIC THERAPIES AGAINST THESE DISORDERS. 2011 20 2212 36 EPIGENETIC MODIFICATIONS AND THERAPY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): AN UPDATE REVIEW. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) THAT IS ONE OF THE MOST PREVALENT CHRONIC ADULT DISEASES AND THE THIRD LEADING CAUSE OF FATALITY UNTIL 2020. ELASTASE/ANTI-ELASTASE HYPOTHESIS, CHRONIC INFLAMMATION, APOPTOSIS, OXIDANT-ANTIOXIDANT BALANCE AND INFECTIVE REPAIR CAUSE PATHOGENESIS OF COPD ARE AMONG THE FACTORS AT PLAY. EPIGENETIC CHANGES ARE POST-TRANSLATIONAL MODIFICATIONS IN HISTONE PROTEINS AND DNA SUCH AS METHYLATION AND ACETYLATION AS WELL AS DYSREGULATION OF MIRNAS EXPRESSION. IN THIS UPDATE REVIEW, WE HAVE EXAMINED RECENT STUDIES ON THE UPREGULATION OR DOWNREGULATION OF METHYLATION IN DIFFERENT GENES ASSOCIATED WITH COPD. DYSREGULATION OF HDAC ACTIVITY WHICH IS CAUSED BY SOME FACTORS AND MIRNAS PLAYS A KEY ROLE IN THE SUPPRESSION AND REDUCTION OF COPD DEVELOPMENT. ALSO, SOME THERAPEUTIC APPROACHES ARE PROPOSED AGAINST COPD BY TARGETING HDAC2 AND MIRNAS, WHICH HAVE THERAPEUTIC EFFECTS. 2020