1 6648 140 UPDATE ON DIAGNOSIS, PATHOPHYSIOLOGY, AND MANAGEMENT OF DIABETIC KIDNEY DISEASE. DIABETIC KIDNEY DISEASE (DKD) IS A CHRONIC COMPLICATION OF DIABETES MELLITUS WHICH MAY EVENTUALLY LEAD TO END-STAGE KIDNEY DISEASE (ESKD). DESPITE IMPROVEMENTS IN GLYCAEMIC CONTROL AND BLOOD PRESSURE MANAGEMENT WITH RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAAS) BLOCKADE, THE CURRENT THERAPY CANNOT COMPLETELY HALT DKD PROGRESSION TO ESKD IN SOME PATIENTS. DKD IS A HETEROGENEOUS DISEASE ENTITY IN TERMS OF ITS CLINICAL MANIFESTATIONS, HISTOPATHOLOGY AND THE RATE OF PROGRESSION, WHICH MAKES IT DIFFICULT TO DEVELOP EFFECTIVE THERAPEUTICS. IT WAS FORMERLY CONSIDERED THAT ALBUMINURIA PRECEDED KIDNEY FUNCTION DECLINE IN DKD, BUT RECENT EPIDEMIOLOGICAL STUDIES REVEALED THAT A DISTINCT GROUP OF PATIENTS PRESENTED KIDNEY DYSFUNCTION WITHOUT DEVELOPING ALBUMINURIA. OTHER COMORBIDITIES, SUCH AS HYPERTENSION, OBESITY AND GOUT, ALSO AFFECT THE CLINICAL COURSE OF DKD. THE PATHOPHYSIOLOGY OF DKD IS COMPLEX AND MULTIFACTORIAL, INVOLVING BOTH METABOLIC AND HAEMODYNAMIC FACTORS. THESE INDUCE ACTIVATION OF INTRACELLULAR SIGNALLING PATHWAYS, OXIDATIVE STRESS, HYPOXIA, DYSREGULATED AUTOPHAGY AND EPIGENETIC CHANGES, WHICH RESULT IN KIDNEY INFLAMMATION AND FIBROSIS. RECENTLY, TWO GROUPS OF ANTIDIABETIC DRUGS, SODIUM-GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITORS AND GLUCAGON-LIKE PEPTIDE-1 (GLP-1) RECEPTOR AGONISTS, WERE DEMONSTRATED TO PROVIDE RENOPROTECTION ON TOP OF THEIR GLUCOSE-LOWERING EFFECTS. SEVERAL OTHER THERAPEUTIC AGENTS ARE ALSO BEING DEVELOPED AND EVALUATED IN CLINICAL TRIALS. 2021 2 6441 37 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 3 6575 52 TREATMENT OF DIABETIC KIDNEY DISEASE: CURRENT AND FUTURE. DIABETIC KIDNEY DISEASE (DKD) IS THE MAJOR CAUSE OF END-STAGE KIDNEY DISEASE. HOWEVER, ONLY RENIN-ANGIOTENSIN SYSTEM INHIBITOR WITH MULTIDISCIPLINARY TREATMENTS IS EFFECTIVE FOR DKD. IN 2019, SODIUM-GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITOR SHOWED EFFICACY AGAINST DKD IN CANAGLIFLOZIN AND RENAL EVENTS IN DIABETES WITH ESTABLISHED NEPHROPATHY CLINICAL EVALUATION (CREDENCE) TRIAL, ADDING A NEW TREATMENT OPTION. HOWEVER, THE PROGRESSION OF DKD HAS NOT BEEN COMPLETELY CONTROLLED. THE PATIENTS WITH TRANSIENT EXPOSURE TO HYPERGLYCEMIA DEVELOP DIABETIC COMPLICATIONS, INCLUDING DKD, EVEN AFTER NORMALIZATION OF THEIR BLOOD GLUCOSE. TEMPORARY HYPERGLYCEMIA CAUSES ADVANCED GLYCATION END PRODUCT (AGE) ACCUMULATIONS AND EPIGENETIC CHANGES AS METABOLIC MEMORY. THE DRUGS THAT IMPROVE METABOLIC MEMORY ARE AWAITED, AND AGE INHIBITORS AND HISTONE MODIFICATION INHIBITORS ARE THE FOCUS OF CLINICAL AND BASIC RESEARCH. IN ADDITION, INCRETIN-RELATED DRUGS SHOWED A RENOPROTECTIVE ABILITY IN MANY CLINICAL TRIALS, AND THESE TRIALS WITH RENAL OUTCOME AS THEIR PRIMARY ENDPOINT ARE CURRENTLY ONGOING. HYPOXIA-INDUCIBLE FACTOR PROLYL HYDROXYLASE INHIBITORS RECENTLY APPROVED FOR RENAL ANEMIA MAY BE RENOPROTECTIVE SINCE THEY IMPROVE TUBULOINTERSTITIAL HYPOXIA. FURTHERMORE, NF-E2-RELATED FACTOR 2 ACTIVATORS IMPROVED THE GLOMERULAR FILTRATION RATE OF DKD PATIENTS IN BARDOXOLONE METHYL TREATMENT: RENAL FUNCTION IN CHRONIC KIDNEY DISEASE/TYPE 2 DIABETES (BEAM) TRIAL AND PHASE II STUDY OF BARDOXOLONE METHYL IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND TYPE 2 DIABETES (TSUBAKI) TRIAL. THUS, FOLLOWING SGLT2 INHIBITOR, NUMEROUS NOVEL DRUGS COULD BE UTILIZED IN TREATING DKD. FUTURE STUDIES ARE EXPECTED TO PROVIDE NEW INSIGHTS. 2021 4 4971 49 PATHOPHYSIOLOGIC MECHANISMS IN DIABETIC KIDNEY DISEASE: A FOCUS ON CURRENT AND FUTURE THERAPEUTIC TARGETS. DIABETIC KIDNEY DISEASE (DKD) IS THE PRIMARY CAUSE OF CHRONIC KIDNEY DISEASE AROUND THE GLOBE AND IS ONE OF THE MAIN COMPLICATIONS IN PATIENTS WITH TYPE 1 AND 2 DIABETES. THE STANDARD TREATMENT FOR DKD IS DRUGS CONTROLLING HYPERGLYCEMIA AND HIGH BLOOD PRESSURE. RENIN ANGIOTENSIN ALDOSTERONE SYSTEM BLOCKADE AND SODIUM GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITION HAVE YIELDED PROMISING RESULTS IN DKD, BUT MANY DIABETIC PATIENTS ON SUCH TREATMENTS NEVERTHELESS CONTINUE TO DEVELOP DKD, LEADING TO KIDNEY FAILURE AND CARDIOVASCULAR COMORBIDITIES. NEW THERAPEUTIC OPTIONS ARE URGENTLY REQUIRED. WE REVIEW HERE THE PROMISING THERAPEUTIC AVENUES BASED ON INSIGHTS INTO THE MECHANISMS OF DKD THAT HAVE RECENTLY EMERGED, INCLUDING MINERALOCORTICOID RECEPTOR ANTAGONISTS, SGLT2 INHIBITORS, GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST, ENDOTHELIN RECEPTOR A INHIBITION, ANTI-INFLAMMATORY AGENTS, AUTOPHAGY ACTIVATORS AND EPIGENETIC REMODELLING. THE INVOLVEMENT OF SEVERAL MOLECULAR MECHANISMS IN DKD PATHOGENESIS, TOGETHER WITH THE GENETIC AND EPIGENETIC VARIABILITY OF THIS CONDITION, MAKES IT DIFFICULT TO TARGET THIS HETEROGENEOUS PATIENT POPULATION WITH A SINGLE DRUG. PERSONALIZED MEDICINE, TAKING INTO ACCOUNT THE GENETIC AND MECHANISTIC VARIABILITY, MAY THEREFORE IMPROVE RENAL AND CARDIOVASCULAR PROTECTION IN DIABETIC PATIENTS WITH DKD. 2020 5 2452 25 EPIGENETIC SUPPRESSION OF POTASSIUM-CHLORIDE CO-TRANSPORTER 2 EXPRESSION IN INFLAMMATORY PAIN INDUCED BY COMPLETE FREUND'S ADJUVANT (CFA). BACKGROUND: MULTIPLE MECHANISMS CONTRIBUTE TO THE STIMULUS-EVOKED PAIN HYPERSENSITIVITY THAT MAY BE EXPERIENCED AFTER PERIPHERAL INFLAMMATION. PERSISTENT PATHOLOGICAL STIMULI IN MANY PAIN CONDITIONS AFFECT THE EXPRESSION OF CERTAIN GENES THROUGH EPIGENETIC ALTERNATIONS. THE MAIN PURPOSE OF OUR STUDY WAS TO INVESTIGATE THE ROLE OF EPIGENETIC MODIFICATION ON POTASSIUM-CHLORIDE CO-TRANSPORTER 2 (KCC2) GENE EXPRESSION IN THE PERSISTENCE OF INFLAMMATORY PAIN. METHODS: PERSISTENT INFLAMMATORY PAIN WAS INDUCED THROUGH THE INJECTION OF COMPLETE FREUND'S ADJUVANT (CFA) IN THE LEFT HIND PAW OF RATS. ACETYL-HISTONE H3 AND H4 LEVEL WAS DETERMINED BY CHROMATIN IMMUNOPRECIPITATION IN THE SPINAL DORSAL HORN. PAIN BEHAVIOUR AND INHIBITORY SYNAPTIC FUNCTION OF SPINAL CORD WERE DETERMINED BEFORE AND AFTER CFA INJECTION. KCC2 EXPRESSION WAS DETERMINED BY REAL TIME RT-PCR AND WESTERN BLOT. INTRATHECAL KCC2 SIRNA (2 MUG PER 10 MUL PER RAT) OR HDAC INHIBITOR (10 MUG PER 10 MUL PER RAT) WAS INJECTED ONCE DAILY FOR 3 DAYS BEFORE CFA INJECTION. RESULTS: PERSISTENT INFLAMMATORY PAIN EPIGENETICALLY SUPPRESSED KCC2 EXPRESSION THROUGH HISTONE DEACETYLASE (HDAC)-MEDIATED HISTONE HYPOACETYLATION, RESULTING IN DECREASED INHIBITORY SIGNALLING EFFICACY. KCC2 KNOCK-DOWN CAUSED BY INTRATHECAL ADMINISTRATION OF KCC2 SIRNA IN NAIVE RATS REDUCED KCC2 EXPRESSION IN THE SPINAL CORD, LEADING TO SENSITIZED PAIN BEHAVIOURS AND IMPAIRED INHIBITORY SYNAPTIC TRANSMISSION IN THEIR SPINAL CORDS. MOREOVER, INTRATHECAL HDAC INHIBITOR INJECTION IN CFA RATS INCREASED KCC2 EXPRESSION, PARTIALLY RESTORING THE SPINAL INHIBITORY SYNAPTIC TRANSMISSION AND RELIEVING THE SENSITIZED PAIN BEHAVIOUR. CONCLUSION: THESE FINDINGS SUGGEST THAT THE TRANSCRIPTION OF SPINAL KCC2 IS REGULATED BY HISTONE ACETYLATION EPIGENETICALLY FOLLOWING CFA. SIGNIFICANCE: PERSISTENT PAIN SUPPRESSES KCC2 EXPRESSION THROUGH HDAC-MEDIATED HISTONE HYPOACETYLATION AND CONSEQUENTLY IMPAIRS THE INHIBITORY FUNCTION OF INHIBITORY INTERNEURONS. DRUGS SUCH AS HDAC INHIBITORS THAT SUPPRESS THE INFLUENCES OF PERSISTENT PAIN ON THE EXPRESSION OF KCC2 MAY SERVE AS A NOVEL ANALGESIC. 2017 6 6473 48 TO DO ONE AND TO GET MORE: PART II. DIABETES AND METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASES. TYPE 2 DIABETES MELLITUS (DM) IS CHARACTERIZED BY INABILITY OF FAULTY PANCREATIC BETA-CELLS TO SECRET A NORMAL AMOUNT OF INSULIN TO MAINTAIN NORMAL BODY CONSUMPTION, AND/OR PERIPHERAL TISSUE HAS A DECREASED SUSCEPTIBILITY TO INSULIN, RESULTING IN HYPERGLYCEMIA AND INSULIN RESISTANCE. SIMILAR TO OTHER CHRONIC SYSTEMIC INFLAMMATORY DISEASES, DM IS A RESULT FROM DYSREGULATED INTERACTIONS BETWEEN ETHNIC, GENETIC, EPIGENETIC, IMMUNOREGULATORY, HORMONAL, AND ENVIRONMENTAL FACTORS. THEREFORE, IT IS RATIONAL TO SUPPOSE THE CONCEPT AS "TO DO ONE AND TO GET MORE", WHILE USING ANTIDIABETIC AGENTS (ADA), A MAIN PHARMACOLOGIC AGENT FOR THE TREATMENT OF DM, CAN PROVIDE AN EXTRAGLYCEMIA EFFECT ON COMORBIDITIES OR CONCOMITTENT COMORBIDITIES TO DM. IN THIS REVIEW, BASED ON THE MUCH STRONG CORRELATION BETWEEN DM AND METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASES (MAFLD) SHOWN BY SIMILAR PATHOPHYSIOLOGICAL MECHANISMS AND A HIGH PREVALENCE OF DM IN MAFLD AND ITS VICE VERSA (A HIGH PREVALENCE OF MAFLD IN DM), IT IS POSSIBLE TO USE THE STRATEGY TO TARGET BOTH DISEASES SIMULTANEOUSLY. WE FOCUS ON A NEW CLASSIFICATION OF ADA, SUCH AS GLUCAGON-LIKE PEPTIDE-1 RECEPTOR (GLP1R) AGONIST AND SODIUM-GLUCOSE COTRANSPORTER-2 (SGLT-2) INHIBITORS TO SHOW THE POTENTIAL BENEFITS OF EXTRAGLYCEMIC EFFECT ON MAFLD. WE CONCLUDE THAT THE MANAGEMENT OF DM PATIENTS, ESPECIALLY FOR THOSE WHO NEED ADA AS ADJUVANT THERAPY SHOULD INCLUDE HEALTHY LIFESTYLE MODIFICATION TO OVERCOME THE METABOLIC SYNDROME, CONTRIBUTING TO THE URGENT NEED OF AN EFFECTIVE WEIGHT-REDUCTION STRATEGY. GLP1R AGONIST IS ONE OF EFFECTIVE BODY WEIGHT-LOWERING MEDICATIONS, WHICH MAY BE A BETTER CHOICE FOR DM COMPLICATED WITH MAFLD OR ITS-ASSOCIATED SEVERE FORM AS METABOLIC ASSOCIATED STEATOHEPATITIS (MASH), ALTHOUGH THE ROLE OF SGLT-2 INHIBITORS IS ALSO IMPRESSIVE. THE PRESCRIPTION OF THESE TWO CLASSES OF ADA MAY SATISFY THE CONCEPT "TO DO ONE AND TO GET MORE", BASED ON SUCCESSFUL SUGAR-LOWERING EFFECT FOR CONTROLLING DM AND EXTRAGLYCEMIA BENEFITS OF HEPATOPROTECTIVE ACTIVITY IN DM PATIENTS. 2022 7 5865 22 SUPPRESSION OF HDAC2 IN SPINAL CORD ALLEVIATES MECHANICAL HYPERALGESIA AND RESTORES KCC2 EXPRESSION IN A RAT MODEL OF BONE CANCER PAIN. EPIGENETIC MODULATION PARTICIPATES IN THE MECHANISM OF MULTIPLE TYPES OF PATHOLOGICAL PAIN, SO TARGETING THE INVOLVED REGULATORS MAY BE A PROMISING STRATEGY FOR PAIN TREATMENT. OUR PREVIOUS RESEARCH IDENTIFIED THE ANALGESIC EFFECT OF THE HISTONE DEACETYLASE (HDAC) INHIBITOR TRICHOSTATIN A (TSA) ON MECHANICAL HYPERALGESIA IN A RAT MODEL OF BONE CANCER PAIN (BCP) VIA RESTORATION OF MU-OPIOID RECEPTOR (MOR) EXPRESSION. HOWEVER, THE SPECIFIC TYPES OF HDACS CONTRIBUTING TO BCP HAVE NOT BEEN EXPLORED. THE PRESENT STUDY INVESTIGATED THE EXPRESSION PATTERN OF SOME COMMON HDACS AND FOUND THAT HDAC2 WAS UP-REGULATED IN A TIME-DEPENDENT MANNER IN THE LUMBAR SPINAL CORD OF BCP RATS. TSA APPLICATION SUPPRESSED HDAC2 EXPRESSION IN CULTURED PC12 CELLS AND REVERSED THE AUGMENTED HDAC2 IN BCP RATS. AN RNA-INTERFERING STRATEGY CONFIRMED THE ESSENTIAL ROLE OF HDAC2 IN THE MODULATION OF MECHANICAL HYPERALGESIA FOLLOWING TUMOR CELL INOCULATION, AND WE FURTHER EXAMINED ITS POSSIBLE DOWNSTREAM TARGETS. NOTABLY, HDAC2 KNOCK-DOWN DID NOT RESTORE MOR EXPRESSION, BUT IT ROBUSTLY REVERSED THE DOWN-REGULATION OF POTASSIUM-CHLORIDE COTRANSPORTER 2 (KCC2). THE IMPAIRED KCC2 EXPRESSION IS A VITAL MECHANISM OF MANY TYPES OF PATHOLOGICAL PAIN. THEREFORE, OUR RESULTS DEMONSTRATED THAT HDAC2 IN SPINAL CORD CONTRIBUTED TO THE MECHANICAL HYPERALGESIA IN BCP RATS, AND THIS EFFECT MAY BE ASSOCIATED WITH KCC2 MODULATION. 2018 8 5328 28 PULSED RADIOFREQUENCY ATTENUATES COMPLETE FREUND'S ADJUVANT-INDUCED EPIGENETIC SUPPRESSION OF POTASSIUM CHLORIDE COTRANSPORTER 2 EXPRESSION. BACKGROUND: PULSED RADIOFREQUENCY (PRF) TREATMENT OFFERS PAIN RELIEF FOR PATIENTS SUFFERING FROM CHRONIC PAIN WHO DO NOT RESPOND WELL TO CONVENTIONAL TREATMENTS. WE TESTED WHETHER PRF TREATMENT ATTENUATED COMPLETE FREUND'S ADJUVANT (CFA)-INDUCED INFLAMMATORY PAIN. EPIGENETIC MODIFICATION OF POTASSIUM-CHLORIDE COTRANSPORTER 2 (KCC2) GENE EXPRESSION WAS EXAMINED TO ELUCIDATE THE POTENTIAL CONTRIBUTING MECHANISM. METHODS: MALE SPRAGUE-DAWLEY RATS WERE INJECTED WITH CFA INTO THE PLANTAR SURFACE OF THE LEFT HIND PAW TO INDUCE INFLAMMATION. PRF (20 MINUTES OF 500-KHZ RF PULSES, DELIVERED AT A RATE OF 2 HZ, MAXIMUM TEMPERATURE 42 MASCULINEC) WAS DELIVERED TO THE L5 AND L6 ANTERIOR PRIMARY RAMUS JUST DISTAL TO THE INTERVERTEBRAL FORAMEN OF ADULT CFA OR SALINE RATS. THE HIND PAW WITHDRAWAL THRESHOLD TO VON FREY FILAMENT STIMULI AND WITHDRAWAL LATENCY TO RADIANT HEAT WERE DETERMINED BEFORE AND AFTER CFA. ACETYL-HISTONE H3 AND H4 WAS DETERMINED BY CHROMATIN IMMUNOPRECIPITATION IN SPINAL DORSAL HORN. KCC2 EXPRESSION WAS DETERMINED BY WESTERN BLOT. INHIBITORY SYNAPTIC FUNCTION WAS EVALUATED BY PATCH CLAMP IN LAMINA II NEURONS. RESULTS: KCC2 GENE EXPRESSION WAS SUPPRESSED THROUGH HISTONE HYPOACETYLATION, RESULTING IN DECREASED EFFICACY OF GABAERGIC SIGNALING IN CFA RATS. PRF INCREASED HISTONE ACETYLATION AND KCC2 EXPRESSION, PARTIALLY RESTORED THE GABA SYNAPTIC FUNCTION, AND RELIEVED SENSITIZED PAIN BEHAVIOR. CONCLUSION: THESE FINDINGS SUGGEST THAT PRF MIGHT BE AN ALTERNATIVE THERAPY FOR INFLAMMATORY PAIN. ONE OF THE UNDERLYING MECHANISMS IS THROUGH MODIFICATION OF KCC2, WHICH IS AN IMPORTANT DETERMINANT FOR THE EFFICACY OF INHIBITORY NEUROTRANSMISSION IN THE SPINAL CORD, AND ITS EXPRESSION LEVELS ARE REGULATED BY HISTONE ACETYLATION EPIGENETICALLY FOLLOWING INFLAMMATION. 2017 9 5715 28 SIRT3 RESTRICTS HEPATITIS B VIRUS TRANSCRIPTION AND REPLICATION THROUGH EPIGENETIC REGULATION OF COVALENTLY CLOSED CIRCULAR DNA INVOLVING SUPPRESSOR OF VARIEGATION 3-9 HOMOLOG 1 AND SET DOMAIN CONTAINING 1A HISTONE METHYLTRANSFERASES. HEPATITIS B VIRUS (HBV) INFECTION REMAINS A MAJOR HEALTH PROBLEM WORLDWIDE. MAINTENANCE OF THE COVALENTLY CLOSED CIRCULAR DNA (CCCDNA), WHICH SERVES AS A TEMPLATE FOR HBV RNA TRANSCRIPTION, IS RESPONSIBLE FOR THE FAILURE OF ERADICATING CHRONIC HBV DURING CURRENT ANTIVIRAL THERAPY. CCCDNA IS ASSEMBLED WITH CELLULAR HISTONE PROTEINS INTO CHROMATIN, BUT LITTLE IS KNOWN ABOUT THE REGULATION OF HBV CHROMATIN BY HISTONE POSTTRANSLATIONAL MODIFICATIONS. IN THIS STUDY, WE IDENTIFIED SILENT MATING TYPE INFORMATION REGULATION 2 HOMOLOG 3 (SIRT3) AS A HOST FACTOR RESTRICTING HBV TRANSCRIPTION AND REPLICATION BY SCREENING SEVEN MEMBERS OF THE SIRTUIN FAMILY, WHICH IS THE CLASS III HISTONE DEACETYLASE. ECTOPIC SIRT3 EXPRESSION SIGNIFICANTLY REDUCED TOTAL HBV RNAS, 3.5-KB RNA, AS WELL AS REPLICATIVE INTERMEDIATE DNA IN HBV-INFECTED HEPG2-NA(+) /TAUROCHOLATE COTRANSPORTING POLYPEPTIDE CELLS AND PRIMARY HUMAN HEPATOCYTES. IN CONTRAST, GENE SILENCING OF SIRT3 PROMOTED HBV TRANSCRIPTION AND REPLICATION. A MECHANISTIC STUDY FOUND THAT NUCLEAR SIRT3 WAS RECRUITED TO THE HBV CCCDNA, WHERE IT DEACETYLATED HISTONE 3 LYSINE 9. IMPORTANTLY, OCCUPANCY OF SIRT3 ON CCCDNA COULD INCREASE THE RECRUITMENT OF HISTONE METHYLTRANSFERASE SUPPRESSOR OF VARIEGATION 3-9 HOMOLOG 1 TO CCCDNA AND DECREASE RECRUITMENT OF SET DOMAIN CONTAINING 1A, LEADING TO A MARKED INCREASE OF TRIMETHYL-HISTONE H3 (LYS9) AND A DECREASE OF TRIMETHYL-HISTONE H3 (LYS4) ON CCCDNA. MOREOVER, SIRT3-MEDIATED HBV CCCDNA TRANSCRIPTIONAL REPRESSION INVOLVED DECREASED BINDING OF HOST RNA POLYMERASE II AND TRANSCRIPTION FACTOR YIN YANG 1 TO CCCDNA. FINALLY, HEPATITIS B VIRAL X PROTEIN COULD RELIEVE SIRT3-MEDIATED CCCDNA TRANSCRIPTIONAL REPRESSION BY INHIBITING BOTH SIRT3 EXPRESSION AND ITS RECRUITMENT TO CCCDNA. CONCLUSION: SIRT3 IS A HOST FACTOR EPIGENETICALLY RESTRICTING HBV CCCDNA TRANSCRIPTION BY ACTING COOPERATIVELY WITH HISTONE METHYLTRANSFERASE; THESE DATA PROVIDE A RATIONALE FOR THE USE OF SIRT3 ACTIVATORS IN THE PREVENTION OR TREATMENT OF HBV INFECTION. (HEPATOLOGY 2018). 2018 10 2795 41 FATTY LIVER AND CHRONIC KIDNEY DISEASE: NOVEL MECHANISTIC INSIGHTS AND THERAPEUTIC OPPORTUNITIES. CHRONIC KIDNEY DISEASE (CKD) IS A RISK FACTOR FOR END-STAGE RENAL DISEASE (ESRD) AND CARDIOVASCULAR DISEASE (CVD). ESRD OR CVD DEVELOP IN A SUBSTANTIAL PROPORTION OF PATIENTS WITH CKD RECEIVING STANDARD-OF-CARE THERAPY, AND MORTALITY IN CKD REMAINS UNCHANGED. THESE DATA SUGGEST THAT KEY PATHOGENETIC MECHANISMS UNDERLYING CKD PROGRESSION GO UNAFFECTED BY CURRENT TREATMENTS. GROWING EVIDENCE SUGGESTS THAT NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND CKD SHARE COMMON PATHOGENETIC MECHANISMS AND POTENTIAL THERAPEUTIC TARGETS. COMMON NUTRITIONAL CONDITIONS PREDISPOSING TO BOTH NAFLD AND CKD INCLUDE EXCESSIVE FRUCTOSE INTAKE AND VITAMIN D DEFICIENCY. MODULATION OF NUCLEAR TRANSCRIPTION FACTORS REGULATING KEY PATHWAYS OF LIPID METABOLISM, INFLAMMATION, AND FIBROSIS, INCLUDING PEROXISOME PROLIFERATOR-ACTIVATED RECEPTORS AND FARNESOID X RECEPTOR, IS ADVANCING TO STAGE III CLINICAL DEVELOPMENT. THE RELEVANCE OF EPIGENETIC REGULATION IN THE PATHOGENESIS OF NAFLD AND CKD IS ALSO EMERGING, AND MODULATION OF MICRORNA21 IS A PROMISING THERAPEUTIC TARGET. ALTHOUGH SINGLE ANTIOXIDANT SUPPLEMENTATION HAS YIELDED VARIABLE RESULTS, MODULATION OF KEY EFFECTORS OF REDOX REGULATION AND MOLECULAR SENSORS OF INTRACELLULAR ENERGY, NUTRIENT, OR OXYGEN STATUS SHOW PROMISING PRECLINICAL RESULTS. OTHER EMERGING THERAPEUTIC APPROACHES TARGET KEY MEDIATORS OF INFLAMMATION, SUCH AS CHEMOKINES; FIBROGENESIS, SUCH AS GALECTIN-3; OR GUT DYSFUNCTION THROUGH GUT MICROBIOTA MANIPULATION AND INCRETIN-BASED THERAPIES. FURTHERMORE, NAFLD PER SE AFFECTS CKD THROUGH LIPOPROTEIN METABOLISM AND HEPATOKINE SECRETION, AND CONVERSELY, TARGETING THE RENAL TUBULE BY SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS CAN IMPROVE BOTH CKD AND NAFLD. IMPLICATIONS FOR THE TREATMENT OF NAFLD AND CKD ARE DISCUSSED IN LIGHT OF THIS NEW THERAPEUTIC ARMAMENTARIUM. 2016 11 84 34 A NOVEL EPIGENETIC MECHANISM OF FXR INHIBITING GLP-1 SECRETION VIA MIR-33 AND ITS DOWNSTREAM TARGETS. TYPE II DIABETES IS A COMPLEX, CHRONIC, AND PROGRESSIVE DISEASE. PREVIOUSLY, WE DEMONSTRATE THAT FXR INHIBITS GLP-1 SECRETION VIA INTERACTING WITH CREB TO INHIBIT THE TRANSCRIPTIONAL ACTIVITY OF CREB, THUS PROMOTING THE DEVELOPMENT OF TYPE II DIABETES. EPIGENETIC MODIFICATIONS, SUCH AS DNA METHYLATION, HISTONE ACETYLATION, AND POST-TRANSCRIPTIONAL RNA REGULATION, ARE ESSENTIAL MEDIATORS CONTRIBUTING TO DIABETES-ASSOCIATED MORBIDITY AND MORTALITY. THUS, WE ATTEMPTED TO INVESTIGATE THE EPIGENETIC MECHANISMS OF FXR MODULATING GLP-1 SECRETION. FIRSTLY, THE INVOLVEMENT OF HISTONE ACETYLATION, DNA METHYLATION, AND POST-TRANSCRIPTIONAL REGULATION IN FXR INHIBITING GLP-1 SECRETION WAS VERIFIED. AS FXR OVEREXPRESSION SIGNIFICANTLY INHIBITED THE ACTIVITY OF GCG 3'-UTR, WE HYPOTHESIZE THAT MIRNA MIGHT PARTICIPATE IN THE MECHANISM. TWO ONLINE TOOLS AND REAL-TIME PCR REVEALED THAT FXR PROMOTED MIR-33 EXPRESSION. MOREOVER, MIR-33 INHIBITED THE EXPRESSION OF GCG AND CREB1 THROUGH DIRECT TARGETING IN STC-1 CELLS. FXR OVEREXPRESSION IN STC-1 CELLS SIGNIFICANTLY REDUCED THE MRNA EXPRESSION AND PROTEIN LEVELS OF BOTH GCG AND CREB1, AS WELL AS THE SECRETION OF GLP-1; MIR-33 INHIBITION EXERTED OPPOSING EFFECTS. MORE IMPORTANTLY, THE EFFECTS OF FXR OVEREXPRESSION WERE SIGNIFICANTLY REVERSED BY MIR-33 INHIBITION, INDICATING THAT FXR INHIBITED GLP-1 SECRETION THROUGH PROMOTING MIR-33 EXPRESSION, THEREFORE INHIBITING THE EXPRESSION OF MIR-33 TARGETS, GCG AND CREB1. IN CONCLUSION, WE PROVIDE A NOVEL EPIGENETIC MECHANISM BY WHICH FXR INHIBITS THE SECRETION OF GLP-1 THROUGH MIR-33 AND ITS TWO DOWNSTREAM TARGETS, GCG AND CREB1. THESE FINDINGS MIGHT PROVIDE INNOVATIVE STRATEGIES FOR IMPROVING TYPE II DIABETES, WHICH NEEDS FURTHER IN VIVO AND CLINICAL INVESTIGATION. 2019 12 5448 35 REPRESSION OF HDAC5 BY ACETATE RESTORES HYPOTHALAMIC-PITUITARY-OVARIAN FUNCTION IN TYPE 2 DIABETES MELLITUS. TYPE 2 DIABETES MELLITUS (T2DM) ACCOUNTS FOR 90-95 % OF WORLDWIDE DIABETES CASES AND IS PRIMARILY CHARACTERIZED BY INSULIN RESISTANCE. ITS PROGRESSION AS A CHRONIC METABOLIC DISEASE HAS BEEN LARGELY ASSOCIATED WITH FEMALE REPRODUCTIVE ABNORMALITIES, INCLUDING OVARIAN DYSFUNCTION WITH CONSEQUENT INFERTILITY. EPIGENETIC MODIFICATIONS HAVE BEEN SUGGESTED AS A POSSIBLE LINK TO METABOLIC COMORBIDITIES. WE THEREFORE HYPOTHESIZED THAT SHORT CHAIN FATTY ACIDS, ACETATE (ACA), A POTENTIAL HISTONE DEACETYLASE INHIBITOR (HDAC) AMELIORATES HYPOTHALAMIC-PITUITARY-OVARIAN (HPO) DYSFUNCTION IN T2DM. FEMALE WISTAR RATS WEIGHING 160-190 G WERE ALLOTTED INTO THREE GROUPS (N = 6/GROUP): CONTROL (VEHICLE; PO), T2D AND T2D + ACA (200 MG/KG; PO). T2DM WAS INDUCED BY FRUCTOSE ADMINISTRATION (10 %; W/V) FOR 6 WEEKS AND SINGLE DOSE OF STREPTOZOTOCIN (35 MG/KG; IP). THE PRESENT DATA SHOWED THAT IN ADDITION TO INSULIN RESISTANCE, INCREASED FASTING BLOOD GLUCOSE AND INSULIN, T2DM INDUCED ELEVATED PLASMA, HYPOTHALAMIC AND OVARIAN TRIGLYCERIDE, LIPID PEROXIDATION, TNF-ALPHA AND GLUTATHIONE DEPLETION. ASIDE, T2DM ALSO LED TO INCREASED PLASMA LACTATE PRODUCTION AND GAMMA-GLUTAMYL TRANSFERASE AS WELL AS DECREASED GONADOTROPINS/17BETA-ESTRADIOL. HISTOLOGICALLY, HYPOTHALAMUS, PITUITARY AND OVARIES REVEALED DISRUPTED NEURONAL CELLS/MODERATE HEMORRHAGE, ALTERED MORPHOLOGY/VASCULAR CONGESTIONS, AND DEGENERATED ANTRAL FOLLICLE/GRAAFIAN FOLLICLE WITH MILD FIBROSIS AND INFILTRATED INFLAMMATORY CELLS RESPECTIVELY IN T2D ANIMALS. INTERESTINGLY, THESE ALTERATIONS WERE ACCOMPANIED BY ELEVATED PLASMA/HYPOTHALAMIC HDAC5 AND ATTENUATED WHEN TREATED WITH ACETATE. THE PRESENT RESULTS DEMONSTRATE THAT T2DM INDUCES HPO DYSFUNCTION, WHICH IS ACCOMPANIED BY ELEVATED CIRCULATING/HYPOTHALAMIC HDAC5. THE RESULTS IN ADDITION SUGGEST THAT ACETATE RESTORES HPO FUNCTION IN T2DM BY SUPPRESSION OF HDAC5 AND ENHANCEMENT OF INSULIN SENSITIVITY. 2021 13 1384 50 DIABETES AND KIDNEY DISEASE: EMPHASIS ON TREATMENT WITH SGLT-2 INHIBITORS AND GLP-1 RECEPTOR AGONISTS. KIDNEY DISEASE IS A FREQUENT MICROVASCULAR COMPLICATION OF BOTH TYPE 1 AND TYPE 2 DIABETES. HISTORIC TRIALS HAVE DEMONSTRATED THAT A TIGHT GLYCAEMIC CONTROL IS THE MOST POWERFUL APPROACH TO DECREASE THE CHANCES OF DEVELOPING DIABETIC NEPHROPATHY. HOWEVER, HAVING AN HBA1C < 7% DOES NOT COMPLETELY SUPPRESS THE RISK OF KIDNEY DISEASE. THE OBSERVED RESIDUAL RISK IS LIKELY ASCRIBABLE TO TWO PHENOMENA: 1- THE PRESENCE OF RISK FACTORS AND ALTERATIONS ADDITIVE TO AND INDEPENDENT OF GLYCAEMIA, AND 2- THE ACTIVATION OF LONG-LASTING IMBALANCES BY PERIODS OF EXPOSURE TO UNCONTROLLED GLYCEMIA, A PHENOMENON REFERRED TO AS METABOLIC MEMORY OR LEGACY EFFECT. LONG-LASTING OXIDATIVE STRESS, EPIGENETIC ALTERATIONS, CELLULAR SENESCENCE, AND THE RESULTING CHRONIC LOW-GRADE INFLAMMATION ARE ALL CANDIDATE MECHANISMS EXPLAINING THE DEVELOPMENT OF NEPHROPATHY DESPITE PROPER CONTROL OF RISK FACTORS. RECENTLY, TWO CLASSES OF DRUGS, I.E. GLUCAGON-LIKE PEPTIDE (GLP) 1 RECEPTOR AGONISTS (RA) AND SODIUM-GLUCOSE TRANSPORTER 2 INHIBITORS (SGLT-I) HAVE CHANGED THIS SCENARIO. INDEED, CARDIOVASCULAR OUTCOME AND OTHER TRIALS HAVE CLEARLY SHOWN A RENOPROTECTIVE EFFECT FOR THESE DRUGS, WELL-BEYOND THEIR GLUCOSE-LOWERING PROPERTIES. IN THIS REVIEW, WE SUMMARIZE: 1- SELECTED KEY TRIALS AND MECHANISMS UNDERLYING THE DEVELOPMENT OF DIABETIC KIDNEY DISEASE AND 2- THE RESULTS RELATIVE TO RENAL ENDPOINTS IN CLINICAL TRIALS OF GLP-1 RA AND SGLT-2I. THEN, WE BRIEFLY DISCUSS SOME OF THE HYPOTHESES POSITED TO EXPLAIN THE MARKED RENOPROTECTIVE PROPERTIES OF THESE TWO CLASSES, EVIDENCING THE STILL EXISTING GAPS IN KNOWLEDGE AND PROPOSING FUTURE DIRECTIONS TO FURTHER IMPLEMENT THE USE OF THESE POWERFUL, DISEASE-MODIFYING DRUGS. 2021 14 4137 37 MECHANISMS OF METABOLIC MEMORY AND RENAL HYPOXIA AS A THERAPEUTIC TARGET IN DIABETIC KIDNEY DISEASE. DIABETIC KIDNEY DISEASE (DKD) IS A WORLDWIDE PUBLIC HEALTH PROBLEM. THE DEFINITION OF DKD IS UNDER DISCUSSION. ALTHOUGH THE TERM DKD WAS ORIGINALLY DEFINED AS 'KIDNEY DISEASE SPECIFIC TO DIABETES,' DKD FREQUENTLY MEANS CHRONIC KIDNEY DISEASE WITH DIABETES MELLITUS AND INCLUDES NOT ONLY CLASSICAL DIABETIC NEPHROPATHY, BUT ALSO KIDNEY DYSFUNCTION AS A RESULT OF NEPHROSCLEROSIS AND OTHER CAUSES. METABOLIC MEMORY PLAYS A CRUCIAL ROLE IN THE PROGRESSION OF VARIOUS COMPLICATIONS OF DIABETES, INCLUDING DKD. THE MECHANISMS OF METABOLIC MEMORY IN DKD ARE SUPPOSED TO INCLUDE ADVANCED GLYCATION END-PRODUCTS, DEOXYRIBONUCLEIC ACID METHYLATION, HISTONE MODIFICATIONS AND NON-CODING RIBONUCLEIC ACID INCLUDING MICRO RIBONUCLEIC ACID. REGARDLESS OF THE PRESENCE OF DIABETES MELLITUS, THE FINAL COMMON PATHWAY IN CHRONIC KIDNEY DISEASE IS CHRONIC KIDNEY HYPOXIA, WHICH INFLUENCES EPIGENETIC PROCESSES, INCLUDING DEOXYRIBONUCLEIC ACID METHYLATION, HISTONE MODIFICATION, AND CONFORMATIONAL CHANGES IN MICRO RIBONUCLEIC ACID AND CHROMATIN. THEREFORE, HYPOXIA AND OXIDATIVE STRESS ARE APPROPRIATE TARGETS OF THERAPIES AGAINST DKD. PROLYL HYDROXYLASE DOMAIN INHIBITOR ENHANCES THE DEFENSIVE MECHANISMS AGAINST HYPOXIA. BARDOXOLONE METHYL PROTECTS AGAINST OXIDATIVE STRESS, AND CAN EVEN REVERSE IMPAIRED RENAL FUNCTION; A PHASE 2 TRIAL WITH CONSIDERABLE ATTENTION TO HEART COMPLICATIONS IS CURRENTLY ONGOING IN JAPAN. 2017 15 6456 27 THYMOSIN BETA4 PREVENTS OXIDATIVE STRESS, INFLAMMATION, AND FIBROSIS IN ETHANOL- AND LPS-INDUCED LIVER INJURY IN MICE. THYMOSIN BETA 4 (TBETA4), AN ACTIN-SEQUESTERING PROTEIN, IS INVOLVED IN TISSUE DEVELOPMENT AND REGENERATION. IT PREVENTS INFLAMMATION AND FIBROSIS IN SEVERAL TISSUES. WE INVESTIGATED THE ROLE OF TBETA4 IN CHRONIC ETHANOL- AND ACUTE LIPOPOLYSACCHARIDE- (LPS-) INDUCED MOUSE LIVER INJURY. C57BL/6 MICE WERE FED 5% ETHANOL IN LIQUID DIET FOR 4 WEEKS PLUS BINGE ETHANOL (5 G/KG, GAVAGE) WITH OR WITHOUT LPS (2 MG/KG, INTRAPERITONEAL) FOR 6 HOURS. TBETA4 (1 MG/KG, INTRAPERITONEAL) WAS ADMINISTERED FOR 1 WEEK. WE DEMONSTRATED THAT TBETA4 PREVENTED ETHANOL- AND LPS-MEDIATED INCREASE IN LIVER INJURY MARKERS AS WELL AS CHANGES IN LIVER PATHOLOGY. IT ALSO PREVENTED ETHANOL- AND LPS-MEDIATED INCREASE IN OXIDATIVE STRESS BY DECREASING ROS AND LIPID PEROXIDATION AND INCREASING THE ANTIOXIDANTS, REDUCED GLUTATHIONE AND MANGANESE-DEPENDENT SUPEROXIDE DISMUTASE. IT ALSO PREVENTED THE ACTIVATION OF NUCLEAR FACTOR KAPPA B BY BLOCKING THE PHOSPHORYLATION OF THE INHIBITORY PROTEIN, IKAPPAB, THEREBY PREVENTED PROINFLAMMATORY CYTOKINE PRODUCTION. MOREOVER, TBETA4 PREVENTED FIBROGENESIS BY SUPPRESSING THE EPIGENETIC REPRESSOR, METHYL-CPG-BINDING PROTEIN 2, THAT COORDINATELY REVERSED THE EXPRESSION OF PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR-GAMMA AND DOWNREGULATED FIBROGENIC GENES, PLATELET-DERIVED GROWTH FACTOR-BETA RECEPTOR, ALPHA-SMOOTH MUSCLE ACTIN, COLLAGEN 1, AND FIBRONECTIN, RESULTING IN REDUCED FIBROSIS. OUR DATA SUGGEST THAT TBETA4 HAS ANTIOXIDANT, ANTI-INFLAMMATORY, AND ANTIFIBROTIC POTENTIAL DURING ALCOHOLIC LIVER INJURY. 2018 16 2745 23 EXPRESS: HISTONE HYPERACETYLATION MODULATES SPINAL TYPE II METABOTROPIC GLUTAMATE RECEPTOR ALLEVIATING STRESS-INDUCED VISCERAL HYPERSENSITIVITY IN FEMALE RATS. STRESS IS OFTEN A TRIGGER TO EXACERBATE CHRONIC PAIN INCLUDING VISCERAL HYPERSENSITIVITY ASSOCIATED WITH IRRITABLE BOWEL SYNDROME, A FEMALE PREDOMINANT FUNCTIONAL BOWEL DISORDER. EPIGENETIC MECHANISMS THAT MEDIATE STRESS RESPONSES ARE A POTENTIAL TARGET TO INTERFERE WITH VISCERAL PAIN. THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE EFFECT OF A HISTONE DEACETYLASE INHIBITOR, SUBEROYLANILIDE HYDROXAMIC ACID, ON VISCERAL HYPERSENSITIVITY INDUCED BY A SUBCHRONIC STRESSOR IN FEMALE RATS AND TO INVESTIGATE THE INVOLVEMENT OF SPINAL GLUTAMATE RECEPTORS. THREE DAILY SESSIONS OF FORCED SWIM INDUCED VISCERAL HYPERSENSITIVITY. INTRATHECAL SUBEROYLANILIDE HYDROXAMIC ACID PREVENTED OR REVERSED THE STRESS-INDUCED VISCERAL HYPERSENSITIVITY, INCREASED SPINAL HISTONE 3 ACETYLATION AND INCREASED MGLUR2 AND MGLUR3 EXPRESSION. CHROMATIN IMMUNOPRECIPITATION (CHIP) ANALYSIS REVEALED ENRICHMENT OF H3K9AC AND H3K18AC AT SEVERAL PROMOTER GRM2 AND GRM3 REGIONS. THE MGLUR2/3 ANTAGONIST LY341495 REVERSED THE INHIBITORY EFFECT OF SUBEROYLANILIDE HYDROXAMIC ACID ON THE STRESS-INDUCED VISCERAL HYPERSENSITIVITY. IN SURPRISING CONTRAST, STRESS AND/OR SUBEROYLANILIDE HYDROXAMIC ACID HAD NO EFFECT ON SPINAL NMDA RECEPTOR EXPRESSION OR FUNCTION. THESE DATA REVEAL HISTONE MODIFICATION MODULATES MGLUR2/3 EXPRESSION IN THE SPINAL CORD TO ATTENUATE STRESSINDUCED VISCERAL HYPERSENSITIVITY. HDAC INHIBITORS MAY PROVIDE A POTENTIAL APPROACH TO RELIEVE VISCERAL HYPERSENSITIVITY ASSOCIATED WITH IRRITABLE BOWEL SYNDROME. 2016 17 743 25 CANNABINOID TYPE 2 RECEPTOR SYSTEM MODULATES PACLITAXEL-INDUCED MICROGLIAL DYSREGULATION AND CENTRAL SENSITIZATION IN RATS. PACLITAXEL INDUCES MICROGLIAL ACTIVATION AND PRODUCTION OF PROINFLAMMATORY MEDIATORS IN THE DORSAL HORN, WHICH CONTRIBUTE TO THE DEVELOPMENT AND MAINTENANCE OF CENTRAL SENSITIZATION AND PAIN BEHAVIOR. MDA7, 1-([3-BENZYL-3-METHYL-2,3-DIHYDRO-1-BENZOFURAN-6-YL]CARBONYL) PIPERIDINE, IS A NOVEL HIGHLY SELECTIVE CANNABINOID TYPE 2 (CB2) AGONIST. WE TESTED THE HYPOTHESIS THAT ACTIVATION OF CB2 RECEPTOR BY MDA7 MODULATES MICROGLIAL DYSREGULATION, SUPPRESSES THE OVEREXPRESSION OF BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) IN MICROGLIA IN THE DORSAL HORN, AND ATTENUATES THE CENTRAL SENSITIZATION AND PAIN BEHAVIOR INDUCED BY PACLITAXEL. FOR 4 CONSECUTICE DAYS, GROUPS OF RATS RANDOMLY RECEIVED SALINE OR 1.0 MG/KG OF PACLITAXEL DAILY INTRAPERITONEALLY FOR A TOTAL CUMULATIVE DOSE OF 4 MG/KG. MDA7 15 MG/KG INTRAPERITONEALLY OR VEHICLE WERE ADMINISTERED 15 MIN BEFORE ADMINISTERING PACLITAXEL FOR 4 DAYS AND THEN CONTINUED FOR ANOTHER 10 DAYS. BEHAVIORAL AND MOLECULAR STUDIES WERE PERFORMED. PACLITAXEL INDUCED THE EXPRESSION OF CB2 RECEPTORS AND PRODUCTION OF INTERLEUKIN (IL)-6 IN MICROGLIA IN THE DORSAL HORN. MDA7 ATTENUATED THE EXPRESSION OF IL-6 AND PROMOTED THE EXPRESSION OF IL-10. PACLITAXEL INDUCED EPIGENETIC UPREGULATION OF IRF8 AND P2X PURINOCEPTOR 4 (P2X4) IN MICROGLIA AND SUBSEQUENTLY INCREASED THE EXPRESSION OF ALPHA ISOFORM OF CALCIUM/CALMODULIN-DEPENDENT PROTEIN KINASE II (CAMKIIALPHA), TRANSCRIPTIONAL FACTORS P-CREB AND DELTAFOSB, LEADING TO THE OVERPRODUCTION OF BDNF IN MICROGLIA. PACLITAXEL ALSO UPREGULATED THE EXPRESSION OF GLUTAMATE RECEPTOR SUBUNITS GLUR1 AND NR2B, DECREASED THE EXPRESSION OF K(+)-CL(-) COTRANSPORTER, AND INDUCED MECHANICAL ALLODYNIA IN RATS. ALL OF THE AFOREMENTIONED MOLECULAR CHANGES WERE ATTENUATED BY MDA7. OUR DATA SHOW THAT MDA7 ATTENUATED PACLITAXEL-INDUCED MOLECULAR AND BEHAVIORAL CHANGES IN RATS. PERSPECTIVE: THIS STUDY PROVIDES EVIDENCE THAT PACLITAXEL INDUCED MICROGLIA DYSREGULATION AND EPIGENETICALLY UPREGULATED THE MICROGLIAL EXPRESSION OF BDNF, WHICH LED TO SENSITIZATION OF DORSAL HORN NEURONS AND MECHANICAL ALLODYNIA IN RATS. THE CB2 AGONIST MDA7 ALLEVIATED THESE PATHOLOGICAL PROCESSES. MDA7 REPRESENTS AN INNOVATIVE THERAPEUTIC APPROACH FOR TREATMENT OF CHEMOTHERAPY-INDUCED NEUROPATHY. 2019 18 5716 26 SIRT6 PROTECTS VASCULAR SMOOTH MUSCLE CELLS FROM OSTEOGENIC TRANSDIFFERENTIATION VIA RUNX2 IN CHRONIC KIDNEY DISEASE. VASCULAR CALCIFICATION (VC) IS REGARDED AS AN IMPORTANT PATHOLOGICAL CHANGE LACKING EFFECTIVE TREATMENT AND ASSOCIATED WITH HIGH MORTALITY. SIRTUIN 6 (SIRT6) IS A MEMBER OF THE SIRTUIN FAMILY, A CLASS III HISTONE DEACETYLASE AND A KEY EPIGENETIC REGULATOR. SIRT6 HAS A PROTECTIVE ROLE IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD). HOWEVER, THE EXACT ROLE AND MOLECULAR MECHANISM OF SIRT6 IN VC IN PATIENTS WITH CKD REMAIN UNCLEAR. HERE, WE DEMONSTRATED THAT SIRT6 WAS MARKEDLY DOWNREGULATED IN PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMCS) AND IN THE RADIAL ARTERY TISSUE OF PATIENTS WITH CKD WITH VC. SIRT6-TRANSGENIC (SIRT6-TG) MICE SHOWED ALLEVIATED VC, WHILE VASCULAR SMOOTH MUSCLE CELL-SPECIFIC (VSMC-SPECIFIC) SIRT6 KNOCKED-DOWN MICE SHOWED SEVERE VC IN CKD. SIRT6 SUPPRESSED THE OSTEOGENIC TRANSDIFFERENTIATION OF VSMCS VIA REGULATION OF RUNT-RELATED TRANSCRIPTION FACTOR 2 (RUNX2). COIMMUNOPRECIPITATION (CO-IP) AND IMMUNOPRECIPITATION (IP) ASSAYS CONFIRMED THAT SIRT6 BOUND TO RUNX2. MOREOVER, RUNX2 WAS DEACETYLATED BY SIRT6 AND FURTHER PROMOTED NUCLEAR EXPORT VIA EXPORTIN 1 (XPO1), WHICH IN TURN CAUSED DEGRADATION OF RUNX2 THROUGH THE UBIQUITIN-PROTEASOME SYSTEM. THESE RESULTS DEMONSTRATED THAT SIRT6 PREVENTED VC BY SUPPRESSING THE OSTEOGENIC TRANSDIFFERENTIATION OF VSMCS, AND AS SUCH TARGETING SIRT6 MAY BE AN APPEALING THERAPEUTIC TARGET FOR VC IN CKD. 2022 19 3955 24 LONG MARCH TOWARD SAFE AND EFFECTIVE ANALGESIA BY ENHANCING GENE EXPRESSION OF KCC2: FIRST STEPS TAKEN. LOW INTRANEURONAL CHLORIDE IN SPINAL CORD DORSAL HORN PAIN RELAY NEURONS IS CRITICAL FOR PHYSIOLOGIC TRANSMISSION OF PRIMARY PAIN AFFERENTS BECAUSE LOW INTRANEURONAL CHLORIDE DICTATES WHETHER GABA-ERGIC AND GLYCIN-ERGIC NEUROTRANSMISSION IS INHIBITORY. IF THE NEURONAL CHLORIDE ELEVATES TO PATHOLOGIC LEVELS, THEN SPINAL CORD PRIMARY PAIN RELAY BECOMES LEAKY AND EXHIBITS THE BEHAVIORAL HALLMARKS OF PATHOLOGIC PAIN, NAMELY HYPERSENSITIVITY AND ALLODYNIA. LOW CHLORIDE IN SPINAL CORD DORSAL HORN NEURONS IS MAINTAINED BY PROPER GENE EXPRESSION OF KCC2 AND SUSTAINED PHYSIOLOGIC FUNCTION OF THE KCC2 CHLORIDE EXTRUDING ELECTRONEUTRAL TRANSPORTER. PERIPHERAL NERVE INJURY AND OTHER FORMS OF NEURAL INJURY EVOKE GREATLY DIMINISHED KCC2 GENE EXPRESSION AND SUBSEQUENT CORRUPTION OF INHIBITORY NEUROTRANSMISSION IN THE SPINAL CORD DORSAL HORN, THUS CAUSING DERAILMENT OF THE GATE FUNCTION FOR PAIN. HERE I REVIEW KEY DISCOVERIES THAT HAVE HELPED US UNDERSTAND THESE FUNDAMENTALS, AND FOCUS ON RECENT INSIGHTS RELATING TO THE DISCOVERY OF KCC2 GENE EXPRESSION ENHANCING COMPOUNDS VIA COMPOUND SCREENS IN NEURONS. ONE SUCH STUDY CHARACTERIZED THE KINASE INHIBITOR, KENPAULLONE, MORE IN-DEPTH, REVEALING ITS FUNCTION AS A ROBUST AND LONG-LASTING ANALGESIC IN PRECLINICAL MODELS OF NERVE INJURY AND CANCER BONE PAIN, ALSO ELUCIDATING ITS MECHANISM OF ACTION VIA GSK3BETA INHIBITION, DIMINISHING DELTA-CATENIN PHOSPHORYLATION, AND FACILITATING ITS NUCLEAR TRANSFER AND SUBSEQUENT ENHANCEMENT OF KCC2 GENE EXPRESSION BY DE-REPRESSING KAISO EPIGENETIC TRANSCRIPTIONAL REGULATOR. FUTURE DIRECTIONS RE KCC2 GENE EXPRESSION ENHANCEMENT ARE DISCUSSED, NAMELY COMBINATION WITH OTHER ANALGESICS AND ANALGESIC METHODS, SUCH AS SPINAL CORD STIMULATION AND ELECTROACUPUNCTURE, GENE THERAPY, AND LEVERAGING KCC2 GENE EXPRESSION-ENHANCING NANOMATERIALS. 2022 20 742 20 CANNABINOID CB2 RECEPTORS ARE UPREGULATED VIA BIVALENT HISTONE MODIFICATIONS AND CONTROL PRIMARY AFFERENT INPUT TO THE SPINAL CORD IN NEUROPATHIC PAIN. TYPE-2 CANNABINOID RECEPTORS (CB2, ENCODED BY THE CNR2 GENE) ARE MAINLY EXPRESSED IN IMMUNE CELLS, AND CB2 AGONISTS NORMALLY HAVE NO ANALGESIC EFFECT. HOWEVER, NERVE INJURY UPREGULATES CB2 IN THE DORSAL ROOT GANGLION (DRG), FOLLOWING WHICH CB2 STIMULATION REDUCES NEUROPATHIC PAIN. IT IS UNCLEAR HOW NERVE INJURY INCREASES CB2 EXPRESSION OR HOW CB2 ACTIVITY IS TRANSFORMED IN NEUROPATHIC PAIN. IN THIS STUDY, IMMUNOBLOTTING SHOWED THAT SPINAL NERVE LIGATION (SNL) INDUCED A DELAYED AND SUSTAINED INCREASE IN CB2 EXPRESSION IN THE DRG AND DORSAL SPINAL CORD SYNAPTOSOMES. RNASCOPE IN SITU HYBRIDIZATION ALSO SHOWED THAT SNL SUBSTANTIALLY INCREASED CB2 MRNA LEVELS, MOSTLY IN MEDIUM AND LARGE DRG NEURONS. FURTHERMORE, WE FOUND THAT THE SPECIFIC CB2 AGONIST JWH-133 SIGNIFICANTLY INHIBITS THE AMPLITUDE OF DORSAL ROOT-EVOKED GLUTAMATERGIC EXCITATORY POSTSYNAPTIC CURRENTS IN SPINAL DORSAL HORN NEURONS IN SNL RATS, BUT NOT IN SHAM CONTROL RATS; INTRATHECAL INJECTION OF JWH-133 REVERSED PAIN HYPERSENSITIVITY IN SNL RATS, BUT HAD NO EFFECT IN SHAM CONTROL RATS. IN ADDITION, CHROMATIN IMMUNOPRECIPITATION-QPCR ANALYSIS SHOWED THAT SNL INCREASED ENRICHMENT OF TWO ACTIVATING HISTONE MARKS (H3K4ME3 AND H3K9AC) AND DIMINISHED OCCUPANCY OF TWO REPRESSIVE HISTONE MARKS (H3K9ME2 AND H3K27ME3) AT THE CNR2 PROMOTER IN THE DRG. IN CONTRAST, SNL HAD NO EFFECT ON DNA METHYLATION LEVELS AROUND THE CNR2 PROMOTER. OUR FINDINGS SUGGEST THAT PERIPHERAL NERVE INJURY PROMOTES CB2 EXPRESSION IN PRIMARY SENSORY NEURONS VIA EPIGENETIC BIVALENT HISTONE MODIFICATIONS AND THAT CB2 ACTIVATION REDUCES NEUROPATHIC PAIN BY ATTENUATING NOCICEPTIVE TRANSMISSION FROM PRIMARY AFFERENT NERVES TO THE SPINAL CORD. 2022