1  6748 145 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
2  1437  47 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
3  4820  33 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
4  4822  28 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
5  3131  52 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
6  4825  28 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
7  3006  51 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
8   932  28 CHRONIC KIDNEY DISEASE WITH UNKNOWN CAUSE ACROSS THE GLOBAL SPECTRUM. PURPOSE OF REVIEW: IN THE 1990S, A TYPE OF CHRONIC KIDNEY DISEASE WITH UNKNOWN CAUSE (CKDU) WAS IDENTIFIED IN CENTRAL AMERICA AND SRI LANKA. PATIENTS LACKED HYPERTENSION, DIABETES, GLOMERULONEPHRITIS, OR OTHER USUAL CAUSES OF KIDNEY FAILURE. AFFECTED PATIENTS ARE PREDOMINANTLY MALE AGRICULTURAL WORKERS AGED 20-60 YEARS, LIVING IN ECONOMICALLY DISADVANTAGED AREAS WITH POOR ACCESS TO MEDICAL CARE. PATIENTS TYPICALLY PRESENT LATE AND PROGRESS TO END-STAGE KIDNEY DISEASE WITHIN 5 YEARS, RESULTING IN SOCIAL AND ECONOMIC HARDSHIP FOR FAMILIES, REGIONS, AND COUNTRIES. THIS REVIEW COVERS THE CURRENT STATE OF KNOWLEDGE FOR THIS DISEASE. RECENT FINDINGS: THE PREVALENCE OF CKDU IS INCREASING IN KNOWN ENDEMIC REGIONS AND ACROSS THE GLOBE, REACHING EPIDEMIC PROPORTIONS. THERE IS PRIMARY TUBULOINTERSTITIAL INJURY WITH SECONDARY GLOMERULAR AND VASCULAR SCLEROSIS. NO DEFINITIVE ETIOLOGIC FACTORS HAVE BEEN IDENTIFIED, AND THESE MAY VARY OR OVERLAP IN DIFFERENT GEOGRAPHIC LOCATIONS. THE LEADING HYPOTHESES INCLUDE EXPOSURE TO AGROCHEMICALS, HEAVY METALS AND TRACE ELEMENTS, AND KIDNEY INJURY FROM DEHYDRATION/HEAT STRESS. INFECTIONS AND LIFESTYLE FACTORS MAY PLAY A ROLE, BUT ARE LIKELY NOT KEY. GENETIC AND EPIGENETIC FACTORS ARE BEGINNING TO BE EXPLORED. SUMMARY: CKDU IS A LEADING CAUSE OF PREMATURE DEATH IN YOUNG-TO-MIDDLE-AGED ADULTS IN ENDEMIC REGIONS AND HAS BECOME A PUBLIC HEALTH CRISIS. STUDIES ARE UNDERWAY TO INVESTIGATE CLINICAL, EXPOSOME, AND OMICS FACTORS, AND HOPEFULLY WILL PROVIDE INSIGHTS INTO PATHOGENETIC MECHANISMS RESULTING IN BIOMARKER DISCOVERY, PREVENTIVE MEASURES, AND THERAPEUTICS.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
9  4182  30 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
10  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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
11  1942  27 EPIDEMIOLOGY OF LIVER CANCER IN AFRICA: CURRENT AND FUTURE TRENDS. HEPATOCELLULAR CARCINOMA (HCC) IS A DISEASE OF GLOBAL PUBLIC HEALTH SIGNIFICANCE WITH MORTALITY ON THE RISE, DESPITE THE PREVENTABLE NATURE OF ITS RISK FACTORS ESPECIALLY IN AFRICA. IT IS NOW THE SIXTH MOST COMMON CANCER WORLDWIDE, FIFTH IN MALES, AND NINTH IN FEMALES. HCC INCIDENCE AND MORTALITY ARE PREDICTED TO INCREASE IN AFRICAN COUNTRIES CONSTRAINED BY LIMITED RESOURCES TO COMBAT ENDEMIC LEVELS OF VIRAL INFECTION AND SYNERGISTIC ENVIRONMENTAL RISK FACTORS. THE CHANGING NATURE OF HCC ETIOLOGY IS PARTICULARLY ILLUSTRATED HERE WITH THE TRADITIONAL RISK FACTORS LIKE VIRAL HEPATITIS COEXISTING ALONGSIDE HIGH HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVALENCE AND RAPIDLY INCREASING URBANIZATION THAT HAVE PROMOTED A SHARP INCREASE IN ADDITIONAL RISK FACTORS LIKE COINFECTION, TYPE 2 DIABETES MELLITUS, AND OBESITY. ALTHOUGH THERE ARE SOME DIFFERENCES IN ETIOLOGY BETWEEN NORTH AFRICA AND SUB-SAHARAN AFRICA, RISK FACTORS LIKE CHRONIC VIRAL HEPATITIS B AND C, AFLATOXIN EXPOSURE, AND IRON OVERLOAD PREDOMINATE. AGGRESSIVE HEPATITIS B GENOTYPES, COMBINED WITH HEPATITIS B VIRUS/HEPATITIS C VIRUS/HIV COINFECTIONS AND AFLATOXIN EXPOSURE, PROMOTE A MORE AGGRESSIVE MOLECULAR PHENOTYPE. IN PARALLEL TO A BETTER UNDERSTANDING OF THE MOLECULAR ETIOLOGY OF HCC, POLICY AND PLANNING INITIATIVES TO ADDRESS THE BURDEN OF HCC MUST BE ANCHORED WITHIN THE REALITY OF THE LIMITED RESOURCES AVAILABLE. ESTABLISHMENT AND COORDINATION OF CANCER REGISTRIES ACROSS AFRICA IS NEEDED TO IMPROVE THE QUALITY OF DATA NECESSARY TO GALVANIZE ACTION. PREVENTIVE MEASURES INCLUDING HEPATITIS B VACCINATION PROGRAMS, MEASURES TO PREVENT MATERNAL-TO-CHILD AND CHILD-TO-CHILD TRANSMISSION, DELIVERY OF UNIVERSALLY ACCESSIBLE ANTIRETROVIRAL AND ANTIVIRAL TREATMENTS, AND REDUCTION OF DIETARY AFLATOXIN EXPOSURE CAN CONTRIBUTE MARKEDLY TO REDUCE HCC INCIDENCE. FINALLY, THE DEVELOPMENT OF BIOMARKERS AND NEW THERAPEUTIC INTERVENTIONS WILL NEED A BETTER UNDERSTANDING OF THE UNIQUE GENETIC AND EPIGENETIC CHARACTERISTICS OF HCC ON THE CONTINENT. WE PRESENT A NARRATIVE REVIEW OF HCC IN AFRICA, DISCUSSING PRESENT AND FUTURE TRENDS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
12  4824  35 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
13  3936  29 LIVING IN ENDEMIC AREA FOR INFECTIOUS DISEASES ACCELERATES EPIGENETIC AGE. INFLAMMAGING IS A LOW-GRADE INFLAMMATORY STATE GENERATED BY THE AGING PROCESS THAT CAN CONTRIBUTE TO FRAILTY AND AGE-RELATED DISEASES IN THE ELDERLY. HOWEVER, IT CAN HAVE DISTINCT EFFECTS IN THE ELDERLY LIVING IN ENDEMIC AREAS FOR INFECTIOUS DISEASES. AN INCREASED INFLAMMATORY RESPONSE MAY CONFER PROTECTION AGAINST INFECTIOUS AGENTS IN THESE AREAS, ALTHOUGH THIS ADVANTAGE CAN CAUSE ACCELERATING EPIGENETIC AGING. IN THIS STUDY, WE EVALUATED THE INFLAMMATORY PROFILE AND THE EPIGENETIC AGE OF INFECTED AND NONINFECTED INDIVIDUALS FROM AN ENDEMIC AREA IN BRAZIL. THE PROFILE OF CYTOKINES, CHEMOKINES AND GROWTH FACTORS ANALYZED IN THE SERA OF THE TWO GROUPS OF INDIVIDUALS SHOWED SIMILARITIES, ALTHOUGH INFECTED INDIVIDUALS HAD A HIGHER CONCENTRATION OF THESE MEDIATORS. A SIGNIFICANT INCREASE IN IL-1RA, CXCL8, CCL2, CCL3 AND CCL4 PRODUCTION WAS ASSOCIATED WITH LEPROSY INFECTION. NOTABLY, ELDERLY INDIVIDUALS DISPLAYED DISTINCT IMMUNE RESPONSES ASSOCIATED WITH THEIR INFECTION STATUS WHEN COMPARED TO ADULTS SUGGESTING AN ADAPTIVE REMODELLING OF THEIR IMMUNE RESPONSES. EPIGENETIC ANALYSIS ALSO SHOWED THAT THERE WAS NO DIFFERENCE IN EPIGENETIC AGE BETWEEN THE TWO GROUPS OF INDIVIDUALS. HOWEVER, INDIVIDUALS FROM THE ENDEMIC AREA HAD A SIGNIFICANT ACCELERATED AGING WHEN COMPARED TO INDIVIDUALS FROM SAO PAULO, A NON-ENDEMIC AREA IN BRAZIL. MOREOVER, THE LATTER COHORT WAS ALSO EPIGENETICALLY AGED IN RELATION TO AN ITALIAN COHORT. OUR DATA SHOWS THAT LIVING IN ENDEMIC AREAS FOR CHRONIC INFECTIOUS DISEASES RESULTS IN REMODELLING OF INFLAMMAGING AND ACCELERATION OF EPIGENETIC AGING IN INDIVIDUALS REGARDLESS OF THEIR INFECTIOUS STATUS. IT ALSO HIGHLIGHTS THAT GEOGRAPHICAL, GENETIC AND ENVIRONMENTAL FACTORS INFLUENCE AGING AND IMMUNOSENESCENCE IN THEIR PACE AND PROFILE.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
14  3272  43 HEPATOCELLULAR CARCINOMA: AN UPDATE. HEPATOCELLULAR CARCINOMA (HCC) IS THE MOST COMMON MALIGNANT TUMOR OF MALES IN THE WORLD, WITH AN INCIDENCE OF 1,000,000 NEW CASES A YEAR. IT IS ENDEMIC IN SOUTHEAST ASIA AND SUB-SAHARAN AFRICA. RISK FACTORS INCLUDE CHRONIC INFECTION WITH HEPATITIS B VIRUS (HBV) AND HEPATITIS C VIRUS (HCV), AFLATOXIN B1 UPTAKE, HEMOCHROMATOSIS, AND ALPHA1 -ANTITRIPSIN DEFICIENCY. EPIDEMIOLOGICAL STUDIES PROVIDE EVIDENCE FOR THE ASSOCIATION OF HCC WITH HBV INFECTION. THE INCIDENCE OF HCC IS HIGH IN REGIONS HYPERENDEMIC FOR HBV. CHRONIC CARRIER STATE AND MATERNAL-INFANT TRANSMISSION ARE IMPORTANT FACTORS IN THE DEVELOPMENT OF HCC. EVIDENCE OF DIRECT ONCOGENIC EFFECT OF H BV IS WELL ESTABLISHED, HCCS CONTAIN VIRAL DNA SEQUENCES INTEGRATED INTO HEPATOCYTE DNA THAT ACT AS RANDOM INSERTIONAL MUTAGENS, AND THESE SITES ARE NEAR GENES INVOLVED IN THE CONTROL OF PROLIFERATION AND DIFFERENTIATION. THE MECHANISM OF HEPATITIS C VIRUS IN HEPATOCARCINOGENESIS IS STILL IMPRECISE BUT A HIGH PERCENTAGE OF CASES ARE RELATED TO THIS VIRUS. CHRONIC ALCOHOL CONSUMPTION AND CIRRHOSIS ARE COFACTORS THAT INCREASE THE DEVELOPMENT OF HCC IN PATIENTS WITH CHRONIC VIRAL INFECTION. IN EXPERIMENTAL CARCINOGENESIS A MULTIPOTENTIAL ELEMENT CALLED OVAL CELL PROLIFERATES IN THE EARLY STAGES. THE CELLULAR EVENTS ARE ACCOMPANIED BY INCREASED EXPRESSION OF SEVERAL GROWTH FACTORS THAT ENHANCE THE SURVIVAL OF CARCINOGEN-ACTIVATED CELLS BY SUPPRESSING APOPTOSIS AND INCREASING ELEMENTS ENTERING THE CELL CYCLE. HEPATIC CARCINOGENESIS IS A COMPLEX PROCESS ASSOCIATED WITH ACCUMULATION OF GENETIC AND EPIGENETIC CHANGES THAT RUN THROUGH STEPS OF INITIATION, PROMOTION AND PROGRESSION. ACTIVATION OF ONCOGENES OF THE "RAS" FAMILY AND OTHERS HAS BEEN DETECTED DURING CHEMICALLY-INDUCED HCC IN RODENTS, BUT THERE IS LITTLE EVIDENCE OF SUCH ACTIVATION IN HUMAN TUMORS. THE ROLE OF TUMOR SUPRESSOR GENES SUCH AS RETINOBLASTOMA (RB) AND P53 GENES HAS BEEN DOCUMENTED. AFLATOXIN B1 THAT CONTAMINATES FOODS IN ENDEMIC AREAS HAS A CLEAR ROLE IN HEPATOCARCINOGENESIS. METABOLITES OF THIS TOXIN PROMOTE APURINIC SITES AND G TO T MUTATIONS IN CHROMOSOMAL DNA, THE THIRD BASE OF CODON 249 OF THE P53 GENE IS PREFERENTIALLY TARGETED TO FORM ADUCTS WITH AFLATOXIN B1, AND THIS MUTATION HAS BEEN SPECIFICALLY IDENTIFIED IN HBV INFECTION. HISTOLOGICAL AND CYTOLOGICAL CRITERIA FOR THE DIAGNOSIS OF HCC ARE WELL ESTABLISHED AND ARE BASED IN ARCHITECTURAL AND CYTOLOGICAL CHANGES. AN IMPORTANT ISSUE IS THE DIAGNOSIS OF LIVER "NODULES" DETECTED BY IMAGE, FROM WHICH SMALL BIOPSIES OR ASPIRATION MATERIAL IS OBTAINED. SPECIAL STUDIES SUCH AS RETICULIN, CD34, CYTOKERATIN PROFILE, AND MOC-31 CAN BE VERY USEFUL FOR THE DIFFERENTIAL DIAGNOSIS OF PRIMARY AND METASTATIC TUMORS. TELOMERASE ACTIVITY HAS BEEN FOUND IN HCC AND NEGATIVE IN PERICANCEROUS TISSUE. IT IS MORE PRONOUNCED IN POORLY DIFFERENTIATED TUMORS AND CORRELATES WITH FACTORS OF CLINICAL IMPORTANCE, SUCH AS PROGNOSIS AND RECURRENCES. CELLS OF WELL-DIFFERENTIATED HCC HAVE AN ULTRASTRUCTURAL APPEARANCE SIMILAR TO NORMAL HEPATOCYTES. DURING THE PROCESS OF DEDIFFERENTIATION, THERE IS PROGRESSIVE LOSS OF ORGANIZATION OF INTRACELLULAR ORGANELLES. THE CELL COHESION IS LOST, INTERCELLULAR GAPS WITH MICROVILLI APPEAR, THE SINUSOIDS BECOME CAPILLARIZED, AND REPARATIVE CHANGES ARE SEEN IN THE SPACES OF DISSE. A VARIETY OF INCLUSIONS, SUCH AS MALLORY BODIES, GRANULAR MATERIAL, SECONDARY LYSOSOMES, AND DUBIN-JOHNSON PIGMENT, HAVE BEEN DESCRIBED. FIBROLAMELLAR CARCINOMA HAS A CHARACTERISTIC HISTOLOGICAL PICTURE AND ULTRASTRUCTURALLY ONCOCYTIC FEATURES. NEUROENDOCRINE GRANULES AND COMBINATION OF HCC WITH BILE DUCT CARCINOMA ARE SEEN BY ELECTRON MICROSCOPY.	2001	

15  6356  20 THE ROLE OF HOST IN THE SPECTRUM OF OUTCOMES IN FAMILY CLUSTERS OF HEPATITIS INFECTION: FROM ASYMPTOMATIC TO HEPATOCELLULAR CARCINOMA. HEPATITIS B VIRUS INFECTIONS ARE PREVALENT WORLDWIDE, BUT THE OUTCOMES OF INFECTION VARY GREATLY FROM HOST TO HOST. IN MANY ENDEMIC REGIONS, VERTICAL TRANSMISSION FROM MOTHER TO CHILD IS MOST COMMON. IN THIS TRANSMISSION SETTING, VIRUS GENOTYPE AND SHARED PATIENT GENETICS MAKE FOR AN INTERESTING COMPARISON OF OUTCOME OF CHRONIC HEPATITIS B INFECTION. THIS CASE SERIES DEMONSTRATES FOUR FAMILY CLUSTERS WHICH DISPLAY DISPARATE OUTCOMES AMONG FAMILY MEMBERS WITH HEPATITIS B VIRUS INFECTIONS, FURTHER STRESSING THE ROLE OF HOST AND NON-GENETIC FACTORS IN THE NATURAL HISTORY OF THE DISEASE. MANY HOST FACTORS HAVE BEEN THEORIZED, FROM EPIGENETIC MECHANISMS TO THE ROLE OF CHRONIC STRESS, BUT MORE RESEARCH IS NEEDED TO BETTER UNDERSTAND THOSE AT HIGHER RISK OF FEARED COMPLICATIONS SUCH AS HEPATOCELLULAR CARCINOMA AND CIRRHOSIS.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
16  1034  25 CKD IN ABORIGINAL AUSTRALIANS. CHRONIC KIDNEY DISEASE (CKD) IS ONE COMPONENT OF A SPECTRUM OF CHRONIC DISEASE IN ABORIGINAL AUSTRALIANS. CKD IS MARKED BY ALBUMINURIA, WHICH PREDICTS RENAL FAILURE AND NONRENAL NATURAL DEATH. RATES VARY GREATLY BY COMMUNITY AND REGION AND ARE MUCH HIGHER IN REMOTE AREAS. THIS REFLECTS THE HETEROGENEOUS CHARACTERISTICS AND CIRCUMSTANCES OF ABORIGINAL PEOPLE. CKD IS MULTIDETERMINANT, AND EARLY-LIFE INFLUENCES (NOTABLY LOW BIRTH WEIGHT), INFECTIONS (INCLUDING POSTSTREPTOCOCCAL GLOMERULONEPHRITIS), METABOLIC/HEMODYNAMIC PARAMETERS, AND EPIGENETIC/GENETIC FACTORS PROBABLY CONTRIBUTE. CKD IS ASSOCIATED INTIMATELY WITH CARDIOVASCULAR RISK. ALBUMINURIA PROGRESSES OVER TIME, WITH A HIGH INCIDENCE OF NEW ONSET OF PATHOLOGIC LEVELS OF ALBUMINURIA IN ALL AGE GROUPS. ALL THE USUAL MORPHOLOGIC FINDINGS ARE FOUND IN RENAL BIOPSY SPECIMENS. HOWEVER, GLOMERULAR ENLARGEMENT IS NOTABLE IN INDIVIDUALS FROM REMOTE REGIONS, BUT NOT THOSE LIVING CLOSER TO POPULATION CENTERS. GLOMERULOMEGALY PROBABLY REPRESENTS COMPENSATORY HYPERTROPHY CAUSED BY LOW NEPHRON NUMBER, WHICH PROBABLY UNDERLIES THE ACCENTUATED SUSCEPTIBILITY TO RENAL DISEASE. IN THE LAST DECADE, HEALTH CARE SERVICES HAVE BEEN TRANSFORMED TO ACCOMMODATE SYSTEMATIC CHRONIC DISEASE SURVEILLANCE AND MANAGEMENT. AFTER A RELENTLESS INCREASE FOR 3 DECADES, RATES OF ABORIGINAL PEOPLE STARTING RENAL REPLACEMENT THERAPY, AS WELL AS CHRONIC DISEASE DEATHS, APPEAR TO BE STABILIZING IN SOME REGIONS. OFFICIAL ENDORSEMENT OF THESE SYSTEM CHANGES, PLUS ONGOING REDUCTIONS IN THE INCIDENCE OF LOW BIRTH WEIGHT AND INFECTIONS, HOLD PROMISE FOR CONTINUED BETTER OUTCOMES.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
17  5470  29 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
18  3265  26 HEPATOCARCINOMA: GENETIC AND EPIGENETIC FEATURES. HCC IS THE THIRD LEADING CAUSE OF CANCER-RELATED DEATHS WORLDWIDE, ACCOUNTING FOR ABOUT 1 MILLION DEATHS ANNUALLY. THE INCIDENCE OF HCC IS HIGHEST IN ASIA AND AFRICA, WHERE THE ENDEMIC HIGH PREVALENCE OF HEPATITIS B AND HEPATITIS C STRONGLY PREDISPOSES TO THE DEVELOPMENT OF CHRONIC LIVER DISEASE AND SUBSEQUENT DEVELOPMENT OF HCC. PATIENTS WITH HCC GENERALLY PRESENT AT AN ADVANCED STAGE DUE TO COMPENSATED CIRRHOSIS DEFINED BY THE ABSENCE OF PATHOGNOMONIC SYMPTOMS, RESULTING IN DEATH WITHIN 6 TO 20 MONTHS, SUGGESTING AN URGENT NEED IN TREATMENT MODALITIES THAT WILL DRAMATICALLY DECREASE THE MORTALITY RATE OF HCC. THE MOLECULAR HEPATOCARCINOGENESIS IS, HOWEVER, A GRADUAL PROCESS DURING WHICH GENETIC ALTERATIONS PROGRESSIVELY ACCUMULATE AND LEAD TO HCC THROUGH INTERMEDIATE PRENEOPLASTIC STAGES. WITH THE ADVENT OF WHOLE GENOME SEQUENCING TOOLS, VARIOUS MUTATIONS ASSOCIATED WITH HCC HAVE BEEN IDENTI FI ED, WHICH HAVE ADVANCED OUR MOLECULAR UNDERSTANDING OF HCC. HOWEVER, THE FREQUENCY OF THESE MUTATIONS IS RARE, AND THESE GENETIC MUTATIONS ONLY PARTLY EXPLAIN THE ETIOLOGY OF THE DISEASE. BETTER UNDERSTANDING AND CHARACTERIZATION OF NOVEL GENETIC AND EPIGENETIC ALTERATIONS, WHICH ARE IMPORTANT TO HEPATOCARCINOGENESIS, MAY HELP UNDERSTAND THE MOLECULAR PATHOGENESIS OF HCC, AS WELL AS PROVIDING NOVEL THERAPEUTIC TARGETS FOR HCC TREATMENT. FURTHER CONSIDERATION SHOULD BE GIVEN TO DEVELOPING MORE EFFECTIVE MOLECULAR DIAGNOSTIC MARKERS AND TARGETED DRUG THERAPY.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
19  1478  21 DIVERSE ROLES OF HEPATITIS B VIRUS IN LIVER CANCER. HEPATITIS B VIRUS (HBV) IS A WIDESPREAD HUMAN PATHOGEN RESPONSIBLE FOR ACUTE AND CHRONIC LIVER DISEASES. THE HEPATITIS B BURDEN IS PARTICULARLY HEAVY IN ENDEMIC COUNTRIES, WHERE LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA ARE LEADING CAUSES OF DEATH. HOWEVER, THE ONCOGENIC ROLE OF HBV REMAINS ENIGMATIC. AS THE VIRUS HAS NO CYTOPATHIC EFFECT, LIVER DAMAGE IS ATTRIBUTED TO IMMUNE RESPONSES THAT INDUCE INFLAMMATION, APOPTOSIS AND REGENERATION, FOSTERING THE ACCUMULATION OF GENETIC AND EPIGENETIC ALTERATIONS. IN A MORE DIRECT ACTION, FREQUENT INTEGRATION OF HBV DNA INTO HOST CHROMOSOMES MAY LEAD TO INSERTIONAL MUTAGENESIS OF CANCER-RELATED GENES AND CHROMOSOMAL INSTABILITY. HBV PROTEINS, NOTABLY THE HBX TRANSACTIVATOR, PARTICIPATE AS CO-FACTORS IN ONCOGENESIS. BETTER UNDERSTANDING OF HEPATITIS B PATHOGENESIS IS MANDATORY FOR IMPROVING DISEASE MANAGEMENT.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
20  2902  25 GENDER DIFFERENCES IN THE LIVERS OF PATIENTS WITH HEPATOCELLULAR CARCINOMA AND CHRONIC HEPATITIS C INFECTION. OBJECTIVES: A UNIQUE CAUSATIVE ASPECT OF HEPATOCELLULAR CARCINOMA (HCC) IS A GENDER DIFFERENCE IN ITS INCIDENCE. TO DETERMINE THE SPECIFIC FACTORS THAT CONTRIBUTE TO A MALE PREDOMINANCE, WE ANALYZED THE CLINICOPATHOLOGICAL FACTORS, AND GENETIC AND EPIGENETIC ALTERATIONS OF HCCS IN MALE AND FEMALE PATIENTS. METHODS: WE RETROSPECTIVELY ANALYZED THREE COHORTS OF PATIENTS: THE FIRST COHORT CONSISTED OF 547 PATIENTS IDENTIFIED WITH THE FIRST EVENT OF HCC, THE SECOND COHORT INCLUDED 176 HCC PATIENTS, AND THE THIRD 127 PATIENTS WITH CHRONIC HEPATITIS C (CHC). RESULTS: MALE PATIENTS WERE FOUND TO HAVE HCC MORE FREQUENTLY THAN FEMALE PATIENTS IN CASES OF NON-CIRRHOTIC LIVER (P = 0.0030 BY THE CHI(2) TEST), ESPECIALLY IN HEPATITIS C-POSITIVE CASES. HOWEVER, THERE WERE NO GENDER-SPECIFIC DIFFERENCES IN THE GENETIC AND EPIGENETIC ALTERATIONS OF CANCER-RELATED GENES. DEPOSITION OF IRON WAS MORE SEVERE IN MALE CHC PATIENTS THAN IN FEMALE PATIENTS. CONCLUSIONS: MALE PATIENTS WITH CHC DEVELOP HCC MORE FREQUENTLY WHEN THEY HAVE A NON-CIRRHOTIC LIVER THAN DO FEMALE PATIENTS. THIS GENDER DIFFERENCE COULD BE, AT LEAST PARTIALLY, ATTRIBUTED TO A DIFFERENT DEGREE OF IRON DEPOSITION, WHICH CONTRIBUTES TO THE DEVELOPMENT OF HCC IN THE ABSENCE OF LIVER CIRRHOSIS IN MEN WITH CHC.	2012