1 1437 156 DIFFERENTIAL METHYLATION PATTERN OF XENOBIOTIC METABOLIZING GENES AND SUSCEPTIBILITY TO BALKAN ENDEMIC NEPHROPATHY, IN A COHORT OF ROMANIAN PATIENTS. A SEVERE, CHRONIC AND IRREVERSIBLE KIDNEY DISEASE AFFECTING DISCRETE RURAL POPULATIONS IN THE BALKAN PENINSULA COUNTRIES, BALKAN ENDEMIC NEPHROPATHY (BEN) HAS BEEN A SCIENTIFIC PUZZLE FOR MORE THAN HALF A CENTURY. MANY ENVIRONMENTAL AND OTHER FACTORS HAVE BEEN SUGGESTED AS THE PRIMARY CAUSE AND RECENT SIGNIFICANT FINDINGS HAVE LINKED BEN TO ARISTOLOCHIC ACIDS, PHYTOTOXINS DERIVED FROM THE PLANT ARISTOLOCHIA CLEMATITIS, FOUND IN HIGH DENSITY IN THE ENDEMIC AREAS. HOWEVER, GIVEN THAT THE INCIDENCE OF BEN IS LESS THAN 10% IN AFFECTED VILLAGES, AND IT TENDS TO HAVE A FAMILY AGGREGATION, AS YET UNIDENTIFIED GENETIC FACTORS MAY ALSO PLAY A ROLE. TO FURTHER EXPLORE THIS POSSIBILITY, A PILOT STUDY WAS INITIATED TO INVESTIGATE THE DNA METHYLATION OF CYP1A1, CYP1A2, NAT1, NQO1 AND GSTT1 IN BLOOD SAMPLES FROM A GROUP OF ROMANIAN BEN PATIENTS, COMPARED TO HEALTHY CONTROLS AND NON-BEN CHRONIC KIDNEY DISEASE (CKD) SUBJECTS. OUR STUDY REVEALED A MORE PRONOUNCED HYPOMETHYLATION PATTERN IN BEN AND NON-BEN CKD GROUPS, COMPARED TO THE HEALTHY CONTROL GROUP AT SPECIFIC CPGS ACROSS ALL FIVE GENES INTERROGATED. AVERAGE METHYLATION ACROSS THE FIVE REGIONS INVESTIGATED INDICATED SIGNIFICANT DIFFERENCES ONLY AT GSTT1, IN BOTH BEN PATIENTS (P = 0.028) AND NON-BEN DISEASE SUBJECTS (P = 0.015), RELATIVE TO HEALTHY INDIVIDUALS. SINCE GSTT1 ACTIVE GENOTYPE APPEARS TO BE A COMMON FEATURE OF SERBIAN AND ROMANIAN BEN PATIENTS, GSTT1 EPIGENETIC VARIATION AND INCREASED GENE ACTIVITY COULD ACT AS A PREDISPOSING (CO)FACTOR IN BEN POPULATIONS FROM THE AFFECTED COUNTRIES. BEN AND NON-BEN CKD GROUPS SHOW SIMILAR METHYLATION PATTERNS WITH EXCEPTION OF GSTT1 CPG8 (P = 0.046). 2020 2 3131 53 GLOBAL AND SPECIFIC HISTONE ACETYLATION PATTERN IN PATIENTS WITH BALKAN ENDEMIC NEPHROPATHY, A WORLDWIDE DISEASE. ABSTRACT BACKGROUND: BALKAN ENDEMIC NEPHROPATHY (BEN) IS A CHRONIC TUBULOINTERSTITIAL NEPHROPATHY PRESENT IN THE DANUBE RIVER REGIONS IN SEVERAL BALKAN COUNTRIES. THERE APPEARS TO BE A POLYGENIC SUSCEPTIBILITY TO THE DISEASE IN INTERACTION WITH MULTIPLE ENVIRONMENTAL FACTORS (ARISTOLOCHIC ACID, OCHRATOXIN A). IN A PREVIOUS STUDY SEC61G, IL17RA, HDAC11 PROVED TO BE DIFFERENTLY METHYLATED THROUGHOUT ALL PATIENT-CONTROL PAIRS OF BEN PATIENTS FROM SERBIA AND BULGARIA. EMERGING CONNECTIONS BETWEEN DNA METHYLATION AND HISTONE ACETYLATION PROMPTED THE PRESENT STUDY ON HISTONE ACETYLATION IN PATIENTS WITH BEN. METHODS: THE STUDY INVOLVED 39 PATIENTS WITH BEN, AND 39 CONTROLS COLLECTED FROM NON-ENDEMIC REGIONS IN SERBIA. THE EPISEEKER HISTONE H3 AND H4 TOTAL ACETYLATION DETECTION COLORIMETRIC KITS AND SPECIFIC ACETYLATED AT LYSINE 18 H3K18 AND H3K36 ACETYLATED AT LYSINE 36 DETECTION KITS WERE USED. RESULTS: IT WAS DOCUMENTED THAT TOTAL H4 HISTONE ACETYLATION LEVEL WAS INCREASED SIGNIFICANTLY, WHILE TOTAL H3 HISTONE ACETYLATION DID NOT DIFFER SIGNIFICANTLY. SPECIFIC HISTONE STRUCTURE AND FUNCTIONAL PROPERTIES MAY BE AFFECTED BY THE OBSERVED DERANGEMENT OF H3 HISTONE ACETYLATION PATTERN, SINCE H3K36 SITE WAS SIGNIFICANTLY MORE ACETYLATED, WHILE H3K18 TENDED TO BE LESS ACETYLATED THAN IN CONTROL SUBJECTS. MULTIPLE REGRESSION ANALYSIS REVEALED A STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN H4, H3T AND H3K36 IN BEN PATIENTS. CONCLUSION: THIS PRELIMINARY STUDY SUGGESTS THAT THE ACETYLATION OF HISTONE LYSINE RESIDUES WAS DETECTABLE AND FOUND INCREASED AT SPECIFIC SITES OF H3 AND TOTAL H4 HISTONES ISOLATED FROM UROTHELIAL CELLS OF PATIENTS WITH BEN. HAVING IN MIND A POSSIBLE MECHANISM AND BIOLOGICAL ROLE OF EPIGENETIC CHROMATIN MODIFICATION IN UROTHELIAL TUMOR DEVELOPMENT THEY OBTAINED RESULTS MAY OPEN OPPORTUNITY FOR SELECTIVE THERAPEUTIC INTERVENTIONS IN PATIENTS WITH BEN. 2014 3 3006 39 GENETIC, GENOMIC AND EPIGENOMIC STUDIES OF BALKAN ENDEMIC NEPHROPATHY (BEN). BEN IS A PRIMARY, CHRONIC TUBULOINTERSTITIAL NEPHRITIS CHARACTERIZED WITH CHRONIC ANEMIA, ABSENCE OF EDEMA, XANTODERMA, NORMAL BLOOD PRESSURE AND NORMAL FINDINGS ON THE FUNDUS OCULI. THE DISEASE IS DISTRIBUTED IN RESTRICTED AREAS IN BULGARIA, ROMANIA, CROATIA, BOSNIA, FORMER YUGOSLAVIA. DESPITE NUMEROUS STUDIES ON GENETIC AND ENVIRONMENTAL FACTORS AND THEIR POSSIBLE INVOLVEMENT IN BEN, ITS ETIOPATHOGENESIS STILL REMAINS ELUSIVE. OUR RECENT STUDY AIM TO ELUCIDATE THE POSSIBLE EPIGENETIC COMPONENT IN BEN DEVELOPMENT. WHOLE GENOME DNA ARRAY METHYLATION ANALYSIS WAS APPLIED TO COMPARE THE METHYLATION PROFILES OF MALE AND FEMALE BEN PATIENTS FROM ENDEMIC REGIONS IN BULGARIA AND SERBIA AND HEALTHY CONTROLS. ALL THREE MOST PROMINENT CANDIDATE GENES WITH ABERRATIONS IN THE EPIGENETIC PROFILE DISCOVERED WITH THIS STUDY ARE INVOLVED IN THE INFLAMMATORY/IMMUNE PROCESSES AND ONCOGENESIS. THESE DATA ARE IN CONCORDANCE WITH THE REPORTED PATHOLOGICAL ALTERATIONS IN BEN. THIS RESEARCH SUPPORTS THE ROLE OF EPIGENETIC CHANGES IN BEN PATHOLOGY. EXOME SEQUENCING OF 22.000 GENES WITH ILLUMINA NEXTERA EXOME ENRICHMENT KIT REVEALED THREE MUTANT GENES (CELA1, HSPG2, AND KCNK5) IN BEN PATIENTS WHICH ENCODE PROTEINS INVOLVED IN BASEMENT MEMBRANE/EXTRACELLULAR MATRIX AND VASCULAR TONE, TIGHTLY CONNECTED TO PROCESS OF ANGIOGENESIS. WE SUGGEST THAT AN ABNORMAL PROCESS OF ANGIOGENESIS PLAYS A KEY ROLE IN THE MOLECULAR PATHOGENESIS OF BEN. 2015 4 6748 47 WHOLE GENOME METHYLATION ARRAY ANALYSIS REVEALS NEW ASPECTS IN BALKAN ENDEMIC NEPHROPATHY ETIOLOGY. BACKGROUND: BALKAN ENDEMIC NEPHROPATHY (BEN) REPRESENTS A CHRONIC PROGRESSIVE INTERSTITIAL NEPHRITIS IN STRIKING CORRELATION WITH UROEPITHELIAL TUMOURS OF THE UPPER URINARY TRACT. THE DISEASE HAS ENDEMIC DISTRIBUTION IN THE DANUBE RIVER REGIONS IN SEVERAL BALKAN COUNTRIES.DNA METHYLATION IS A PRIMARY EPIGENETIC MODIFICATION THAT IS INVOLVED IN MAJOR PROCESSES SUCH AS CANCER, GENOMIC IMPRINTING, GENE SILENCING, ETC. THE SIGNIFICANCE OF CPG ISLAND METHYLATION STATUS IN NORMAL DEVELOPMENT, CELL DIFFERENTIATION AND GENE EXPRESSION IS WIDELY RECOGNIZED, ALTHOUGH STILL STAYS POORLY UNDERSTOOD. METHODS: WE PERFORMED WHOLE GENOME DNA METHYLATION ARRAY ANALYSIS ON DNA POOL SAMPLES FROM PERIPHERAL BLOOD FROM 159 AFFECTED INDIVIDUALS AND 170 HEALTHY INDIVIDUALS. THIS TECHNIQUE ALLOWED US TO DETERMINE THE METHYLATION STATUS OF 27 627 CPG ISLANDS THROUGHOUT THE WHOLE GENOME IN HEALTHY CONTROLS AND BEN PATIENTS. THUS WE OBTAINED THE METHYLATION PROFILE OF BEN PATIENTS FROM BULGARIAN AND SERBIAN ENDEMIC REGIONS. RESULTS: USING SPECIFICALLY DEVELOPED SOFTWARE WE COMPARED THE METHYLATION PROFILES OF BEN PATIENTS AND CORRESPONDING CONTROLS AND REVEALED THE DIFFERENTLY METHYLATED REGIONS. WE THEN COMPARED THE DMRS BETWEEN ALL PATIENT-CONTROL PAIRS TO DETERMINE COMMON CHANGES IN THE EPIGENETIC PROFILES.SEC61G, IL17RA, HDAC11 PROVED TO BE DIFFERENTLY METHYLATED THROUGHOUT ALL PATIENT-CONTROL PAIRS. THE CPG ISLANDS OF ALL 3 GENES WERE HYPOMETHYLATED COMPARED TO CONTROLS. THIS SUGGESTS THAT DYSREGULATION OF THESE GENES INVOLVED IN IMMUNOLOGICAL RESPONSE COULD BE A COMMON MECHANISM IN BEN PATHOGENESIS IN BOTH ENDEMIC REGIONS AND IN BOTH GENDERS. CONCLUSION: OUR DATA PROPOSE A NEW HYPOTHESIS THAT IMMUNOLOGIC DYSREGULATION HAS A PLACE IN BEN ETIOPATHOGENESIS. 2013 5 4822 33 OCHRATOXIN A: 50 YEARS OF RESEARCH. SINCE OCHRATOXIN A (OTA) WAS DISCOVERED, IT HAS BEEN UBIQUITOUS AS A NATURAL CONTAMINANT OF MOLDY FOOD AND FEED. THE MULTIPLE TOXIC EFFECTS OF OTA ARE A REAL THREAT FOR HUMAN BEINGS AND ANIMAL HEALTH. FOR EXAMPLE, OTA CAN CAUSE PORCINE NEPHROPATHY BUT CAN ALSO DAMAGE POULTRIES. HUMANS EXPOSED TO OTA CAN DEVELOP (NOTABLY BY INHALATION IN THE DEVELOPMENT OF ACUTE RENAL FAILURE WITHIN 24 H) A RANGE OF CHRONIC DISORDERS SUCH AS UPPER UROTHELIAL CARCINOMA. OTA PLAYS THE MAIN ROLE IN THE PATHOGENESIS OF SOME RENAL DISEASES INCLUDING BALKAN ENDEMIC NEPHROPATHY, KIDNEY TUMORS OCCURRING IN CERTAIN ENDEMIC REGIONS OF THE BALKAN PENINSULA, AND CHRONIC INTERSTITIAL NEPHROPATHY OCCURRING IN NORTHERN AFRICAN COUNTRIES AND LIKELY IN OTHER PARTS OF THE WORLD. OTA LEADS TO DNA ADDUCT FORMATION, WHICH IS KNOWN FOR ITS GENOTOXICITY AND CARCINOGENICITY. THE PRESENT ARTICLE DISCUSSES HOW RENAL CARCINOGENICITY AND NEPHROTOXICITY CAUSE BOTH OXIDATIVE STRESS AND DIRECT GENOTOXICITY. CAREFUL ANALYSES OF THE DATA SHOW THAT OTA CARCINOGENIC EFFECTS ARE DUE TO COMBINED DIRECT AND INDIRECT MECHANISMS (E.G., GENOTOXICITY, OXIDATIVE STRESS, EPIGENETIC FACTORS). ALTOGETHER THIS PROVIDES STRONG EVIDENCE THAT OTA CARCINOGENICITY CAN ALSO OCCUR IN HUMANS. 2016 6 4820 37 OCHRATOXIN A AS A POTENTIAL ETIOLOGIC FACTOR IN ENDEMIC NEPHROPATHY: LESSONS FROM TOXICITY STUDIES IN RATS. VARIOUS REPORTS SUGGEST THAT CHRONIC DIETARY EXPOSURE TO OCHRATOXIN A (OTA), A MYCOTOXIN FREQUENTLY DETECTED IN VARIOUS FOOD ITEMS MAY BE LINKED TO THE PATHOGENESIS OF ENDEMIC NEPHROPATHY, A CHRONIC TUBULOINTERSTITIAL KIDNEY DISEASE WHICH OCCURS IN GEOGRAPHICALLY LIMITED AREAS OF THE BALKAN REGION. OTA IS A POTENT NEPHROTOXIN AND RENAL CARCINOGEN. HOWEVER, THE PATHOLOGICAL LESIONS OBSERVED IN KIDNEYS OF RATS TREATED WITH OTA APPEAR BE RATHER DIFFERENT FROM THE CLINICAL AND PATHOLOGICAL CHARACTERISTICS OF ENDEMIC NEPHROPATHY. MOREOVER, INCREASING EVIDENCE SUGGESTS THAT OTA DOES NOT BIND TO DNA BUT INDUCES TUMORS BY AN EPIGENETIC, THRESHOLDED MECHANISM. THIS IMPLIES THAT THERE IS A DOSE BELOW WHICH NO ADVERSE HEALTH EFFECTS ARE EXPECTED TO OCCUR. BASED ON FOOD CONSUMPTION DATA AND OTA SERUM CONCENTRATIONS, IT APPEARS THAT HUMAN EXPOSURE - EVEN IN AREAS WITH RELATIVELY HIGH DIETARY EXPOSURE TO OTA SUCH AS ENDEMIC VILLAGES - IS SEVERAL ORDERS OF MAGNITUDE BELOW DOSES KNOWN TO CAUSE NEPHROTOXICITY AND TUMOR FORMATION IN LABORATORY ANIMALS. WHILE IT IS UNDOUBTEDLY IMPORTANT TO ENCOURAGE PREVENTION OF FOOD CONTAMINATION BY OTA AND OTHER MYCOTOXINS, THESE OBSERVATIONS SUGGEST THAT OTA IS NOT LIKELY TO BE AN ETIOLOGICAL FACTOR INVOLVED IN BEN AND INDICATE A NEED TO SEARCH FOR NEW CLUES FOR THE ETIOLOGY OF THIS ENDEMIC KIDNEY DISEASE. 2007 7 4825 32 OCULAR FUNDUS ABNORMALITIES IN PATIENTS WITH BALKAN ENDEMIC NEPHROPATHY AND OTHER CHRONIC KIDNEY DISEASES. AIM: THE AIM OF THIS STUDY WAS TO EXAMINE THE OCULAR FUNDUS PATHOLOGY IN PATIENTS WITH BALKAN ENDEMIC NEPHROPATHY (BN) AND CHRONIC KIDNEY DISEASES (CKD). METHODS: THE STUDY INCLUDED 51 PATIENTS WITH BN FROM THE SOUTH MORAVA RIVER REGION IN SERBIA, AND 102 SUBJECTS WITH DIFFERENT STAGES OF CHRONIC RENAL DISEASES, MATCHED ACCORDING TO AGE AND GENDER, OBTAINED FROM A DATABASE USED IN A RECENTLY PUBLISHED STUDY. ALL PATIENTS HAD VISITED OUTPATIENT DEPARTMENT OF THE CLINIC OF NEPHROLOGY, CLINICAL CENTER NIS. ALL PATIENTS UNDERWENT ROUTINE OPHTHALMIC EXAMINATIONS. RESULTS: THERE WERE SIGNIFICANTLY MORE (P < 0.001) PATIENTS WITH AGE-RELATED MACULAR DEGENERATION (AMD) IN THE GROUP WITH BN (31.37 %) THAN IN THOSE WITH CKD (5.88 %). MULTIVARIATE LOGISTIC REGRESSION ANALYSIS CONFIRMED THAT THE SIGNIFICANT FACTORS RELATED TO AMD IN THE GROUP WITH BN WERE ALBUMINURIA (P < 0.05) AND PROTEINURIA (P < 0.05); IN CKD PATIENTS, THE LEVEL OF HDL (P < 0.05), WHILE NEGATIVE CORRELATION WITH THE LEVEL OF TRIGLYCERIDE WAS REGISTERED (P < 0.05). THERE WAS NO ASSOCIATION BETWEEN ESTIMATED GLOMERULAR FILTRATION RATE AND AMD. THE SIGNIFICANT FACTORS RELATED TO RETINOPATHY IN THE GROUP WITH BN ARE AGE (P < 0.05) AND SERUM CREATININE VALUES (P < 0.05), IN PATIENTS WITH CKD INCREASING AGE (P < 0.001) AND DM (P < 0.05). CONCLUSION: OCULAR FUNDUS PATHOLOGY IN PATIENTS WITH BN IS SIMILAR TO THE PATHOLOGY OF OTHER CKD, BUT WITH SIGNIFICANTLY MORE AMD (ABOUT FOUR TIMES), PROBABLY RELATED TO THE GENETIC/EPIGENETIC FACTORS. 2015 8 4824 33 OCHRATOXIN A: THE CONTINUING ENIGMA. THE MYCOTOXIN OCHRATOXIN A (OTA) HAS BEEN LINKED TO THE GENESIS OF SEVERAL DISEASE STATES IN BOTH ANIMALS AND HUMANS. IT HAS BEEN DESCRIBED AS NEPHROTOXIC, CARCINOGENIC, TERATOGENIC, IMMUNOTOXIC, AND HEPATOTOXIC IN LABORATORY AND DOMESTIC ANIMALS, AS WELL AS BEING THOUGHT TO BE THE PROBABLE CAUSAL AGENT IN THE DEVELOPMENT OF NEPHROPATHIES (BALKAN ENDEMIC NEPHROPATHY, BEN AND CHRONIC INTERSTITIAL NEPHROPATHY, CIN) AND UROTHELIAL TUMORS IN HUMANS. AS A RESULT, SEVERAL INTERNATIONAL AGENCIES ARE CURRENTLY ATTEMPTING TO DEFINE SAFE LEGAL LIMITS FOR OTA CONCENTRATION IN FOODSTUFFS (E.G., GRAIN, MEAT, WINE, AND COFFEE), IN PROCESSED FOODS, AND IN ANIMAL FODDER. IN ORDER TO ACHIEVE THIS GOAL, AN ACCURATE RISK ASSESSMENT OF OTA TOXICITY INCLUDING MECHANISTIC AND EPIDEMIOLOGICAL STUDIES MUST BE CARRIED OUT. OCHRATOXIN HAS BEEN SUGGESTED BY VARIOUS RESEARCHERS TO MEDIATE ITS TOXIC EFFECTS VIA INDUCTION OF APOPTOSIS, DISRUPTION OF MITOCHONDRIAL RESPIRATION AND/OR THE CYTOSKELETON, OR, INDEED, VIA THE GENERATION OF DNA ADDUCTS. THUS, IT IS STILL UNCLEAR IF THE PREDOMINANT MECHANISM IS OF A GENOTOXIC OR AN EPIGENETIC NATURE. ONE ASPECT THAT IS CLEAR, HOWEVER, IS THAT THE TOXICITY OF OTA IS SUBJECT TO AND CHARACTERIZED BY LARGE SPECIES- AND SEX-SPECIFIC DIFFERENCES, AS WELL AS AN APPARENTLY STRICT STRUCTURE-ACTIVITY RELATIONSHIP. THESE CONSIDERATIONS COULD BE CRUCIAL IN THE INVESTIGATION OF OTA-MEDIATED TOXICITY. FURTHERMORE, THE USE OF APPROPRIATE IN VIVO AND IN VITRO MODEL SYSTEMS APPEARS TO BE VITAL IN THE GENERATION OF RELEVANT EXPERIMENTAL DATA. THE INTENTION OF THIS REVIEW IS TO COLLATE AND DISCUSS THE CURRENTLY AVAILABLE DATA ON OTA-MEDIATED TOXICITY WITH PARTICULAR FOCUS ON THEIR RELEVANCE FOR THE IN VIVO SITUATION, AND ALSO TO SUGGEST POSSIBLE FUTURE STRATEGIES FOR UNLOCKING THE SECRETS OF OCHRATOXIN A. 2005 9 1819 22 EFFECTS OF CHRONIC OCHRATOXIN A EXPOSURE ON P53 HETEROZYGOUS AND P53 HOMOZYGOUS MICE. EXPOSURE TO THE MYCOTOXIN OCHRATOXIN A (OTA) CAUSES NEPHROPATHY IN DOMESTIC ANIMALS AND RODENTS AND RENAL TUMORS IN RODENTS AND POULTRY. HUMANS ARE EXPOSED TO OTA BY CONSUMING FOODS MADE WITH CONTAMINATED CEREAL GRAINS AND OTHER COMMODITIES. MANAGEMENT OF HUMAN HEALTH RISKS DUE TO OTA EXPOSURE DEPENDS, IN PART, ON ESTABLISHING A MODE OF ACTION (MOA) FOR OTA CARCINOGENESIS. TO FURTHER INVESTIGATE OTA'S MOA, P53 HETEROZYGOUS (P53+/-) AND P53 HOMOZYGOUS (P53+/+) MICE WERE EXPOSED TO OTA IN DIET FOR 26 WEEKS. THE FORMER ARE SUSCEPTIBLE TO TUMORIGENESIS UPON CHRONIC EXPOSURE TO GENOTOXIC CARCINOGENS. OTA-INDUCED RENAL DAMAGE BUT NO TUMORS WERE OBSERVED IN EITHER STRAIN, INDICATING THAT P53 HETEROZYGOSITY CONFERRED LITTLE ADDITIONAL SENSITIVITY TO OTA. RENAL CHANGES INCLUDED DOSE-DEPENDENT INCREASES IN CELLULAR PROLIFERATION, APOPTOSIS, KARYOMEGALY, AND TUBULAR DEGENERATION IN PROXIMAL TUBULES, WHICH WERE CONSISTENT WITH OCHRATOXICOSIS. THE LOWEST OBSERVED EFFECT LEVEL FOR RENAL CHANGES IN P53+/- AND P53+/+ MICE WAS 200 MUG OTA/KG BW/DAY. BASED ON THE LACK OF TUMORS AND THE SEVERITY OF RENAL AND BODY WEIGHT CHANGES AT A MAXIMUM TOLERATED DOSE, THE RESULTS WERE INTERPRETED AS SUGGESTIVE OF A PRIMARILY NONGENOTOXIC (EPIGENETIC) MOA FOR OTA CARCINOGENESIS IN THIS MOUSE MODEL. 2015 10 4821 32 OCHRATOXIN A: 13-WEEK ORAL TOXICITY AND CELL PROLIFERATION IN MALE F344/N RATS. OCHRATOXIN A (OTA) IS NEPHROTOXIC AND A POTENT RENAL CARCINOGEN. MALE RATS ARE MOST SUSCEPTIBLE TO OTA TOXICITY, AND CHRONIC ADMINISTRATION OF OTA (70 AND 210 MICROG/KG BW) FOR 2 YEARS HAS BEEN SHOWN TO INDUCE HIGH INCIDENCES OF ADENOMAS AND CARCINOMAS ARISING FROM THE STRAIGHT SEGMENT OF THE PROXIMAL TUBULE EPITHELIUM. IN CONTRAST, TREATMENT WITH A LOWER DOSE OF 21 MICROG/KG BW DID NOT RESULT IN INCREASED TUMOR RATES, SUGGESTING A NONLINEAR DOSE RESPONSE FOR RENAL TUMOR FORMATION BY OTA. SINCE THE MECHANISM OF OTA CARCINOGENICITY IS STILL LARGELY UNKNOWN, THIS STUDY WAS CONDUCTED TO INVESTIGATE EARLY FUNCTIONAL AND PATHOLOGICAL EFFECTS OF OTA AND TO DETERMINE IF SUSTAINED STIMULATION OF RENAL CELL PROLIFERATION PLAYS A ROLE. MALE F344/N RATS WERE TREATED WITH OTA FOR UP TO 13 WEEKS UNDER CONDITIONS OF THE NATIONAL TOXICOLOGY PROGRAM (NTP) BIOASSAY. CELL PROLIFERATION IN THE RENAL CORTEX AND OUTER STRIPE OF THE OUTER MEDULLA (OSOM) WAS DETERMINED USING BROMODEOXYURIDINE INCORPORATION AND IMMUNOHISTOCHEMISTRY. HISTOPATHOLOGICAL EXAMINATION SHOWED RENAL ALTERATIONS IN MID- AND HIGH-DOSE-TREATED ANIMALS INVOLVING SINGLE-CELL DEATH AND PROMINENT NUCLEAR ENLARGEMENT WITHIN THE STRAIGHT PROXIMAL TUBULES. TREATMENT WITH OTA AT DOSES OF 70 AND 210 MICROG/KG BW LED TO A MARKED DOSE- AND TIME-DEPENDENT INCREASE IN RENAL CELL PROLIFERATION, EXTENDING FROM THE MEDULLARY RAYS INTO THE OSOM. NO EFFECTS WERE EVIDENT IN KIDNEYS OF LOW-DOSE-TREATED ANIMALS OR IN THE LIVER, WHICH IS NOT A TARGET FOR OTA CARCINOGENICITY. A NO OBSERVED EFFECT LEVEL IN THIS STUDY WAS ESTABLISHED AT 21 MICROG/KG BW, CORRELATING WITH THE DOSE IN THE NTP 2-YEAR BIOASSAY THAT DID NOT PRODUCE RENAL TUMORS. THE APPARENT CORRELATION BETWEEN ENHANCED CELL TURNOVER AND TUMOR FORMATION INDUCED BY OTA INDICATES THAT STIMULATION OF CELL PROLIFERATION MAY PLAY AN IMPORTANT ROLE IN OTA CARCINOGENICITY AND PROVIDES FURTHER EVIDENCE FOR AN EPIGENETIC, THRESHOLDED MECHANISM. 2007 11 6670 40 URINARY MICRORNA ANALYSIS INDICATES AN EPIGENETIC REGULATION OF CHRONIC KIDNEY DISEASE OF UNKNOWN ETIOLOGY IN SRI LANKA. BACKGROUND: CHRONIC KIDNEY DISEASE OF UNKNOWN ETIOLOGY (CKDU) IS REPORTED AMONG MALE PADDY FARMERS IN THE DRY ZONE OF SRI LANKA. THE EXACT CAUSE OF THIS DISEASE REMAINS UNDETERMINED. GENETIC SUSCEPTIBILITY IS IDENTIFIED AS A MAJOR RISK FACTOR FOR CKDU OBJECTIVES: IN THIS STUDY, SMALL URINARY RNAS WERE CHARACTERIZED IN CKDU PATIENTS, HEALTHY ENDEMIC AND NON-ENDEMIC CONTROLS. DIFFERENTLY EXPRESSED URINARY MIRNAS AND THEIR ASSOCIATED PATHWAYS WERE IDENTIFIED IN THE STUDY POPULATION. METHODS: HEALTHY AND DISEASED MALE VOLUNTEERS (N = 9) WERE RECRUITED FROM GIRANDURUKOTTE (ENDEMIC) AND MAWANELLA (NON-ENDEMIC) DISTRICTS. URINARY SMALL RNAS WERE PURIFIED AND SEQUENCED USING ILLUMINA MISEQTM. THE SEQUENCE TRACE FILES WERE ASSEMBLED AND ANALYZED. DIFFERENTIALLY EX-PRESSED MIRNAS AMONG THESE THREE GROUPS WERE IDENTIFIED AND PATHWAY ANALYSIS WAS CONDUCTED. RESULTS: THE URINE SAMPLES CONTAINED 130,623 SEQUENCE READS IDENTIFIED AS NON-CODING RNAS, PIWI-INTERACTING RNAS (PIRNA), AND MIRNAS. APPROXIMATELY FOUR PERCENT OF THE TOTAL SMALL RNA READS REPRESENTED MIRNA, AND 29% REPRESENTED PIRNA. A TOTAL OF 409 MIRNA SPECIES WERE EX-PRESSED IN URINE. INTERESTINGLY, BOTH DISEASED AND ENDEMIC CONTROLS POPULATION SHOWED SIGNIFICANTLY LOW EXPRESSION OF MIRNA AND PIRNA. REGARDLESS OF THE HEALTH STATUS, THE ENDEMIC POPULATION EX-PRESSED SIGNIFICANTLY LOW LEVELS OF MIR-10A, MIR-21, MIR-148A, AND MIR-30A WHICH HAVE BEEN LINKED WITH SEVERAL ENVIRONMENTAL TOXINS CONCLUSION: SIGNIFICANT DOWNREGULATION OF MIRNA AND PIRNA EXPRESSION IN BOTH DISEASED AND HEALTHY ENDEMIC SAMPLES INDICATES AN EPIGENETIC REGULATION OF CKDU INVOLVING GENETIC AND ENVIRONMENTAL INTERACTION. FURTHER STUDIES OF SPECIFIC MIRNA SPECIES ARE REQUIRED TO DEVELOP A MIRNA PANEL TO IDENTIFY INDIVIDUALS SUSCEPTIBLE TO CKDU. 2023 12 4823 21 OCHRATOXIN A: POTENTIAL EPIGENETIC MECHANISMS OF TOXICITY AND CARCINOGENICITY. ASSESSMENT OF THE SIGNIFICANCE TO HUMAN HEALTH OF OCHRATOXIN A (OTA) IN FOOD IS LIMITED BY A LACK OF HUMAN TOXICITY DATA. THEREFORE, OTA RISK EVALUATION RELIES MAINLY ON THE USE OF ANIMAL DATA, WITH RENAL CARCINOGENICITY IN RAT BEING CONSIDERED AS THE PIVOTAL EFFECT. THE ELUCIDATION OF THE MECHANISM OF ACTION WOULD IMPROVE THE USE OF THE CARCINOGENICITY DATA FOR RISK ASSESSMENT. DIRECT GENOTOXICITY VERSUS EPIGENETIC MECHANISMS APPEARS TO BE A KEY QUESTION. IN THIS PRESENTATION, NEW BIOCHEMICAL AND TOXICOGENOMIC RESULTS OBTAINED IN A RECENT EUROPEAN PROJECT (EU-GRANT # QLK1-CT-2001-011614) WILL BE SUMMARIZED IN THE CONTEXT OF PREVIOUSLY REPORTED MECHANISMS OF ACTION INCLUDING INHIBITION OF PROTEIN SYNTHESIS, PRODUCTION OF OXIDATIVE STRESS AND ALTERATION OF CELL SIGNALLING. AMONGST OTHERS, THE NEW DATA INDICATE THAT CHRONIC ADMINISTRATION OF A CARCINOGENIC DOSE OF OTA AFFECTED CELL-SIGNALLING PATHWAYS RESULTING IN A SIGNIFICANTLY REDUCED RENAL ANTIOXIDANT DEFENCE AND INCREASED OXIDATIVE DNA DAMAGE. THESE DATA CONFIRM PREVIOUS HYPOTHESES INVOLVING OXIDATIVE STRESS AS A POSSIBLE KEY EPIGENETIC MECHANISM OF OTA TOXICITY AND CARCINOGENICITY. 2005 13 3383 30 HNF1B NEPHROPATHY HAS A SLOW-PROGRESSIVE PHENOTYPE IN CHILDHOOD-WITH THE EXCEPTION OF VERY EARLY ONSET CASES: RESULTS OF THE GERMAN MULTICENTER HNF1B CHILDHOOD REGISTRY. BACKGROUND: HNF1B GENE MUTATIONS ARE AN IMPORTANT CAUSE OF BILATERAL (CYSTIC) DYSPLASIA IN CHILDREN, COMPLICATED BY CHRONIC RENAL INSUFFICIENCY. THE CLINICAL VARIABILITY, THE ABSENCE OF GENOTYPE-PHENOTYPE CORRELATIONS, AND LIMITED LONG-TERM DATA RENDER COUNSELING OF AFFECTED FAMILIES DIFFICULT. METHODS: LONGITUDINAL DATA OF 62 CHILDREN PROBANDS WITH GENETICALLY PROVEN HNF1B NEPHROPATHY WAS OBTAINED IN A MULTICENTER APPROACH. GENETIC FAMILY CASCADE SCREENING WAS PERFORMED IN 30/62 CASES. RESULTS: EIGHTY-SEVEN PERCENT OF PATIENTS HAD BILATERAL DYSPLASIA, 74% VISIBLE BILATERAL, AND 16% UNILATERAL RENAL CYSTS AT THE END OF OBSERVATION. CYST DEVELOPMENT WAS NON-PROGRESSIVE IN 72% WITH A MEAN GLOMERULAR FILTRATION RATE (GFR) LOSS OF - 0.33 ML/MIN/1.73M(2) PER YEAR (+/- 8.9). IN PATIENTS WITH AN INCREASE IN CYST NUMBER, THE ANNUAL GFR REDUCTION WAS - 2.8 ML/MIN/1.73M(2) (+/- 13.2), IN THE TOTAL COHORT - 1.0 ML/MIN/1.73M(2) (+/-10.3). A SUBSET OF HNF1B PATIENTS DIFFERS FROM THIS GROUP AND DEVELOPS END STAGE RENAL DISEASE (ESRD) AT VERY EARLY AGES < 2 YEARS. HYPERURICEMIA (37%) WAS A FREQUENT FINDING AT YOUNG AGE (MEDIAN 1 YEAR), WHEREAS HYPOMAGNESEMIA (24%), ELEVATED LIVER ENZYMES (21%), AND HYPERGLYCEMIA (8%) SHOWED AN INCREASED INCIDENCE IN THE TEENAGED CHILD. GENETIC ANALYSIS REVEALED NO GENOTYPE-PHENOTYPE CORRELATIONS BUT A SIGNIFICANT PARENT-OF-ORIGIN EFFECT WITH A PREPONDERANCE OF 81% OF MATERNAL INHERITANCE IN DOMINANT CASES. CONCLUSIONS: IN MOST CHILDREN, HNF1B NEPHROPATHY HAS A NON-PROGRESSIVE COURSE OF CYST DEVELOPMENT AND A SLOW-PROGRESSIVE COURSE OF KIDNEY FUNCTION. A SUBGROUP OF PATIENTS DEVELOPED ESRD AT VERY YOUNG AGE < 2 YEARS REQUIRING SPECIAL MEDICAL ATTENTION. THE PARENT-OF-ORIGIN EFFECT SUGGESTS AN INFLUENCE OF EPIGENETIC MODIFIERS IN HNF1B DISEASE. 2019 14 126 42 A TOXICOGENOMICS APPROACH TO IDENTIFY NEW PLAUSIBLE EPIGENETIC MECHANISMS OF OCHRATOXIN A CARCINOGENICITY IN RAT. OCHRATOXIN A (OTA) IS A MYCOTOXIN OCCURRING NATURALLY IN A WIDE RANGE OF FOOD COMMODITIES. IN ANIMALS, IT HAS BEEN SHOWN TO CAUSE A VARIETY OF ADVERSE EFFECTS, NEPHROCARCINOGENICITY BEING THE MOST PROMINENT. BECAUSE OF ITS HIGH TOXIC POTENCY AND THE CONTINUOUS EXPOSURE OF THE HUMAN POPULATION, OTA HAS RAISED PUBLIC HEALTH CONCERNS. THERE IS SIGNIFICANT DEBATE ON HOW TO USE THE RAT CARCINOGENICITY DATA TO ASSESS THE POTENTIAL RISK TO HUMANS. IN THIS CONTEXT, THE QUESTION OF THE MECHANISM OF ACTION OF OTA APPEARS OF KEY IMPORTANCE AND WAS STUDIED THROUGH THE APPLICATION OF A TOXICOGENOMICS APPROACH. MALE FISCHER RATS WERE FED OTA FOR UP TO 2 YEARS. RENAL TUMORS WERE DISCOVERED DURING THE LAST 6 MONTHS OF THE STUDY. THE TOTAL TUMOR INCIDENCE REACHED 25% AT THE END OF THE STUDY. GENE EXPRESSION PROFILE WAS ANALYZED IN GROUPS OF ANIMALS TAKEN IN INTERVALS FROM 7 DAYS TO 12 MONTHS. TISSUE-SPECIFIC RESPONSES WERE OBSERVED IN KIDNEY VERSUS LIVER. FOR SELECTED GENES, MICROARRAY DATA WERE CONFIRMED AT BOTH MRNA AND PROTEIN LEVELS. IN KIDNEY, SEVERAL GENES KNOWN AS MARKERS OF KIDNEY INJURY AND CELL REGENERATION WERE SIGNIFICANTLY MODULATED BY OTA. THE EXPRESSION OF GENES KNOWN TO BE INVOLVED IN DNA SYNTHESIS AND REPAIR, OR GENES INDUCED AS A RESULT OF DNA DAMAGE, WAS ONLY MARGINALLY MODULATED. VERY LITTLE OR NO EFFECT WAS FOUND AMONGST GENES ASSOCIATED WITH APOPTOSIS. ALTERATIONS OF GENE EXPRESSION INDICATING EFFECTS ON CALCIUM HOMEOSTASIS AND A DISRUPTION OF PATHWAYS REGULATED BY THE TRANSCRIPTION FACTORS HEPATOCYTE NUCLEAR FACTOR 4 ALPHA (HNF4ALPHA) AND NUCLEAR FACTOR-ERYTHROID 2-RELATED FACTOR 2 (NRF2) WERE OBSERVED IN THE KIDNEY BUT NOT IN THE LIVER. PREVIOUS DATA HAVE SUGGESTED THAT A REDUCTION IN HNF4ALPHA MAY BE ASSOCIATED WITH NEPHROCARCINOGENICITY. MANY NRF2-REGULATED GENES ARE INVOLVED IN CHEMICAL DETOXICATION AND ANTIOXIDANT DEFENSE. THE DEPLETION OF THESE GENES IS LIKELY TO IMPAIR THE DEFENSE POTENTIAL OF THE CELLS, RESULTING IN CHRONIC ELEVATION OF OXIDATIVE STRESS IN THE KIDNEY. THE INHIBITION OF DEFENSE MECHANISM APPEARS AS A HIGHLY PLAUSIBLE NEW MECHANISM, WHICH COULD CONTRIBUTE TO OTA CARCINOGENICITY. 2006 15 4182 37 MESOAMERICAN NEPHROPATHY (MEN): WHAT WE KNOW SO FAR. IN 2002, A REPORT FROM EL SALVADOR DESCRIBED A HIGH INCIDENCE OF CHRONIC KIDNEY DISEASE (CKD) OF UNKNOWN CAUSE, MOSTLY IN YOUNG MALES FROM SPECIFIC COASTAL AREAS. SIMILAR SITUATIONS WERE OBSERVED ALONG THE PACIFIC OCEAN COASTLINE OF OTHER CENTRAL AMERICAN COUNTRIES AND SOUTHERN MEXICO (MESOAMERICA). THIS NEW FORM OF CKD HAS BEEN DENOMINATED MESOAMERICAN ENDEMIC NEPHROPATHY (MEN). THE TYPICAL PRESENTATION OF MEN IS A YOUNG MALE FROM AN ENDEMIC AREA WITH A FAMILY HISTORY OF CKD, LOW EGFR, HIGH SERUM CREATININE, LOW LEVEL OF ALBUMINURIA, HYPOKALEMIA, HYPERURICEMIA, AND URINE URATE CRYSTALS. KIDNEY BIOPSY DEMONSTRATING TUBULOINTERSTITIAL NEPHRITIS REMAINS THE GOLD STANDARD FOR DIAGNOSIS BUT IS AVAILABLE ONLY FOR A MINORITY. COMMONLY PROPOSED CAUSES INCLUDE THERMAL STRESS/DEHYDRATION AND/OR EXPOSURE TO ENVIRONMENTAL POLLUTANTS. HOWEVER, LIKELY, A THIRD FACTOR, WHICH COULD BE GENETIC OR EPIGENETIC, COULD CONTRIBUTE TO THE CAUSE AND DEVELOPMENT OF THE DISEASE, ALONG WITH SOCIAL DETERMINANTS. CURRENTLY, PREVENTIVE MEASURES FOCUS ON MINIMIZING WORKERS EXPOSURE TO THERMAL STRESS/DEHYDRATION. THERE ARE MANY RESEARCH OPPORTUNITIES AND PRIORITIES SHOULD INCLUDE CLINICAL TRIALS TO EVALUATE THE EFFICACY AND SAFETY OF THE CURRENT TREATMENT PROTOCOLS, ALONG WITH ETIOLOGICAL AND GENETIC STUDIES, AND THE DEVELOPMENT OF KIDNEY DISEASE DATA SYSTEMS. ALTHOUGH THERE IS SCANT AND CONTROVERSIAL LITERATURE WITH REGARD S TO THE ETIOLOGY, DIAGNOSIS AND MANAGEMENT OF THE DISEASE, OUR AIM IS TO PROVIDE THE READER A VISION OF THE DISEASE BASED ON OUR EXPERIENCE. 2020 16 471 33 ARISTOLOCHIC ACID CONTAINING HERBS INDUCE GENDER-RELATED ONCOLOGICAL DIFFERENCES IN UPPER TRACT UROTHELIAL CARCINOMA PATIENTS. BACKGROUND: IN CHINA, UPPER TRACT UROTHELIAL CARCINOMA (UTUC) IS LESS PREVALENT BUT MORE MALIGNANT IN MALES. THIS STUDY INVESTIGATES THE PROGNOSTIC FACTORS AND CAUSES OF GENDER-BASED DIFFERENCES IN CHINESE POPULATIONS. METHODS: BETWEEN 1999 AND 2011, 687 UTUC PATIENTS WHO UNDERWENT SURGERY WERE UTILIZED FOR THIS STUDY. WE EVALUATED THE DIFFERENCES IN ONCOLOGICAL CHARACTERISTICS, EPIGENETIC BIOMARKERS, CANCER-SPECIFIC SURVIVAL (CSS), BLADDER RECURRENCE (BR) RATE, AND CONTRALATERAL UPPER TRACT RECURRENCE (CUTR) RATE. SMOKING HISTORY, BENZENE EXPOSURE HISTORY, AND THE HISTORY OF USING ARISTOLOCHIC ACID (AA) CONTAINING HERBS WERE ANALYZED IN DETAIL. RESULTS: COMPARED WITH MALE PATIENTS, FEMALE PATIENTS SHOWED POORER RENAL FUNCTION, LOWER PROPORTIONS OF TUMOR STAGE III/IV, AND SMALLER TUMOR DIAMETERS. THE CSS IN MALE PATIENTS WAS LOWER THAN THAT IN FEMALE PATIENTS. SIGNIFICANT GENDER-RELATED DIFFERENCES WERE OBSERVED CONCERNING VARIOUS PROGNOSTIC FACTORS. IN FEMALE PATIENTS, POORER SURVIVAL RATES WERE ATTRIBUTED TO THE PRIMARY TUMOR LOCATION IN THE URETER, LARGE DIAMETER PRIMARY TUMORS, SEVERE CHRONIC KIDNEY DISEASE, PAPILLARY TUMOR ARCHITECTURE, HIGH TUMOR STAGES, POSITIVE N STATUS, AND METHYLATED ABCC6 PROMOTERS. IN MALE PATIENTS, OLDER AGE, IPSILATERAL HYDRONEPHROSIS, LARGE TUMOR DIAMETERS, SESSILE TUMOR ARCHITECTURE, HIGH TUMOR STAGES, AND METHYLATED TMEFF2 PROMOTERS WERE ASSOCIATED WITH HIGHER CANCER-SPECIFIC MORTALITY. AA MIGHT BE THE MAIN CAUSE OF THESE GENDER-BASED DIFFERENCES. THE AA-INDUCED UTUC PATIENTS PRESENTED SMALLER TUMOR DIAMETERS, LOWER TUMOR STAGES, FEWER POSITIVE N STATUSES, MORE MULTIFOCAL TUMORS, LOWER METHYLATION INDICES, AND POORER RENAL FUNCTION. ALTHOUGH AA-INDUCED UTUC PATIENTS EXHIBITED BETTER SURVIVAL RATES, BR AND CUTR RATES WERE SIGNIFICANTLY WORSE. CONCLUSION: IN CHINA, THERE EXIST SIGNIFICANT AA-INDUCED DIFFERENCES BETWEEN MALE AND FEMALE UTUC PATIENTS. THE BLADDERS AND CONTRALATERAL UPPER URINARY TRACTS OF AA-INDUCED UTUC PATIENTS SHOULD BE CAREFULLY MONITORED AFTER SURGERY. 2018 17 1592 36 DNA METHYLATION PROFILING OF GENOMIC DNA ISOLATED FROM URINE IN DIABETIC CHRONIC KIDNEY DISEASE: A PILOT STUDY. AIM: TO CHARACTERISE THE GENOMIC DNA (GDNA) YIELD FROM URINE AND QUALITY OF DERIVED METHYLATION DATA GENERATED FROM THE WIDELY USED ILLUMINIA INFINIUM METHYLATIONEPIC (HM850K) PLATFORM AND COMPARE THIS WITH BUFFY COAT SAMPLES. BACKGROUND: DNA METHYLATION IS THE MOST WIDELY STUDIED EPIGENETIC MARK AND VARIATIONS IN DNA METHYLATION PROFILE HAVE BEEN IMPLICATED IN DIABETES WHICH AFFECTS APPROXIMATELY 415 MILLION PEOPLE WORLDWIDE. METHODS: QIAAMP VIRAL RNA MINI KIT AND QIAAMP DNA MICRO KIT WERE USED TO EXTRACT DNA FROM FROZEN AND FRESH URINE SAMPLES AS WELL AS INCREASING VOLUMES OF FRESH URINE. MATCHED BUFFY COATS TO THE FROZEN URINE WERE ALSO OBTAINED AND DNA WAS EXTRACTED FROM THE BUFFY COATS USING THE QIAAMP DNA MINI KIT. GENOMIC DNA OF GREATER CONCENTRATION THAN 20MUG/ML WERE USED FOR METHYLATION ANALYSIS USING THE HM850K ARRAY. RESULTS: IRRESPECTIVE OF EXTRACTION TECHNIQUE OR THE USE OF FRESH VERSUS FROZEN URINE SAMPLES, LIMITED GENOMIC DNA WAS OBTAINED USING A STARTING SAMPLE VOLUME OF 5ML (0-0.86MUG/ML). IN ORDER TO OPTIMIZE THE YIELD, WE INCREASED STARTING VOLUMES TO 50ML FRESH URINE, WHICH YIELDED ONLY 0-9.66MUG/ML A DIFFERENT KIT, QIAAMP DNA MICRO KIT, WAS TRIALLED IN SIX FRESH URINE SAMPLES AND TEN FROZEN URINE SAMPLES WITH INADEQUATE DNA YIELDS FROM 0-17.7MUG/ML AND 0-1.6MUG/ML RESPECTIVELY. SUFFICIENT GENOMIC DNA WAS OBTAINED FROM ONLY 4 OF THE INITIAL 41 FROZEN URINE SAMPLES (10%) FOR DNA METHYLATION PROFILING. IN COMPARISON, ALL FOUR BUFFY COAT SAMPLES (100%) PROVIDED SUFFICIENT GENOMIC DNA. CONCLUSION: HIGH QUALITY DATA CAN BE OBTAINED PROVIDED A SUFFICIENT YIELD OF GENOMIC DNA IS ISOLATED. DESPITE OPTIMIZING VARIOUS EXTRACTION METHODOLOGIES, THE MODEST AMOUNT OF GENOMIC DNA DERIVED FROM URINE, MAY LIMIT THE GENERALISABILITY OF THIS APPROACH FOR THE IDENTIFICATION OF DNA METHYLATION BIOMARKERS OF CHRONIC DIABETIC KIDNEY DISEASE. 2018 18 1585 36 DNA METHYLATION PROFILING IDENTIFIES EPIGENETIC DIFFERENCES BETWEEN DIABETES PATIENTS WITH ESRD AND DIABETES PATIENTS WITHOUT NEPHROPATHY. WE IDENTIFIED POTENTIAL EPIGENETIC BIOMARKERS FOR CHRONIC KIDNEY DISEASE PROGRESSION BY COMPARING SITE-SPECIFIC DNA METHYLATION LEVELS IN MORE THAN 14,000 GENES BETWEEN AFRICAN AMERICAN AND HISPANIC DIABETES PATIENTS WITH END STAGE RENAL DISEASE (ESRD) AND DIABETES PATIENTS WITHOUT NEPHROPATHY. WE IDENTIFIED 187 GENES THAT ARE DIFFERENTIALLY METHYLATED BETWEEN THE TWO GROUPS ON AT LEAST TWO CPG SITES IN EACH GENE IN DNA EXTRACTED FROM SALIVA. OF THE 187 GENES WHOSE MEAN METHYLATION LEVELS DIFFERED BETWEEN THE TWO GROUPS, 39 GENES, OR CLOSELY RELATED GENE FAMILY MEMBERS, HAVE BEEN REPORTED TO BE INVOLVED IN KIDNEY DEVELOPMENT OR DIABETIC NEPHROPATHY, PER SE, OR HAVE BEEN ASSOCIATED WITH DIALYSIS-INDUCED CHANGES IN GENE EXPRESSION IN PERIPHERAL BLOOD CELLS. THE FACT THAT SUCH A SUBSTANTIAL FRACTION (21%) OF THE 187 CANDIDATE GENES HAVE BEEN IMPLICATED PREVIOUSLY THROUGH GENOME ASSOCIATION OR TRANSCRIPTION PROFILING STUDIES SUGGESTS STRONGLY THAT THE DNA METHYLATION DIFFERENCES WE OBSERVE ARE ASSOCIATED WITH DISEASE PREDISPOSITION AND/OR TREATMENT. THE FACT THAT THESE NEPHROPATHY AND/OR DIALYSIS-ASSOCIATED DIFFERENCES BETWEEN PATIENTS WERE IDENTIFIED IN DNA EXTRACTED FROM SALIVA OFFERS PROOF-OF-PRINCIPLE THAT INTER-INDIVIDUAL EPIGENETIC DIFFERENCES MAY PROVE USEFUL AS PREDICTIVE BIOMARKERS OF DISEASE SUSCEPTIBILITY. 2011 19 5470 31 RESOLVING THE ENIGMA OF THE MESOAMERICAN NEPHROPATHY: A RESEARCH WORKSHOP SUMMARY. THE FIRST INTERNATIONAL RESEARCH WORKSHOP ON MESOAMERICAN NEPHROPATHY (MEN) MET IN COSTA RICA IN NOVEMBER 2012 TO DISCUSS HOW TO ESTABLISH THE EXTENT AND DEGREE OF MEN, EXAMINE RELEVANT CAUSAL HYPOTHESES, AND FOCUS EFFORTS TO CONTROL OR ELIMINATE THE DISEASE BURDEN. MEN DESCRIBES A DEVASTATING EPIDEMIC OF CHRONIC KIDNEY DISEASE OF UNKNOWN ORIGIN PREDOMINANTLY OBSERVED AMONG YOUNG MALE SUGARCANE CUTTERS. THE CAUSE OF MEN REMAINS UNCERTAIN; HOWEVER, THE STRONGEST HYPOTHESIS PURSUED TO DATE IS REPEATED EPISODES OF OCCUPATIONAL HEAT STRESS AND WATER AND SOLUTE LOSS, PROBABLY IN COMBINATION WITH OTHER POTENTIAL RISK FACTOR(S), SUCH AS NONSTEROIDAL ANTI-INFLAMMATORY DRUG AND OTHER NEPHROTOXIC MEDICATION USE, INORGANIC ARSENIC, LEPTOSPIROSIS, OR PESTICIDES. AT THE RESEARCH WORKSHOP, CLINICAL AND EPIDEMIOLOGIC CASE DEFINITIONS WERE PROPOSED IN ORDER TO FACILITATE BOTH PUBLIC HEALTH AND RESEARCH EFFORTS. RECOMMENDATIONS EMANATING FROM THE WORKSHOP INCLUDED MEASURING WORKLOAD, HEAT, AND WATER AND SOLUTE LOSS AMONG WORKERS; QUANTIFYING NEPHROTOXIC AGENTS IN DRINKING WATER AND FOOD; USING BIOMARKERS OF EARLY KIDNEY INJURY TO EXPLORE POTENTIAL CAUSES OF MEN; AND CHARACTERIZING SOCIAL AND WORKING CONDITIONS TOGETHER WITH METHODS FOR VALID DATA COLLECTION OF EXPOSURES AND PERSONAL RISK FACTORS. ADVANTAGES AND DISADVANTAGES OF DIFFERENT POPULATION STUDY DESIGNS WERE DETAILED. TO ELUCIDATE THE ETIOLOGY OF MEN, MULTICOUNTRY STUDIES WITH PROSPECTIVE COHORT DESIGN, PREFERABLY INTEGRATING AN ECOSYSTEM HEALTH APPROACH, WERE CONSIDERED THE MOST PROMISING. IN ADDITION, GENETIC, EXPERIMENTAL, AND MECHANISTIC METHODS AND DESIGNS WERE ADDRESSED, SPECIFICALLY THE NEED FOR KIDNEY BIOPSY ANALYSIS, STUDIES IN ANIMAL MODELS, ADVANCES IN BIOMARKERS, GENETIC AND EPIGENETIC STUDIES, A COMMON REGISTRY AND REPOSITORY OF BIOLOGICAL AND DEMOGRAPHIC DATA AND/OR SPECIMENS, AND OTHER AREAS OF POTENTIAL CHRONIC KIDNEY DISEASE EXPERIMENTAL RESEARCH. FINALLY, IN ORDER TO IMPROVE INTERNATIONAL COLLABORATION ON MEN, WORKSHOP PARTICIPANTS AGREED TO ESTABLISH A RESEARCH CONSORTIUM TO LINK THESE MESOAMERICAN EFFORTS TO OTHER EFFORTS WORLDWIDE. 2014 20 119 34 A SYSTEMATIC EXAMINATION OF BRAIN VOLUMETRIC ABNORMALITIES IN RECENT-ONSET SCHIZOPHRENIA USING VOXEL-BASED, SURFACE-BASED AND REGION-OF-INTEREST-BASED MORPHOMETRIC ANALYSES. BACKGROUND: BRAIN MORPHOMETRIC ABNORMALITIES IN SCHIZOPHRENIA HAVE BEEN EXTENSIVELY REPORTED IN THE LITERATURE. WHOLE-BRAIN VOLUMETRIC REDUCTIONS ARE ALMOST UNIVERSALLY REPORTED BY MOST STUDIES IRRESPECTIVE OF THE CHARACTERISTICS OF THE SAMPLES STUDIED (E.G., CHRONIC/RECENT-ONSET; MEDICATED/NEUROLEPTIC-NAIVE ETC.). HOWEVER, THE SAME CANNOT BE SAID OF THE REPORTED REGIONAL MORPHOMETRIC ABNORMALITIES IN SCHIZOPHRENIA. WHILE CERTAIN REGIONAL MORPHOMETRIC ABNORMALITIES ARE MORE FREQUENTLY REPORTED THAN OTHERS, THERE ARE NO SUCH ABNORMALITIES THAT ARE UNIVERSALLY REPORTED ACROSS STUDIES. VARIABILITY OF SOCIO-DEMOGRAPHIC AND CLINICAL CHARACTERISTICS ACROSS STUDY SAMPLES AS WELL AS TECHNICAL AND METHODOLOGICAL ISSUES RELATED TO ACQUISITION AND ANALYSES OF BRAIN STRUCTURAL IMAGES MAY CONTRIBUTE TO INCONSISTENCY OF BRAIN MORPHOMETRIC FINDINGS IN SCHIZOPHRENIA. THE OBJECTIVE OF THE PRESENT STUDY THEREFORE WAS TO SYSTEMATICALLY EXAMINE BRAIN MORPHOMETRY IN PATIENTS WITH RECENT-ONSET SCHIZOPHRENIA TO FIND OUT IF THERE ARE SIGNIFICANT WHOLE-BRAIN OR REGIONAL VOLUMETRIC DIFFERENCES DETECTABLE AT THE APPROPRIATE SIGNIFICANCE THRESHOLD, AFTER ATTEMPTING TO CONTROL FOR VARIOUS CONFOUNDING FACTORS THAT COULD IMPACT BRAIN VOLUMES. METHODS: STRUCTURAL MAGNETIC RESONANCE IMAGES OF 90 SUBJECTS (SCHIZOPHRENIA = 45; HEALTHY SUBJECTS = 45) WERE ACQUIRED USING A 3 TESLA MAGNET. MORPHOMETRIC ANALYSES WERE CARRIED OUT FOLLOWING STANDARD ANALYSES PIPELINES OF THREE MOST COMMONLY USED STRATEGIES, VIZ., WHOLE-BRAIN VOXEL-BASED MORPHOMETRY, WHOLE-BRAIN SURFACE-BASED MORPHOMETRY, AND BETWEEN-GROUP COMPARISONS OF REGIONAL VOLUMES GENERATED BY AUTOMATED SEGMENTATION AND PARCELLATION. RESULTS: IN OUR SAMPLE OF PATIENTS HAVING RECENT-ONSET SCHIZOPHRENIA WITH LIMITED NEUROLEPTIC EXPOSURE, THERE WERE NO SIGNIFICANT WHOLE BRAIN OR REGIONAL BRAIN MORPHOMETRIC ABNORMALITIES NOTED AT THE APPROPRIATE STATISTICAL SIGNIFICANCE THRESHOLDS WITH OR WITHOUT INCLUDING AGE, GENDER AND INTRACRANIAL VOLUME OR TOTAL BRAIN VOLUME IN THE STATISTICAL ANALYSES. CONCLUSIONS: IN THE BACKGROUND OF THE CONFLICTING FINDINGS IN THE LITERATURE, OUR FINDINGS INDICATE THAT BRAIN MORPHOMETRIC ABNORMALITIES MAY NOT BE DIRECTLY RELATED TO THE SCHIZOPHRENIA PHENOTYPE. ANALYSIS OF THE REASONS FOR THE INCONSISTENT RESULTS ACROSS STUDIES AS WELL AS CONSIDERATION OF ALTERNATE SOURCES OF VARIABILITY OF BRAIN MORPHOLOGY IN SCHIZOPHRENIA SUCH AS EPISTATIC AND EPIGENETIC MECHANISMS COULD PERHAPS ADVANCE OUR UNDERSTANDING OF STRUCTURAL BRAIN ALTERATIONS IN SCHIZOPHRENIA. 2015