1  4850 145 OPIOIDS AND OPIOID RECEPTORS; UNDERSTANDING PHARMACOLOGICAL MECHANISMS AS A KEY TO THERAPEUTIC ADVANCES AND MITIGATION OF THE MISUSE CRISIS. OPIOIDS ARE A MAINSTAY IN ACUTE PAIN MANAGEMENT AND PRODUCE THEIR EFFECTS AND SIDE EFFECTS (E.G., TOLERANCE, OPIOID-USE DISORDER AND IMMUNE SUPPRESSION) BY INTERACTION WITH OPIOID RECEPTORS. I WILL DISCUSS OPIOID PHARMACOLOGY IN SOME CONTROVERSIAL AREAS OF ENQUIRY OF ANAESTHETIC RELEVANCE. THE MAIN OPIOID TARGET IS THE MICRO (MU,MOP) RECEPTOR BUT OTHER MEMBERS OF THE OPIOID RECEPTOR FAMILY, DELTA (DELTA; DOP) AND KAPPA (KAPPA; KOP) OPIOID RECEPTORS ALSO PRODUCE ANALGESIC ACTIONS. THESE ARE NALOXONE-SENSITIVE. THERE IS IMPORTANT CLINICAL DEVELOPMENT RELATING TO THE NOCICEPTIN/ORPHANIN FQ (NOP) RECEPTOR, AN OPIOID RECEPTOR THAT IS NOT NALOXONE-SENSITIVE. BETTER UNDERSTANDING OF THE DRIVERS FOR OPIOID EFFECTS AND SIDE EFFECTS MAY FACILITATE SEPARATION OF SIDE EFFECTS AND PRODUCTION OF SAFER DRUGS. OPIOIDS BIND TO THE RECEPTOR ORTHOSTERIC SITE TO PRODUCE THEIR EFFECTS AND CAN ENGAGE MONOMER OR HOMO-, HETERODIMER RECEPTORS. SOME LIGANDS CAN DRIVE ONE INTRACELLULAR PATHWAY OVER ANOTHER. THIS IS THE BASIS OF BIASED AGONISM (OR FUNCTIONAL SELECTIVITY). OPIOID ACTIONS AT THE ORTHOSTERIC SITE CAN BE MODULATED ALLOSTERICALLY AND POSITIVE ALLOSTERIC MODULATORS THAT ENHANCE OPIOID ACTION ARE IN DEVELOPMENT. AS WELL AS TARGETING LIGAND-RECEPTOR INTERACTION AND TRANSDUCTION, MODULATING RECEPTOR EXPRESSION AND HENCE FUNCTION IS ALSO TRACTABLE. THERE IS EVIDENCE FOR EPIGENETIC ASSOCIATIONS WITH DIFFERENT TYPES OF PAIN AND ALSO SUBSTANCE MISUSE. AS LONG AS THE OPIOID NARRATIVE IS DEFINED BY THE 'OPIOID CRISIS' THE DRIVE TO REMOVE THEM COULD GATHER PACE. THIS WILL DENY USE WHERE THEY ARE EFFECTIVE, AND ACCESS TO MORPHINE FOR PAIN RELIEF IN LOW INCOME COUNTRIES.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
2  6239  31 THE MANAGEMENT OF POLYPS IN FEMALE REPRODUCTIVE ORGANS. POLYPS OF THE LOWER REPRODUCTIVE TRACT ARE FOUND IN 7.8-50% OF WOMEN. IT HAS BEEN HYPOTHESIZED THAT CYTOGENETIC MODIFICATIONS ON CHROMOSOMES 6, 7 AND 12 AS WELL AS EPIGENETIC FACTORS INVOLVING ENZYME AND METABOLIC ACTIVITIES MAY CAUSE POLYPS TO DEVELOP. CERVICAL POLYPS FOUND IN 2-5% OF CASES ARE OF LOW CLINICAL SIGNIFICANCE AND CAN CAUSE, ALTHOUGH RARELY, POST COITAL BLEEDINGS. CERVICAL POLYPS GROW DURING PREGNANCY AND MUCORRHOEA. TRANS VAGINAL ULTRASOUND (TVU) PROVIDES AN EXCELLENT DIAGNOSTIC TECHNIQUE TO DIAGNOSE THE SIZE AND THE ANATOMIC LOCATION OF ENDOMETRIAL POLYPS (EPS). IN ASYMPTOMATIC YOUNG WOMAN WITH SMALL EPS <10 MM IN SIZE, CONSERVATIVE MANAGEMENT CAN BE SAFELY FOLLOWED BY MONITORING THE POLYP GROWTH. EPS LOCATED AT THE FUNDAL AND TUBOCORNUAL REGIONS MECHANICALLY AFFECT FERTILITY AND DISTURB NORMAL CELLULAR FUNCTION DUE TO CHRONIC INFLAMMATION. IN CASES WHERE EPS ARE A CAUSE OF SUBFERTILITY MECHANICAL HYSTEROSCOPIC RESECTION IS ADVISABLE. WHEN THE SOLE REASON FOR INFERTILITY IS AN EP, THE PATIENT OFTEN BECOMES SPONTANEOUSLY PREGNANT SHORTLY AFTER REMOVAL. EP DETECTION IN EITHER PERI- OR POST-MENOPAUSAL AGE, IN SYMPTOMATIC OR ASYMPTOMATIC PATIENTS CALLS FOR METICULOUS HYSTEROSCOPIC EXAMINATION AND POLYPECTOMY IS MANDATORY. ENDOMETRIAL CURETTAGE IS ALSO RECOMMENDED TO RULE OUT SUB CLINICAL ENDOMETRIAL HYPERPLASIA OR CANCER. HYSTEROSCOPIC SURGERY FOR LARGE EPS USING BIPOLAR RESECTOSCOPES, HYSTEROSCOPIC MORCELLATORS OR SHAVERS ARE CONSIDERED EQUALLY EFFICIENT AND SAFE UNDER GENERAL ANAESTHESIA. RECURRENCE RATE OF EPS AFTER RESECTION IS UNKNOWN. THE RECENT ADVANCES IN TVU AND HYSTEROSCOPY, HOWEVER, SHOULD PROVIDE AN ACCURATE DIAGNOSIS AND EFFECTIVE TREATMENT OF POLYP IN THE FEMALE REPRODUCTIVE TRACT WITH MINIMAL RECURRENCE OR SURGERY COMPLICATIONS. THE SIGNIFICANTLY INCREASED INCIDENCE OF COLORECTAL POLYPS IN COHORTS THAT ALSO HAD EPS MIGHT INDICATE THAT PATIENTS WITH EPS SHOULD BE ALSO REFERRED FOR COLONOSCOPY. EPS HAVE THE LOWEST INCIDENCE OF MALIGNANT TRANSFORMATION AS COMPARED TO COLON, URINARY BLADDER, OROPHARYNGEAL, NASAL AND LARYNGEAL CARCINOMAS.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                    
3  2561  31 EPIGENETICS IN THE PERIOPERATIVE PERIOD. THE PERIOPERATIVE PERIOD IS CHARACTERIZED BY PROFOUND CHANGES IN THE BODY'S HOMOEOSTATIC PROCESSES. THIS REVIEW SEEKS TO ADDRESS WHETHER EPIGENETIC MECHANISMS MAY INFLUENCE AN INDIVIDUAL'S REACTION TO SURGERY AND ANAESTHESIA. EVIDENCE FROM ANIMAL AND HUMAN STUDIES SUGGESTS THAT EPIGENETIC MECHANISMS CAN EXPLAIN MANY FACETS OF SUSCEPTIBILITY TO ACUTE AND CHRONIC PAIN, MAKING THEM POTENTIAL THERAPEUTIC TARGETS. MODERN PAIN MANAGEMENT IS STILL BASED UPON OPIATES, AND BOTH THE DEVELOPMENTAL EXPRESSION OF OPIOID RECEPTORS AND OPIOID-INDUCED HYPERALGESIA HAVE BEEN LINKED TO EPIGENETIC MECHANISMS. IN GENERAL, OPIATES SEEM TO INCREASE GLOBAL DNA METHYLATION LEVELS. THIS IS IN CONTRAST TO LOCAL ANAESTHETICS, WHICH HAVE BEEN ASCRIBED A GLOBAL DEMETHYLATING EFFECT. EVEN THOUGH NO DIRECT INVESTIGATIONS HAVE BEEN CARRIED OUT, THE POTENTIAL INFLUENCE OF EPIGENETICS ON THE INFLAMMATORY RESPONSE THAT FOLLOWS SURGERY SEEMS A PROMISING AREA FOR RESEARCH. THERE IS A CONSIDERABLE BODY OF EVIDENCE THAT SUPPORTS THE INVOLVEMENT OF EPIGENETICS IN THE COMPLEX PROCESS OF WOUND HEALING. EPIGENETICS IS AN IMPORTANT EMERGING RESEARCH TOPIC IN PERIOPERATIVE MEDICINE, WITH A HUGE POTENTIAL TO POSITIVELY INFLUENCE PATIENT OUTCOME.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
4  3325  24 HISTONE DEACETYLASE 2-MEDIATED EPIGENETIC REGULATION IS INVOLVED IN THE EARLY ISOFLURANE EXPOSURE-RELATED INCREASE IN SUSCEPTIBILITY TO ANXIETY-LIKE BEHAVIOUR EVOKED BY CHRONIC VARIABLE STRESS IN MICE. INCREASING STUDIES REPORT THAT PROLONGED OR MULTIPLE ANAESTHETIC EXPOSURES EARLY IN LIFE ARE ASSOCIATED WITH DETRIMENTAL EFFECTS ON BRAIN FUNCTION. ALTHOUGH STUDIES HAVE EVALUATED THE DETRIMENTAL EFFECTS ON NEUROCOGNITIVE FUNCTION, FEW HAVE FOCUSED ON LONG-TERM NEUROPSYCHIATRIC EFFECTS. IN THE PRESENT STUDY, C57BL/6 MICE RECEIVED EITHER THREE NEONATAL ISOFLURANE EXPOSURES OR CONTROL EXPOSURE. STARTING ON POSTNATAL DAY 45, THE MICE WERE EITHER EXPOSED OR NOT TO A CHRONIC VARIABLE STRESS (CVS) PARADIGM, AND CVS-RELATED NEUROPSYCHIATRIC PERFORMANCE WAS EVALUATED USING A SERIES OF BEHAVIOURAL TESTS. THE EXPRESSION LEVELS OF HISTONE 3 LYSINE 9 ACETYLATION (ACETYL-H3K9), BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF), CAMP RESPONSE ELEMENT-BINDING PROTEIN-BINDING PROTEIN, AND HISTONE DEACETYLASES 1-4 IN THE AMYGDALA WERE MEASURED BY IMMUNOBLOTTING OR IMMUNOHISTOCHEMISTRY ANALYSIS. IN MICE WITH NEONATAL ISOFLURANE EXPOSURE, THE EFFECTS OF SODIUM BUTYRATE (NAB), A COMMONLY USED HDAC INHIBITOR, WERE EXAMINED ON CVS-RELATED BEHAVIOURAL AND MOLECULAR ALTERATIONS. THE RESULTS SHOWED THAT REPEATED NEONATAL ISOFLURANE EXPOSURE DID NOT AFFECT INNATE DEPRESSION-LIKE AND ANXIETY-LIKE BEHAVIOURS UNDER NON-STRESS CONDITIONS BUT FACILITATED THE CVS-INDUCED ANXIETY-LIKE BEHAVIOURAL PHENOTYPE. INCREASED HDAC2 EXPRESSION IN THE AMYGDALA WAS ASSOCIATED WITH AN INCREASE IN THE CVS-INDUCED REPRESSION OF ACETYL-H3K9 AND BDNF EXPRESSION AND AN ENHANCED CVS-EVOKED ANXIETY-LIKE BEHAVIOURAL PHENOTYPE IN MICE NEONATAL ISOFLURANE EXPOSURE. NAB SIGNIFICANTLY DECREASED THE CVS-INDUCED ANXIETY LEVEL BY ELEVATING ACETYL-H3K9 AND BDNF EXPRESSION. THESE RESULTS SUGGESTED THAT EARLY ANAESTHESIA EXPOSURE FACILITATED CHRONIC STRESS-INDUCED NEUROPSYCHIATRIC OUTCOMES, AND THE HDAC2-RELATED EPIGENETIC DYSREGULATION OF BDNF GENE EXPRESSION IS INVOLVED IN THE UNDERLYING MECHANISM.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
5  5051  37 PHARMACOLOGICAL RESCUE OF NOCICEPTIVE HYPERSENSITIVITY AND OXYTOCIN ANALGESIA IMPAIRMENT IN A RAT MODEL OF NEONATAL MATERNAL SEPARATION. OXYTOCIN (OT), KNOWN FOR ITS NEUROHORMONAL EFFECTS AROUND BIRTH, HAS RECENTLY BEEN SUGGESTED FOR BEING A CRITICAL DETERMINANT IN NEURODEVELOPMENTAL DISORDERS. THIS HYPOTHALAMIC NEUROPEPTIDE EXERTS A POTENT ANALGESIC EFFECT THROUGH AN ACTION ON THE NOCICEPTIVE SYSTEM. THIS ENDOGENOUS CONTROL OF PAIN HAS AN IMPORTANT ADAPTIVE VALUE BUT MIGHT BE ALTERED BY EARLY LIFE STRESS, POSSIBLY CONTRIBUTING TO ITS LONG-TERM CONSEQUENCES ON PAIN RESPONSES AND ASSOCIATED COMORBIDITIES. WE TESTED THIS HYPOTHESIS USING A RAT MODEL OF NEONATAL MATERNAL SEPARATION (NMS) KNOWN TO INDUCE LONG-TERM CONSEQUENCES ON SEVERAL BRAIN FUNCTIONS INCLUDING CHRONIC STRESS, ANXIETY, ALTERED SOCIAL BEHAVIOR, AND VISCERAL HYPERSENSITIVITY. WE FOUND THAT ADULT RATS WITH A HISTORY OF NMS WERE HYPERSENSITIVE TO NOXIOUS MECHANICAL/THERMAL HOT STIMULI AND TO INFLAMMATORY PAIN. WE FAILED TO OBSERVE OT RECEPTOR-MEDIATED STRESS-INDUCED ANALGESIA AND OT ANTIHYPERALGESIA AFTER CARRAGEENAN INFLAMMATION. THESE ALTERATIONS WERE PARTIALLY RESCUED IF NMS PUPS WERE TREATED BY INTRAPERITONEAL DAILY INJECTION DURING NMS WITH OT OR ITS DOWNSTREAM SECOND MESSENGER ALLOPREGNANOLONE. THE INVOLVEMENT OF EPIGENETIC CHANGES IN THESE ALTERATIONS WAS CONFIRMED SINCE NEONATAL TREATMENT WITH THE HISTONE DEACETYLASE INHIBITOR SAHA, NOT ONLY NORMALIZED NOCICEPTIVE SENSITIVITIES BUT ALSO RESTORED OT RECEPTOR-MEDIATED STRESS-INDUCED ANALGESIA AND THE ENDOGENOUS ANTIHYPERALGESIA IN INFLAMED NMS RATS. THERE IS GROWING EVIDENCE IN THE LITERATURE THAT EARLY LIFE STRESS MIGHT IMPAIR THE NOCICEPTIVE SYSTEM ONTOGENY AND FUNCTION. THIS STUDY SUGGESTS THAT THESE ALTERATIONS MIGHT BE RESTORED WHILE STIMULATING OT RECEPTOR SIGNALING OR HISTONE DEACETYLASE INHIBITORS, USING MOLECULES THAT ARE CURRENTLY AVAILABLE OR PART OF CLINICAL TRIALS FOR OTHER PATHOLOGIES.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
6  6617  44 UNDERPINNING THE NEUROBIOLOGICAL INTRICACIES ASSOCIATED WITH OPIOID TOLERANCE. THE OPIOID CRISIS IS A MAJOR THREAT OF THE 21ST CENTURY, WITH A REMARKABLE JUXTAPOSITION OF USE AND ABUSE. OPIOIDS ARE THE MOST POTENT AND EFFICACIOUS CLASS OF ANALGESICS, BUT DESPITE THEIR PROVEN THERAPEUTIC EFFICACY, THEY HAVE RECENTLY BEEN DEGRADED TO THIRD-LINE THERAPY FOR THE MANAGEMENT OF CHRONIC PAIN IN CLINICS. THE REASON BEHIND THIS IS THE DEVELOPMENT OF POTENTIAL SIDE EFFECTS AND TOLERANCE AFTER REPEATED DOSING. OPIOID TOLERANCE IS THE MAJOR LIMITING FACTOR LEADING TO THE WITHDRAWAL OF TREATMENT, SEVERE SIDE EFFECTS DUE TO DOSE ESCALATION, AND SOMETIMES EVEN DEATH OF THE PATIENTS. EVERY DAY MORE THAN 90 PEOPLE DIE DUE TO OPIOIDS OVERDOSE IN AMERICA, AND A SIMILAR TREND HAS BEEN SEEN ACROSS THE GLOBE. OVER THE PAST TWO DECADES, RESEARCHERS HAVE BEEN TRYING TO DISSECT THE NEUROBIOLOGICAL MECHANISM OF OPIOID TOLERANCE. RESEARCH ON OPIOID TOLERANCE SHIFTED TOWARD CENTRAL NERVOUS SYSTEM-BASED ADAPTATIONS BECAUSE TOLERANCE IS MUCH MORE THAN JUST A CELLULAR PHENOMENON. THUS, NEUROBIOLOGICAL ADAPTATIONS ASSOCIATED WITH OPIOID TOLERANCE ARE IMPORTANT TO UNDERSTAND IN ORDER TO FIND NEWER PAIN THERAPEUTICS. THESE ADAPTATIONS ARE ASSOCIATED WITH ALTERATIONS IN ASCENDING AND DESCENDING PAIN PATHWAYS, REWARD CIRCUITRY MODULATIONS, RECEPTOR DESENSITIZATION AND DOWN-REGULATION, RECEPTOR INTERNALIZATION, HETERODIMERIZATION, AND ALTERED EPIGENETIC REGULATION. THE PRESENT REVIEW IS FOCUSED ON NOVEL CIRCUITRIES ASSOCIATED WITH OPIOID TOLERANCE IN DIFFERENT AREAS OF THE BRAIN, SUCH AS PERIAQUEDUCTAL GRAY, ROSTRAL VENTROMEDIAL MEDULLA, DORSAL RAPHE NUCLEUS, VENTRAL TEGMENTAL AREA, AND NUCLEUS ACCUMBENS. UNDERSTANDING THE NEUROBIOLOGICAL MODULATIONS ASSOCIATED WITH CHRONIC OPIOID EXPOSURE AND TOLERANCE WILL PAVE THE WAY FOR THE DEVELOPMENT OF NOVEL PHARMACOLOGICAL TOOLS FOR SAFER AND BETTER MANAGEMENT OF CHRONIC PAIN IN PATIENTS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
7  5035  32 PHARMACOEPIGENOMICS OF OPIATES AND METHADONE MAINTENANCE TREATMENT: CURRENT DATA AND PERSPECTIVES. CURRENT TREATMENTS OF OPIOID ADDICTION INCLUDE PRIMARILY MAINTENANCE MEDICATIONS SUCH AS METHADONE. CHRONIC EXPOSURE TO OPIATE AND/OR LONG-LASTING MAINTENANCE TREATMENT INDUCE MODULATIONS OF GENE EXPRESSION IN BRAIN AND PERIPHERAL TISSUES. THERE IS INCREASING EVIDENCE THAT EPIGENETIC MODIFICATIONS UNDERLIE THESE MODULATIONS. THIS REVIEW SUMMARIZES PUBLISHED RESULTS ON OPIOID-INDUCED EPIGENETIC CHANGES IN ANIMAL MODELS AND IN PATIENTS. THE EPIGENETIC MODIFICATIONS OBSERVED WITH OTHER DRUGS OF ABUSE OFTEN USED BY OPIATE ABUSERS ARE ALSO OUTLINED. SPECIFIC METHADONE MAINTENANCE TREATMENT INDUCED EPIGENETIC MODIFICATIONS AT DIFFERENT TREATMENT STAGES MAY BE COMBINED WITH THE ONES RESULTING FROM PATIENTS' SUBSTANCE USE HISTORY. THEREFORE, RESEARCH COMPARING GROUPS OF ADDICTS WITH SIMILAR HISTORY AND SUBSTANCES USE DISORDERS BUT CONTRASTING FOR WELL-CHARACTERIZED TREATMENT PHENOTYPES SHOULD BE ENCOURAGED.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
8  4402  32 MODULATION OF NOCICEPTION BY SOCIAL FACTORS IN RODENTS: CONTRIBUTION OF THE OPIOID SYSTEM. RATIONALE: THE OPIOID SYSTEM IS INVOLVED IN THE REGULATION OF SEVERAL BEHAVIORAL AND PHYSIOLOGICAL RESPONSES, CONTROLLING PAIN, REWARD, AND ADDICTIVE BEHAVIORS. OPIOID ADMINISTRATION, DEPENDING ON DRUGS AND DOSES, USUALLY AFFECTS SOCIABILITY REDUCING INTERACTIONS BETWEEN CONSPECIFICS, WHEREAS SOME AFFILIATIVE BEHAVIORS SUCH AS SEXUAL ACTIVITY, SOCIAL GROOMING, AND PLAY BEHAVIOR INCREASE THE ENDOGENOUS OPIOID ACTIVITY. OBJECTIVES: THE POSSIBLE INTERACTION BETWEEN ENDOGENOUS OPIOIDS RELEASED DURING SOCIO/SEXUAL BEHAVIOR AND THEIR ANALGESIC EFFECT ON PAIN RESPONSE IS REVIEWED IN THE RODENT LITERATURE. RESULTS: DIRECT EVIDENCE FOR SOCIALLY MEDIATED OPIOID CHANGES RESULTING IN INCREASE IN NOCICEPTIVE THRESHOLD DERIVES FROM STUDIES EXPLORING THE EFFECTS OF DEFEAT EXPERIENCES, SOCIAL ISOLATION, MATERNAL, SEXUAL BEHAVIOR, AND SOCIAL REUNION AMONG KIN OR FAMILIAR ANIMALS IN LABORATORY RODENTS. INDIRECT EVIDENCE FOR ENDOGENOUS ACTIVATION OF THE OPIOID SYSTEM, POSSIBLY AFFECTING PAIN SENSITIVITY, DERIVES FROM STUDIES INVESTIGATING THE RELEVANCE OF NATURAL SOCIAL REWARD USING THE CONDITIONED PLACE PREFERENCE PROTOCOLS OR ANALYZING ULTRASONIC VOCALIZATIONS ASSOCIATED TO POSITIVE AFFECTIVE CONTEXTS. FINALLY, GENETIC AND EPIGENETIC FACTORS THAT AFFECT THE OPIOID SYSTEM DURING DEVELOPMENT ARE REPORTED TO BE INVOLVED IN MODULATING THE RESPONSE TO SOCIAL STIMULI AS WELL AS NOCICEPTION. CONCLUSIONS: ALL STUDIES HIGHLIGHT THE RELEVANCE OF AFFILIATIVE CONTACT BEHAVIOR BETWEEN CONSPECIFICS THAT IS RESPONSIBLE FOR THE ACTIVATION OF THE ENDOGENOUS MU-OPIOID SYSTEM, INDUCING NOCICEPTIVE THRESHOLD INCREASE.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
9  4937  29 PATERNAL MORPHINE EXPOSURE IN RATS REDUCES SOCIAL PLAY IN ADOLESCENT MALE PROGENY WITHOUT AFFECTING DRUG-TAKING BEHAVIOR IN JUVENILE MALES OR FEMALE OFFSPRING. THE ONGOING OPIOID ADDICTION CRISIS NECESSITATES THE IDENTIFICATION OF NOVEL RISK FACTORS TO IMPROVE PREVENTION AND TREATMENT OF OPIOID USE DISORDER. PARENTAL OPIOID EXPOSURE HAS RECENTLY EMERGED AS A POTENTIAL REGULATOR OF OFFSPRING VULNERABILITY TO OPIOID MISUSE, IN ADDITION TO HERITABLE GENETIC LIABILITY. AN UNDERSTUDIED ASPECT OF THIS "MISSING HERITABILITY" IS THE DEVELOPMENTAL PRESENTATION OF THESE CROSS-GENERATIONAL PHENOTYPES. THIS IS AN ESPECIALLY RELEVANT QUESTION IN THE CONTEXT OF INHERITED ADDICTION-RELATED PHENOTYPES, GIVEN THE PROMINENT ROLE OF DEVELOPMENTAL PROCESSES IN THE ETIOLOGY OF PSYCHIATRIC DISORDERS. PATERNAL MORPHINE SELF-ADMINISTRATION WAS PREVIOUSLY SHOWN TO ALTER THE SENSITIVITY TO THE REINFORCING AND ANTINOCICEPTIVE PROPERTIES OF OPIOIDS IN THE NEXT GENERATION. HERE, PHENOTYPING WAS EXPANDED TO INCLUDE THE ADOLESCENT PERIOD, WITH A FOCUS ON ENDOPHENOTYPES RELATED TO OPIOID USE DISORDERS AND PAIN. PATERNAL MORPHINE EXPOSURE DID NOT ALTER HEROIN OR COCAINE SELF-ADMINISTRATION IN MALE AND FEMALE JUVENILE PROGENY. FURTHER, BASELINE SENSORY REFLEXES RELATED TO PAIN WERE UNALTERED IN MORPHINE-SIRED ADOLESCENT RATS OF EITHER SEX. HOWEVER, MORPHINE-SIRED ADOLESCENT MALES EXHIBITED A REDUCTION IN SOCIAL PLAY BEHAVIOR. OUR FINDINGS SUGGEST THAT, IN MORPHINE-SIRED MALE OFFSPRING, PATERNAL OPIOID EXPOSURE DOES NOT AFFECT OPIOID INTAKE DURING ADOLESCENCE, SUGGESTING THAT THIS PHENOTYPE DOES NOT EMERGE UNTIL LATER IN LIFE. ALTERED SOCIAL BEHAVIORS IN MALE MORPHINE-SIRED ADOLESCENTS INDICATE THAT THE CHANGES IN DRUG-TAKING BEHAVIOR IN ADULTS SIRED BY MORPHINE-EXPOSED SIRES MAY BE DUE TO MORE COMPLEX FACTORS NOT YET FULLY ASSESSED.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
10  4207  32 METABOTROPIC GLUTAMATE RECEPTORS AND THE CONTROL OF CHRONIC PAIN. OVER THE PAST TWO DECADES METABOTROPIC GLUTAMATE (MGLU) RECEPTOR LIGANDS HAVE BEEN INVESTIGATED FOR THEIR POTENTIAL THERAPEUTIC EFFECTS IN DIFFERENT DISORDERS OF THE CENTRAL NERVOUS SYSTEM (CNS), INCLUDING ANXIETY, DEPRESSION, SCHIZOPHRENIA, AND NEURODEGENERATIVE DISEASES. IN ADDITION, IT HAS BEEN WIDELY DEMONSTRATED THAT MGLU RECEPTORS ARE ABLE TO MODULATE PAIN TRANSMISSION BOTH IN INFLAMMATORY AND NEUROPATHIC PAIN MODELS. A LARGE NUMBER OF PRECLINICAL STUDIES COMBINING THE USE OF SELECTIVE LIGANDS WITH THE KNOCKOUT STRATEGY HAVE REVEALED MORE DETAILS ABOUT THE ROLE OF THE DIFFERENT MGLU RECEPTOR SUBTYPES IN THE MODULATION OF PAIN INFORMATION. THIS REVIEW WILL ADDRESS THE ROLE OF MGLU RECEPTORS IN PAIN SENSITIVITY FOCUSING ON DIFFERENT STRATEGIES TO ACHIEVE PAIN CONTROL BY TARGETING SPECIFIC MGLU RECEPTOR SUBTYPES. SPECIFICALLY, PHARMACOLOGICAL INTERVENTIONS AIMED AT INHIBITING GROUP I MGLU RECEPTOR-MEDIATED SIGNALING AND/OR POTENTIATING GROUPS II AND III MGLU RECEPTOR SIGNALING TOGETHER WITH AN EPIGENETIC APPROACH LEADING TO AN INCREASED EXPRESSION OF MGLU2 RECEPTORS WILL BE DISCUSSED.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
11  4532  37 MULTIMODAL ANALGESIA FOR PERIOPERATIVE MANAGEMENT OF PATIENTS PRESENTING FOR SPINAL SURGERY. MULTIMODAL, NON-OPIOID BASED ANALGESIA HAS BECOME THE CORNERSTONE OF ERAS PROTOCOLS FOR EFFECTIVE ANALGESIA AFTER SPINAL SURGERY. OPIOID SIDE EFFECTS, DEPENDENCE AND LEGISLATION RESTRICTING LONG TERM OPIOID USE HAS LED TO A RESURGENCE IN INTEREST IN OPIOID SPARING TECHNIQUES. THE INCREASING ARRAY OF MULTIMODAL OPIOID SPARING ANALGESICS AVAILABLE FOR SPINAL SURGERY TARGETING NOVEL RECEPTORS, TRANSMITTERS, AND ALTERING EPIGENETICS CAN HELP PROVIDE AN OPTIMAL PERIOPERATIVE EXPERIENCE WITH LESS OPIOID SIDE EFFECTS AND LONG-TERM DEPENDENCE. EPIGENETIC MECHANISMS OF PAIN MAY ENHANCE OR SUPPRESS GENE EXPRESSION, WITHOUT ALTERING THE GENOME ITSELF. SUCH MECHANISMS ARE COMPLEX, DYNAMIC AND RESPONSIVE TO ENVIRONMENT. ALTERATIONS THAT OCCUR CAN AFFECT THE PATHOPHYSIOLOGY OF PAIN MANAGEMENT AT A DNA LEVEL, MODIFYING PERCEIVED PAIN RELIEF. IN THIS REVIEW, WE PROVIDE A BRIEF OVERVIEW OF EPIGENETICS OF PAIN, SYSTEMIC LOCAL ANESTHETICS AND NEURAXIAL TECHNIQUES THAT CONTINUE TO REMAIN USEFUL FOR SPINAL SURGERY, NEUROPATHIC AGENTS, AS WELL AS OTHER COMMON AND LESS COMMON TARGET RECEPTORS FOR A TRULY MULTIMODAL APPROACH TO PERIOPERATIVE PAIN MANAGEMENT.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
12  2363  37 EPIGENETIC REGULATION OF SPINAL CORD GENE EXPRESSION CONTRIBUTES TO ENHANCED POSTOPERATIVE PAIN AND ANALGESIC TOLERANCE SUBSEQUENT TO CONTINUOUS OPIOID EXPOSURE. BACKGROUND: OPIOIDS HAVE BECOME THE MAINSTAY FOR TREATMENT OF MODERATE TO SEVERE PAIN AND ARE COMMONLY USED TO TREAT SURGICAL PAIN. WHILE OPIOID ADMINISTRATION HAS BEEN SHOWN TO CAUSE OPIOID-INDUCED HYPERALGESIA AND TOLERANCE, INTERACTIONS BETWEEN OPIOID ADMINISTRATION AND SURGERY WITH RESPECT TO THESE PROBLEMATIC ADAPTATIONS HAVE SCARCELY BEEN ADDRESSED. ACCUMULATING EVIDENCE SUGGESTS OPIOIDS AND NOCICEPTIVE SIGNALING MAY CONVERGE ON EPIGENETIC MECHANISMS IN SPINAL CORD TO ENHANCE OR PROLONG NEUROPLASTIC CHANGES. EPIGENETIC REGULATION OF BDNF (BRAIN-DERIVED NEUROTROPHIC FACTOR) AND PDYN (PRODYNORPHIN) GENES MAY BE INVOLVED. RESULTS: FOUR DAYS OF ASCENDING DOSES OF MORPHINE TREATMENT CAUSED OPIOID-INDUCED HYPERALGESIA AND REDUCED OPIOID ANALGESIC EFFICACY IN MICE. BOTH OPIOID-INDUCED HYPERALGESIA AND THE REDUCED OPIOID ANALGESIC EFFICACY WERE ENHANCED IN MICE THAT RECEIVED HINDPAW INCISIONS. THE EXPRESSION OF BDNF AND PDYN (QPCR) WAS INCREASED AFTER MORPHINE TREATMENT AND INCISION. CHROMATIN IMMUNOPRECIPITATION ASSAYS DEMONSTRATED THAT THE PDYN AND BDNF PROMOTERS WERE MORE STRONGLY ASSOCIATED WITH ACETYLATED H3K9 AFTER MORPHINE PLUS INCISION THAN IN THE MORPHINE OR INCISION ALONE GROUPS. SELECTIVE TROPOMYOSIN-RELATED KINASE B (ANA-12) AND KAPPA-OPIOID RECEPTOR (NOR-BINALTORPHIMINE) ANTAGONISTS WERE ADMINISTERED INTRATHECALLY, BOTH REDUCED HYPERALGESIA ONE OR THREE DAYS AFTER SURGERY. ADMINISTRATION OF ANA-12 OR NOR-BINALTORPHIMINE ATTENUATED THE DECREASED MORPHINE ANALGESIC EFFICACY ON DAY 1, BUT ONLY NOR-BINALTORPHIMINE WAS EFFECTIVE ON DAY 3 AFTER INCISION IN OPIOID-EXPOSED GROUP. COADMINISTRATION OF HISTONE ACETYLTRANSFERASE INHIBITOR ANACARDIC ACID DAILY WITH MORPHINE BLOCKED THE DEVELOPMENT OF OPIOID-INDUCED HYPERALGESIA AND ATTENUATED INCISION-ENHANCED HYPERALGESIA IN MORPHINE-TREATED MICE. ANACARDIC ACID HAD SIMILAR EFFECTS ON ANALGESIC TOLERANCE, SHOWING THE INVOLVEMENT OF HISTONE ACETYLATION IN THE INTERACTIONS DETECTED. CONCLUSIONS: SPINAL EPIGENETIC CHANGES INVOLVING BDNF AND PDYN MAY CONTRIBUTE TO THE ENHANCED POSTOPERATIVE NOCICEPTIVE SENSITIZATION AND ANALGESIC TOLERANCE OBSERVED AFTER CONTINUOUS OPIOID EXPOSURE. TREATMENTS BLOCKING THE EPIGENETICALLY MEDIATED UP-REGULATION OF THESE GENES OR ADMINISTRATION OF TRKB OR KAPPA-OPIOID RECEPTOR ANTAGONISTS MAY IMPROVE THE CLINICAL UTILITY OF OPIOIDS, PARTICULARLY AFTER SURGERY.	2016	

13   189  28 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
14  1160  24 CONTINUING WAR ON PAIN: A PERSONALIZED APPROACH TO THE THERAPY WITH NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND OPIOIDS. SUCCESSFUL PAIN MANAGEMENT REQUIRES THE DELIVERY OF ANALGESIA WITH MINIMAL RISK OF ADVERSE DRUG REACTIONS. NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND OPIOIDS REMAIN THE MAINSTAY OF TREATMENT FOR THE MAJORITY OF PATIENTS. UNFORTUNATELY, ALMOST 50% OF ALL PATIENTS EXPERIENCE INADEQUATE PAIN RELIEF AND SERIOUS SIDE EFFECTS. ALLELIC VARIANTS IN GENES CODING FOR TARGET PROTEINS, TRANSPORTERS AND ENZYMES, WHICH GOVERN ANALGESIC DRUGS ACTION AND THEIR FATE IN THE ORGANISM, MIGHT EXPLAIN INTER-INDIVIDUAL VARIABILITY IN PAIN SEVERITY AND IN DRUG-INDUCED PAIN RELIEF AND TOXICITIES. ADDITIONALLY, IT SEEMS THAT EPIGENETIC CHANGES CONTRIBUTE TO THE HIGHLY VARIABLE RESPONSE TO PAIN TREATMENT. THEREFORE, PHARMACOGENOMIC TESTING MIGHT BE A VALUABLE TOOL FOR PERSONALIZATION OF PAIN TREATMENT, WITH A MULTIDISCIPLINARY TEAM APPROACH INVOLVED.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
15   881  29 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
16  3606  30 IMPROVING TREATMENT OF NEURODEVELOPMENTAL DISORDERS: RECOMMENDATIONS BASED ON PRECLINICAL STUDIES. INTRODUCTION: NEURODEVELOPMENTAL DISORDERS (NDDS) ARE COMMON AND SEVERELY DEBILITATING. THEIR CHRONIC NATURE AND RELIANCE ON BOTH GENETIC AND ENVIRONMENTAL FACTORS MAKES STUDYING NDDS AND THEIR TREATMENT A CHALLENGING TASK. AREAS COVERED: HEREIN, THE AUTHORS DISCUSS THE NEUROBIOLOGICAL MECHANISMS OF NDDS, AND PRESENT RECOMMENDATIONS ON THEIR TRANSLATIONAL RESEARCH AND THERAPY, OUTLINED BY THE INTERNATIONAL STRESS AND BEHAVIOR SOCIETY. VARIOUS DRUGS CURRENTLY PRESCRIBED TO TREAT NDDS ALSO REPRESENT A HIGHLY DIVERSE GROUP. ACTING ON VARIOUS NEUROTRANSMITTER AND PHYSIOLOGICAL SYSTEMS, THESE DRUGS OFTEN LACK SPECIFICITY OF ACTION, AND ARE COMMONLY USED TO TREAT MULTIPLE OTHER PSYCHIATRIC CONDITIONS. THERE HAS ALSO BEEN RELATIVELY LITTLE PROGRESS IN THE DEVELOPMENT OF NOVEL MEDICATIONS TO TREAT NDDS. BASED ON CLINICAL, PRECLINICAL AND TRANSLATIONAL MODELS OF NDDS, OUR RECOMMENDATIONS COVER A WIDE RANGE OF METHODOLOGICAL APPROACHES AND CONCEPTUAL STRATEGIES. EXPERT OPINION: TO IMPROVE PHARMACOTHERAPY AND DRUG DISCOVERY FOR NDDS, WE NEED A STRONGER EMPHASIS ON TARGETING MULTIPLE ENDOPHENOTYPES, A BETTER DISSECTION OF GENETIC/EPIGENETIC FACTORS OR "HIDDEN HERITABILITY," AND A CAREFUL CONSIDERATION OF POTENTIAL DEVELOPMENTAL/TROPHIC ROLES OF BRAIN NEUROTRANSMITTERS. THE VALIDITY OF ANIMAL NDD MODELS CAN BE IMPROVED THROUGH DISCOVERY OF NOVEL (BEHAVIORAL, PHYSIOLOGICAL AND NEUROIMAGING) BIOMARKERS, APPLYING PROPER ENVIRONMENTAL ENRICHMENT, WIDENING THE SPECTRUM OF MODEL ORGANISMS, TARGETING DEVELOPMENTAL TRAJECTORIES OF NDD-RELATED BEHAVIORS AND COMORBID CONDITIONS BEYOND TRADITIONAL NDDS. WHILE THESE RECOMMENDATIONS CANNOT BE ADDRESSED ALL IN ONCE, OUR INCREASED UNDERSTANDING OF NDD PATHOBIOLOGY MAY TRIGGER INNOVATIVE CROSS-DISCIPLINARY RESEARCH EXPANDING BEYOND TRADITIONAL METHODS AND CONCEPTS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
17    29  29 A BIOPSYCHOSOCIAL OVERVIEW OF THE OPIOID CRISIS: CONSIDERING NUTRITION AND GASTROINTESTINAL HEALTH. THE OPIOID CRISIS HAS REACHED EPIDEMIC PROPORTIONS IN THE UNITED STATES WITH RISING OVERDOSE DEATH RATES. IDENTIFYING THE UNDERLYING FACTORS THAT CONTRIBUTE TO ADDICTION VULNERABILITY MAY LEAD TO MORE EFFECTIVE PREVENTION STRATEGIES. SUPPLY SIDE ENVIRONMENTAL FACTORS ARE A MAJOR CONTRIBUTING COMPONENT. PSYCHOSOCIAL FACTORS SUCH AS STRESS, TRAUMA, AND ADVERSE CHILDHOOD EXPERIENCES HAVE BEEN LINKED TO EMOTIONAL PAIN LEADING TO SELF-MEDICATION. GENETIC AND EPIGENETIC FACTORS ASSOCIATED WITH BRAIN REWARD PATHWAYS AND IMPULSIVITY ARE KNOWN PREDICTORS OF ADDICTION VULNERABILITY. THIS REVIEW ATTEMPTS TO PRESENT A BIOPSYCHOSOCIAL APPROACH THAT CONNECTS VARIOUS SOCIAL AND BIOLOGICAL THEORIES RELATED TO THE ADDICTION CRISIS. THE EMERGING ROLE OF NUTRITION THERAPY WITH AN EMPHASIS ON GASTROINTESTINAL HEALTH IN THE TREATMENT OF OPIOID USE DISORDER IS PRESENTED. THE BIOPSYCHOSOCIAL MODEL INTEGRATES CONCEPTS FROM SEVERAL DISCIPLINES, EMPHASIZING MULTICAUSALITY RATHER THAN A REDUCTIONIST APPROACH. POTENTIAL SOLUTIONS AT MULTIPLE LEVELS ARE PRESENTED, CONSIDERING INDIVIDUAL AS WELL AS POPULATION HEALTH. THIS SINGLE COHESIVE FRAMEWORK IS BASED ON THE INTERDEPENDENCY OF THE ENTIRE SYSTEM, IDENTIFYING RISK AND PROTECTIVE FACTORS THAT MAY INFLUENCE SUBSTANCE-SEEKING BEHAVIOR. NUTRITION SHOULD BE INCLUDED AS ONE FACET OF A MULTIDISCIPLINARY APPROACH TOWARD IMPROVED RECOVERY OUTCOMES. CROSS-DISCIPLINARY COLLABORATIVE EFFORTS, NEW IDEAS, AND FISCAL RESOURCES WILL BE CRITICAL TO ADDRESS THE EPIDEMIC.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
18  4608  31 NEONATAL ANESTHESIA AND DYSREGULATION OF THE EPIGENOMEDAGGER. EACH YEAR, MILLIONS OF INFANTS AND CHILDREN ARE ANESTHETIZED FOR MEDICAL AND SURGICAL PROCEDURES. YET, A SUBSTANTIAL BODY OF PRECLINICAL EVIDENCE SUGGESTS THAT ANESTHETICS ARE NEUROTOXINS THAT CAUSE RAPID AND WIDESPREAD APOPTOTIC CELL DEATH IN THE BRAINS OF INFANT RODENTS AND NONHUMAN PRIMATES. THESE ANIMALS HAVE PERSISTENT IMPAIRMENTS IN COGNITION AND BEHAVIOR MANY WEEKS OR MONTHS AFTER ANESTHESIA EXPOSURE, LEADING US TO HYPOTHESIZE THAT ANESTHETICS DO MORE THAN SIMPLY KILL BRAIN CELLS. INDEED, ANESTHETICS CAUSE CHRONIC NEUROPATHOLOGY IN NEURONS THAT SURVIVE THE INSULT, WHICH THEN INTERFERES WITH MAJOR ASPECTS OF BRAIN DEVELOPMENT, SYNAPTIC PLASTICITY, AND NEURONAL FUNCTION. UNDERSTANDING THE PHENOMENON OF ANESTHESIA-INDUCED DEVELOPMENTAL NEUROTOXICITY IS OF CRITICAL PUBLIC HEALTH IMPORTANCE BECAUSE CLINICAL STUDIES NOW REPORT THAT ANESTHESIA IN HUMAN INFANCY IS ASSOCIATED WITH COGNITIVE AND BEHAVIORAL DEFICITS. IN OUR SEARCH FOR MECHANISTIC EXPLANATIONS FOR WHY A YOUNG AND PLIABLE BRAIN CANNOT FULLY RECOVER FROM A RELATIVELY BRIEF PERIOD OF ANESTHESIA, WE HAVE ACCUMULATED EVIDENCE THAT NEONATAL ANESTHESIA CAN DYSREGULATE EPIGENETIC TAGS THAT INFLUENCE GENE TRANSCRIPTION SUCH AS HISTONE ACETYLATION AND DNA METHYLATION. IN THIS REVIEW, WE BRIEFLY SUMMARIZE THE PHENOMENON OF ANESTHESIA-INDUCED DEVELOPMENTAL NEUROTOXICITY. WE THEN DISCUSS CHRONIC NEUROPATHOLOGY CAUSED BY NEONATAL ANESTHESIA, INCLUDING DISTURBANCES IN COGNITION, SOCIO-AFFECTIVE BEHAVIOR, NEURONAL MORPHOLOGY, AND SYNAPTIC PLASTICITY. FINALLY, WE PRESENT EVIDENCE OF ANESTHESIA-INDUCED GENETIC AND EPIGENETIC DYSREGULATION WITHIN THE DEVELOPING BRAIN THAT MAY BE TRANSMITTED INTERGENERATIONALLY TO ANESTHESIA-NAIVE OFFSPRING.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
19  4848  30 OPIOID-INDUCED STRUCTURAL AND FUNCTIONAL PLASTICITY OF MEDIUM-SPINY NEURONS IN THE NUCLEUS ACCUMBENS. OPIOID USE DISORDER (OUD) IS A CHRONIC RELAPSING CLINICAL CONDITION WITH TREMENDOUS MORBIDITY AND MORTALITY THAT FREQUENTLY PERSISTS, DESPITE TREATMENT, DUE TO AN INDIVIDUAL'S UNDERLYING PSYCHOLOGICAL, NEUROBIOLOGICAL, AND GENETIC VULNERABILITIES. EVIDENCE SUGGESTS THAT THESE VULNERABILITIES MAY HAVE NEUROCHEMICAL, CELLULAR, AND MOLECULAR BASES. KEY NEUROPLASTIC EVENTS WITHIN THE MESOCORTICOLIMBIC SYSTEM THAT EMERGE THROUGH CHRONIC EXPOSURE TO OPIOIDS MAY HAVE A DETERMINATIVE INFLUENCE ON BEHAVIORAL SYMPTOMS ASSOCIATED WITH OUD. IN PARTICULAR, STRUCTURAL AND FUNCTIONAL ALTERATIONS IN THE DENDRITIC SPINES OF MEDIUM SPINY NEURONS (MSNS) WITHIN THE NUCLEUS ACCUMBENS (NAC) AND ITS DOPAMINERGIC PROJECTIONS FROM THE VENTRAL TEGMENTAL AREA (VTA) ARE BELIEVED TO FACILITATE THESE BEHAVIORAL SEQUELAE. ADDITIONALLY, GLUTAMATERGIC NEURONS FROM THE PREFRONTAL CORTEX, THE BASOLATERAL AMYGDALA, THE HIPPOCAMPUS, AND THE THALAMUS PROJECT TO THESE SAME MSNS, PROVIDING AN ENRICHED TARGET FOR SYNAPTIC PLASTICITY. HERE, WE REVIEW LITERATURE RELATED TO NEUROADAPTATIONS IN NAC MSNS FROM DOPAMINERGIC AND GLUTAMATERGIC PATHWAYS IN OUD. WE ALSO DESCRIBE NEW FINDINGS RELATED TO TRANSCRIPTIONAL, EPIGENETIC, AND MOLECULAR MECHANISMS IN MSN PLASTICITY IN THE DIFFERENT STAGES OF OUD.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
20  6536  31 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