1 6726 94 VITAMIN-DEPENDENT METHIONINE METABOLISM AND ALCOHOLIC LIVER DISEASE. EMERGING EVIDENCE INDICATES THAT ETHANOL-INDUCED ALTERATIONS IN HEPATIC METHIONINE METABOLISM PLAY A CENTRAL ROLE IN THE PATHOGENESIS OF ALCOHOLIC LIVER DISEASE (ALD). BECAUSE MALNUTRITION IS A UNIVERSAL CLINICAL FINDING IN THIS DISEASE AND HEPATIC METHIONINE METABOLISM IS DEPENDENT UPON DIETARY FOLATE AND VITAMINS B-6 AND B-12, ALD CAN BE CONSIDERED AN INDUCED NUTRITIONAL DISORDER THAT IS CONDITIONED BY ALCOHOL ABUSE. THE PRESENT REVIEW DESCRIBES THE ETIOLOGIES OF THESE 3 VITAMIN DEFICIENCIES IN ALD AND HOW THEY INTERACT WITH CHRONIC ETHANOL EXPOSURE TO ALTER HEPATIC METHIONINE METABOLISM. SUBSEQUENT SECTIONS FOCUS ON MOLECULAR MECHANISMS FOR THE INTERACTIONS OF ABERRANT METHIONINE METABOLISM WITH ETHANOL IN THE PATHOGENESIS OF ALD, IN PARTICULAR THE ROLE OF S-ADENOSYLMETHIONINE (SAM) IN REGULATING THE EPIGENETIC EXPRESSIONS OF GENES RELEVANT TO PATHWAYS OF LIVER INJURY. THE REVIEW WILL CONCLUDE WITH DESCRIPTIONS OF STUDIES ON THE EFFICACY OF SAM IN THE TREATMENT OF ALD AND WITH DISCUSSION OF POTENTIALLY FRUITFUL FUTURE AVENUES OF RESEARCH. 2011 2 318 37 ALCOHOL-INDUCED EPIGENETIC CHANGES IN CANCER. CHRONIC, HEAVY ALCOHOL CONSUMPTION IS ASSOCIATED WITH SERIOUS NEGATIVE HEALTH EFFECTS, INCLUDING THE DEVELOPMENT OF SEVERAL CANCER TYPES. ONE OF THE PATHWAYS AFFECTED BY ALCOHOL TOXICITY IS THE ONE-CARBON METABOLISM. THE ALCOHOL-INDUCED IMPAIRMENT OF THIS METABOLIC PATHWAY RESULTS IN EPIGENETIC CHANGES ASSOCIATED WITH CANCER DEVELOPMENT. THESE EPIGENETIC CHANGES ARE INDUCED BY FOLATE DEFICIENCY AND BY PRODUCTS OF THE ETHANOL METABOLISM. THE CHANGES INDUCED BY LONG-TERM HEAVY ETHANOL CONSUMPTION RESULT IN ELEVATIONS OF HOMOCYSTEINE AND S-ADENOSYL-HOMOCYSTEINE (SAH) AND REDUCTIONS IN S-ADENOSYLMETHIONINE (SAM) AND ANTIOXIDANT GLUTATHIONE (GSH) LEVELS, LEADING TO ABNORMAL PROMOTER GENE HYPERMETHYLATION, GLOBAL HYPOMETHYLATION, AND METABOLIC INSUFFICIENCY OF ANTIOXIDANT DEFENSE MECHANISMS. IN ADDITION, REACTIVE OXYGEN SPECIES (ROS) GENERATED DURING THE ETHANOL METABOLISM INDUCE ALTERATIONS IN DNA METHYLATION PATTERNS THAT PLAY A CRITICAL ROLE IN CANCER DEVELOPMENT. SPECIFIC EPIGENETIC CHANGES IN ESOPHAGEAL, HEPATIC, AND COLORECTAL CANCERS HAVE BEEN DETECTED IN BLOOD SAMPLES AND PROPOSED TO BE USED CLINICALLY AS EPIGENETIC BIOMARKERS FOR DIAGNOSIS AND PROGNOSIS OF THESE CANCERS. ALSO, GENETIC VARIANTS OF GENES INVOLVED IN ONE-CARBON METABOLISM AND ETHANOL METABOLISM WERE FOUND TO MODULATE THE RELATIONSHIP BETWEEN ALCOHOL-INDUCED EPIGENETIC CHANGES AND CANCER RISK. FURTHERMORE, ALCOHOL METABOLISM PRODUCTS HAVE BEEN ASSOCIATED WITH AN INCREASE IN NADH LEVELS, WHICH LEAD TO HISTONE MODIFICATIONS AND CHANGES IN GENE EXPRESSION THAT IN TURN INFLUENCE CANCER SUSCEPTIBILITY. CHRONIC EXCESSIVE USE OF ALCOHOL ALSO AFFECTS SELECTED MEMBERS OF THE FAMILY OF MICRORNAS, AND AS MIRNAS COULD ACT AS EPIGENETIC REGULATORS, THIS MAY PLAY AN IMPORTANT ROLE IN CARCINOGENESIS. IN CONCLUSION, TARGETING ALCOHOL-INDUCED EPIGENETIC CHANGES IN SEVERAL CANCER TYPES COULD MAKE AVAILABLE CLINICAL TOOLS FOR THE DIAGNOSIS, PROGNOSIS, AND TREATMENT OF THESE CANCERS, WITH AN IMPORTANT ROLE IN PRECISION MEDICINE. 2018 3 320 34 ALCOHOLIC LIVER DISEASE: PATHOGENESIS AND NEW THERAPEUTIC TARGETS. ALCOHOLIC LIVER DISEASE (ALD) IS A MAJOR CAUSE OF CHRONIC LIVER DISEASE WORLDWIDE AND CAN LEAD TO FIBROSIS AND CIRRHOSIS. THE LATEST SURVEILLANCE REPORT PUBLISHED BY THE NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM SHOWED THAT LIVER CIRRHOSIS WAS THE 12TH LEADING CAUSE OF DEATH IN THE UNITED STATES, WITH A TOTAL OF 29,925 DEATHS IN 2007, 48% OF WHICH WERE ALCOHOL RELATED. THE SPECTRUM OF ALD INCLUDES SIMPLE STEATOSIS, ALCOHOLIC HEPATITIS, FIBROSIS, CIRRHOSIS, AND SUPERIMPOSED HEPATOCELLULAR CARCINOMA. EARLY WORK ON THE PATHOGENESIS OF THE DISEASE FOCUSED ON ETHANOL METABOLISM-ASSOCIATED OXIDATIVE STRESS AND GLUTATHIONE DEPLETION, ABNORMAL METHIONINE METABOLISM, MALNUTRITION, AND PRODUCTION OF ENDOTOXINS THAT ACTIVATE KUPFFER CELLS. WE REVIEW FINDINGS FROM RECENT STUDIES THAT HAVE CHARACTERIZED SPECIFIC INTRACELLULAR SIGNALING PATHWAYS, TRANSCRIPTIONAL FACTORS, ASPECTS OF INNATE IMMUNITY, CHEMOKINES, EPIGENETIC FEATURES, MICRORNAS, AND STEM CELLS THAT ARE ASSOCIATED WITH ALD, IMPROVING OUR UNDERSTANDING OF ITS PATHOGENESIS. DESPITE THIS PROGRESS, NO TARGETED THERAPIES ARE AVAILABLE. THE CORNERSTONE OF TREATMENT FOR ALCOHOLIC HEPATITIS REMAINS AS IT WAS 40 YEARS AGO: ABSTINENCE, NUTRITIONAL SUPPORT, AND CORTICOSTEROIDS. THERE IS AN URGENT NEED TO DEVELOP NEW PATHOPHYSIOLOGY-ORIENTED THERAPIES. RECENT TRANSLATIONAL STUDIES OF HUMAN SAMPLES AND ANIMAL MODELS HAVE IDENTIFIED PROMISING THERAPEUTIC TARGETS. 2011 4 315 31 ALCOHOL, DNA METHYLATION, AND CANCER. CANCER IS ONE OF THE MOST SIGNIFICANT DISEASES ASSOCIATED WITH CHRONIC ALCOHOL CONSUMPTION, AND CHRONIC DRINKING IS A STRONG RISK FACTOR FOR CANCER, PARTICULARLY OF THE UPPER AERODIGESTIVE TRACT, LIVER, COLORECTUM, AND BREAST. SEVERAL FACTORS CONTRIBUTE TO ALCOHOL-INDUCED CANCER DEVELOPMENT (I.E., CARCINOGENESIS), INCLUDING THE ACTIONS OF ACETALDEHYDE, THE FIRST AND PRIMARY METABOLITE OF ETHANOL, AND OXIDATIVE STRESS. HOWEVER, INCREASING EVIDENCE SUGGESTS THAT ABERRANT PATTERNS OF DNA METHYLATION, AN IMPORTANT EPIGENETIC MECHANISM OF TRANSCRIPTIONAL CONTROL, ALSO COULD BE PART OF THE PATHOGENETIC MECHANISMS THAT LEAD TO ALCOHOL-INDUCED CANCER DEVELOPMENT. THE EFFECTS OF ALCOHOL ON GLOBAL AND LOCAL DNA METHYLATION PATTERNS LIKELY ARE MEDIATED BY ITS ABILITY TO INTERFERE WITH THE AVAILABILITY OF THE PRINCIPAL BIOLOGICAL METHYL DONOR, S-ADENOSYLMETHIONINE (SAME), AS WELL AS PATHWAYS RELATED TO IT. SEVERAL MECHANISMS MAY MEDIATE THE EFFECTS OF ALCOHOL ON DNA METHYLATION, INCLUDING REDUCED FOLATE LEVELS AND INHIBITION OF KEY ENZYMES IN ONE-CARBON METABOLISM THAT ULTIMATELY LEAD TO LOWER SAME LEVELS, AS WELL AS INHIBITION OF ACTIVITY AND EXPRESSION OF ENZYMES INVOLVED IN DNA METHYLATION (I.E., DNA METHYLTRANSFERASES). FINALLY, VARIATIONS (I.E., POLYMORPHISMS) OF SEVERAL GENES INVOLVED IN ONE-CARBON METABOLISM ALSO MODULATE THE RISK OF ALCOHOL-ASSOCIATED CARCINOGENESIS. 2013 5 558 47 B-VITAMIN DEPENDENT METHIONINE METABOLISM AND ALCOHOLIC LIVER DISEASE. CONVINCING EVIDENCE LINKS ABERRANT B-VITAMIN DEPENDENT HEPATIC METHIONINE METABOLISM TO THE PATHOGENESIS OF ALCOHOLIC LIVER DISEASE (ALD). THIS REVIEW FOCUSES ON THE ESSENTIAL ROLES OF FOLATE AND VITAMINS B6 AND B12 IN HEPATIC METHIONINE METABOLISM, THE CAUSES OF THEIR DEFICIENCIES AMONG CHRONIC ALCOHOLIC PERSONS, AND HOW THEIR DEFICIENCIES TOGETHER WITH CHRONIC ALCOHOL EXPOSURE IMPACT ON ABERRANT METHIONINE METABOLISM IN THE PATHOGENESIS OF ALD. FOLATE IS THE DIETARY TRANSMETHYLATION DONOR FOR THE PRODUCTION OF S-ADENOSYLMETHIONINE (SAM), WHICH IS THE SUBSTRATE FOR ALL METHYLTRANSFERASES THAT REGULATE GENE EXPRESSIONS IN PATHWAYS OF LIVER INJURY, AS WELL AS A REGULATOR OF THE TRANSSULFURATION PATHWAY THAT IS ESSENTIAL FOR PRODUCTION OF GLUTATHIONE (GSH), THE PRINCIPAL ANTIOXIDANT FOR DEFENSE AGAINST OXIDATIVE LIVER INJURY. VITAMIN B12 REGULATES TRANSMETHYLATION REACTIONS FOR SAM PRODUCTION AND VITAMIN B6 REGULATES TRANSSULFURATION REACTIONS FOR GSH PRODUCTION. FOLATE DEFICIENCY ACCELERATES THE EXPERIMENTAL DEVELOPMENT OF ALD IN ETHANOL-FED ANIMALS WHILE REDUCING LIVER SAM LEVELS WITH RESULTANT ABNORMAL GENE EXPRESSION AND DECREASED PRODUCTION OF ANTIOXIDANT GSH. THROUGH ITS EFFECTS ON FOLATE METABOLISM, REDUCED SAM ALSO IMPAIRS NUCLEOTIDE BALANCE WITH RESULTANT INCREASED DNA STRAND BREAKS, OXIDATION, HEPATOCELLULAR APOPTOSIS, AND RISK OF CARCINOGENESIS. THE REVIEW ENCOMPASSES REFERENCED STUDIES ON MECHANISMS FOR PERTURBATIONS OF METHIONINE METABOLISM IN ALD, EVIDENCE FOR ALTERED GENE EXPRESSIONS AND THEIR EPIGENETIC REGULATION IN THE PATHOGENESIS OF ALD, AND CLINICAL STUDIES ON POTENTIAL PREVENTION AND TREATMENT OF ALD BY CORRECTION OF METHIONINE METABOLISM WITH SAM. 2013 6 2104 34 EPIGENETIC EVENTS IN LIVER CANCER RESULTING FROM ALCOHOLIC LIVER DISEASE. EPIGENETIC MECHANISMS PLAY AN EXTENSIVE ROLE IN THE DEVELOPMENT OF LIVER CANCER (I.E., HEPATOCELLULAR CARCINOMA [HCC]) ASSOCIATED WITH ALCOHOLIC LIVER DISEASE (ALD) AS WELL AS IN LIVER DISEASE ASSOCIATED WITH OTHER CONDITIONS. FOR EXAMPLE, EPIGENETIC MECHANISMS, SUCH AS CHANGES IN THE METHYLATION AND/OR ACETYLATION PATTERN OF CERTAIN DNA REGIONS OR OF THE HISTONE PROTEINS AROUND WHICH THE DNA IS WRAPPED, CONTRIBUTE TO THE REVERSION OF NORMAL LIVER CELLS INTO PROGENITOR AND STEM CELLS THAT CAN DEVELOP INTO HCC. CHRONIC EXPOSURE TO BEVERAGE ALCOHOL (I.E., ETHANOL) CAN INDUCE ALL OF THESE EPIGENETIC CHANGES. THUS, ETHANOL METABOLISM RESULTS IN THE FORMATION OF COMPOUNDS THAT CAN CAUSE CHANGES IN DNA METHYLATION AND INTERFERE WITH OTHER COMPONENTS OF THE NORMAL PROCESSES REGULATING DNA METHYLATION. ALCOHOL EXPOSURE ALSO CAN ALTER HISTONE ACETYLATION/DEACETYLATION AND METHYLATION PATTERNS THROUGH A VARIETY OF MECHANISMS AND SIGNALING PATHWAYS. ALCOHOL ALSO ACTS INDIRECTLY ON ANOTHER MOLECULE CALLED TOLL-LIKE RECEPTOR 4 (TLR4) THAT IS A KEY COMPONENT IN A CRUCIAL REGULATORY PATHWAY IN THE CELLS AND WHOSE DYSREGULATION IS INVOLVED IN THE DEVELOPMENT OF HCC. FINALLY, ALCOHOL USE REGULATES AN EPIGENETIC MECHANISM INVOLVING SMALL MOLECULES CALLED MIRNAS THAT CONTROL TRANSCRIPTIONAL EVENTS AND THE EXPRESSION OF GENES IMPORTANT TO ALD. 2013 7 4659 38 NEW APPROACHES FOR STUDYING ALCOHOLIC LIVER DISEASE. ALCOHOLIC LIVER DISEASE (ALD) IS MAJOR CAUSE OF CHRONIC LIVER INJURY WHICH RESULTS IN LIVER FIBROSIS AND CIRRHOSIS. ACCORDING TO THE SURVEILLANCE REPORT PUBLISHED BY THE NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM, LIVER CIRRHOSIS IS THE 12TH LEADING CAUSE OF DEATH IN THE UNITED STATES WITH 48 % OF THESE DEATHS BEING ATTRIBUTED TO EXCESSIVE ALCOHOL CONSUMPTION. ALD INCLUDES A SPECTRUM OF DISORDERS FROM SIMPLE STEATOSIS TO STEATOHEPATITIS, FIBROSIS, AND HEPATOCELLULAR CARCINOMA. SEVERAL MECHANISMS PLAY A CRITICAL ROLE IN THE PATHOGENESIS OF ALD. THESE INCLUDE ETHANOL-INDUCED OXIDATIVE STRESS AND DEPLETION OF GLUTATHIONE, PATHOLOGICAL METHIONINE METABOLISM, INCREASED GUT PERMEABILITY AND RELEASE OF ENDOTOXINS INTO THE PORTAL BLOOD, RECRUITMENT AND ACTIVATION OF INFLAMMATORY CELLS INCLUDING BONE MARROW-DERIVED AND LIVER RESIDENT MACROPHAGES (KUPFFER CELLS). CHRONIC ALCOHOL CONSUMPTION RESULTS IN LIVER DAMAGE AND ACTIVATION OF HEPATIC STELLATE CELLS (HSCS) AND MYOFIBROBLASTS, LEADING TO LIVER FIBROSIS. HERE WE DISCUSS THE CURRENT VIEW ON FACTORS THAT ARE SPECIFIC FOR DIFFERENT STAGES OF ALD AND THOSE THAT REGULATE ITS PROGRESSION, INCLUDING CYTOKINES AND CHEMOKINES, ALCOHOL-RESPONSIVE INTRACELLULAR SIGNALING PATHWAYS, AND TRANSCRIPTIONAL FACTORS. WE ALSO REVIEW RECENT STUDIES DEMONSTRATING THAT ALCOHOL-MEDIATED CHANGES CAN BE REGULATED ON AN EPIGENETIC LEVEL, INCLUDING MICRORNAS. FINALLY, WE DISCUSS THE REVERSIBILITY OF LIVER FIBROSIS AND INACTIVATION OF HSCS AS A POTENTIAL STRATEGY FOR TREATING ALCOHOL-INDUCED LIVER DAMAGE. 2014 8 2833 28 FOLATE AND DNA METHYLATION: A REVIEW OF MOLECULAR MECHANISMS AND THE EVIDENCE FOR FOLATE'S ROLE. DNA METHYLATION IS AN EPIGENETIC MODIFICATION CRITICAL TO NORMAL GENOME REGULATION AND DEVELOPMENT. THE VITAMIN FOLATE IS A KEY SOURCE OF THE ONE CARBON GROUP USED TO METHYLATE DNA. BECAUSE NORMAL MAMMALIAN DEVELOPMENT IS DEPENDENT ON DNA METHYLATION, THERE IS ENORMOUS INTEREST IN ASSESSING THE POTENTIAL FOR CHANGES IN FOLATE INTAKE TO MODULATE DNA METHYLATION BOTH AS A BIOMARKER FOR FOLATE STATUS AND AS A MECHANISTIC LINK TO DEVELOPMENTAL DISORDERS AND CHRONIC DISEASES INCLUDING CANCER. THIS REVIEW HIGHLIGHTS THE ROLE OF DNA METHYLATION IN NORMAL GENOME FUNCTION, HOW IT CAN BE ALTERED, AND THE EVIDENCE OF THE ROLE OF FOLATE/FOLIC ACID IN THESE PROCESSES. 2012 9 4705 31 NLRP3: A NEW THERAPEUTIC TARGET IN ALCOHOLIC LIVER DISEASE. THE LIVER IS IN CHARGE OF A WIDE RANGE OF CRITICAL PHYSIOLOGICAL PROCESSES AND IT PLAYS AN IMPORTANT ROLE IN ACTIVATING THE INNATE IMMUNE SYSTEM WHICH ELICITS THE INFLAMMATORY EVENTS. CHRONIC ETHANOL EXPOSURE DISRUPTS HEPATIC INFLAMMATORY MECHANISM AND LEADS TO THE RELEASE OF PROINFLAMMATORY MEDIATORS SUCH AS CHEMOKINES, CYTOKINES AND ACTIVATION OF INFLAMMASOMES. THE MECHANISM OF LIVER FIBROSIS/CIRRHOSIS INVOLVE ACTIVATION OF NLRP3 INFLAMMASOME, LEADING TO THE DESTRUCTION OF HEPATOCYTES AND SUBSEQUENT METABOLIC DYSREGULATION IN HUMANS. IN ADDITION, INCREASING EVIDENCE SUGGESTS THAT ALCOHOL INTAKE SIGNIFICANTLY MODIFIES LIVER EPIGENETICS, PROMOTING THE DEVELOPMENT OF ALCOHOLIC LIVER DISEASE (ALD). EPIGENETIC CHANGES INCLUDING HISTONE MODIFICATION, MICRORNA-INDUCED GENETIC MODULATION, AND DNA METHYLATION ARE CRUCIAL IN ALCOHOL-EVOKED CELL SIGNALING THAT AFFECTS GENE EXPRESSION IN THE HEPATIC SYSTEM. THOUGH WE ARE AT THE BEGINNING STAGE WITHOUT HAVING THE ENTIRE PRINT OF EPIGENETIC SIGNATURE, IT IS TIME TO FOCUS MORE ON NLRP3 INFLAMMASOME AND EPIGENETIC MODIFICATIONS. HERE WE REVIEW THE NOVEL ASPECT OF ALD PATHOLOGY LINKING TO INFLAMMATION AND HIGHLIGHTING THE ROLE OF EPIGENETIC MODIFICATION ASSOCIATED WITH NLRP3 INFLAMMASOME AND HOW IT COULD BE A THERAPEUTIC TARGET IN ALD. 2023 10 4897 30 OXIDATIVE STRESS IN ALCOHOL-RELATED LIVER DISEASE. ALCOHOL CONSUMPTION IS ONE OF THE LEADING CAUSES OF THE GLOBAL BURDEN OF DISEASE AND RESULTS IN HIGH HEALTHCARE AND ECONOMIC COSTS. HEAVY ALCOHOL MISUSE LEADS TO ALCOHOL-RELATED LIVER DISEASE, WHICH IS RESPONSIBLE FOR A SIGNIFICANT PROPORTION OF ALCOHOL-ATTRIBUTABLE DEATHS GLOBALLY. OTHER THAN REDUCING ALCOHOL CONSUMPTION, THERE ARE CURRENTLY NO EFFECTIVE TREATMENTS FOR ALCOHOL-RELATED LIVER DISEASE. OXIDATIVE STRESS REFERS TO AN IMBALANCE IN THE PRODUCTION AND ELIMINATION OF REACTIVE OXYGEN SPECIES AND ANTIOXIDANTS. IT PLAYS IMPORTANT ROLES IN SEVERAL ASPECTS OF ALCOHOL-RELATED LIVER DISEASE PATHOGENESIS. HERE, WE REVIEW HOW CHRONIC ALCOHOL USE RESULTS IN OXIDATIVE STRESS THROUGH INCREASED METABOLISM VIA THE CYTOCHROME P450 2E1 SYSTEM PRODUCING REACTIVE OXYGEN SPECIES, ACETALDEHYDE AND PROTEIN AND DNA ADDUCTS. THESE TRIGGER INFLAMMATORY SIGNALING PATHWAYS WITHIN THE LIVER LEADING TO EXPRESSION OF PRO-INFLAMMATORY MEDIATORS CAUSING HEPATOCYTE APOPTOSIS AND NECROSIS. REACTIVE OXYGEN SPECIES EXPOSURE ALSO RESULTS IN MITOCHONDRIAL STRESS WITHIN HEPATOCYTES CAUSING STRUCTURAL AND FUNCTIONAL DYSREGULATION OF MITOCHONDRIA AND UPREGULATING APOPTOTIC SIGNALING. THERE IS ALSO EVIDENCE THAT OXIDATIVE STRESS AS WELL AS THE DIRECT EFFECT OF ALCOHOL INFLUENCES EPIGENETIC REGULATION. INCREASED GLOBAL HISTONE METHYLATION AND ACETYLATION AND SPECIFIC HISTONE ACETYLATION INHIBITS ANTIOXIDANT RESPONSES AND PROMOTES EXPRESSION OF KEY PRO-INFLAMMATORY GENES. THIS REVIEW HIGHLIGHTS ASPECTS OF THE ROLE OF OXIDATIVE STRESS IN DISEASE PATHOGENESIS THAT WARRANT FURTHER STUDY INCLUDING MITOCHONDRIAL STRESS AND EPIGENETIC REGULATION. IMPROVED UNDERSTANDING OF THESE PROCESSES MAY IDENTIFY NOVEL TARGETS FOR THERAPY. 2020 11 4104 29 MECHANISM AND THERAPEUTIC OPPORTUNITIES OF HISTONE MODIFICATIONS IN CHRONIC LIVER DISEASE. CHRONIC LIVER DISEASE (CLD) REPRESENTS A GLOBAL HEALTH PROBLEM, ACCOUNTING FOR THE HEAVY BURDEN OF DISABILITY AND INCREASED HEALTH CARE UTILIZATION. EPIGENOME ALTERATIONS PLAY AN IMPORTANT ROLE IN THE OCCURRENCE AND PROGRESSION OF CLD. HISTONE MODIFICATIONS, WHICH INCLUDE ACETYLATION, METHYLATION, AND PHOSPHORYLATION, REPRESENT AN ESSENTIAL PART OF EPIGENETIC MODIFICATIONS THAT AFFECT THE TRANSCRIPTIONAL ACTIVITY OF GENES. DIFFERENT FROM GENETIC MUTATIONS, HISTONE MODIFICATIONS ARE PLASTIC AND REVERSIBLE. THEY CAN BE MODULATED PHARMACOLOGICALLY WITHOUT CHANGING THE DNA SEQUENCE. THUS, THERE MIGHT BE CHANCES TO ESTABLISH INTERVENTIONAL SOLUTIONS BY TARGETING HISTONE MODIFICATIONS TO REVERSE CLD. HERE WE SUMMARIZED THE ROLES OF HISTONE MODIFICATIONS IN THE CONTEXT OF ALCOHOLIC LIVER DISEASE (ALD), METABOLIC ASSOCIATED FATTY LIVER DISEASE (MAFLD), VIRAL HEPATITIS, AUTOIMMUNE LIVER DISEASE, DRUG-INDUCED LIVER INJURY (DILI), AND LIVER FIBROSIS OR CIRRHOSIS. THE POTENTIAL TARGETS OF HISTONE MODIFICATIONS FOR TRANSLATION INTO THERAPEUTICS WERE ALSO INVESTIGATED. IN PROSPECT, HIGH EFFICACY AND LOW TOXICITY DRUGS THAT ARE SELECTIVELY TARGETING HISTONE MODIFICATIONS ARE REQUIRED TO COMPLETELY REVERSE CLD AND PREVENT THE DEVELOPMENT OF LIVER CIRRHOSIS AND MALIGNANCY. 2021 12 4683 43 NEW PERSPECTIVES ON FOLATE TRANSPORT IN RELATION TO ALCOHOLISM-INDUCED FOLATE MALABSORPTION--ASSOCIATION WITH EPIGENOME STABILITY AND CANCER DEVELOPMENT. FOLATES ARE MEMBERS OF THE B-CLASS OF VITAMINS, WHICH ARE REQUIRED FOR THE SYNTHESIS OF PURINES AND PYRIMIDINES, AND FOR THE METHYLATION OF ESSENTIAL BIOLOGICAL SUBSTANCES, INCLUDING PHOSPHOLIPIDS, DNA, AND NEUROTRANSMITTERS. FOLATES CANNOT BE SYNTHESIZED DE NOVO BY MAMMALS; HENCE, AN EFFICIENT INTESTINAL ABSORPTION PROCESS IS REQUIRED. INTESTINAL FOLATE TRANSPORT IS CARRIER-MEDIATED, PH-DEPENDENT AND ELECTRONEUTRAL, WITH SIMILAR AFFINITY FOR OXIDIZED AND REDUCED FOLIC ACID DERIVATIVES. THE VARIOUS TRANSPORTERS, I.E. REDUCED FOLATE CARRIER, PROTON-COUPLED FOLATE TRANSPORTER, FOLATE-BINDING PROTEIN, AND ORGANIC ANION TRANSPORTERS, ARE INVOLVED IN THE FOLATE TRANSPORT PROCESS IN VARIOUS TISSUES. ANY IMPAIRMENT IN UPTAKE OF FOLATE CAN LEAD TO A STATE OF FOLATE DEFICIENCY, THE MOST PREVALENT VITAMIN DEFICIENCY IN WORLD, AFFECTING 10% OF THE POPULATION IN THE USA. SUCH IMPAIRMENTS IN FOLATE TRANSPORT OCCUR IN A VARIETY OF CONDITIONS, INCLUDING CHRONIC USE OF ETHANOL, SOME INBORN HEREDITARY DISORDERS, AND CERTAIN DISEASES. AMONG THESE, ETHANOL INGESTION HAS BEEN THE MAJOR CONTRIBUTOR TO FOLATE DEFICIENCY. ETHANOL-ASSOCIATED FOLATE DEFICIENCY CAN DEVELOP BECAUSE OF DIETARY INADEQUACY, INTESTINAL MALABSORPTION, ALTERED HEPATOBILIARY METABOLISM, ENHANCED COLONIC METABOLISM, AND INCREASED RENAL EXCRETION. ETHANOL REDUCES THE INTESTINAL AND RENAL UPTAKE OF FOLATE BY ALTERING THE BINDING AND TRANSPORT KINETICS OF FOLATE TRANSPORT SYSTEMS. ALSO, ETHANOL REDUCES THE EXPRESSION OF FOLATE TRANSPORTERS IN BOTH INTESTINE AND KIDNEY, AND THIS MIGHT BE A CONTRIBUTING FACTOR FOR FOLATE MALABSORPTION, LEADING TO FOLATE DEFICIENCY. THE MAINTENANCE OF INTRACELLULAR FOLATE HOMEOSTASIS IS ESSENTIAL FOR THE ONE-CARBON TRANSFER REACTIONS NECESSARY FOR DNA SYNTHESIS AND BIOLOGICAL METHYLATION REACTIONS. DNA METHYLATION IS AN IMPORTANT EPIGENETIC DETERMINANT IN GENE EXPRESSION, IN THE MAINTENANCE OF DNA INTEGRITY AND STABILITY, IN CHROMOSOMAL MODIFICATIONS, AND IN THE DEVELOPMENT OF MUTATIONS. ETHANOL, A TOXIN THAT IS CONSUMED REGULARLY, HAS BEEN FOUND TO AFFECT THE METHYLATION OF DNA. IN ADDITION TO ITS EFFECT ON DNA METHYLATION DUE TO FOLATE DEFICIENCY, ETHANOL COULD DIRECTLY EXERT ITS EFFECT THROUGH ITS INTERACTION WITH ONE-CARBON METABOLISM, IMPAIRMENT OF METHYL GROUP SYNTHESIS, AND AFFECTING THE ENZYMES REGULATING THE SYNTHESIS OF S-ADENOSYLMETHIONINE, THE PRIMARY METHYL GROUP DONOR FOR MOST BIOLOGICAL METHYLATION REACTIONS. THUS, ETHANOL PLAYS AN IMPORTANT ROLE IN THE PATHOGENESIS OF SEVERAL DISEASES THROUGH ITS POTENTIAL ABILITY TO MODULATE THE METHYLATION OF BIOLOGICAL MOLECULES. THIS REVIEW DISCUSSES THE UNDERLYING MECHANISM OF FOLATE MALABSORPTION IN ALCOHOLISM, THE MECHANISM OF METHYLATION-ASSOCIATED SILENCING OF GENES, AND HOW THE INTERACTION BETWEEN ETHANOL AND FOLATE DEFICIENCY AFFECTS THE METHYLATION OF GENES, THEREBY MODULATING EPIGENOME STABILITY AND THE RISK OF CANCER. 2009 13 4216 34 METHYL DONOR MICRONUTRIENTS: A POTENTIAL DIETARY EPIGENETIC TARGET IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IS A CHRONIC AUTOIMMUNE DISEASE CHARACTERIZED BY AN ABERRANT IMMUNE RESPONSE AND PERSISTENT INFLAMMATION. ITS PATHOGENESIS REMAINS UNKNOWN; HOWEVER, A COMPLEX INTERACTION BETWEEN ENVIRONMENTAL, GENETIC, AND EPIGENETIC FACTORS HAS BEEN SUGGESTED TO CAUSE DISEASE ONSET. SEVERAL STUDIES HAVE DEMONSTRATED THAT EPIGENETIC ALTERATIONS, SUCH AS DNA HYPOMETHYLATION, MIRNA OVEREXPRESSION, AND ALTERED HISTONE ACETYLATION, MAY CONTRIBUTE TO SLE ONSET AND THE DISEASE'S CLINICAL MANIFESTATIONS. EPIGENETIC CHANGES, ESPECIALLY METHYLATION PATTERNS, ARE MODIFIABLE AND SUSCEPTIBLE TO ENVIRONMENTAL FACTORS SUCH AS DIET. IT IS WELL KNOWN THAT METHYL DONOR NUTRIENTS, SUCH AS FOLATE, METHIONINE, CHOLINE, AND SOME B VITAMINS, PLAY A RELEVANT ROLE IN DNA METHYLATION BY PARTICIPATING AS METHYL DONORS OR COENZYMES IN ONE-CARBON METABOLISM. BASED ON THIS KNOWLEDGE, THIS CRITICAL LITERATURE REVIEW AIMED TO INTEGRATE THE EVIDENCE IN ANIMAL MODELS AND HUMANS REGARDING THE ROLE OF NUTRIENTS IN EPIGENETIC HOMEOSTASIS AND THEIR IMPACT ON IMMUNE SYSTEM REGULATION TO SUGGEST A POTENTIAL EPIGENETIC DIET THAT COULD SERVE AS ADJUVANT THERAPY IN SLE. 2023 14 6717 30 VITAMIN B SUPPLEMENTATION AND NUTRITIONAL INTAKE OF METHYL DONORS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A CRITICAL REVIEW OF THE IMPACT ON EPIGENETIC MACHINERY. CARDIOVASCULAR MORBIDITY AND MORTALITY ARE SEVERAL-FOLD HIGHER IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE (CKD) AND END-STAGE RENAL DISEASE (ESRD) THAN IN THE GENERAL POPULATION. HYPERHOMOCYSTEINEMIA HAS UNDOUBTEDLY A CENTRAL ROLE IN SUCH A PROMINENT CARDIOVASCULAR BURDEN. THE LEVELS OF HOMOCYSTEINE ARE REGULATED BY METHYL DONORS (FOLATE, METHIONINE, CHOLINE, BETAINE), AND COFACTORS (VITAMIN B6, VITAMIN B12,). UREMIA-INDUCED HYPERHOMOCYSTEINEMIA HAS AS ITS MAIN TARGETS DNA METHYLTRANSFERASES, AND THIS LEADS TO AN ALTERED EPIGENETIC CONTROL OF GENES REGULATED THROUGH METHYLATION. IN RENAL PATIENTS, THE EPIGENETIC LANDSCAPE IS STRICTLY CORRELATED WITH THE UREMIC PHENOTYPE AND DEPENDENT ON DIETARY INTAKE OF MICRONUTRIENTS, INFLAMMATION, GUT MICROBIOME, INFLAMMATORY STATUS, OXIDATIVE STRESS, AND LIFESTYLE HABITS. ALL THESE FACTORS ARE KEY CONTRIBUTORS IN METHYLOME MAINTENANCE AND IN THE MODULATION OF GENE TRANSCRIPTION THROUGH DNA HYPO- OR HYPERMETHYLATION IN CKD. THIS IS AN OVERVIEW OF THE EPIGENETIC CHANGES RELATED TO DNA METHYLATION IN PATIENTS WITH ADVANCED CKD AND ESRD. WE EXPLORED THE CURRENTLY AVAILABLE DATA ON THE MOLECULAR DYSREGULATIONS RESULTING FROM ALTERED GENE EXPRESSION IN UREMIA. SPECIAL ATTENTION WAS PAID TO THE EFFICACY OF B-VITAMINS SUPPLEMENTATION AND DIETARY INTAKE OF METHYL DONORS ON HOMOCYSTEINE LOWERING AND CARDIOVASCULAR PROTECTION. 2020 15 321 26 ALCOHOLIC-RELATED LIVER DISEASE: PATHOGENESIS, MANAGEMENT AND FUTURE THERAPEUTIC DEVELOPMENTS. ALCOHOL-RELATED LIVER DISEASE (ALD) IS THE MOST FREQUENT CAUSE OF ADVANCED CHRONIC LIVER DISEASE WORLDWIDE. EXCESSIVE AND PROLONGED ALCOHOL USE LEADS TO ALD, WHICH RANGES FROM EARLY FORMS SUCH AS ALCOHOLIC FATTY LIVER (AFL) AND ALCOHOLIC STEATOHEPATITIS (ASH), THROUGH PROGRESSIVE FIBROSIS TO CIRRHOSIS AND THE DEVELOPMENT OF HEPATOCELLULAR CANCER (HCC). IN ADDITION, PATIENTS WITH UNDERLYING ALD AND CONTINUOUS ALCOHOL USE CAN DEVELOP ALCOHOLIC HEPATITIS (AH), WHICH PRESENTS A RAPID PROGRESSION OF LIVER FAILURE AND HAS A HIGH SHORT-TERM MORTALITY. GENETIC, ENVIRONMENTAL AND EPIGENETIC FACTORS INFLUENCE THE PROGRESSION OF ALD TO MORE SEVERE FORMS. THE PATHOGENESIS OF ALD IS COMPLEX AND INVOLVES MULTIPLE PATHWAYS. RECENT TRANSLATIONAL STUDIES HAVE DEMONSTRATED A KEY ROLE OF THE GUT-LIVER AXIS AND INNATE IMMUNITY IN HEPATOCELLULAR DAMAGE AND FIBROSIS. IN SEVERE FORMS, HEPATOCELLULAR DE-DIFFERENTIATION AND SYSTEMIC INFLAMMATION CONTRIBUTE TO LIVER FAILURE AND MULTIORGAN FAILURE. ALCOHOL ABSTINENCE IS THE CORNERSTONE OF THERAPY FOR ALD AND THE PREVENTION OF ITS COMPLICATIONS, BUT THE EFFICACY AND ACCESSIBILITY OF PSYCHO-FAMILIAL-SOCIAL INTERVENTIONS IS STILL POOR AND EFFECTIVE PUBLIC HEALTH POLICIES TO LIMIT PROBLEMATIC ALCOHOL USE NEED TO BE IMPLEMENTED. PREDNISOLONE IS THE ONLY CURRENT OPTION FOR AH, WITH A TRANSIENT BENEFICIAL EFFECT OVER PLACEBO. FOR PATIENTS WITH DECOMPENSATED ALD-CIRRHOSIS AND/OR DEVELOPMENT OF HCC, LIVER TRANSPLANTATION (LT) MAY BE REQUIRED. IN RECENT YEARS, EARLY LT IS BEING INCREASINGLY OFFERED TO CAREFULLY SELECTED AH PATIENTS, WITH EXCELLENT LONG-TERM SURVIVAL. NEW TRIALS OF AH TREATMENTS ARE CURRENTLY ONGOING, AND TRANSLATIONAL STUDIES IN HUMAN SAMPLES ARE PAVING THE WAY TO NEW PROMISING TARGETED THERAPIES. 2020 16 1491 33 DNA HYDROXYMETHYLATION AT THE INTERFACE OF THE ENVIRONMENT AND NONALCOHOLIC FATTY LIVER DISEASE. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS ONE OF THE MOST PREVALENT FORMS OF CHRONIC LIVER DISORDERS AMONG ADULTS, CHILDREN, AND ADOLESCENTS, AND A GROWING EPIDEMIC, WORLDWIDE. NOTWITHSTANDING THE KNOWN SUSCEPTIBILITY FACTORS FOR NAFLD, I.E., OBESITY AND METABOLIC SYNDROME, THE EXACT CAUSE(S) OF THIS DISEASE AND THE UNDERLYING MECHANISMS OF ITS INITIATION AND PROGRESSION ARE NOT FULLY ELUCIDATED. NAFLD IS A MULTI-FACETED DISEASE WITH METABOLIC, GENETIC, EPIGENETIC, AND ENVIRONMENTAL DETERMINANTS. ACCUMULATING EVIDENCE SHOWS THAT EXPOSURE TO ENVIRONMENTAL TOXICANTS CONTRIBUTES TO THE DEVELOPMENT OF NAFLD BY PROMOTING MITOCHONDRIAL DYSFUNCTION AND GENERATING REACTIVE OXYGEN SPECIES IN THE LIVER. IMBALANCES IN THE REDOX STATE OF THE CELLS ARE KNOWN TO CAUSE ALTERATIONS IN THE PATTERNS OF 5-HYDROXYMETHYLCYTOSINE (5HMC), THE OXIDATIVE PRODUCT OF 5-METHYLCYTOSINE (5MC), THEREBY INFLUENCING GENE REGULATION. THE 5HMC-MEDIATED DEREGULATION OF GENES INVOLVED IN HEPATIC METABOLISM IS AN EMERGING AREA OF RESEARCH IN NAFLD. THIS REVIEW SUMMARIZES OUR CURRENT KNOWLEDGE ON THE INTERACTIVE ROLE OF XENOBIOTIC EXPOSURE AND DNA HYDROXYMETHYLATION IN THE PATHOGENESIS OF FATTY LIVER DISEASE. INCREASING THE MECHANISTIC KNOWLEDGE OF NAFLD INITIATION AND PROGRESSION IS CRUCIAL FOR THE DEVELOPMENT OF NEW AND EFFECTIVE STRATEGIES FOR PREVENTION AND TREATMENT OF THIS DISEASE. 2019 17 2456 28 EPIGENETIC TARGETS FOR REVERSING IMMUNE DEFECTS CAUSED BY ALCOHOL EXPOSURE. ALCOHOL CONSUMPTION ALTERS FACTORS THAT MODIFY GENE EXPRESSION WITHOUT CHANGING THE DNA CODE (I.E., EPIGENETIC MODULATORS) IN MANY ORGAN SYSTEMS, INCLUDING THE IMMUNE SYSTEM. ALCOHOL ENHANCES THE RISK FOR DEVELOPING SEVERAL SERIOUS MEDICAL CONDITIONS RELATED TO IMMUNE SYSTEM DYSFUNCTION, INCLUDING ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), LIVER CANCER, AND ALCOHOLIC LIVER DISEASE (ALD). BINGE AND CHRONIC DRINKING ALSO RENDER PATIENTS MORE SUSCEPTIBLE TO MANY INFECTIOUS PATHOGENS AND ADVANCE THE PROGRESSION OF HIV INFECTION BY WEAKENING BOTH INNATE AND ADAPTIVE IMMUNITY. EPIGENETIC MECHANISMS PLAY A PIVOTAL ROLE IN THESE PROCESSES. FOR EXAMPLE, ALCOHOL-INDUCED EPIGENETIC VARIATIONS ALTER THE DEVELOPMENTAL PATHWAYS OF SEVERAL TYPES OF IMMUNE CELLS (E.G., GRANULOCYTES, MACROPHAGES, AND T-LYMPHOCYTES) AND THROUGH THESE AND OTHER MECHANISMS PROMOTE EXAGGERATED INFLAMMATORY RESPONSES. IN ADDITION, EPIGENETIC MECHANISMS MAY UNDERLIE ALCOHOL'S ABILITY TO INTERFERE WITH THE BARRIER FUNCTIONS OF THE GUT AND RESPIRATORY SYSTEMS, WHICH ALSO CONTRIBUTE TO THE HEIGHTENED RISK OF INFECTIONS. BETTER UNDERSTANDING OF ALCOHOL'S EFFECTS ON THESE EPIGENETIC PROCESSES MAY HELP RESEARCHERS IDENTIFY NEW TARGETS FOR THE DEVELOPMENT OF NOVEL MEDICATIONS TO PREVENT OR AMELIORATE ALCOHOL'S DETRIMENTAL EFFECTS ON THE IMMUNE SYSTEM. 2013 18 4217 29 METHYL DONOR NUTRIENTS IN CHRONIC KIDNEY DISEASE: IMPACT ON THE EPIGENETIC LANDSCAPE. EPIGENETIC ALTERATIONS, SUCH AS THOSE LINKED TO DNA METHYLATION, MAY POTENTIALLY PROVIDE MOLECULAR EXPLANATIONS FOR COMPLICATIONS ASSOCIATED WITH ALTERED GENE EXPRESSION IN ILLNESSES, SUCH AS CHRONIC KIDNEY DISEASE (CKD). ALTHOUGH BOTH DNA HYPO- AND HYPERMETHYLATION HAVE BEEN OBSERVED IN THE UREMIC MILIEU, THIS REMAINS ONLY A SINGLE ASPECT OF THE EPIGENETIC LANDSCAPE AND, THUS, OF ANY BIOCHEMICAL DYSREGULATION ASSOCIATED WITH CKD. NEVERTHELESS, THE ROLE OF UREMIA-PROMOTING ALTERATIONS ON THE EPIGENETIC LANDSCAPE REGULATING GENE EXPRESSION IS STILL A NOVEL AND SCARCELY STUDIED FIELD. ALTHOUGH FEW STUDIES HAVE ACTUALLY REPORTED ALTERATIONS OF DNA METHYLATION VIA METHYL DONOR NUTRIENT INTAKE, EMERGING EVIDENCE INDICATES THAT NUTRITIONAL MODIFICATION OF THE MICROBIOME CAN AFFECT ONE-CARBON METABOLISM AND THE CAPACITY TO METHYLATE THE GENOME IN CKD. IN THIS REVIEW, WE DISCUSS THE NUTRITIONAL MODIFICATIONS THAT MAY AFFECT ONE-CARBON METABOLISM AND THE POSSIBLE IMPACT OF METHYL DONOR NUTRIENTS ON THE MICROBIOME, CKD, AND ITS PHENOTYPE. 2019 19 6092 29 THE EFFECTS OF EPIGENETIC MODIFICATION ON THE OCCURRENCE AND PROGRESSION OF LIVER DISEASES AND THE INVOLVED MECHANISM. INTRODUCTION: EPIGENETIC MODIFICATION IS A TYPE OF GENE EXPRESSION AND REGULATION THAT DOES NOT INVOLVE CHANGES IN DNA SEQUENCES. AN INCREASING NUMBER OF STUDIES HAVE PROVEN THAT EPIGENETIC MODIFICATIONS PLAY AN IMPORTANT ROLE IN THE OCCURRENCE AND PROGRESSION OF LIVER DISEASES THROUGH THE GENE REGULATION AND PROTEIN EXPRESSIONS OF HEPATOCELLULAR LIPID METABOLISM, INFLAMMATORY REACTION, CELL PROLIFERATION, AND ACTIVATION, ETC.AREAS COVERED: IN THIS STUDY, WE ELABORATED AND ANALYZED THE UNDERLYING FUNCTIONAL MECHANISM OF EPIGENETIC MODIFICATION IN ALCOHOLIC LIVER DISEASE (ALD), NONALCOHOLIC FATTY LIVER DISEASE (NAFLD), LIVER FIBROSIS (LF), VIRAL HEPATITIS, HEPATOCELLULAR CARCINOMA (HCC), AND RESEARCH PROGRESS OF RECENT YEARS.EXPERT OPINION: THE FURTHER UNDERSTANDING OF EPIGENETIC MECHANISMS THAT CAN REGULATE GENE EXPRESSION AND CELL PHENOTYPE LEADS TO NEW INSIGHTS IN EPIGENETIC CONTROL OF CHRONIC LIVER DISEASE. CURRENTLY, HEPATOLOGISTS ARE EXPLORING THE ROLE OF DNA METHYLATION, HISTONE/CHROMATIN MODIFICATION, AND NON-CODING RNA IN SPECIFIC LIVER PATHOLOGY. THESE FINDINGS HAVE LED TO ADVANCES IN DIRECT EPIGENETIC BIOMARKER TESTING OF PATIENT TISSUE OR BODY FLUID SPECIMENS, AS WELL AS QUANTITATIVE ANALYSIS. BASED ON THESE FINDINGS, DRUG VALIDATION OF SOME TARGETS INVOLVED IN THE EPIGENETIC MECHANISM OF LIVER DISEASE IS GRADUALLY BEING CARRIED OUT CLINICALLY. 2020 20 3680 28 INFLAMMATION IN ALCOHOLIC LIVER DISEASE. FRANK BURR MALLORY'S LANDMARK OBSERVATION IN 1911 ON THE HISTOPATHOLOGY OF ALCOHOLIC LIVER DISEASE (ALD) WAS THE FIRST IDENTIFICATION OF A LINK BETWEEN INFLAMMATION AND ALD. IN THIS REVIEW, WE SUMMARIZE RECENT ADVANCES REGARDING THE ORIGINS AND ROLES OF VARIOUS INFLAMMATORY COMPONENTS IN ALD. METABOLISM OF ETHANOL GENERATES A NUMBER OF METABOLITES, INCLUDING ACETATE, REACTIVE OXYGEN SPECIES, ACETALDEHYDE, AND EPIGENETIC CHANGES, THAT CAN INDUCE INFLAMMATORY RESPONSES. ALCOHOL AND ITS METABOLITES CAN ALSO INITIATE AND AGGRAVATE INFLAMMATORY CONDITIONS BY PROMOTING GUT LEAKINESS OF MICROBIAL PRODUCTS, BY SENSITIZING IMMUNE CELLS TO STIMULATION, AND BY ACTIVATING INNATE IMMUNE PATHWAYS, SUCH AS COMPLEMENT. CHRONIC ALCOHOL CONSUMPTION ALSO SENSITIZES NONIMMUNE CELLS, E.G., HEPATOCYTES, TO INFLAMMATORY SIGNALS AND IMPAIRS THEIR ABILITY TO RESPOND TO PROTECTIVE SIGNALS. BASED ON THESE ADVANCES, A NUMBER OF INFLAMMATORY TARGETS HAVE BEEN IDENTIFIED WITH POTENTIAL FOR THERAPEUTIC INTERVENTION IN ALD, PRESENTING NEW OPPORTUNITIES AND CHALLENGES FOR TRANSLATIONAL RESEARCH. 2012