1 4205 153 METABOLO-EPIGENETIC INTERPLAY PROVIDES TARGETED NUTRITIONAL INTERVENTIONS IN CHRONIC DISEASES AND AGEING. EPIGENETIC MODIFICATIONS ARE CHEMICAL MODIFICATIONS THAT AFFECT GENE EXPRESSION WITHOUT ALTERING DNA SEQUENCES. IN PARTICULAR, EPIGENETIC CHEMICAL MODIFICATIONS CAN OCCUR ON HISTONE PROTEINS -MAINLY ACETYLATION, METHYLATION-, AND ON DNA AND RNA MOLECULES -MAINLY METHYLATION-. ADDITIONAL MECHANISMS, SUCH AS RNA-MEDIATED REGULATION OF GENE EXPRESSION AND DETERMINANTS OF THE GENOMIC ARCHITECTURE CAN ALSO AFFECT GENE EXPRESSION. IMPORTANTLY, DEPENDING ON THE CELLULAR CONTEXT AND ENVIRONMENT, EPIGENETIC PROCESSES CAN DRIVE DEVELOPMENTAL PROGRAMS AS WELL AS FUNCTIONAL PLASTICITY. HOWEVER, MISBALANCED EPIGENETIC REGULATION CAN RESULT IN DISEASE, PARTICULARLY IN THE CONTEXT OF METABOLIC DISEASES, CANCER, AND AGEING. NON-COMMUNICABLE CHRONIC DISEASES (NCCD) AND AGEING SHARE COMMON FEATURES INCLUDING ALTERED METABOLISM, SYSTEMIC META-INFLAMMATION, DYSFUNCTIONAL IMMUNE SYSTEM RESPONSES, AND OXIDATIVE STRESS, AMONG OTHERS. IN THIS SCENARIO, UNBALANCED DIETS, SUCH AS HIGH SUGAR AND HIGH SATURATED FATTY ACIDS CONSUMPTION, TOGETHER WITH SEDENTARY HABITS, ARE RISK FACTORS IMPLICATED IN THE DEVELOPMENT OF NCCD AND PREMATURE AGEING. THE NUTRITIONAL AND METABOLIC STATUS OF INDIVIDUALS INTERACT WITH EPIGENETICS AT DIFFERENT LEVELS. THUS, IT IS CRUCIAL TO UNDERSTAND HOW WE CAN MODULATE EPIGENETIC MARKS THROUGH BOTH LIFESTYLE HABITS AND TARGETED CLINICAL INTERVENTIONS -INCLUDING FASTING MIMICKING DIETS, NUTRACEUTICALS, AND BIOACTIVE COMPOUNDS- WHICH WILL CONTRIBUTE TO RESTORE THE METABOLIC HOMEOSTASIS IN NCCD. HERE, WE FIRST DESCRIBE KEY METABOLITES FROM CELLULAR METABOLIC PATHWAYS USED AS SUBSTRATES TO "WRITE" THE EPIGENETIC MARKS; AND COFACTORS THAT MODULATE THE ACTIVITY OF THE EPIGENETIC ENZYMES; THEN, WE BRIEFLY SHOW HOW METABOLIC AND EPIGENETIC IMBALANCES MAY RESULT IN DISEASE; AND, FINALLY, WE SHOW SEVERAL EXAMPLES OF NUTRITIONAL INTERVENTIONS - DIET BASED INTERVENTIONS, BIOACTIVE COMPOUNDS, AND NUTRACEUTICALS- AND EXERCISE TO COUNTERACT EPIGENETIC ALTERATIONS. 2023 2 397 31 AN UPDATE ON FETAL ALCOHOL SYNDROME-PATHOGENESIS, RISKS, AND TREATMENT. ALCOHOL IS A WELL-ESTABLISHED TERATOGEN THAT CAN CAUSE VARIABLE PHYSICAL AND BEHAVIORAL EFFECTS ON THE FETUS. THE MOST SEVERE CONDITION IN THIS SPECTRUM OF DISEASES IS KNOWN AS FETAL ALCOHOL SYNDROME (FAS). THE DIFFERENCES IN MATERNAL AND FETAL ENZYMES, IN TERMS OF ABUNDANCE AND EFFICIENCY, IN ADDITION TO REDUCED ELIMINATION, ALLOW FOR ALCOHOL TO HAVE A PROLONGED EFFECT ON THE FETUS. THIS CAN ACT AS A TERATOGEN THROUGH NUMEROUS METHODS INCLUDING REACTIVE OXYGEN SPECIES (GENERATED AS BY PRODUCTS OF CYP2E1), DECREASED ENDOGENOUS ANTIOXIDANT LEVELS, MITOCHONDRIAL DAMAGE, LIPID PEROXIDATION, DISRUPTED NEURONAL CELL-CELL ADHESION, PLACENTAL VASOCONSTRICTION, AND INHIBITION OF COFACTORS REQUIRED FOR FETAL GROWTH AND DEVELOPMENT. MORE RECENTLY, ALCOHOL HAS ALSO BEEN SHOWN TO HAVE EPIGENETIC EFFECTS. INCREASED FETAL EXPOSURE TO ALCOHOL AND SUSTAINED ALCOHOL INTAKE DURING ANY TRIMESTER OF PREGNANCY IS ASSOCIATED WITH AN INCREASED RISK OF FAS. OTHER RISK FACTORS INCLUDE GENETIC INFLUENCES, MATERNAL CHARACTERISTICS, FOR EXAMPLE, LOWER SOCIOECONOMIC STATUSES AND SMOKING, AND PATERNAL CHRONIC ALCOHOL USE. THE TREATMENT OPTIONS FOR FAS HAVE RECENTLY STARTED TO BE EXPLORED ALTHOUGH NONE ARE CURRENTLY APPROVED CLINICALLY. THESE INCLUDE PRENATAL ANTIOXIDANT ADMINISTRATION FOOD SUPPLEMENTS, FOLIC ACID, CHOLINE, NEUROACTIVE PEPTIDES, AND NEUROTROPHIC GROWTH FACTORS. TACKLING THE WIDER IMPACTS OF FAS, SUCH AS COMORBIDITIES, AND THE FAMILY SYSTEM HAVE BEEN SHOWN TO IMPROVE THE QUALITY OF LIFE OF FAS PATIENTS. THIS REVIEW AIMED TO FOCUS ON THE PATHOGENESIS, ESPECIALLY MECHANISMS OF ALCOHOL TERATOGENICITY, AND RISKS OF DEVELOPING FAS. RECENT DEVELOPMENTS IN POTENTIAL MANAGEMENT STRATEGIES, INCLUDING PRENATAL INTERVENTIONS, ARE DISCUSSED. 2016 3 48 35 A CRUCIAL ROLE FOR MATERNAL DIETARY METHYL DONOR INTAKE IN EPIGENETIC PROGRAMMING AND FETAL GROWTH OUTCOMES. THE FETAL ORIGINS OF HEALTH AND DISEASE FRAMEWORK HAS IDENTIFIED EXTREMES IN FETAL GROWTH AND BIRTH WEIGHT AS FACTORS ASSOCIATED WITH THE LIFELONG GENERATION OF CHRONIC DISEASES SUCH AS OBESITY, DIABETES, CARDIOVASCULAR DISEASE, AND HYPERTENSION. MATERNAL NUTRITION PLAYS A CRITICAL ROLE IN FETAL AND PLACENTAL DEVELOPMENT, IN PART BY PROVIDING THE METHYL GROUPS REQUIRED TO ESTABLISH THE FETUS'S GENOME STRUCTURE AND FUNCTION, NOTABLY THROUGH DNA METHYLATION. THE GOAL OF THIS NARRATIVE REVIEW IS TO DESCRIBE THE ROLE OF MATERNAL DIETARY METHYL DONOR (METHIONINE, FOLATE, AND CHOLINE) AND COFACTOR (ZINC AND VITAMINS B2, B6, AND B12) INTAKE IN ONE-CARBON METABOLISM AND DNA METHYLATION IN THE FETUS AND PLACENTA, AS WELL AS THEIR IMPACTS ON FETAL GROWTH AND LIFELONG HEALTH OUTCOMES, WITH SPECIFIC EXAMPLES IN ANIMALS AND HUMANS. BASED ON THE AVAILABLE EVIDENCE, IT IS CONCLUDED THAT INTAKE OF DIFFERENT AMOUNTS OF DIETARY METHYL DONORS AND COFACTORS DURING PREGNANCY MAY ALTER FETAL GROWTH AND DEVELOPMENT, THUS ESTABLISHING A MAJOR LINK BETWEEN EARLY ENVIRONMENTAL EXPOSURE AND DISEASE DEVELOPMENT IN THE OFFSPRING LATER IN LIFE. 2018 4 6717 36 VITAMIN B SUPPLEMENTATION AND NUTRITIONAL INTAKE OF METHYL DONORS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A CRITICAL REVIEW OF THE IMPACT ON EPIGENETIC MACHINERY. CARDIOVASCULAR MORBIDITY AND MORTALITY ARE SEVERAL-FOLD HIGHER IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE (CKD) AND END-STAGE RENAL DISEASE (ESRD) THAN IN THE GENERAL POPULATION. HYPERHOMOCYSTEINEMIA HAS UNDOUBTEDLY A CENTRAL ROLE IN SUCH A PROMINENT CARDIOVASCULAR BURDEN. THE LEVELS OF HOMOCYSTEINE ARE REGULATED BY METHYL DONORS (FOLATE, METHIONINE, CHOLINE, BETAINE), AND COFACTORS (VITAMIN B6, VITAMIN B12,). UREMIA-INDUCED HYPERHOMOCYSTEINEMIA HAS AS ITS MAIN TARGETS DNA METHYLTRANSFERASES, AND THIS LEADS TO AN ALTERED EPIGENETIC CONTROL OF GENES REGULATED THROUGH METHYLATION. IN RENAL PATIENTS, THE EPIGENETIC LANDSCAPE IS STRICTLY CORRELATED WITH THE UREMIC PHENOTYPE AND DEPENDENT ON DIETARY INTAKE OF MICRONUTRIENTS, INFLAMMATION, GUT MICROBIOME, INFLAMMATORY STATUS, OXIDATIVE STRESS, AND LIFESTYLE HABITS. ALL THESE FACTORS ARE KEY CONTRIBUTORS IN METHYLOME MAINTENANCE AND IN THE MODULATION OF GENE TRANSCRIPTION THROUGH DNA HYPO- OR HYPERMETHYLATION IN CKD. THIS IS AN OVERVIEW OF THE EPIGENETIC CHANGES RELATED TO DNA METHYLATION IN PATIENTS WITH ADVANCED CKD AND ESRD. WE EXPLORED THE CURRENTLY AVAILABLE DATA ON THE MOLECULAR DYSREGULATIONS RESULTING FROM ALTERED GENE EXPRESSION IN UREMIA. SPECIAL ATTENTION WAS PAID TO THE EFFICACY OF B-VITAMINS SUPPLEMENTATION AND DIETARY INTAKE OF METHYL DONORS ON HOMOCYSTEINE LOWERING AND CARDIOVASCULAR PROTECTION. 2020 5 4770 48 NUCLEAR RECEPTORS AND EPIGENETIC REGULATION: OPPORTUNITIES FOR NUTRITIONAL TARGETING AND DISEASE PREVENTION. POSTTRANSLATIONAL MODIFICATIONS OF HISTONES, ALTERATIONS IN THE RECRUITMENT AND FUNCTIONS OF NON-HISTONE PROTEINS, DNA METHYLATION, AND CHANGES IN EXPRESSION OF NONCODING RNAS CONTRIBUTE TO CURRENT MODELS OF EPIGENETIC REGULATION. NUCLEAR RECEPTORS (NRS) ARE A GROUP OF TRANSCRIPTION FACTORS THAT, THROUGH LIGAND-BINDING, ACT AS SENSORS TO CHANGES IN NUTRITIONAL, ENVIRONMENTAL, DEVELOPMENTAL, PATHOPHYSIOLOGIC, AND ENDOCRINE CONDITIONS AND DRIVE ADAPTIVE RESPONSES VIA GENE REGULATION. ONE MECHANISM THROUGH WHICH NRS DIRECT GENE EXPRESSION IS THE ASSEMBLY OF TRANSCRIPTION COMPLEXES WITH COFACTORS AND COREGULATORS THAT POSSESS CHROMATIN-MODIFYING PROPERTIES. CHROMATIN MODIFICATIONS CAN BE TRANSIENT OR BECOME PART OF THE CELLULAR "MEMORY" AND CONTRIBUTE TO GENOMIC IMPRINTING. BECAUSE MANY FOOD COMPONENTS BIND TO NRS, THEY CAN ULTIMATELY INFLUENCE TRANSCRIPTION OF GENES ASSOCIATED WITH BIOLOGIC PROCESSES, SUCH AS INFLAMMATION, PROLIFERATION, APOPTOSIS, AND HORMONAL RESPONSE, AND ALTER THE SUSCEPTIBILITY TO CHRONIC DISEASES (E.G., CANCER, DIABETES, OBESITY). THE OBJECTIVE OF THIS REVIEW IS TO HIGHLIGHT HOW NRS INFLUENCE EPIGENETIC REGULATION AND THE RELEVANCE OF DIETARY COMPOUND-NR INTERACTIONS IN HUMAN NUTRITION AND FOR DISEASE PREVENTION AND TREATMENT. IDENTIFYING GENE TARGETS OF UNLIGANDED AND BOUND NRS MAY ASSIST IN THE DEVELOPMENT OF EPIGENETIC MAPS FOR FOOD COMPONENTS AND DIETARY PATTERNS. PROGRESS IN THESE AREAS MAY LEAD TO THE FORMULATION OF DISEASE-PREVENTION MODELS BASED ON EPIGENETIC CONTROL BY INDIVIDUAL OR ASSOCIATIONS OF FOOD LIGANDS OF NRS. 2014 6 4711 40 NON-ALCOHOLIC FATTY LIVER DISEASE IN OBESE CHILDREN AND ADOLESCENTS: A ROLE FOR NUTRITION? NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) HAS BECOME THE MOST COMMON CAUSE OF CHRONIC LIVER DISEASE IN CHILDREN, PARALLELING THE INCREASING PREVALENCE OF OBESITY WORLDWIDE. THE PATHOGENESIS OF PAEDIATRIC NAFLD IS NOT FULLY UNDERSTOOD, BUT IT IS KNOWN THAT OBESITY, NUTRITION, LIFESTYLE VARIABLES, GENETIC AND EPIGENETIC FACTORS MAY BE CAUSALLY INVOLVED IN THE DEVELOPMENT OF THIS COMMON METABOLIC LIVER DISEASE. IN PARTICULAR, OBESITY AND NUTRITION ARE AMONG THE STRONGEST RISK FACTORS FOR PAEDIATRIC NAFLD, WHICH MAY EXERT THEIR ADVERSE HEPATIC EFFECTS ALREADY BEFORE BIRTH. EXCESS ENERGY INTAKE INDUCES HYPERTROPHY AND HYPERPLASIA OF ADIPOSE TISSUE WITH SUBSEQUENT DEVELOPMENT OF SYSTEMIC INSULIN RESISTANCE, WHICH IS ANOTHER IMPORTANT RISK FACTOR FOR NAFLD. DIET COMPOSITION AND IN PARTICULAR SIMPLE CARBOHYDRATE INTAKE (ESPECIALLY HIGH FRUCTOSE INTAKE) MAY PROMOTE THE DEVELOPMENT OF NAFLD, WHEREAS NON-DIGESTIBLE CARBOHYDRATES (DIETARY FIBER), BY AFFECTING GUT MICROBIOTA, MAY FAVOUR THE INTEGRITY OF GUT WALL AND REDUCE INFLAMMATION, OPPOSING THIS PROCESS. SATURATED FAT INTAKE MAY ALSO PROMOTE NAFLD DEVELOPMENT, WHEREAS UNSATURATED FAT INTAKE HAS SOME BENEFICIAL EFFECTS. PROTEIN INTAKE DOES NOT SEEM TO AFFECT THE DEVELOPMENT OF NAFLD, BUT FURTHER INVESTIGATION IS NEEDED. IN CONCLUSION, LIFESTYLE MODIFICATIONS TO INDUCE WEIGHT LOSS, THROUGH DIET AND PHYSICAL ACTIVITY, REMAIN THE MAINSTAY OF TREATMENT FOR PAEDIATRIC NAFLD. THE USE OF DIETARY SUPPLEMENTS, SUCH AS OMEGA-3 FATTY ACIDS AND PROBIOTICS, NEEDS FURTHER STUDY BEFORE RECOMMENDATION. 2022 7 558 35 B-VITAMIN DEPENDENT METHIONINE METABOLISM AND ALCOHOLIC LIVER DISEASE. CONVINCING EVIDENCE LINKS ABERRANT B-VITAMIN DEPENDENT HEPATIC METHIONINE METABOLISM TO THE PATHOGENESIS OF ALCOHOLIC LIVER DISEASE (ALD). THIS REVIEW FOCUSES ON THE ESSENTIAL ROLES OF FOLATE AND VITAMINS B6 AND B12 IN HEPATIC METHIONINE METABOLISM, THE CAUSES OF THEIR DEFICIENCIES AMONG CHRONIC ALCOHOLIC PERSONS, AND HOW THEIR DEFICIENCIES TOGETHER WITH CHRONIC ALCOHOL EXPOSURE IMPACT ON ABERRANT METHIONINE METABOLISM IN THE PATHOGENESIS OF ALD. FOLATE IS THE DIETARY TRANSMETHYLATION DONOR FOR THE PRODUCTION OF S-ADENOSYLMETHIONINE (SAM), WHICH IS THE SUBSTRATE FOR ALL METHYLTRANSFERASES THAT REGULATE GENE EXPRESSIONS IN PATHWAYS OF LIVER INJURY, AS WELL AS A REGULATOR OF THE TRANSSULFURATION PATHWAY THAT IS ESSENTIAL FOR PRODUCTION OF GLUTATHIONE (GSH), THE PRINCIPAL ANTIOXIDANT FOR DEFENSE AGAINST OXIDATIVE LIVER INJURY. VITAMIN B12 REGULATES TRANSMETHYLATION REACTIONS FOR SAM PRODUCTION AND VITAMIN B6 REGULATES TRANSSULFURATION REACTIONS FOR GSH PRODUCTION. FOLATE DEFICIENCY ACCELERATES THE EXPERIMENTAL DEVELOPMENT OF ALD IN ETHANOL-FED ANIMALS WHILE REDUCING LIVER SAM LEVELS WITH RESULTANT ABNORMAL GENE EXPRESSION AND DECREASED PRODUCTION OF ANTIOXIDANT GSH. THROUGH ITS EFFECTS ON FOLATE METABOLISM, REDUCED SAM ALSO IMPAIRS NUCLEOTIDE BALANCE WITH RESULTANT INCREASED DNA STRAND BREAKS, OXIDATION, HEPATOCELLULAR APOPTOSIS, AND RISK OF CARCINOGENESIS. THE REVIEW ENCOMPASSES REFERENCED STUDIES ON MECHANISMS FOR PERTURBATIONS OF METHIONINE METABOLISM IN ALD, EVIDENCE FOR ALTERED GENE EXPRESSIONS AND THEIR EPIGENETIC REGULATION IN THE PATHOGENESIS OF ALD, AND CLINICAL STUDIES ON POTENTIAL PREVENTION AND TREATMENT OF ALD BY CORRECTION OF METHIONINE METABOLISM WITH SAM. 2013 8 6441 28 THERAPEUTIC APPROACHES FOR NONALCOHOLIC FATTY LIVER DISEASE: ESTABLISHED TARGETS AND DRUGS. NONALCOHOLIC FATTY LIVER DISEASE (NAFLD), AS A MULTISYSTEMIC DISEASE, IS THE MOST PREVALENT CHRONIC LIVER DISEASE CHARACTERIZED BY EXTREMELY COMPLEX PATHOGENIC MECHANISMS AND MULTIFACTORIAL ETIOLOGY, WHICH OFTEN DEVELOPS AS A CONSEQUENCE OF OBESITY, METABOLIC SYNDROME. PATHOPHYSIOLOGICAL MECHANISMS INVOLVED IN THE DEVELOPMENT OF NAFLD INCLUDE DIET, OBESITY, INSULIN RESISTANCE (IR), GENETIC AND EPIGENETIC DETERMINANTS, INTESTINAL DYSBIOSIS, OXIDATIVE/NITROSATIVE STRESS, AUTOPHAGY DYSREGULATION, HEPATIC INFLAMMATION, GUT-LIVER AXIS, GUT MICROBES, IMPAIRED MITOCHONDRIAL METABOLISM AND REGULATION OF HEPATIC LIPID METABOLISM. SOME OF THE NEW DRUGS FOR THE TREATMENT OF NAFLD ARE INTRODUCED HERE. ALL OF THEM ACHIEVE THERAPEUTIC OBJECTIVES BY INTERFERING WITH CERTAIN PATHOPHYSIOLOGICAL PATHWAYS OF NAFLD, INCLUDING FIBROBLAST GROWTH FACTORS (FGF) ANALOGUES, PEROXISOME PROLIFERATOR-ACTIVATED RECEPTORS (PPARS) AGONISTS, GLUCAGON-LIKE PEPTIDE-1 (GLP-1) AGONISTS, G PROTEIN-COUPLED RECEPTORS (GPCRS), SODIUM-GLUCOSE COTRANSPORTER-2 INHIBITORS (SGLT-2I), FARNESOID X RECEPTOR (FXR), FATTY ACID SYNTHASE INHIBITOR (FASNI), ANTIOXIDANTS, ETC. THIS REVIEW DESCRIBES SOME PATHOPHYSIOLOGICAL MECHANISMS OF NAFLD AND ESTABLISHED TARGETS AND DRUGS. 2023 9 615 29 BIOACTIVE COMPONENTS AND POSSIBLE ACTIVITIES OF MEDICINAL MUSHROOMS IN ALLEVIATING THE PATHOGENESIS OF NONALCOHOLIC FATTY LIVER DISEASE (REVIEW). NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS A GLOBAL DISEASE THAT IS CLOSELY ASSOCIATED WITH OBESITY, TYPE 2 DIABETES MELLITUS, AND CARDIOVASCULAR DISEASE. EXCESSIVE FAT ACCUMULATION, FATTY DEGENERATION, AND CHRONIC INFLAMMATION OF THE LIVER ACTIVATE THE PROGRESSION OF NAFLD FROM SIMPLE STEATOSIS TO NONALCOHOLIC STEATOHEPATITIS AND FURTHER TO LIVER FIBROSIS, CIRRHOSIS, AND HEPATOCELLULAR CARCINOMA. THE UNDERLYING MECHANISM FOR THE DEVELOPMENT AND PROGRESSION OF NAFLD IS COMPLEX AND A MULTIPLE-HIT HYPOTHESIS INCLUDING DIETARY, ENVIRONMENTAL, GENETIC, AND EPIGENETIC FACTORS HAS BEEN RAISED. INCREASED DE NOVO LIPOGENESIS, DECREASED LIPOLYSIS, AND INSULIN RESISTANCE ARE ASSOCIATED WITH THE DEVELOPMENT OF NAFLD. CURRENTLY, NO EFFECTIVE DRUG THERAPIES ARE APPROVED FOR THE TREATMENT OF NAFLD. SEVERAL MEDICINAL MUSHROOMS HAVE BEEN FOUND TO HAVE SIGNIFICANT WEIGHT CONTROL AND GUT MICROBE MODULATION ACTIVITIES AND ANTIHYPERTRIGLYCERIDEMIC, ANTIHYPERGLYCEMIC, ANTIOXIDANT, AND ANTI-INFLAMMATORY EFFECTS, WHICH MAY BE USEFUL TO PREVENT AND ATTENUATE THE DEVELOPMENT AND PROGRESSION OF NAFLD. THESE BENEFICIAL EFFECTS ARE ASSOCIATED WITH MUSHROOMS' BIOACTIVE COMPONENTS, SUCH AS POLYSACCHARIDES, DIETARY FIBERS, ANTIOXIDANTS, AND OTHER COMPOUNDS DERIVED FROM FRUITING BODIES, CULTURED MYCELIUM, AND/OR BROTH OF MEDICINAL MUSHROOMS. THIS ARTICLE PRESENTS AN OVERVIEW OF MULTIPLE ASPECTS OF NAFLD, INCLUDING THE EPIDEMIOLOGY, PATHOGENESIS, MANAGEMENT, AND TREATMENT. THE BIOACTIVE COMPONENTS AND POSSIBLE ACTIVITIES OF MEDICINAL MUSHROOMS IN ALLEVIATING THE PATHOGENESIS OF NAFLD ARE ALSO REVIEWED. 2021 10 1412 52 DIETARY PATTERNS INFLUENCE TARGET GENE EXPRESSION THROUGH EMERGING EPIGENETIC MECHANISMS IN NONALCOHOLIC FATTY LIVER DISEASE. NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) REFERS TO THE PATHOLOGIC BUILDUP OF EXTRA FAT IN THE FORM OF TRIGLYCERIDES IN LIVER CELLS WITHOUT EXCESSIVE ALCOHOL INTAKE. NAFLD BECAME THE MOST COMMON CAUSE OF CHRONIC LIVER DISEASE THAT IS TIGHTLY ASSOCIATED WITH KEY ASPECTS OF METABOLIC DISORDERS, INCLUDING INSULIN RESISTANCE, OBESITY, DIABETES, AND METABOLIC SYNDROME. IT IS GENERALLY ACCEPTED THAT MULTIPLE MECHANISMS AND PATHWAYS ARE INVOLVED IN THE PATHOGENESIS OF NAFLD. HEREDITY, SEDENTARY LIFESTYLE, WESTERNIZED HIGH SUGAR SATURATED FAT DIET, METABOLIC DERANGEMENTS, AND GUT MICROBIOTA, ALL MAY INTERACT ON A ON GENETICALLY SUSCEPTIBLE INDIVIDUAL TO CAUSE THE DISEASE INITIATION AND PROGRESSION. WHILE THERE IS AN UNQUESTIONABLE ROLE FOR GENE-DIET INTERACTION IN THE ETIOPATHOGENESIS OF NAFLD, IT IS INCREASINGLY APPARENT THAT EPIGENETIC PROCESSES CAN ORCHESTRATE MANY ASPECTS OF THIS INTERACTION AND PROVIDE ADDITIONAL MECHANISTIC INSIGHT. EXCITING RESEARCH DEMONSTRATED THAT EPIGENETIC ALTERATIONS IN CHROMATIN CAN INFLUENCE GENE EXPRESSION CHIEFLY AT THE TRANSCRIPTIONAL LEVEL IN RESPONSE TO UNBALANCED DIET, AND THEREFORE PREDISPOSE AN INDIVIDUAL TO NAFLD. THUS, FURTHER DISCOVERIES INTO MOLECULAR EPIGENETIC MECHANISMS UNDERLYING THE LINK BETWEEN NUTRITION AND ABERRANT HEPATIC GENE EXPRESSION CAN YIELD NEW INSIGHTS INTO THE PATHOGENESIS OF NAFLD, AND ALLOW INNOVATIVE EPIGENETIC-BASED STRATEGIES FOR ITS EARLY PREVENTION AND TARGETED THERAPIES. HEREIN, WE OUTLINE THE CURRENT KNOWLEDGE OF THE INTERACTIVE ROLE OF A HIGH-FAT HIGH-CALORIES DIET AND GENE EXPRESSION THROUGH DNA METHYLATION AND HISTONE MODIFICATIONS ON THE PATHOGENESIS OF NAFLD. WE ALSO PROVIDE PERSPECTIVES ON THE ADVANCEMENT OF THE EPIGENOMICS IN THE FIELD AND POSSIBLE SHORTCOMINGS AND LIMITATIONS AHEAD. 2021 11 4314 35 MICRORNAS AS CONTROLLED SYSTEMS AND CONTROLLERS IN NON-ALCOHOLIC FATTY LIVER DISEASE. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS A MULTI-FACETED CONDITION INCLUDING SIMPLE STEATOSIS ALONE OR ASSOCIATED WITH INFLAMMATION AND BALLOONING (NON-ALCOHOLIC STEATOHEPATITIS) AND EVENTUALLY FIBROSIS. THE NAFLD INCIDENCE HAS INCREASED OVER THE LAST TWENTY YEARS BECOMING THE MOST FREQUENT CHRONIC LIVER DISEASE IN INDUSTRIALIZED COUNTRIES. OBESITY, VISCERAL ADIPOSITY, INSULIN RESISTANCE, AND MANY OTHER DISORDERS THAT CHARACTERIZE METABOLIC SYNDROME ARE THE MAJOR PREDISPOSING RISK FACTORS FOR NAFLD. FURTHERMORE, DIFFERENT FACTORS, INCLUDING GENETIC BACKGROUND, EPIGENETIC MECHANISMS AND ENVIRONMENTAL FACTORS, SUCH AS DIET AND PHYSICAL EXERCISE, CONTRIBUTE TO NAFLD DEVELOPMENT AND PROGRESSION. SEVERAL LINES OF EVIDENCE DEMONSTRATE THAT SPECIFIC MICRORNAS EXPRESSION PROFILES ARE STRONGLY ASSOCIATED WITH SEVERAL PATHOLOGICAL CONDITIONS INCLUDING NAFLD. IN NAFLD, MICRORNA DEREGULATION IN RESPONSE TO INTRINSIC GENETIC OR EPIGENETIC FACTORS OR ENVIRONMENTAL FACTORS CONTRIBUTES TO METABOLIC DYSFUNCTION. IN THIS REVIEW WE FOCUSED ON MICRORNAS ROLE BOTH AS CONTROLLED AND CONTROLLERS MOLECULES IN NAFLD DEVELOPMENT AND/OR THEIR EVENTUAL VALUE AS NON-INVASIVE BIOMARKERS OF DISEASE. 2014 12 6305 35 THE QUESTION IS WHETHER INTAKE OF FOLIC ACID FROM DIET ALONE DURING PREGNANCY IS SUFFICIENT. PREGNANCY AND FOLIC ACID: PREGNANCY IS THE MOST IMPORTANT PERIOD IN LIFE OF EVERY WOMAN, PARTIALLY FOR THE NUMBER OF PHYSIOLOGICAL ADAPTATIONS SHE IS GOING THROUGH, PARTIALLY FOR THE EXPECTANCE OF NEW LIFE. IN ADDITION, PREGNANCY IS THE "CRITICAL WINDOW" FOR DEVELOPMENT LATER IN CHILDHOOD, AS A PERIOD OF FOETAL PROGRAMMING DURING WHICH NUTRITION PLAYS ONE OF CRUCIAL ROLES. DESPITE THE GENERAL BELIEF THAT NUTRITION THROUGH PREGNANCY IS ADEQUATE AND CHARACTERIZED BY BETTER NUTRITIONAL HABITS, A NUMBER OF STUDIES DO NOT CORROBORATE THIS BELIEF. ROLE OF FOLIC ACID: AN ADEQUATE FOLATE BLOOD LEVEL IS NECESSARY FOR NORMAL CELL GROWTH, SYNTHESIS OF SEVERAL COMPOUNDS INCLUDING DEOXYRIBONUCLEIC ACID AND RIBONUCLEIC ACID, PROPER BRAIN AND NEUROLOGIC FUNCTIONS; IT IS INCLUDED IN THE REGULATION OF HOMOCYSTEINE LEVEL, AND CLOSELY RELATED TO THE VITAMIN B12 METABOLISM. FOLATE DEFICIENCY IN PREGNANCY IS RELATED TO NEURAL TUBE DEFECTS, OTHER NEUROLOGICAL DISORDERS, PRETERM DELIVERY AND LOW BIRTH WEIGHT. FOOD SOURCES: A CORRELATION BETWEEN FOLATE AND THE PREVENTION OF BROAD SPECTRUM OF CHRONIC DISEASES HAS BEEN CONFIRMED. EMERGING EVIDENCE FROM THE EPIGENETIC STUDIES IS NOW BRINGING EVEN MORE LIGHT ON THE LEVEL OF SIGNIFICANCE OF FOLIC ACID. A WIDE RANGE OF PLANT AND ANIMAL FOODS ARE THE NATURAL SOURCES OF FOLATE; LIVER, YEAST, MUSHROOMS, AND GREEN LEAFY VEGETABLES BEING THE MOST SIGNIFICANT. DIFFERENT WAYS OF FOOD PREPARATION INFLUENCE THE FOLATE STABILITY AND ITS BIOAVAILABILITY VARIES FROM 25 TO 50% FROM FOODS, 85% FROM ENRICHED FOODS OR 100% FROM SUPPLEMENTS. CONCLUSION: A GREAT AMOUNT OF SCIENTIFIC RESULTS HAS LED TO OFFICIAL RECOMMENDATIONS FOR FOLIC ACID SUPPLEMENTATION IN PREGNANT WOMEN AS WELL AS IN A NUMBER OF OBLIGATORY OR VOLUNTARY FORTIFICATION PROGRAMMES IN ORDER TO PREVENT THE FOLATE DEFICIENCY ON THE LEVEL OF DIFFERENT POPULATION GROUPS. NEVERTHELESS, THERE MUST BE A CERTAIN LEVEL OF PRECAUTION FOR ELDERLY BECAUSE FOLATE CAN MASK THE VITAMIN B12 DEFICIENCY WITH POSSIBLE FATAL OUTCOMES. 2014 13 5654 36 SEX, NUTRITION, AND NAFLD: RELEVANCE OF ENVIRONMENTAL POLLUTION. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS THE MOST COMMON FORM OF CHRONIC LIVER DISEASE AND REPRESENTS AN INCREASING PUBLIC HEALTH ISSUE GIVEN THE LIMITED TREATMENT OPTIONS AND ITS ASSOCIATION WITH SEVERAL OTHER METABOLIC AND INFLAMMATORY DISORDERS. THE EPIDEMIC, STILL GROWING PREVALENCE OF NAFLD WORLDWIDE CANNOT BE MERELY EXPLAINED BY CHANGES IN DIET AND LIFESTYLE THAT OCCURRED IN THE LAST FEW DECADES, NOR FROM THEIR ASSOCIATION WITH GENETIC AND EPIGENETIC RISK FACTORS. IT IS CONCEIVABLE THAT ENVIRONMENTAL POLLUTANTS, WHICH ACT AS ENDOCRINE AND METABOLIC DISRUPTORS, MAY CONTRIBUTE TO THE SPREADING OF THIS PATHOLOGY DUE TO THEIR ABILITY TO ENTER THE FOOD CHAIN AND BE INGESTED THROUGH CONTAMINATED FOOD AND WATER. GIVEN THE STRICT INTERPLAY BETWEEN NUTRIENTS AND THE REGULATION OF HEPATIC METABOLISM AND REPRODUCTIVE FUNCTIONS IN FEMALES, POLLUTANT-INDUCED METABOLIC DYSFUNCTIONS MAY BE OF PARTICULAR RELEVANCE FOR THE FEMALE LIVER, DAMPENING SEX DIFFERENCES IN NAFLD PREVALENCE. DIETARY INTAKE OF ENVIRONMENTAL POLLUTANTS CAN BE PARTICULARLY DETRIMENTAL DURING GESTATION, WHEN ENDOCRINE-DISRUPTING CHEMICALS MAY INTERFERE WITH THE PROGRAMMING OF LIVER METABOLISM, ACCOUNTING FOR THE DEVELOPMENTAL ORIGIN OF NAFLD IN OFFSPRING. THIS REVIEW SUMMARIZES CAUSE-EFFECT EVIDENCE BETWEEN ENVIRONMENTAL POLLUTANTS AND INCREASED INCIDENCE OF NAFLD AND EMPHASIZES THE NEED FOR FURTHER STUDIES IN THIS FIELD. 2023 14 74 37 A MULTIDISCIPLINARY APPROACH AND CURRENT PERSPECTIVE OF NONALCOHOLIC FATTY LIVER DISEASE: A SYSTEMATIC REVIEW. IN RECENT TIMES, NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) HAS BEEN CONSIDERED ONE OF THE MAJOR CAUSES OF LIVER DISEASE ACROSS THE WORLD. NAFLD IS DEFINED AS THE DEPOSITION OF TRIGLYCERIDES IN THE LIVER AND IS ASSOCIATED WITH OBESITY AND METABOLIC SYNDROME. HYPERINSULINEMIA, INSULIN RESISTANCE (IR), FATTY LIVER, HEPATOCYTE INJURY, UNBALANCED PROINFLAMMATORY CYTOKINES, MITOCHONDRIAL DYSFUNCTION, OXIDATIVE STRESS, LIVER INFLAMMATION, AND FIBROSIS ARE THE MAIN PATHOGENESIS IN NAFLD. RECENT STUDIES SUGGEST THAT THE ACTION OF INTESTINAL MICROBIOTA THROUGH CHRONIC INFLAMMATION, INCREASED INTESTINAL PERMEABILITY, AND ENERGY UPTAKE PLAYS A VITAL ROLE IN NAFLD. MOREOVER, POLYCYSTIC OVARIAN SYNDROME ALSO CAUSES NAFLD DEVELOPMENT THROUGH IR. AGE, GENDER, RACE, ETHNICITY, SLEEP, DIET, SEDENTARY LIFESTYLE, AND GENETIC AND EPIGENETIC PATHWAYS ARE SOME CONTRIBUTING FACTORS OF NAFLD THAT CAN EXACERBATE THE RISK OF LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA (HCC) AND EVENTUALLY LEAD TO DEATH. NAFLD HAS VARIOUS PRESENTATIONS, INCLUDING FATIGUE, UNEXPLAINED WEIGHT LOSS, BLOATING, UPPER ABDOMINAL PAIN, DECREASED APPETITE, HEADACHE, ANXIETY, POOR SLEEP, INCREASED THIRST, PALPITATION, AND A FEELING OF WARMTH. SOME STUDIES HAVE SHOWN THAT NAFLD WITH SEVERE CORONAVIRUS DISEASE 2019 (COVID-19) HAS POOR OUTCOMES. THE GOLD STANDARD FOR NAFLD DIAGNOSIS IS LIVER BIOPSY. OTHER DIAGNOSTIC TOOLS ARE IMAGING TESTS, SERUM BIOMARKERS, MICROBIOTA MARKERS, AND TESTS FOR EXTRAHEPATIC COMPLICATIONS. THERE ARE NO SPECIFIC TREATMENTS FOR NAFLD. THEREFORE, THE MAIN CONCERN FOR NAFLD IS TREATING THE COMORBID CONDITIONS SUCH AS ANTI-DIABETIC AGENTS FOR TYPE 2 DIABETES MELLITUS, STATINS TO REDUCE HCC PROGRESSION, ANTIOXIDANTS TO PREVENT HEPATOCELLULAR DAMAGE, AND BARIATRIC SURGERY FOR PATIENTS WITH A BMI OF >40 KG/M(2) AND >35 KG/M(2) WITH COMORBIDITIES. LIFESTYLE AND DIETARY CHANGES ARE CONSIDERED PREVENTIVE STRATEGIES AGAINST NAFLD ADVANCEMENT. INADEQUATE TREATMENT OF NAFLD FURTHER LEADS TO CARDIAC CONSEQUENCES, SLEEP APNEA, CHRONIC KIDNEY DISEASE, AND INFLAMMATORY BOWEL DISEASE. IN THIS SYSTEMATIC REVIEW, WE HAVE BRIEFLY DISCUSSED THE RISK FACTORS, PATHOGENESIS, CLINICAL FEATURES, AND NUMEROUS CONSEQUENCES OF NAFLD. WE HAVE ALSO REVIEWED VARIOUS GUIDELINES FOR NAFLD DIAGNOSIS ALONG WITH EXISTING THERAPEUTIC STRATEGIES FOR THE MANAGEMENT AND PREVENTION OF THE DISEASE. 2022 15 5807 26 STRATEGIES, MODELS AND BIOMARKERS IN EXPERIMENTAL NON-ALCOHOLIC FATTY LIVER DISEASE RESEARCH. NON-ALCOHOLIC FATTY LIVER DISEASE ENCOMPASSES A SPECTRUM OF LIVER DISEASES, INCLUDING SIMPLE STEATOSIS, STEATOHEPATITIS, LIVER FIBROSIS AND CIRRHOSIS AND HEPATOCELLULAR CARCINOMA. NON-ALCOHOLIC FATTY LIVER DISEASE IS CURRENTLY THE MOST DOMINANT CHRONIC LIVER DISEASE IN WESTERN COUNTRIES DUE TO THE FACT THAT HEPATIC STEATOSIS IS ASSOCIATED WITH INSULIN RESISTANCE, TYPE 2 DIABETES MELLITUS, OBESITY, METABOLIC SYNDROME AND DRUG-INDUCED INJURY. A VARIETY OF CHEMICALS, MAINLY DRUGS, AND DIETS IS KNOWN TO CAUSE HEPATIC STEATOSIS IN HUMANS AND RODENTS. EXPERIMENTAL NON-ALCOHOLIC FATTY LIVER DISEASE MODELS RELY ON THE APPLICATION OF A DIET OR THE ADMINISTRATION OF DRUGS TO LABORATORY ANIMALS OR THE EXPOSURE OF HEPATIC CELL LINES TO THESE DRUGS. MORE RECENTLY, GENETICALLY MODIFIED RODENTS OR ZEBRAFISH HAVE BEEN INTRODUCED AS NON-ALCOHOLIC FATTY LIVER DISEASE MODELS. CONSIDERABLE INTEREST NOW LIES IN THE DISCOVERY AND DEVELOPMENT OF NOVEL NON-INVASIVE BIOMARKERS OF NON-ALCOHOLIC FATTY LIVER DISEASE, WITH SPECIFIC FOCUS ON HEPATIC STEATOSIS. EXPERIMENTAL DIAGNOSTIC BIOMARKERS OF NON-ALCOHOLIC FATTY LIVER DISEASE, SUCH AS (EPI)GENETIC PARAMETERS AND '-OMICS'-BASED READ-OUTS ARE STILL IN THEIR INFANCY, BUT SHOW GREAT PROMISE. IN THIS PAPER, THE ARRAY OF TOOLS AND MODELS FOR THE STUDY OF LIVER STEATOSIS IS DISCUSSED. FURTHERMORE, THE CURRENT STATE-OF-ART REGARDING EXPERIMENTAL BIOMARKERS SUCH AS EPIGENETIC, GENETIC, TRANSCRIPTOMIC, PROTEOMIC AND METABONOMIC BIOMARKERS WILL BE REVIEWED. 2015 16 375 27 AN ENERGETIC VIEW OF STRESS: FOCUS ON MITOCHONDRIA. ENERGY IS REQUIRED TO SUSTAIN LIFE AND ENABLE STRESS ADAPTATION. AT THE CELLULAR LEVEL, ENERGY IS LARGELY DERIVED FROM MITOCHONDRIA - UNIQUE MULTIFUNCTIONAL ORGANELLES WITH THEIR OWN GENOME. FOUR MAIN ELEMENTS CONNECT MITOCHONDRIA TO STRESS: (1) ENERGY IS REQUIRED AT THE MOLECULAR, (EPI)GENETIC, CELLULAR, ORGANELLAR, AND SYSTEMIC LEVELS TO SUSTAIN COMPONENTS OF STRESS RESPONSES; (2) GLUCOCORTICOIDS AND OTHER STEROID HORMONES ARE PRODUCED AND METABOLIZED BY MITOCHONDRIA; (3) RECIPROCALLY, MITOCHONDRIA RESPOND TO NEUROENDOCRINE AND METABOLIC STRESS MEDIATORS; AND (4) EXPERIMENTALLY MANIPULATING MITOCHONDRIAL FUNCTIONS ALTERS PHYSIOLOGICAL AND BEHAVIORAL RESPONSES TO PSYCHOLOGICAL STRESS. THUS, MITOCHONDRIA ARE ENDOCRINE ORGANELLES THAT PROVIDE BOTH THE ENERGY AND SIGNALS THAT ENABLE AND DIRECT STRESS ADAPTATION. NEURAL CIRCUITS REGULATING SOCIAL BEHAVIOR - AS WELL AS PSYCHOPATHOLOGICAL PROCESSES - ARE ALSO INFLUENCED BY MITOCHONDRIAL ENERGETICS. AN INTEGRATIVE VIEW OF STRESS AS AN ENERGY-DRIVEN PROCESS OPENS NEW OPPORTUNITIES TO STUDY MECHANISMS OF ADAPTATION AND REGULATION ACROSS THE LIFESPAN. 2018 17 4991 47 PEDIATRIC NON-ALCOHOLIC FATTY LIVER DISEASE: NUTRITIONAL ORIGINS AND POTENTIAL MOLECULAR MECHANISMS. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS THE NUMBER ONE CHRONIC LIVER DISEASE WORLDWIDE AND IS ESTIMATED TO AFFECT NEARLY 40% OF OBESE YOUTH AND UP TO 10% OF THE GENERAL PEDIATRIC POPULATION WITHOUT ANY OBVIOUS SIGNS OR SYMPTOMS. ALTHOUGH THE EARLY STAGES OF NAFLD ARE REVERSIBLE WITH DIET AND LIFESTYLE MODIFICATIONS, DETECTING SUCH STAGES IS HINDERED BY A LACK OF NON-INVASIVE METHODS OF RISK ASSESSMENT AND DIAGNOSIS. THIS ABSENCE OF NON-INVASIVE MEANS OF DIAGNOSIS IS DIRECTLY RELATED TO THE SCARCITY OF LONG-TERM PROSPECTIVE STUDIES OF PEDIATRIC NAFLD IN CHILDREN AND ADOLESCENTS. IN THE MAJORITY OF PEDIATRIC NAFLD CASES, THE MECHANISMS DRIVING THE ORIGIN AND RAPID PROGRESSION OF NAFLD REMAIN UNKNOWN. THE PROGRESSION FROM NAFLD TO NON-ALCOHOLIC STEATOHEPATITIS (NASH) IN YOUTH IS ASSOCIATED WITH UNIQUE HISTOLOGICAL FEATURES AND POSSIBLE IMMUNE PROCESSES AND METABOLIC PATHWAYS THAT MAY REFLECT DIFFERENT MECHANISMS COMPARED WITH ADULTS. RECENT DATA SUGGEST THAT CIRCULATING MICRORNAS (MIRNAS) ARE IMPORTANT NEW BIOMARKERS UNDERLYING PATHWAYS OF LIVER INJURY. SEVERAL FACTORS MAY CONTRIBUTE TO PEDIATRIC NAFLD DEVELOPMENT, INCLUDING HIGH-SUGAR DIETS, IN UTERO EXPOSURES VIA EPIGENETIC ALTERATIONS, CHANGES IN THE NEONATAL MICROBIOME, AND ALTERED IMMUNE SYSTEM DEVELOPMENT AND MITOCHONDRIAL FUNCTION. THIS REVIEW FOCUSES ON THE UNIQUE ASPECTS OF PEDIATRIC NAFLD AND HOW NUTRITIONAL EXPOSURES IMPACT THE IMMUNE SYSTEM, MITOCHONDRIA, AND LIVER/GASTROINTESTINAL METABOLIC HEALTH. THESE FACTORS HIGHLIGHT THE NEED FOR ANSWERS TO HOW NAFLD DEVELOPS IN CHILDREN AND FOR EARLY STAGE-SPECIFIC INTERVENTIONS. 2020 18 4188 39 METABOLIC ASSOCIATED FATTY LIVER DISEASE IN CHILDREN AND ADOLESCENTS: MECHANISMS OF A SILENT EPIDEMIC AND THERAPEUTIC OPTIONS. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS NOW IDENTIFIED AS A HEPATIC SIGN OF METABOLIC SYNDROME AND IS THE MOST FREQUENT CAUSE OF CHRONIC LIVER DISEASE IN ALL AGES. IT IS ASSUMED THAT A GENETIC PREDISPOSITION ASSOCIATED WITH EPIGENETIC FACTORS PARTICIPATES IN THE EVOLUTION OF THIS CONDITION. VISCERAL OBESITY AND INSULIN RESISTANCE (IR) HAVE ALWAYS BEEN CONSIDERED THE MOST IMPORTANT CAUSATIVE FACTORS OF METABOLIC SYNDROME (METS) AND NAFLD, BUT CURRENTLY, THE INTERACTION BETWEEN GENETIC HERITAGE AND ENVIRONMENTAL FACTORS IS INCREASINGLY CONSIDERED FUNDAMENTAL IN THE GENESIS OF METABOLIC DISORDERS ASSOCIATED WITH NAFLD. IN FACT, IN PATIENTS WITH NAFLD, INSULIN RESISTANCE, ARTERIAL HYPERTENSION, ABDOMINAL OBESITY, DYSLIPIDEMIA AND REDUCED INTESTINAL PERMEABILITY HAVE OFTEN BEEN FOUND, AS WELL AS A HIGHER PREVALENCE OF CORONARY ARTERY DISEASE, OBSTRUCTIVE SLEEP APNEA, POLYCYSTIC OVARY SYNDROME AND OSTEOPENIA, WHICH DEFINE A METS FRAMEWORK. EARLY DIAGNOSIS IS NEEDED TO PREVENT DISEASE PROGRESSION THROUGH PRIMARILY LIFESTYLE INTERVENTIONS. UNFORTUNATELY, AT PRESENT, THERE ARE NO MOLECULES RECOMMENDED FOR PEDIATRIC PATIENTS. HOWEVER, SEVERAL NEW DRUGS ARE IN CLINICAL TRIALS. FOR THIS REASON, TARGETED STUDIES ON THE INTERACTION BETWEEN GENETICS AND ENVIRONMENTAL FACTORS INVOLVED IN THE DEVELOPMENT OF NAFLD AND METS AND ON THE PATHOGENETIC MECHANISMS THAT DETERMINE THE EVOLUTION IN NON-ALCOHOLIC STEATOHEPATITIS (NASH), SHOULD BE IMPLEMENTED. THEREFORE, IT IS DESIRABLE THAT FUTURE STUDIES MAY BE USEFUL IN IDENTIFYING PATIENTS AT RISK OF DEVELOPING NAFLD AND METS EARLY. 2023 19 4712 32 NON-ALCOHOLIC FATTY LIVER DISEASE: METABOLIC, GENETIC, EPIGENETIC AND ENVIRONMENTAL RISK FACTORS. NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS ONE OF THE MOST FREQUENT CAUSES OF CHRONIC LIVER DISEASE IN THE WESTERN WORLD, PROBABLY DUE TO THE GROWING PREVALENCE OF OBESITY, METABOLIC DISEASES, AND EXPOSURE TO SOME ENVIRONMENTAL AGENTS. IN CERTAIN PATIENTS, SIMPLE HEPATIC STEATOSIS CAN PROGRESS TO NON-ALCOHOLIC STEATOHEPATITIS (NASH), WHICH CAN SOMETIMES LEAD TO LIVER CIRRHOSIS AND ITS COMPLICATIONS INCLUDING HEPATOCELLULAR CARCINOMA. UNDERSTANDING THE MECHANISMS THAT CAUSE THE PROGRESSION OF NAFLD TO NASH IS CRUCIAL TO BE ABLE TO CONTROL THE ADVANCEMENT OF THE DISEASE. THE MAIN HYPOTHESIS CONSIDERS THAT IT IS DUE TO MULTIPLE FACTORS THAT ACT TOGETHER ON GENETICALLY PREDISPOSED SUBJECTS TO SUFFER FROM NAFLD INCLUDING INSULIN RESISTANCE, NUTRITIONAL FACTORS, GUT MICROBIOTA, AND GENETIC AND EPIGENETIC FACTORS. IN THIS ARTICLE, WE WILL DISCUSS THE EPIDEMIOLOGY OF NAFLD, AND WE OVERVIEW SEVERAL TOPICS THAT INFLUENCE THE DEVELOPMENT OF THE DISEASE FROM SIMPLE STEATOSIS TO LIVER CIRRHOSIS AND ITS POSSIBLE COMPLICATIONS. 2021 20 1373 29 DEVELOPMENTAL ORIGINS OF NONALCOHOLIC FATTY LIVER DISEASE. OBESE PREGNANT WOMEN MAY TRANSMIT THEIR METABOLIC PHENOTYPE TO OFFSPRING, LEADING TO A CYCLE OF OBESITY AND DIABETES OVER GENERATIONS. EARLY CHILDHOOD OBESITY PREDICTS NONALCOHOLIC FATTY LIVER DISEASE (NAFLD), THE MOST COMMON CHRONIC HUMAN LIVER DISEASE. THE FETUS MAY BE VULNERABLE TO STEATOSIS BECAUSE IMMATURE FETAL ADIPOSE DEPOTS ARE NOT AVAILABLE TO BUFFER THE EXCESS TRANSPLACENTAL LIPID DELIVERY IN MATERNAL OBESITY. IN ANIMAL MODELS, IN UTERO HIGH-FAT DIET EXPOSURE RESULTS IN AN INCREASE IN THE ACCUMULATION OF LIVER TRIGLYCERIDES IN OFFSPRING AND INCREASED HEPATIC OXIDATIVE STRESS AND APOPTOSIS, PERHAPS PRIMING THE LIVER FOR LATER DEVELOPMENT OF NAFLD. INNATE IMMUNE DYSFUNCTION AND NECROINFLAMMATORY CHANGES HAVE BEEN OBSERVED IN POSTNATAL OFFSPRING LIVER OF ANIMALS BORN TO HIGH-FAT-FED DAMS. POSTWEANING, LIVERS OF OFFSPRING EXPOSED TO MATERNAL HIGH-FAT FEEDING IN UTERO SHARE PATHOPHYSIOLOGIC FEATURES WITH HUMAN NAFLD, INCLUDING INCREASED DE NOVO LIPOGENESIS AND DECREASED FREE FATTY ACID OXIDATION. HUMAN STUDIES USING MAGNETIC RESONANCE IMAGING HAVE SHOWN THAT MATERNAL BMI PREDICTS INFANT INTRAHEPATOCELLULAR LIPID STORAGE, AS SEEN IN ANIMAL MODELS. THE GENERATIONAL TRANSFER OF NAFLD MAY OCCUR VIA EPIGENETIC CHANGES IN OFFSPRING LIVER. TRANSMISSION OF MICROBIOTA FROM MOTHER TO INFANT MAY IMPACT ENERGY RETENTION AND IMMUNE FUNCTION THAT CONTRIBUTE TO A PREDISPOSITION TO NAFLD. 2014