1 4116 140 MECHANISMS OF AIRWAY EPITHELIAL INJURY AND ABNORMAL REPAIR IN ASTHMA AND COPD. THE AIRWAY EPITHELIUM COMPRISES OF DIFFERENT CELL TYPES AND ACTS AS A PHYSICAL BARRIER PREVENTING PATHOGENS, INCLUDING INHALED PARTICLES AND MICROBES, FROM ENTERING THE LUNGS. GOBLET CELLS AND SUBMUCOSAL GLANDS PRODUCE MUCUS THAT TRAPS PATHOGENS, WHICH ARE EXPELLED FROM THE RESPIRATORY TRACT BY CILIATED CELLS. BASAL CELLS ACT AS PROGENITOR CELLS, DIFFERENTIATING INTO DIFFERENT EPITHELIAL CELL TYPES, TO MAINTAIN HOMEOSTASIS FOLLOWING INJURY. ADHERENS AND TIGHT JUNCTIONS BETWEEN CELLS MAINTAIN THE EPITHELIAL BARRIER FUNCTION AND REGULATE THE MOVEMENT OF MOLECULES ACROSS IT. IN THIS REVIEW WE DISCUSS HOW ABNORMAL EPITHELIAL STRUCTURE AND FUNCTION, CAUSED BY CHRONIC INJURY AND ABNORMAL REPAIR, DRIVES AIRWAY DISEASE AND SPECIFICALLY ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). IN BOTH DISEASES, INHALED ALLERGENS, POLLUTANTS AND MICROBES DISRUPT JUNCTIONAL COMPLEXES AND PROMOTE CELL DEATH, IMPAIRING THE BARRIER FUNCTION AND LEADING TO INCREASED PENETRATION OF PATHOGENS AND A CONSTANT AIRWAY IMMUNE RESPONSE. IN ASTHMA, THE INFLAMMATORY RESPONSE PRECIPITATES THE EPITHELIAL INJURY AND DRIVES ABNORMAL BASAL CELL DIFFERENTIATION. THIS LEADS TO REDUCED CILIATED CELLS, GOBLET CELL HYPERPLASIA AND INCREASED EPITHELIAL MESENCHYMAL TRANSITION, WHICH CONTRIBUTE TO IMPAIRED MUCOCILIARY CLEARANCE AND AIRWAY REMODELLING. IN COPD, CHRONIC OXIDATIVE STRESS AND INFLAMMATION TRIGGER PREMATURE EPITHELIAL CELL SENESCENCE, WHICH CONTRIBUTES TO LOSS OF EPITHELIAL INTEGRITY AND AIRWAY INFLAMMATION AND REMODELLING. INCREASED NUMBERS OF BASAL CELLS SHOWING DEREGULATED DIFFERENTIATION, CONTRIBUTES TO CILIARY DYSFUNCTION AND MUCOUS HYPERPRODUCTION IN COPD AIRWAYS. DEFECTIVE ANTIOXIDANT, ANTIVIRAL AND DAMAGE REPAIR MECHANISMS, POSSIBLY DUE TO GENETIC OR EPIGENETIC FACTORS, MAY CONFER SUSCEPTIBILITY TO AIRWAY EPITHELIAL DYSFUNCTION IN THESE DISEASES. THE CURRENT EVIDENCE SUGGESTS THAT A CONSTANT CYCLE OF INJURY AND ABNORMAL REPAIR OF THE EPITHELIUM DRIVES CHRONIC AIRWAY INFLAMMATION AND REMODELLING IN ASTHMA AND COPD. MECHANISTIC UNDERSTANDING OF INJURY SUSCEPTIBILITY AND DAMAGE RESPONSE MAY LEAD TO IMPROVED THERAPIES FOR THESE DISEASES. 2023 2 6005 40 THE AIRWAY EPITHELIUM-A CENTRAL PLAYER IN ASTHMA PATHOGENESIS. ASTHMA IS A CHRONIC INFLAMMATORY AIRWAY DISEASE CHARACTERIZED BY VARIABLE AIRFLOW OBSTRUCTION IN RESPONSE TO A WIDE RANGE OF EXOGENOUS STIMULI. THE AIRWAY EPITHELIUM IS THE FIRST LINE OF DEFENSE AND PLAYS AN IMPORTANT ROLE IN INITIATING HOST DEFENSE AND CONTROLLING IMMUNE RESPONSES. INDEED, INCREASING EVIDENCE INDICATES A RANGE OF ABNORMALITIES IN VARIOUS ASPECTS OF EPITHELIAL BARRIER FUNCTION IN ASTHMA. A CENTRAL PART OF THIS IMPAIRMENT IS A DISRUPTION OF THE AIRWAY EPITHELIAL LAYER, ALLOWING INHALED SUBSTANCES TO PASS MORE EASILY INTO THE SUBMUCOSA WHERE THEY MAY INTERACT WITH IMMUNE CELLS. FURTHERMORE, MANY OF THE IDENTIFIED SUSCEPTIBILITY GENES FOR ASTHMA ARE EXPRESSED IN THE AIRWAY EPITHELIUM. THIS REVIEW FOCUSES ON THE BIOLOGY OF THE AIRWAY EPITHELIUM IN HEALTH AND ITS PATHOBIOLOGY IN ASTHMA. WE WILL SPECIFICALLY DISCUSS EXTERNAL TRIGGERS SUCH AS ALLERGENS, VIRUSES AND ALARMINS AND THE EFFECT OF TYPE 2 INFLAMMATORY RESPONSES ON AIRWAY EPITHELIAL FUNCTION IN ASTHMA. WE WILL ALSO DISCUSS EPIGENETIC MECHANISMS RESPONDING TO EXTERNAL STIMULI ON THE LEVEL OF TRANSCRIPTIONAL AND POSTTRANSCRIPTIONAL REGULATION OF GENE EXPRESSION, AS WELL THE AIRWAY EPITHELIUM AS A POTENTIAL TREATMENT TARGET IN ASTHMA. 2020 3 305 33 AIRWAY WALL REMODELING IN CHILDHOOD ASTHMA-A PERSONALIZED PERSPECTIVE FROM CELL TYPE-SPECIFIC BIOLOGY. AIRWAY WALL REMODELING IS A PATHOLOGY OCCURRING IN CHRONIC INFLAMMATORY LUNG DISEASES INCLUDING ASTHMA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND FIBROSIS. IN 2017, THE AMERICAN THORACIC SOCIETY RELEASED A RESEARCH STATEMENT HIGHLIGHTING THE GAPS IN KNOWLEDGE AND UNDERSTANDING OF AIRWAY WALL REMODELING. THE FOUR MAJOR CHALLENGES ADDRESSED IN THIS STATEMENT WERE: (I) THE LACK OF CONSENSUS TO DEFINE "AIRWAY WALL REMODELING" IN DIFFERENT DISEASES, (II) METHODOLOGIC LIMITATIONS AND INAPPROPRIATE MODELS, (III) THE LACK OF ANTI-REMODELING THERAPIES, AND (IV) THE DIFFICULTY TO DEFINE ENDPOINTS AND OUTCOMES IN RELEVANT STUDIES. THIS REVIEW FOCUSES ON THE IMPORTANCE OF CELL-CELL INTERACTION, ESPECIALLY THE BRONCHIAL EPITHELIUM, IN ASTHMA-ASSOCIATED AIRWAY WALL REMODELING. THE PATHOLOGY OF "AIRWAY WALL REMODELING" SUMMARIZES ALL STRUCTURAL CHANGES OF THE AIRWAY WALL WITHOUT DIFFERENTIATING BETWEEN DIFFERENT PHENO- OR ENDO-TYPES OF ASTHMA. INDICATORS OF AIRWAY WALL REMODELING HAVE BEEN REPORTED IN CHILDHOOD ASTHMA IN THE ABSENCE OF ANY SIGN OF INFLAMMATION; THUS, THE INITIATION EVENT REMAINS UNKNOWN. RECENT STUDIES HAVE IMPLIED THAT THE INTERACTION BETWEEN THE EPITHELIUM WITH IMMUNE CELLS AND SUB-EPITHELIAL MESENCHYMAL CELLS IS MODIFIED IN ASTHMA BY A YET UNKNOWN EPIGENETIC MECHANISM DURING EARLY CHILDHOOD. 2021 4 6440 27 THERAPEUTIC APPROACHES FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) EXACERBATIONS. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS A PROGRESSIVE PULMONARY DISORDER UNDERPINNED BY POORLY REVERSIBLE AIRFLOW RESULTING FROM CHRONIC BRONCHITIS OR EMPHYSEMA. THE PREVALENCE AND MORTALITY OF COPD CONTINUE TO INCREASE. PHARMACOTHERAPY FOR PATIENTS WITH COPD HAS INCLUDED ANTIBIOTICS, BRONCHODILATORS, AND ANTI-INFLAMMATORY CORTICOSTEROIDS (BUT WITH LITTLE SUCCESS). ORAL DISEASES HAVE LONG BEEN ESTABLISHED AS CLINICAL RISK FACTORS FOR DEVELOPING RESPIRATORY DISEASES. THE ESTABLISHMENT OF A VERY SIMILAR MICROBIOME IN THE MOUTH AND THE LUNG CONFIRMS THE ORAL-LUNG CONNECTION. THE ASPIRATION OF PATHOGENIC MICROBES FROM THE ORAL CAVITY HAS BEEN IMPLICATED IN SEVERAL RESPIRATORY DISEASES, INCLUDING PNEUMONIA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). THIS REVIEW FOCUSES ON CURRENT AND FUTURE PHARMACOTHERAPEUTIC APPROACHES FOR COPD EXACERBATION INCLUDING ANTIMICROBIALS, MUCOREGULATORS, THE USE OF BRONCHODILATORS AND ANTI-INFLAMMATORY DRUGS, MODIFYING EPIGENETIC MARKS, AND MODULATING DYSBIOSIS OF THE MICROBIOME. 2022 5 4954 36 PATHOGENESIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. THE PATHOGENESIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ENCOMPASSES A NUMBER OF INJURIOUS PROCESSES, INCLUDING AN ABNORMAL INFLAMMATORY RESPONSE IN THE LUNGS TO INHALED PARTICLES AND GASES. OTHER PROCESSES, SUCH AS FAILURE TO RESOLVE INFLAMMATION, ABNORMAL CELL REPAIR, APOPTOSIS, ABNORMAL CELLULAR MAINTENANCE PROGRAMS, EXTRACELLULAR MATRIX DESTRUCTION (PROTEASE/ANTIPROTEASE IMBALANCE), AND OXIDATIVE STRESS (OXIDANT/ANTIOXIDANT IMBALANCE) ALSO HAVE A ROLE. THE INFLAMMATORY RESPONSES TO THE INHALATION OF ACTIVE AND PASSIVE TOBACCO SMOKE AND URBAN AND RURAL AIR POLLUTION ARE MODIFIED BY GENETIC AND EPIGENETIC FACTORS. THE SUBSEQUENT CHRONIC INFLAMMATORY RESPONSES LEAD TO MUCUS HYPERSECRETION, AIRWAY REMODELING, AND ALVEOLAR DESTRUCTION. THIS ARTICLE PROVIDES AN UPDATE ON THE CELLULAR AND MOLECULAR MECHANISMS OF THESE PROCESSES IN THE PATHOGENESIS OF COPD. 2007 6 927 38 CHRONIC INFLAMMATION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND LUNG CANCER. PURPOSE OF REVIEW: SMOKING IS A MAJOR RISK FACTOR FOR LUNG CANCER, WHICH IS THE LEADING CAUSE OF CANCER-RELATED DEATHS BOTH IN THE USA AND WORLDWIDE. CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND EMPHYSEMA ARE COMORBID CONDITIONS OFTEN FOUND IN LUNG CANCER PATIENTS. THE INFLAMMATORY PATHWAYS THAT LINK CHRONIC OBSTRUCTIVE PULMONARY DISEASE, EMPHYSEMA, AND LUNG CANCER LIKELY INVOLVE GENETIC AND EPIGENETIC MODULATIONS DUE TO CHRONIC TISSUE INJURY AND ABNORMAL TUMOR IMMUNITY IN SUSCEPTIBLE HOSTS. RECENT FINDINGS: CHRONIC AIRWAY INFLAMMATION CONTRIBUTES TO ALTERATIONS IN THE BRONCHIAL EPITHELIUM AND LUNG MICROENVIRONMENT, PROVOKING A MILIEU CONDUCIVE TO PULMONARY CARCINOGENESIS. FOR EXAMPLE, INFLAMMATION-INDUCIBLE CYCLOOXYGENASE-2 IS UPREGULATED IN NONSMALL CELL LUNG CANCER AND ALSO PLAYS AN IMPORTANT ROLE IN PROMOTING EPITHELIAL-TO-MESENCHYMAL TRANSITION. GENETIC CHANGES IN THE AIRWAY EPITHELIUM OF SMOKERS MAY HELP PREDICT OR IDENTIFY INDIVIDUALS AT RISK FOR LUNG CANCER. FINALLY, RADIOGRAPHIC FINDINGS OF EMPHYSEMA HAVE BEEN ESTABLISHED AS INDEPENDENT RISK FACTORS FOR LUNG CANCER. SUMMARY: THE RELATIONSHIPS BETWEEN INFLAMMATION, AIRFLOW OBSTRUCTION, AND LUNG CANCER ARE COMPLEX. DEREGULATED INFLAMMATION IS COMPLICIT IN THE PATHOGENESIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND LUNG CANCER, BUT THE OVERLAP OF SIGNALING EVENTS IS NOT YET FULLY UNDERSTOOD. TOBACCO EXPOSURE IS AN IMPORTANT RISK FACTOR THAT CONFERS LONG-TERM RISK OF LUNG DISEASE. DIAGNOSTIC SENSITIVITY OF DETECTING LUNG CANCER MAY IMPROVE WITH THE UTILIZATION OF GENETIC PROFILING IN COMBINATION WITH PATHOLOGIC EVALUATION OF AIRWAY EPITHELIUM. ADDITIONAL RESEARCH IS REQUIRED TO UNDERSTAND THE ROLE OF EPITHELIAL-TO-MESENCHYMAL TRANSITION IN CHRONIC INFLAMMATORY LUNG DISEASES AND LUNG CARCINOGENESIS. 2009 7 2737 38 EXPOSING A DEADLY ALLIANCE: NOVEL INSIGHTS INTO THE BIOLOGICAL LINKS BETWEEN COPD AND LUNG CANCER. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AFFECTS MORE THAN 200 MILLION PEOPLE WORLDWIDE AND IS EXPECTED TO BECOME THE THIRD LEADING CAUSE OF DEATH IN 2020. COPD IS CHARACTERIZED BY PROGRESSIVE AIRFLOW LIMITATION, DUE TO A COMBINATION OF CHRONIC INFLAMMATION AND REMODELING OF THE SMALL AIRWAYS (BRONCHIOLITIS) AND LOSS OF ELASTIC RECOIL CAUSED BY DESTRUCTION OF THE ALVEOLAR WALLS (EMPHYSEMA). LUNG CANCER IS THE MOST IMPORTANT CAUSE OF CANCER-RELATED DEATH IN THE WORLD. (CIGARETTE) SMOKING IS THE PRINCIPAL CULPRIT CAUSING BOTH COPD AND LUNG CANCER; IN ADDITION, EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE, BIOMASS FUEL SMOKE, COAL SMOKE AND OUTDOOR AIR POLLUTION HAVE ALSO BEEN ASSOCIATED WITH AN INCREASED INCIDENCE OF BOTH DISEASES. IMPORTANTLY, SMOKERS WITH COPD--DEFINED AS EITHER NOT FULLY REVERSIBLE AIRFLOW LIMITATION OR EMPHYSEMA--HAVE A TWO- TO FOUR-FOLD INCREASED RISK TO DEVELOP LUNG CANCER. IN THIS REVIEW, WE HIGHLIGHT SEVERAL OF THE GENETIC, EPIGENETIC AND INFLAMMATORY MECHANISMS, WHICH LINK COPD AND CARCINOGENESIS IN THE LUNGS. ELUCIDATING THE BIOLOGICAL PATHWAYS AND NETWORKS, WHICH UNDERLIE THE INCREASED SUSCEPTIBILITY OF LUNG CANCER IN PATIENTS WITH COPD, HAS IMPORTANT IMPLICATIONS FOR SCREENING, PREVENTION, DIAGNOSIS AND TREATMENT OF THESE TWO DEVASTATING PULMONARY DISEASES. 2013 8 3966 39 LONG NONCODING TRANSCRIPTOME IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE. CHRONIC AIRWAY INFLAMMATION FROM RECURRING EXPOSURES TO NOXIOUS ENVIRONMENTAL STIMULI RESULTS IN A PROGRESSIVE AND IRREVERSIBLE AIRFLOW LIMITATION AND THE LUNG PARENCHYMAL DAMAGE THAT CHARACTERIZES CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). THE LARGE VARIABILITY OBSERVED IN THE ONSET AND PROGRESSION OF COPD IS PRIMARILY DRIVEN BY COMPLEX GENE-ENVIRONMENT INTERACTIONS. THE TRANSCRIPTOMIC AND EPIGENETIC MEMORY POTENTIAL OF LUNG EPITHELIAL AND INNATE IMMUNE CELLS DRIVE RESPONSES, SUCH AS MUCUS HYPERREACTIVITY AND AIRWAY REMODELING, THAT ARE TIGHTLY REGULATED BY VARIOUS MOLECULAR MECHANISMS, FOR WHICH SEVERAL CANDIDATE SUSCEPTIBILITY GENES HAVE BEEN DESCRIBED. HOWEVER, THE RECENTLY DESCRIBED NONCODING RNA SPECIES, IN PARTICULAR THE LONG NONCODING RNAS, MAY ALSO HAVE AN IMPORTANT ROLE IN MODULATING PULMONARY RESPONSES TO CHRONIC INHALATION OF TOXIC SUBSTANCES AND THE DEVELOPMENT OF COPD. THIS REVIEW OUTLINES THE FEATURES OF LONG NONCODING RNAS THAT HAVE BEEN IMPLICATED IN REGULATING THE AIRWAY INFLAMMATORY RESPONSES TO CIGARETTE SMOKE EXPOSURE AND THEIR POSSIBLE ASSOCIATION WITH COPD PATHOGENESIS. AS COPD CONTINUES TO DEBILITATE THE INCREASINGLY AGING POPULATION AND CONTRIBUTE TO HIGHER MORBIDITY AND MORTALITY RATES WORLDWIDE, THE SEARCH FOR BETTER BIOMARKERS AND ALTERNATIVE THERAPEUTIC OPTIONS IS PIVOTAL. 2019 9 137 33 ABERRANT DNA METHYLATION AND EXPRESSION OF SPDEF AND FOXA2 IN AIRWAY EPITHELIUM OF PATIENTS WITH COPD. BACKGROUND: GOBLET CELL METAPLASIA, A COMMON FEATURE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), IS ASSOCIATED WITH MUCUS HYPERSECRETION WHICH CONTRIBUTES TO THE MORBIDITY AND MORTALITY AMONG PATIENTS. TRANSCRIPTION FACTORS SAM-POINTED DOMAIN-CONTAINING ETS-LIKE FACTOR (SPDEF) AND FORKHEAD BOX PROTEIN A2 (FOXA2) REGULATE GOBLET CELL DIFFERENTIATION. THIS STUDY AIMED TO (1) INVESTIGATE DNA METHYLATION AND EXPRESSION OF SPDEF AND FOXA2 DURING GOBLET CELL DIFFERENTIATION AND (2) COMPARE THIS IN AIRWAY EPITHELIAL CELLS FROM PATIENTS WITH COPD AND CONTROLS DURING MUCOCILIARY DIFFERENTIATION. METHODS: TO ASSESS DNA METHYLATION AND EXPRESSION OF SPDEF AND FOXA2 DURING GOBLET CELL DIFFERENTIATION, PRIMARY AIRWAY EPITHELIAL CELLS, ISOLATED FROM TRACHEA (NON-COPD CONTROLS) AND BRONCHIAL TISSUE (PATIENTS WITH COPD), WERE DIFFERENTIATED BY CULTURE AT THE AIR-LIQUID INTERFACE (ALI) IN THE PRESENCE OF CYTOKINE INTERLEUKIN (IL)-13 TO PROMOTE GOBLET CELL DIFFERENTIATION. RESULTS: WE FOUND THAT SPDEF EXPRESSION WAS INDUCED DURING GOBLET CELL DIFFERENTIATION, WHILE FOXA2 EXPRESSION WAS DECREASED. IMPORTANTLY, CPG NUMBER 8 IN THE SPDEF PROMOTER WAS HYPERMETHYLATED UPON DIFFERENTIATION, WHEREAS DNA METHYLATION OF FOXA2 PROMOTER WAS NOT CHANGED. IN THE ABSENCE OF IL-13, COPD-DERIVED ALI-CULTURED CELLS DISPLAYED HIGHER SPDEF EXPRESSION THAN CONTROL-DERIVED ALI CULTURES, WHEREAS NO DIFFERENCE WAS FOUND FOR FOXA2 EXPRESSION. THIS WAS ACCOMPANIED WITH HYPOMETHYLATION OF CPG NUMBER 6 IN THE SPDEF PROMOTER AND ALSO HYPOMETHYLATION OF CPG NUMBERS 10 AND 11 IN THE FOXA2 PROMOTER. CONCLUSIONS: THESE FINDINGS SUGGEST THAT ABERRANT DNA METHYLATION OF SPDEF AND FOXA2 IS ONE OF THE FACTORS UNDERLYING MUCUS HYPERSECRETION IN COPD, OPENING NEW AVENUES FOR EPIGENETIC-BASED INHIBITION OF MUCUS HYPERSECRETION. 2017 10 6161 26 THE GENETICS OF ASTHMA: ADAM33 AS AN EXAMPLE OF A SUSCEPTIBILITY GENE. THE ABILITY TO IDENTIFY NOVEL DISEASE GENES BY POSITIONAL CLONING LED TO THE IDENTIFICATION OF A DISINTEGRIN AND METALLOPROTEASE (ADAM)33 GENE ON CHROMOSOME 20P13 AS A SUSCEPTIBILITY GENE FOR ASTHMA. CASE-CONTROL AND FAMILY-BASED ASSOCIATION STUDIES HAVE MOSTLY CONFIRMED A LINK BETWEEN ADAM33 AND ASTHMA. ITS RESTRICTED EXPRESSION TO MESENCHYMAL CELLS AS WELL AS ITS ASSOCIATION WITH BRONCHIAL HYPERRESPONSIVENESS AND ACCELERATED DECLINE IN LUNG FUNCTION OVER TIME POINT STRONGLY TO ITS INVOLVEMENT IN THE STRUCTURAL AIRWAY COMPONENTS OF ASTHMA, SUCH AS REMODELING. EXTENSIVE ALTERNATIVE SPLICING, EXPRESSION DURING BRANCHING MORPHOGENSIS IN THE DEVELOPING FETUS, IMPAIRED LUNG FUNCTION IN CHILDHOOD, THE PRODUCTION OF A SOLUBLE FORM LINKED TO CHRONIC ASTHMA, AND TIGHT EPIGENETIC REGULATION INDICATE A LEVEL OF COMPLEXITY IN THE WAY ADAM33 INFLUENCES DISEASE PHENOTYPE. ITS RECENT ASSOCIATION WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AS WELL AS WITH ASTHMA AND LUNG DEVELOPMENT POINTS TO FUNCTIONS RELATING TO AIRWAY WALL MODELING AND REMODELING AS A GENERAL MORPHOGENETIC REPAIR GENE RATHER THAN BEING RESTRICTED TO ASTHMA. 2006 11 5411 37 REGULATION OF AIRWAY MUCIN GENE EXPRESSION. MUCINS ARE IMPORTANT COMPONENTS THAT EXERT A VARIETY OF FUNCTIONS IN CELL-CELL INTERACTION, EPIDERMAL GROWTH FACTOR RECEPTOR SIGNALING, AND AIRWAYS PROTECTION. IN THE CONDUCTING AIRWAYS OF THE LUNGS, MUCINS ARE THE MAJOR CONTRIBUTOR TO THE VISCOELASTIC PROPERTY OF MUCOUS SECRETION, WHICH IS THE MAJOR BARRIER TO TRAPPING INHALED MICROBIAL ORGANISM, PARTICULATES, AND OXIDATIVE POLLUTANTS. THE HOMEOSTASIS OF MUCIN PRODUCTION IS AN IMPORTANT FEATURE IN CONDUCTING AIRWAYS FOR THE MAINTENANCE OF MUCOCILIARY FUNCTION. ABERRANT MUCIN SECRETION AND ACCUMULATION IN AIRWAY LUMEN ARE CLINICAL HALLMARKS ASSOCIATED WITH VARIOUS LUNG DISEASES, SUCH AS ASTHMA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CYSTIC FIBROSIS, EMPHYSEMA, AND LUNG CANCER. AMONG 20 KNOWN MUCIN GENES IDENTIFIED, 11 OF THEM HAVE BEEN VERIFIED AT EITHER THE MRNA AND/OR PROTEIN LEVEL IN AIRWAYS. THE REGULATION OF MUCIN GENES IS COMPLICATED, AS ARE THE MEDIATORS AND SIGNALING PATHWAYS. THIS REVIEW SUMMARIZES THE CURRENT VIEW ON THE MEDIATORS, THE SIGNALING PATHWAYS, AND THE TRANSCRIPTIONAL UNITS THAT ARE INVOLVED IN THE REGULATION OF AIRWAY MUCIN GENE EXPRESSION. IN ADDITION, WE ALSO POINT OUT ESSENTIAL FEATURES OF EPIGENETIC MECHANISMS FOR THE REGULATION OF THESE GENES. 2008 12 1551 30 DNA METHYLATION IS GLOBALLY DISRUPTED AND ASSOCIATED WITH EXPRESSION CHANGES IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE SMALL AIRWAYS. DNA METHYLATION IS AN EPIGENETIC MODIFICATION THAT IS HIGHLY DISRUPTED IN RESPONSE TO CIGARETTE SMOKE AND INVOLVED IN A WIDE SPECTRUM OF MALIGNANT AND NONMALIGNANT DISEASES, BUT SURPRISINGLY NOT PREVIOUSLY ASSESSED IN SMALL AIRWAYS OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). SMALL AIRWAYS ARE THE PRIMARY SITES OF AIRFLOW OBSTRUCTION IN COPD. WE SOUGHT TO DETERMINE WHETHER DNA METHYLATION PATTERNS ARE DISRUPTED IN SMALL AIRWAY EPITHELIA OF PATIENTS WITH COPD, AND EVALUATE WHETHER CHANGES IN GENE EXPRESSION ARE ASSOCIATED WITH THESE DISRUPTIONS. GENOME-WIDE METHYLATION AND GENE EXPRESSION ANALYSIS WERE PERFORMED ON SMALL AIRWAY EPITHELIAL DNA AND RNA OBTAINED FROM THE SAME PATIENT DURING BRONCHOSCOPY, USING ILLUMINA'S INFINIUM HM27 AND AFFYMETRIX'S GENECHIP HUMAN GENE 1.0 ST ARRAYS. TO CONTROL FOR KNOWN EFFECTS OF CIGARETTE SMOKING ON DNA METHYLATION, METHYLATION AND GENE EXPRESSION PROFILES WERE COMPARED BETWEEN FORMER SMOKERS WITH AND WITHOUT COPD MATCHED FOR AGE, PACK-YEARS, AND YEARS OF SMOKING CESSATION. OUR RESULTS INDICATE THAT ABERRANT DNA METHYLATION IS (1) A GENOME-WIDE PHENOMENON IN SMALL AIRWAYS OF PATIENTS WITH COPD, AND (2) ASSOCIATED WITH ALTERED EXPRESSION OF GENES AND PATHWAYS IMPORTANT TO COPD, SUCH AS THE NF-E2-RELATED FACTOR 2 OXIDATIVE RESPONSE PATHWAY. DNA METHYLATION IS LIKELY AN IMPORTANT MECHANISM CONTRIBUTING TO MODULATION OF GENES IMPORTANT TO COPD PATHOLOGY. BECAUSE THESE METHYLATION EVENTS MAY UNDERLIE DISEASE-SPECIFIC GENE EXPRESSION CHANGES, THEIR CHARACTERIZATION IS A CRITICAL FIRST STEP TOWARD THE DEVELOPMENT OF EPIGENETIC MARKERS AND AN OPPORTUNITY FOR DEVELOPING NOVEL EPIGENETIC THERAPEUTIC INTERVENTIONS FOR COPD. 2014 13 4658 29 NEW ANTI-INFLAMMATORY TARGETS FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS ASSOCIATED WITH CHRONIC INFLAMMATION OF THE PERIPHERAL AIRWAYS AND LUNG PARENCHYMA, WHICH LEADS TO PROGRESSIVE OBSTRUCTION OF THE AIRWAYS. CURRENT MANAGEMENT WITH LONG-ACTING BRONCHODILATORS DOES NOT REDUCE DISEASE PROGRESSION, AND THERE ARE NO TREATMENTS THAT EFFECTIVELY SUPPRESS CHRONIC INFLAMMATION IN COPD. AN INCREASED UNDERSTANDING OF THE INFLAMMATORY PROCESSES THAT ARE INVOLVED IN THE PATHOPHYSIOLOGY OF COPD HAS IDENTIFIED SEVERAL NEW THERAPEUTIC TARGETS. THIS REVIEW DISCUSSES SOME OF THE MOST PROMISING OF THESE TARGETS, INCLUDING NEW ANTIOXIDANTS, KINASE INHIBITORS AND DRUGS THAT TARGET CELLULAR SENESCENCE, MICROBIAL COLONIZATION, EPIGENETIC REGULATION OF INFLAMMATORY GENE EXPRESSION AND CORTICOSTEROID RESISTANCE. 2013 14 348 41 ALTERED DNA METHYLATION IS ASSOCIATED WITH ABERRANT GENE EXPRESSION IN PARENCHYMAL BUT NOT AIRWAY FIBROBLASTS ISOLATED FROM INDIVIDUALS WITH COPD. BACKGROUND: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS A HETEROGENEOUS DISEASE OF THE LUNGS THAT IS CURRENTLY THE FOURTH LEADING CAUSE OF DEATH WORLDWIDE. GENETIC FACTORS ACCOUNT FOR ONLY A SMALL AMOUNT OF COPD RISK, BUT EPIGENETIC MECHANISMS, INCLUDING DNA METHYLATION, HAVE THE POTENTIAL TO MEDIATE THE INTERACTIONS BETWEEN AN INDIVIDUAL'S GENETICS AND ENVIRONMENTAL EXPOSURE. DNA METHYLATION IS HIGHLY CELL TYPE-SPECIFIC, AND INDIVIDUAL CELL TYPE STUDIES OF DNA METHYLATION IN COPD ARE SPARSE. FIBROBLASTS ARE PRESENT WITHIN THE AIRWAY AND PARENCHYMA OF THE LUNG AND CONTRIBUTE TO THE ABERRANT DEPOSITION OF EXTRACELLULAR MATRIX IN COPD. NO ASSESSMENT OR COMPARISON OF GENOME-WIDE DNA METHYLATION PROFILES IN THE AIRWAY AND PARENCHYMAL FIBROBLASTS FROM INDIVIDUALS WITH AND WITHOUT COPD HAS BEEN UNDERTAKEN. THESE DATA PROVIDE VALUABLE INSIGHT INTO THE MOLECULAR MECHANISMS CONTRIBUTING TO COPD AND THE DIFFERING PATHOLOGIES OF SMALL AIRWAYS DISEASE AND EMPHYSEMA IN COPD. METHODS: GENOME-WIDE DNA METHYLATION WAS EVALUATED AT OVER 485,000 CPG SITES USING THE ILLUMINA INFINIUM HUMANMETHYLATION450 BEADCHIP ARRAY IN THE AIRWAY (NON-COPD N = 8, COPD N = 7) AND PARENCHYMAL FIBROBLASTS (NON-COPD N = 17, COPD N = 29) ISOLATED FROM INDIVIDUALS WITH AND WITHOUT COPD. TARGETED GENE EXPRESSION WAS ASSESSED BY QPCR IN MATCHED RNA SAMPLES. RESULTS: DIFFERENTIALLY METHYLATED DNA REGIONS WERE IDENTIFIED BETWEEN CELLS ISOLATED FROM INDIVIDUALS WITH AND WITHOUT COPD IN BOTH AIRWAY AND PARENCHYMAL FIBROBLASTS. ONLY IN PARENCHYMAL FIBROBLASTS WAS DIFFERENTIAL DNA METHYLATION ASSOCIATED WITH DIFFERENTIAL GENE EXPRESSION. A SECOND ANALYSIS OF DIFFERENTIAL DNA METHYLATION VARIABILITY IDENTIFIED 359 INDIVIDUAL DIFFERENTIALLY VARIABLE CPG SITES IN PARENCHYMAL FIBROBLASTS. NO DIFFERENTIALLY VARIABLE CPG SITES WERE IDENTIFIED IN THE AIRWAY FIBROBLASTS. FIVE DIFFERENTIALLY VARIABLE-METHYLATED CPG SITES, ASSOCIATED WITH THREE GENES, WERE SUBSEQUENTLY ASSESSED FOR GENE EXPRESSION DIFFERENCES. TWO GENES (OAT AND GRIK2) DISPLAYED SIGNIFICANTLY INCREASED GENE EXPRESSION IN CELLS ISOLATED FROM INDIVIDUALS WITH COPD. CONCLUSIONS: DIFFERENTIAL AND VARIABLE DNA METHYLATION WAS ASSOCIATED WITH COPD STATUS IN THE PARENCHYMAL FIBROBLASTS BUT NOT AIRWAY FIBROBLASTS. ABERRANT DNA METHYLATION WAS ASSOCIATED WITH ALTERED GENE EXPRESSION IMPARTING BIOLOGICAL FUNCTION TO DNA METHYLATION CHANGES. CHANGES IN DNA METHYLATION ARE THEREFORE IMPLICATED IN THE MOLECULAR MECHANISMS UNDERLYING COPD PATHOGENESIS AND MAY REPRESENT NOVEL THERAPEUTIC TARGETS. 2018 15 1143 34 CONCISE REVIEW: CLINICAL PROSPECTS FOR TREATING CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH REGENERATIVE APPROACHES. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS BECOMING A MAJOR CAUSE OF DEATH WORLDWIDE. COPD IS CHARACTERIZED BY A PROGRESSIVE AND NOT FULLY REVERSIBLE AIRFLOW LIMITATION CAUSED BY CHRONIC SMALL AIRWAY DISEASE AND LUNG PARENCHYMAL DESTRUCTION. CLINICALLY AVAILABLE DRUGS IMPROVE AIRFLOW OBSTRUCTION AND RESPIRATORY SYMPTOMS BUT CANNOT CURE THE DISEASE. SLOWING THE PROGRESSIVE LUNG DESTRUCTION OR REBUILDING THE DESTROYED LUNG STRUCTURE IS A PROMISING STRATEGY TO CURE COPD. IN CONTRAST TO SMALL ANIMAL MODELS, PHARMACOLOGICAL LUNG REGENERATION IS DIFFICULT IN HUMAN COPD. MATURATION, AGING, AND SENESCENCE IN COPD LUNG CELLS, INCLUDING ENDOGENOUS STEM CELLS, MAY AFFECT THE REGENERATIVE CAPACITY FOLLOWING PHARMACOLOGICAL THERAPY. THE LUNG IS A COMPLEX ORGAN COMPOSED OF MORE THAN 40 DIFFERENT CELL TYPES; THEREFORE, DETAILED ANALYSES, SUCH AS EPIGENETIC MODIFICATION ANALYSIS, IN EACH SPECIFIC CELL TYPE HAVE NOT BEEN PERFORMED IN LUNGS WITH COPD. RECENTLY, A METHOD FOR THE DIRECT ISOLATION OF INDIVIDUAL CELL TYPES FROM HUMAN LUNG HAS BEEN DEVELOPED, AND FINGERPRINTS OF EACH CELL TYPE IN COPD LUNGS CAN BE ANALYZED. RESEARCH USING THIS TECHNIQUE COMBINED WITH THE RECENTLY DISCOVERED LUNG ENDOGENOUS STEM-PROGENITOR POPULATIONS WILL GIVE A BETTER UNDERSTANDING ABOUT THE FATE OF COPD LUNG CELLS AND PROVIDE A FUTURE FOR CELL-BASED THERAPY TO TREAT THIS INTRACTABLE DISEASE. 2012 16 1245 38 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 17 3767 29 INTEGRATIVE EPIGENOMIC ANALYSIS IN DIFFERENTIATED HUMAN PRIMARY BRONCHIAL EPITHELIAL CELLS EXPOSED TO CIGARETTE SMOKE. CIGARETTE SMOKE (CS) IS ONE OF THE MAJOR RISK FACTORS FOR MANY PULMONARY DISEASES, INCLUDING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND LUNG CANCER. THE FIRST LINE OF DEFENSE FOR CS EXPOSURE IS THE BRONCHIAL EPITHELIAL CELLS. ELUCIDATION OF THE EPIGENETIC CHANGES DURING CS EXPOSURE IS KEY TO GAINING A MECHANISTIC UNDERSTANDING INTO HOW MATURE AND DIFFERENTIATED BRONCHIAL EPITHELIAL CELLS RESPOND TO CS. THEREFORE, WE PERFORMED EPIGENOMIC PROFILING IN CONJUNCTION WITH TRANSCRIPTIONAL PROFILING IN WELL-DIFFERENTIATED HUMAN BRONCHIAL EPITHELIAL (HBE) CELLS CULTURED IN AIR-LIQUID INTERFACE (ALI) EXPOSED TO THE VAPOR PHASE OF CS. THE GENOME-WIDE ENRICHMENT OF HISTONE 3 LYSINE 27 ACETYLATION WAS DETECTED BY CHROMATIN IMMUNOPRECIPITATION FOLLOWED BY NEXT GENERATION SEQUENCING (CHIP-SEQ) IN HBE CELLS AND SUGGESTED THE PLAUSIBLE BINDING OF SPECIFIC TRANSCRIPTION FACTORS RELATED TO CS EXPOSURE. ADDITIONALLY, INTERROGATION OF CHIP-SEQ DATA WITH GENE EXPRESSION PROFILING OF HBE CELLS AFTER CS EXPOSURE FOR DIFFERENT DURATIONS (3 HOURS, 2 DAYS, 4 DAYS) SUGGESTED THAT EARLIER EPIGENETIC CHANGES (3 HOURS AFTER CS EXPOSURE) MAY BE ASSOCIATED WITH LATER GENE EXPRESSION CHANGES INDUCED BY CS EXPOSURE (4 DAYS). THE INTEGRATION OF EPIGENETICS AND GENE EXPRESSION DATA REVEALED SIGNALING PATHWAYS RELATED TO CS-INDUCED EPIGENETIC CHANGES IN HBE CELLS THAT MAY IDENTIFY NOVEL REGULATORY PATHWAYS RELATED TO CS-INDUCED COPD. 2018 18 6450 33 THERAPEUTIC TARGETS FOR INFLAMMATION-MEDIATED AIRWAY REMODELING IN CHRONIC LUNG DISEASE. ACUTE EXACERBATIONS OF CHRONIC LUNG DISEASE ACCOUNT FOR SUBSTANTIAL MORBIDITY AND HEALTH COSTS. REPEATED INFLAMMATORY EPISODES AND ATTENDANT BRONCHOCONSTRICTION CAUSE STRUCTURAL REMODELING OF THE AIRWAY. REMODELING IS A MULTICELLULAR RESPONSE TO MUCOSAL INJURY THAT RESULTS IN EPITHELIAL CELL-STATE CHANGES, ENHANCED EXTRACELLULAR DEPOSITION, AND EXPANSION OF PRO-FIBROTIC MYOFIBROBLAST POPULATIONS. AREAS COVERED: THIS MANUSCRIPT OVERVIEWS MECHANISTIC STUDIES IDENTIFYING KEY SENTINEL CELL POPULATIONS IN THE AIRWAY AND HOW PATTERN RECOGNITION SIGNALING INDUCES MALADAPTIVE MUCOSAL CHANGES AND AIRWAY REMODELING. STUDIES ELUCIDATING HOW NFKAPPAB COUPLES WITH AN ATYPICAL HISTONE ACETYLTRANSFERASE, BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) THAT REPROGRAMS MUCOSAL FIBROGENIC RESPONSES, ARE DESCRIBED. THE APPROACHES TO DEVELOPMENT AND CHARACTERIZATION OF SELECTIVE INHIBITORS OF EPIGENETIC REPROGRAMMING ON INNATE INFLAMMATION AND STRUCTURAL REMODELING IN PRECLINICAL MODELS ARE DETAILED. EXPERT COMMENTARY: BRONCHIOLAR CELLS DERIVED FROM SCGB1A1-EXPRESSING PROGENITORS FUNCTION AS MAJOR SENTINEL CELLS OF THE AIRWAY, RESPONSIBLE FOR INITIATING ANTIVIRAL AND AEROALLERGEN RESPONSES. IN THESE SENTINEL CELLS, ACTIVATION OF INNATE INFLAMMATION IS COUPLED TO NEUTROPHILIC RECRUITMENT, MESENCHYMAL TRANSITION AND MYOFIBROBLAST EXPANSION. THERAPEUTICS TARGETING THE NFKB-BRD4 MAY BE EFFICACIOUS IN REDUCING PATHOLOGICAL EFFECTS OF ACUTE EXACERBATIONS IN CHRONIC LUNG DISEASE. 2018 19 1244 36 CURRENT CONCEPTS ON OXIDATIVE/CARBONYL STRESS, INFLAMMATION AND EPIGENETICS IN PATHOGENESIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS A GLOBAL HEALTH PROBLEM. THE CURRENT THERAPIES FOR COPD ARE POORLY EFFECTIVE AND THE MAINSTAYS OF PHARMACOTHERAPY ARE BRONCHODILATORS. A BETTER UNDERSTANDING OF THE PATHOBIOLOGY OF COPD IS CRITICAL FOR THE DEVELOPMENT OF NOVEL THERAPIES. IN THE PRESENT REVIEW, WE HAVE DISCUSSED THE ROLES OF OXIDATIVE/ALDEHYDE STRESS, INFLAMMATION/IMMUNITY, AND CHROMATIN REMODELING IN THE PATHOGENESIS OF COPD. AN IMBALANCE OF OXIDANTS/ANTIOXIDANTS CAUSED BY CIGARETTE SMOKE AND OTHER POLLUTANTS/BIOMASS FUELS PLAYS AN IMPORTANT ROLE IN THE PATHOGENESIS OF COPD BY REGULATING REDOX-SENSITIVE TRANSCRIPTION FACTORS (E.G., NF-KAPPAB), AUTOPHAGY AND UNFOLDED PROTEIN RESPONSE LEADING TO CHRONIC LUNG INFLAMMATORY RESPONSE. CIGARETTE SMOKE ALSO ACTIVATES CANONICAL/ALTERNATIVE NF-KAPPAB PATHWAYS AND THEIR UPSTREAM KINASES LEADING TO SUSTAINED INFLAMMATORY RESPONSE IN LUNGS. RECENTLY, EPIGENETIC REGULATION HAS BEEN SHOWN TO BE CRITICAL FOR THE DEVELOPMENT OF COPD BECAUSE THE EXPRESSION/ACTIVITY OF ENZYMES THAT REGULATE THESE EPIGENETIC MODIFICATIONS HAVE BEEN REPORTED TO BE ABNORMAL IN AIRWAYS OF COPD PATIENTS. HENCE, THE SIGNIFICANT ADVANCES MADE IN UNDERSTANDING THE PATHOPHYSIOLOGY OF COPD AS DESCRIBED HEREIN WILL IDENTIFY NOVEL THERAPEUTIC TARGETS FOR INTERVENTION IN COPD. 2011 20 6915 18 [VULNERABILITY OF WOMEN TO TOBACCO: THE BRONCHO-PULMONARY CONSEQUENCES (ASTHMA, COPD)]. SMOKING REMAINS COMMON, WITH AN EXPOSURE THAT BEGINS EARLY DURING PREGNANCY. IT INDUCES EPIGENETIC CHANGES, WITH A TRANS-GENERATIONAL TRANSMISSION. SMOKING INCREASES THE RISK OF UNCONTROLLED ASTHMA DURING CHILDHOOD AND ADULT LIFE. ASTHMA IS ALSO ASSOCIATED WITH INCREASED RISK OF A DECLINE OF LUNG FUNCTION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). WOMEN ARE MORE AT RISK OF DEVELOPING EARLY AND SEVERE COPD. THE MECHANISMS ARE CURRENTLY POORLY KNOWN. 2019