1 6126 185 THE EPIGENETIC MODIFIER PBRM1 RESTRICTS THE BASAL ACTIVITY OF THE INNATE IMMUNE SYSTEM BY REPRESSING RETINOIC ACID-INDUCIBLE GENE-I-LIKE RECEPTOR SIGNALLING AND IS A POTENTIAL PROGNOSTIC BIOMARKER FOR COLON CANCER. IT HAS LONG BEEN KNOWN THAT PATIENTS SUFFERING FROM INFLAMMATORY BOWEL DISEASE (IBD) HAVE AN INCREASED RISK OF DEVELOPING COLORECTAL CANCER (CRC). THE INNATE IMMUNE SYSTEM OF HOST CELLS PROVIDES A FIRST-LINE DEFENCE AGAINST PATHOGENIC INFECTION, WHEREAS AN UNCONTROLLED INFLAMMATORY RESPONSE UNDER HOMEOSTATIC CONDITIONS USUALLY LEADS TO PATHOLOGICAL CONSEQUENCES, AS EXEMPLIFIED BY THE CHRONIC INFLAMMATION OF IBD. THE KEY MOLECULES AND PATHWAYS KEEPING INNATE IMMUNITY IN CHECK ARE STILL POORLY DEFINED. HERE, WE REPORT THAT THE CHROMATIN REMODELLER POLYBROMO-1 (PBRM1) IS A REPRESSOR OF INNATE IMMUNE SIGNALLING MEDIATED BY RETINOIC ACID-INDUCIBLE GENE-I (RIG-I)-LIKE RECEPTORS (RLRS). KNOCKDOWN OF PBRM1 IN COLON CANCER CELLS INCREASED THE EXPRESSION OF TWO RECEPTOR GENES (RIG-I AND MDA5) AND UPREGULATED INTERFERON (IFN)-RELATED AND INFLAMMATION-RELATED GENE SIGNATURES. THE INNATE IMMUNE SIGNAL STIMULATED BY A DOUBLE-STRANDED RNA VIRAL MIMIC WAS EXAGGERATED BY PBRM1 SUPPRESSION. PBRM1 COOPERATED WITH POLYCOMB PROTEIN EZH2 TO DIRECTLY BIND THE CIS-REGULATORY ELEMENTS OF RIG-I AND MDA5, THEREBY SUPPRESSING THEIR TRANSCRIPTION. MOREOVER, UPREGULATION OF RIG-I AND MDA5 IS REQUIRED FOR IFN RESPONSE ACTIVATION INDUCED BY PBRM1 SILENCING. TRIM25, A PROTEIN STIMULATED BY THE RLR PATHWAY AND IFN PRODUCTION, PHYSICALLY INTERACTED WITH PBRM1 AND INDUCED PBRM1 PROTEIN DESTABILIZATION BY PROMOTING ITS UBIQUITINATION. THESE FINDINGS REVEAL A PBRM1-RLR REGULATORY CIRCUIT THAT CAN KEEP INNATE IMMUNE ACTIVITY AT A MINIMAL LEVEL IN RESTING CELLS, AND ALSO ENSURE A ROBUST INFLAMMATORY RESPONSE IN THE CASE OF PATHOGEN INVASION. PBRM1 WAS FOUND TO BE DOWNREGULATED IN PRIMARY TISSUES FROM PATIENTS WITH CRC OR IBD, AND ITS EXPRESSION CORRELATED NEGATIVELY WITH THAT OF RLR GENES AND INTERFERON-STIMULATED GENES IN CRC SAMPLES. LOWER PBRM1 EXPRESSION WAS ASSOCIATED WITH ADVANCED PATHOLOGICAL GRADE AND POORER SURVIVAL OF CRC PATIENTS, INDICATING THAT PBRM1 COULD SERVE AS A POTENTIAL PROGNOSTIC BIOMARKER FOR CRC. COPYRIGHT (C) 2017 PATHOLOGICAL SOCIETY OF GREAT BRITAIN AND IRELAND. PUBLISHED BY JOHN WILEY & SONS, LTD. 2018 2 1665 39 DOWNREGULATION OF KIDNEY PROTECTIVE FACTORS BY INFLAMMATION: ROLE OF TRANSCRIPTION FACTORS AND EPIGENETIC MECHANISMS. CHRONIC KIDNEY DISEASE (CKD) IS ASSOCIATED TO AN INCREASED RISK OF DEATH, CKD PROGRESSION, AND ACUTE KIDNEY INJURY (AKI) EVEN FROM EARLY STAGES, WHEN GLOMERULAR FILTRATION RATE (GFR) IS PRESERVED. THE LINK BETWEEN EARLY CKD AND THESE RISKS IS UNCLEAR, SINCE THERE IS NO ACCUMULATION OF UREMIC TOXINS. HOWEVER, PATHOLOGICAL ALBUMINURIA AND KIDNEY INFLAMMATION ARE FREQUENT FEATURES OF EARLY CKD, AND THE PRODUCTION OF KIDNEY PROTECTIVE FACTORS MAY BE DECREASED. INDEED, KLOTHO EXPRESSION IS ALREADY DECREASED IN CKD CATEGORY G1 (NORMAL GFR). KLOTHO HAS ANTI-AGING AND NEPHROPROTECTIVE PROPERTIES, AND DECREASED KLOTHO LEVELS MAY CONTRIBUTE TO INCREASE THE RISK OF DEATH, CKD PROGRESSION, AND AKI. IN THIS REVIEW, WE DISCUSS THE DOWNREGULATION BY MEDIATORS OF INFLAMMATION OF MOLECULES WITH SYSTEMIC AND/OR RENAL LOCAL PROTECTIVE FUNCTIONS, EXEMPLIFIED BY KLOTHO AND PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR GAMMA COACTIVATOR-1ALPHA (PGC-1ALPHA), A TRANSCRIPTION FACTOR THAT PROMOTES MITOCHONDRIAL BIOGENESIS. CYTOKINES SUCH AS TWEAK, TNF-ALPHA, OR TRANSFORMING GROWTH FACTOR -BETA1 PRODUCED LOCALLY DURING KIDNEY INJURY OR RELEASED FROM INFLAMMATORY SITES AT OTHER ORGANS MAY DECREASE KIDNEY EXPRESSION OF KLOTHO AND PGC-1ALPHA OR LEAD TO SUBOPTIMAL RECRUITMENT OF THESE NEPHROPROTECTIVE PROTEINS. TRANSCRIPTION FACTORS (E.G., SMAD3 AND NF-KAPPAB) AND EPIGENETIC MECHANISMS (E.G., HISTONE ACETYLATION OR METHYLATION) CONTRIBUTE TO DOWNREGULATE THE EXPRESSION OF KLOTHO AND/OR PGC-1ALPHA, WHILE HISTONE CROTONYLATION PROMOTES PGC-1ALPHA EXPRESSION. NF-KAPPABIZ FACILITATES THE REPRESSIVE EFFECT OF NF-KAPPAB ON KLOTHO EXPRESSION. A DETAILED UNDERSTANDING OF THESE MEDIATORS MAY CONTRIBUTE TO THE DEVELOPMENT OF NOVEL THERAPEUTIC APPROACHES TO PREVENT CKD PROGRESSION AND ITS NEGATIVE IMPACT ON MORTALITY AND AKI. 2016 3 557 28 B-CELL ANTIGEN RECEPTOR SIGNALING IN CHRONIC LYMPHOCYTIC LEUKEMIA: THERAPEUTIC TARGETS AND TRANSLATIONAL OPPORTUNITIES. B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS CHARACTERIZED BY CLONALLY EXPANDED AND MOLECULARLY HETEROGENEOUS POPULATIONS OF B LYMPHOCYTES WITH IMPAIRED APOPTOTIC MECHANISMS. THIS OCCURS AS A RESULT OF MULTIPLE GENETIC AND EPIGENETIC ABNORMALITIES, INCLUDING CHROMOSOMAL ABERRATIONS AND ENHANCER REGION HYPOMETHYLATION, OFTEN IMPINGING ON INTRACELLULAR SIGNALING PATHWAYS THAT ARE ESSENTIAL TO NORMAL B-CELL ACTIVATION, PROLIFERATION, AND SURVIVAL. THE B-CELL ANTIGEN RECEPTOR (BCR) SIGNALING IS ONE SUCH PATHWAY USURPED BY MALIGNANT B CELLS, AS EXEMPLIFIED BY THE EARLY PHASE CLINICAL SUCCESS ACHIEVED BY SMALL-MOLECULE AGENTS TARGETING KEY PLAYERS INVOLVED IN THE PATHWAY. SUCH NEW TARGETED AGENTS, INCLUDING THOSE THAT INHIBIT THE FUNCTION OF SPLEEN TYROSINE KINASE (SYK), BRUTON'S TYROSINE KINASE (BTK), PHOSPHATIDYLINOSITOL 3-KINASES (PI3K), AND B-CELL LYMPHOMA 2 (BCL-2), ALONG WITH THE CURRENT STANDARD THERAPY COMPRISING CHEMO-IMMUNOTHERAPIES WITH OR WITHOUT B-CELL DEPLETING BIOLOGIC AGENT RITUXIMAB (ANTI-CD20 MONOCLONAL ANTIBODY), SHOULD EXPAND THE ARMAMENTARIUM FOR CLL THERAPY. WE REVIEW THE THERAPEUTIC AGENTS CURRENTLY IN CLINICAL DEVELOPMENT WHICH TARGET DIFFERENT EFFECTORS OF THE MALIGNANT BCR SIGNALING, AND DISCUSS THEIR OVERLAPPING AND DISCRIMINATING TRANSLATIONAL OPPORTUNITIES IN THE CONTEXT OF CLL TREATMENT. 2013 4 6588 30 TUMOR HETEROGENEITY IN LYMPHOMAS: A DIFFERENT BREED. THE FACTS THAT CANCER REPRESENTS TISSUES CONSISTING OF HETEROGENEOUS NEOPLASTIC, AS WELL AS REACTIVE, CELL POPULATIONS AND THAT CANCERS OF THE SAME HISTOTYPE MAY SHOW PROFOUND DIFFERENCES IN CLINICAL BEHAVIOR HAVE LONG BEEN RECOGNIZED. WITH THE ADVENT OF NEW TECHNOLOGIES AND THE DEMANDS OF PRECISION MEDICINE, THE INVESTIGATION OF TUMOR HETEROGENEITY HAS GAINED MUCH INTEREST. AN UNDERSTANDING OF INTERTUMORAL HETEROGENEITY IN PATIENTS WITH THE SAME DISEASE ENTITY IS NECESSARY TO OPTIMALLY GUIDE PERSONALIZED TREATMENT. IN ADDITION, INCREASING EVIDENCE INDICATES THAT DIFFERENT TUMOR AREAS OR PRIMARY TUMORS AND METASTASES IN AN INDIVIDUAL PATIENT CAN SHOW SIGNIFICANT INTRATUMORAL HETEROGENEITY ON DIFFERENT LEVELS. THIS PHENOMENON CAN BE DRIVEN BY GENOMIC INSTABILITY, EPIGENETIC EVENTS, THE TUMOR MICROENVIRONMENT, AND STOCHASTIC VARIATIONS IN CELLULAR FUNCTION AND ANTITUMORAL THERAPIES. THESE MECHANISMS MAY LEAD TO BRANCHED SUBCLONAL EVOLUTION FROM A COMMON PROGENITOR CLONE, RESULTING IN SPATIAL VARIATION BETWEEN DIFFERENT TUMOR SITES, DISEASE PROGRESSION, AND TREATMENT RESISTANCE. THIS REVIEW ADDRESSES TUMOR HETEROGENEITY IN LYMPHOMAS FROM A PATHOLOGIST'S VIEWPOINT. THE RELATIONSHIP BETWEEN MORPHOLOGIC, IMMUNOPHENOTYPIC, AND GENETIC HETEROGENEITY IS EXEMPLIFIED IN DIFFERENT LYMPHOMA ENTITIES AND REVIEWED IN THE CONTEXT OF HIGH-GRADE TRANSFORMATION AND TRANSDIFFERENTIATION. IN ADDITION, FACTORS DRIVING HETEROGENEITY, AS WELL AS CLINICAL AND THERAPEUTIC IMPLICATIONS OF LYMPHOMA HETEROGENEITY, WILL BE DISCUSSED. 2018 5 6563 31 TRANSIENT AND STABLE VECTOR TRANSFECTION: PITFALLS, OFF-TARGET EFFECTS, ARTIFACTS. TRANSIENT AND STABLE VECTOR TRANSFECTIONS HAVE PLAYED IMPORTANT ROLES IN ILLUSTRATING THE FUNCTION OF SPECIFIC GENES/PROTEINS. THE GENERAL ASSUMPTION IS THAT SUCH A PLATFORM COULD EFFECTIVELY LINK A GIVEN GENE/PROTEIN TO GAINED PHENOTYPES, REVEALING THE MECHANISM OF HOW A GENE WORKS. HOWEVER, IN REALITY, INCREASED STUDIES HAVE SURPRISINGLY NOTICED SOME UNEXPECTED RESULTS. IN THIS REVIEW, WE DEMONSTRATE THAT AN ASSUMPTION THAT EMPTY VECTOR-TRANSFECTED CELLS PRESERVE THE CYTOGENETIC AND PHENOTYPIC CHARACTERISTICS, AND REPRESENT THE ADEQUATE CONTROL IN TRANSFECTION EXPERIMENTS IS NOT UNIVERSALLY VALID. A DNA VECTOR, A TRANSFECTION REAGENT, EXPRESSION OF AN ANTIBIOTIC RESISTANCE (TRANS)GENE, EXPRESSION OF A REPORTER (TRANS)GENE, AND SELECTION BY ACUTE/CHRONIC ANTIBIOTIC TREATMENT MAY EVOKE CELLULAR RESPONSES THAT AFFECT THE BIOCHEMICAL PROCESSES UNDER INVESTIGATION. WE EXEMPLIFY A NUMBER OF STUDIES, WHICH REPORTED OBVIOUS GENOMIC, TRANSCRIPTOMIC AND PHENOTYPIC CHANGES OF TUMOR CELLS AFTER TRANSIENT/STABLE TRANSFECTION OF AN EMPTY VECTOR. TO FURTHER ADDRESS THE COMMON MECHANISMS OF THESE UNEXPECTED FINDINGS, WE WILL APPLY THE GENOME THEORY OF SOMATIC EVOLUTION TO EXPLAIN STRESS-MEDIATED SYSTEM DYNAMICS AND THE LIMITATIONS OF PREDICTING THE SYSTEM BEHAVIOR SOLELY BASED ON TARGETED GENES. WE CONCEPTUALIZE THAT THE DIVERSE EXPERIMENTAL MANIPULATIONS (E.G., TRANSGENE OVEREXPRESSION, GENE KNOCK OUT/DOWN, CHEMICAL TREATMENTS, ACUTE CHANGES IN CULTURE CONDITIONS, ETC.) MAY ACT AS A SYSTEM STRESS, PROMOTING INTENSIVE GENOME-LEVEL ALTERATIONS (CHROMOSOMAL INSTABILITY, CIN), EPIGENETIC AND PHENOTYPIC ALTERATIONS, WHICH ARE BEYOND THE FUNCTION OF MANIPULATED GENES. SUCH ANALYSIS CALLS FOR MORE ATTENTION ON THE REDUCED SPECIFICITIES OF GENE-FOCUSED METHODOLOGIES. 2017 6 6774 32 [AGE-RELATED VASCULAR CHANGES EXEMPLIFIED BY THE CAROTID ARTERY]. ONE OF THE MAIN RISK FACTORS FOR THE PRESENCE OF CAROTID STENOSIS AND CAROTID-RELATED STROKE IS AGE. THE AIM OF THIS REVIEW ARTICLE IS TO PRESENT THE CURRENT STATE OF KNOWLEDGE ON AGE-RELATED VASCULAR CHANGES USING CAROTID STENOSIS AS AN EXAMPLE.VASCULAR AGING (VASCULAR SENESCENCE) IS A DECREASE OF STRUCTURAL AND FUNCTIONAL PROPERTIES OF THE VESSEL WALL THAT TAKES PLACE ON DIFFERENT LEVELS. AT THE MULTICELLULAR LEVEL AN INCREASE IN VESSEL VOLUME AND DIAMETER AS WELL AS INTIMA MEDIA THICKNESS OCCURS WITH AGE MAINLY DUE TO ATHEROSCLEROTIC CHANGES IN THE VESSEL WALL. AT THE CELLULAR AND EXTRACELLULAR LEVELS THERE IS A DECREASE IN ELASTIN FIBERS, SMOOTH MUSCLE CELLS, AND TOTAL CELLULARITY, AN INCREASE IN LIPID, CHOLESTEROL, AND CALCIUM PHOSPHATE DEPOSITION AS WELL AS NEOVASCULARIZATION. THE CAUSES OF VASCULAR AGING AT THE MOLECULAR LEVEL INCLUDE, IN PARTICULAR OXIDATIVE STRESS, CHRONIC INFLAMMATORY RESPONSE, MITOCHONDRIAL DYSFUNCTION, EPIGENETIC CHANGES, DYSREGULATION OF THE EXPRESSION OF NON-CODING RNAS (NCRNAS), AND THE INCREASE IN SENESCENCE. AGE-RELATED LOSS OF TISSUE HEALING AND REPAIR CAPACITY MAKE PLAQUES MORE VULNERABLE AND, IN THE CASE OF THE CAROTID ARTERY, MORE SUSCEPTIBLE TO ISCHEMIC STROKE.INCREASING KNOWLEDGE OF THE INFLUENCE OF AGING ON THE EPIGENETICS AND NCRNAS IN ATHEROSCLEROTIC PLAQUES CAN IN THE FUTURE MORE ACCURATELY QUANTIFY INDIVIDUAL PATIENT RISK AND CONTRIBUTE TO THE DEVELOPMENT OF TARGETED THERAPEUTIC STRATEGIES; HOWEVER, FURTHER STUDIES ARE NEEDED IN THIS FIELD TO UNDERSTAND THE FULL EXTENT OF VASCULAR AGING AND ITS ASSOCIATED DISEASES SO THAT THESE CAN THEN BE SPECIFICALLY TARGETED. 2022 7 6384 42 THE ROLE OF POLYCARBONATE MONOMER BISPHENOL-A IN INSULIN RESISTANCE. BISPHENOL A (BPA) IS A SYNTHETIC UNIT OF POLYCARBONATE POLYMERS AND EPOXY RESINS, THE TYPES OF PLASTICS THAT COULD BE FOUND IN ESSENTIALLY EVERY HUMAN POPULATION AND INCORPORATED INTO ALMOST EVERY ASPECT OF THE MODERN HUMAN SOCIETY. BPA POLYMERS APPEAR IN A WIDE RANGE OF PRODUCTS, FROM LIQUID STORAGES (PLASTIC BOTTLES, CAN AND GLASS LININGS, WATER PIPES AND TANKS) AND FOOD STORAGES (PLASTICS WRAPS AND CONTAINERS), TO MEDICAL AND DENTAL DEVICES. BPA POLYMERS COULD BE HYDROLYZED SPONTANEOUSLY OR IN A PHOTO- OR TEMPERATURE-CATALYZED PROCESS, PROVIDING WIDESPREAD ENVIRONMENTAL DISTRIBUTION AND CHRONIC EXPOSURE TO THE BPA MONOMER IN CONTEMPORARY HUMAN POPULATIONS. BISPHENOL A IS ALSO A XENOESTROGEN, AN ENDOCRINE-DISRUPTING CHEMICAL (EDC) THAT INTERFERES WITH THE ENDOCRINE SYSTEM MIMICKING THE EFFECTS OF AN ESTROGEN AND COULD POTENTIALLY KEEP OUR ENDOCRINE SYSTEM IN A CONSTANT PERTURBATION THAT PARALLELS ENDOCRINE DISRUPTION ARISING DURING PREGNANCY, SUCH AS INSULIN RESISTANCE (IR). GESTATIONAL INSULIN RESISTANCE REPRESENTS A NATURAL BIOLOGICAL PHENOMENON OF HIGHER INSULIN RESISTANCE IN PERIPHERAL TISSUES OF THE PREGNANT FEMALES, WHEN NUTRIENTS ARE INCREASINGLY BEING DIRECTED TO THE EMBRYO INSTEAD OF BEING STORED IN PERIPHERAL TISSUES. GESTATIONAL DIABETES MELLITUS MAY APPEAR IN HEALTHY NON-DIABETIC FEMALES, DUE TO GESTATIONAL INSULIN RESISTANCE THAT LEADS TO INCREASED BLOOD SUGAR LEVELS AND HYPERINSULINEMIA (INCREASED INSULIN PRODUCTION FROM THE PANCREATIC BETA CELLS). THE HYPOTHESIS STATES THAT UNNOTICED AND CONSTANT EXPOSURE TO THIS ENVIRONMENTAL CHEMICAL MIGHT POTENTIALLY LEAD TO THE FORMATION OF CHRONIC LOW-LEVEL ENDOCRINE DISRUPTIVE STATE THAT RESEMBLES GESTATIONAL INSULIN RESISTANCE, WHICH MIGHT CONTRIBUTE TO THE DEVELOPMENT OF DIABETES. THE INCREASING BODY OF EVIDENCE SUPPORTS THE MAJOR PREMISES OF THIS HYPOTHESIS, AS EXEMPLIFIED BY THE NUMEROUS PUBLICATIONS EXAMINING THE ASSOCIATION OF BPA AND INSULIN RESISTANCE, BOTH EPIDEMIOLOGICAL AND MECHANISTIC. HOWEVER, TO WHAT EXTENT BPA MIGHT CONTRIBUTE TO THE DEVELOPMENT OF DIABETES IN THE MODERN SOCIETIES STILL REMAINS UNKNOWN. IN THIS REVIEW, I DISCUSS THE CHEMICAL PROPERTIES OF BPA AND THE SOURCES OF BPA CONTAMINATION FOUND IN THE ENVIRONMENT AND IN HUMAN TISSUES. I PROVIDE AN OVERVIEW OF MECHANISMS FOR THE PROPOSED ROLE OF BISPHENOL A IN INSULIN RESISTANCE AND DIABETES, AS WELL AS OTHER RELATED DISEASES, SUCH AS CARDIOVASCULAR DISEASES. I DESCRIBE THE TRANSMISSION OF BPA EFFECTS TO THE OFFSPRING AND POSTULATE THAT GENDER RELATED DIFFERENCES MIGHT ORIGINATE FROM DIFFERENCES IN LIVER ENZYME LEVELS, SUCH AS UDP-GLUCURONOSYLTRANSFERASE, WHICH IS INVOLVED IN BPA PROCESSING AND ITS ELIMINATION FROM THE ORGANISM. I DISCUSS THE MOLECULAR MECHANISMS OF BPA ACTION THROUGH NUCLEAR AND MEMBRANE-BOUND ER RECEPTORS, NON-MONOTONIC DOSE RESPONSE, EPIGENETIC MODIFICATIONS OF THE DNA AND PROPOSE THAT CHRONIC EXPOSURE TO WEAK BINDERS, SUCH AS BPA, MAY MIMIC THE EFFECTS OF STRONG BINDERS, SUCH AS ESTROGENS. 2017 8 3890 31 KLOTHO, PHOSPHATE AND INFLAMMATION/AGEING IN CHRONIC KIDNEY DISEASE. EVIDENCE IS EMERGING FOR THE INFLAMMATORY NATURE OF MANY AGEING-ASSOCIATED DISEASES, INCLUDING ATHEROSCLEROSIS, VASCULAR CALCIFICATION, DIABETES AND CHRONIC KIDNEY DISEASE (CKD), AMONG OTHERS. AGEING ITSELF RESULTS IN CHRONIC LOW-GRADE INFLAMMATION THAT PROMOTES END-ORGAN DAMAGE. INFLAMMATORY ORGAN DAMAGE, IN TURN, MAY CONTRIBUTE TO INFLAMMATION. RECENT RESEARCH HAS IDENTIFIED THE KIDNEY-SECRETED HORMONE KLOTHO AS A CENTRAL PLAYER AT THE AGEING-INFLAMMATION INTERFACE. THUS, SYSTEMIC OR LOCAL RENAL INFLAMMATION DECREASES KIDNEY KLOTHO EXPRESSION. KLOTHO DOWN-REGULATION MAY BE INDUCED BY SPECIFIC CYTOKINES SUCH AS TUMOUR NECROSIS FACTOR-ALPHA OR TWEAK THROUGH THE CANONICAL ACTIVATION OF THE INFLAMMATORY TRANSCRIPTION FACTOR NUCLEAR FACTOR KAPPA B (NFKAPPAB) AND, SPECIFICALLY RELA. IN ADDITION, INFLAMMATORY CYTOKINES LEAD TO THE EPIGENETIC INACTIVATION OF KLOTHO TRANSCRIPTION. KLOTHO ITSELF HAS ANTIOXIDANT AND ANTI-INFLAMMATORY PROPERTIES AND THE CANONICAL NFKAPPAB COMPONENT RELA IS ONE OF ITS TARGETS. KLOTHO IS A KEY REGULATOR OF PHOSPHATE BALANCE AND A ROLE OF PHOSPHATE IN AGEING HAS BEEN SHOWN. HOWEVER, THE POTENTIAL RELATIONSHIP BETWEEN PHOSPHATE AND INFLAMMATION REQUIRES FURTHER CLARIFICATION. A CORRECT UNDERSTANDING OF THESE INTERACTIONS MAY LEAD TO THE DESIGN OF NOVEL THERAPEUTIC APPROACHES TO CKD AND CKD-RELATED INFLAMMATORY AND AGEING FEATURES AS WELL AS TO INFLAMMATION/AGEING IN GENERAL. 2012 9 2500 23 EPIGENETICS AND IMPRINTED GENES: INSIGHTS FROM THE IMPRINTED GNAS LOCUS. THE HALLMARKS OF EPIGENETICS--THE MEMORY OF DEFINING EARLIER DEVELOPMENTAL EVENTS AND THE DISTINCTION OF ACTIVE AND INACTIVE GENES--ARE EXEMPLIFIED BY IMPRINTED GENES. IN THIS ARTICLE, I SHALL CONSIDER THE IMPRINTED GNAS LOCUS IN SOME DETAIL. GNAS ENCODES THE STIMULATORY G-PROTEIN SUBUNIT, GSALPHA, AN ESSENTIAL INTERMEDIATE BETWEEN RECEPTOR COUPLING AND CYCLIC ADENOSINE MONOPHOSPHATE GENERATION. IT PROVIDES AN EXCELLENT ILLUSTRATION OF THE PLEIOTROPIC EFFECTS OF IMPRINTED GENES, PARTICULARLY ON SKELETAL GROWTH AND METABOLISM, AND IS A POWERFUL EXAMPLE OF THE CONFLICTING EFFECTS OF IMPRINTED GENES WITH OPPOSING PATTERNS OF IMPRINTING. I SHALL DESCRIBE THE EFFECTS OF GSALPHA DEFICIENCY IN HUMANS AND THE KNOWLEDGE GAINED FROM GENETIC MANIPULATION IN THE MOUSE. FINALLY, GIVEN THE PERVASIVE EFFECTS OF IMPRINTED GENES, I SHALL DISCUSS THE LIKELIHOOD THAT EPIGENETIC DEREGULATION, FOR EXAMPLE OF IMPRINTED GENES, COULD CONTRIBUTE TO THE DEVELOPMENTAL PROGRAMMING OF CHRONIC ADULT DISEASES. 2009 10 307 36 ALBUMINURIA DOWNREGULATION OF THE ANTI-AGING FACTOR KLOTHO: THE MISSING LINK POTENTIALLY EXPLAINING THE ASSOCIATION OF PATHOLOGICAL ALBUMINURIA WITH PREMATURE DEATH. TEN PERCENT OF THE ADULT POPULATION HAS CHRONIC KIDNEY DISEASE (CKD), WHICH IS DIAGNOSED WHEN THE GLOMERULAR FILTRATION RATE (GFR) IS BELOW 60 ML/MIN PER 1.73 M(2) OR WHEN ALBUMINURIA IS ABOVE 30 MG/DAY. THE NUMERICAL THRESHOLDS WERE CHOSEN BECAUSE THEY ARE ASSOCIATED WITH AN INCREASED RISK OF CKD PROGRESSION OR PREMATURE DEATH WITHIN A WIDER SCENARIO OF ACCELERATED AGING. INDEED, CKD IS ONE OF THE FASTEST GROWING CAUSES OF DEATH WORLDWIDE. A DECREASED GFR IS ASSOCIATED WITH THE ACCUMULATION OF URAEMIC TOXINS THAT MAY PROMOTE TISSUE AND ORGAN DAMAGE. HOWEVER, CKD MAY BE DIAGNOSED WHEN THE GFR IS COMPLETELY NORMAL, AS LONG AS THERE IS PATHOLOGICAL ALBUMINURIA. A KEY UNANSWERED QUESTION TO STEM THE RISE OF CKD-ASSOCIATED DEATHS IS WHETHER THE ASSOCIATION BETWEEN ISOLATED ALBUMINURIA (WHEN THE GFR IS NORMAL) AND PREMATURE DEATH IS CAUSAL. THE RECENT DEMONSTRATION THAT ALBUMINURIA PER SE DIRECTLY SUPPRESSES THE PRODUCTION OF THE ANTI-AGING FACTOR KLOTHO BY KIDNEY TUBULAR CELLS MAY BE ONE OF THE FIRST STEPS TO ADDRESS THE CAUSALITY OF THE ALBUMINURIA-PREMATURE DEATH-ACCELERATED AGING ASSOCIATION. THIS HYPOTHESIS SHOULD BE TESTED IN INTERVENTIONAL STUDIES THAT SHOULD DRAW FROM TRANSLATIONAL SCIENCE ADVANCES. THUS, THE OBSERVATION THAT ALBUMINURIA DECREASES KLOTHO PRODUCTION THROUGH EPIGENETIC MECHANISMS IMPLIES THAT KLOTHO DOWNREGULATION MAY PERSIST AFTER THE CORRECTION OF ALBUMINURIA, AND INNOVATIVE THERAPEUTIC APPROACHES ARE NEEDED TO RESTORE KLOTHO PRODUCTION. ON THE BASIS OF RECENT LITERATURE, THESE MAY INCLUDE MANIPULATION OF NF-KAPPAB REGULATORS SUCH AS B CELL LYMPHOMA 3 PROTEIN (BCL-3), AND EPIGENETIC REGULATORS SUCH AS HISTONE DEACETYLASES, OR THE REPURPOSING OF DRUGS SUCH AS PENTOXIFYLLINE. 2020 11 3678 45 INFLAMMATION AND REGENERATION IN THE DENTIN-PULP COMPLEX: A DOUBLE-EDGED SWORD. DENTAL TISSUE INFECTION AND DISEASE RESULT IN ACUTE AND CHRONIC ACTIVATION OF THE INNATE IMMUNE RESPONSE, WHICH IS MEDIATED BY MOLECULAR AND CELLULAR SIGNALING. DIFFERENT CELL TYPES WITHIN THE DENTIN-PULP COMPLEX ARE ABLE TO DETECT INVADING BACTERIA AT ALL STAGES OF THE INFECTION. INDEED, AT RELATIVELY EARLY DISEASE STAGES, ODONTOBLASTS WILL RESPOND TO BACTERIAL COMPONENTS, AND AS THE DISEASE PROGRESSES, CORE PULPAL CELLS INCLUDING FIBROBLASTS, STEMS CELLS, ENDOTHELIAL CELLS, AND IMMUNE CELLS WILL BECOME INVOLVED. PATTERN RECOGNITION RECEPTORS, SUCH AS TOLL-LIKE RECEPTORS EXPRESSED ON THESE CELL TYPES, ARE RESPONSIBLE FOR DETECTING BACTERIAL COMPONENTS, AND THEIR LIGAND BINDING LEADS TO THE ACTIVATION OF THE NUCLEAR FACTOR-KAPPA B AND P38 MITOGEN-ACTIVATED PROTEIN (MAP) KINASE INTRACELLULAR SIGNALING CASCADES. SUBSEQUENT NUCLEAR TRANSLOCATION OF THE TRANSCRIPTION FACTOR SUBUNITS FROM THESE PATHWAYS WILL LEAD TO PROINFLAMMATORY MEDIATOR EXPRESSION, INCLUDING INCREASES IN CYTOKINES AND CHEMOKINES, WHICH TRIGGER HOST CELLULAR DEFENSE MECHANISMS. THE COMPLEX MOLECULAR SIGNALING WILL RESULT IN THE RECRUITMENT OF IMMUNE SYSTEM CELLS TARGETED AT COMBATING THE INVADING MICROBES; HOWEVER, THE TRAFFICKING AND ANTIBACTERIAL ACTIVITY OF THESE CELLS CAN LEAD TO COLLATERAL TISSUE DAMAGE. RECENT EVIDENCE SUGGESTS THAT IF INFLAMMATION IS RESOLVED RELATIVELY LOW LEVELS OF PROINFLAMMATORY MEDIATORS MAY PROMOTE TISSUE REPAIR, WHEREAS IF CHRONIC INFLAMMATION ENSUES REPAIR MECHANISMS BECOME INHIBITED. THUS, THE EFFECTS OF MEDIATORS ARE TEMPORAL CONTEXT DEPENDENT. ALTHOUGH CONTAINMENT AND REMOVAL OF THE INFECTION ARE KEYS TO ENABLE DENTAL TISSUE REPAIR, IT IS FEASIBLE THAT THE DEVELOPMENT OF ANTI-INFLAMMATORY AND IMMUNOMODULATORY APPROACHES, BASED ON MOLECULAR, EPIGENETIC, AND PHOTOBIOMODULATORY TECHNOLOGIES, MAY ALSO BE BENEFICIAL FOR FUTURE ENDODONTIC TREATMENTS. 2014 12 551 44 AUTOIMMUNITY AS AN ETIOLOGICAL FACTOR OF CANCER: THE TRANSFORMATIVE POTENTIAL OF CHRONIC TYPE 2 INFLAMMATION. RECENT EPIDEMIOLOGICAL STUDIES HAVE FOUND AN ALARMING TREND OF INCREASED CANCER INCIDENCE IN ADULTS YOUNGER THAN 50 YEARS OF AGE AND PROJECTED A SUBSTANTIAL RISE IN CANCER INCIDENCE OVER THE NEXT 10 YEARS IN THIS AGE GROUP. THIS TREND WAS EXEMPLIFIED IN THE INCIDENCE OF NON-CARDIA GASTRIC CANCER AND ITS DISPROPORTIONATE IMPACT ON NON-HISPANIC WHITE FEMALES UNDER THE AGE OF 50. THE TREND IS CONCURRENT WITH THE INCREASING INCIDENCE OF AUTOIMMUNE DISEASES IN INDUSTRIALIZED COUNTRIES, SUGGESTING A CAUSAL LINK BETWEEN THE TWO. WHILE AUTOIMMUNITY HAS BEEN SUSPECTED TO BE A RISK FACTOR FOR SOME CANCERS, THE EXACT MECHANISMS UNDERLYING THE CONNECTION BETWEEN AUTOIMMUNITY AND CANCER REMAIN UNCLEAR AND ARE OFTEN CONTROVERSIAL. THE LINK HAS BEEN ATTRIBUTED TO SEVERAL MEDIATORS SUCH AS IMMUNE SUPPRESSION, INFECTION, DIET, ENVIRONMENT, OR, PERHAPS MOST PLAUSIBLY, CHRONIC INFLAMMATION BECAUSE OF ITS WELL-RECOGNIZED ROLE IN TUMORIGENESIS. IN THAT REGARD, AUTOIMMUNE CONDITIONS ARE COMMON CAUSES OF CHRONIC INFLAMMATION AND MAY TRIGGER REPETITIVE CYCLES OF ANTIGEN-SPECIFIC CELL DAMAGE, TISSUE REGENERATION, AND WOUND HEALING. ILLUSTRATING THE CONNECTION BETWEEN AUTOIMMUNE DISEASES AND CANCER ARE PATIENTS WHO HAVE AN INCREASED RISK OF CANCER DEVELOPMENT ASSOCIATED WITH GENETICALLY PREDISPOSED INSUFFICIENCY OF CYTOTOXIC T LYMPHOCYTE-ASSOCIATED PROTEIN 4 (CTLA4), A PROTOTYPICAL IMMUNE CHECKPOINT AGAINST AUTOIMMUNITY AND ONE OF THE MAIN TARGETS OF CANCER IMMUNE THERAPY. THE TUMORIGENIC PROCESS TRIGGERED BY CTLA4 INSUFFICIENCY HAS BEEN SHOWN IN A MOUSE MODEL TO BE DEPENDENT ON THE TYPE 2 CYTOKINES INTERLEUKIN-4 (IL4) AND INTERLEUKIN-13 (IL13). IN THIS TYPE 2 INFLAMMATORY MILIEU, CROSSTALK WITH TYPE 2 IMMUNE CELLS MAY INITIATE EPIGENETIC REPROGRAMMING OF EPITHELIAL CELLS, LEADING TO A METAPLASTIC DIFFERENTIATION AND EVENTUALLY MALIGNANT TRANSFORMATION EVEN IN THE ABSENCE OF CLASSICAL ONCOGENIC MUTATIONS. THOSE FINDINGS COMPLEMENT A LARGE BODY OF EVIDENCE FOR TYPE 1, TYPE 3, OR OTHER INFLAMMATORY MEDIATORS IN INFLAMMATORY TUMORIGENESIS. THIS REVIEW ADDRESSES THE POTENTIAL OF AUTOIMMUNITY AS A CAUSAL FACTOR FOR TUMORIGENESIS, THE UNDERLYING INFLAMMATORY MECHANISMS THAT MAY VARY DEPENDING ON HOST-ENVIRONMENT VARIATIONS, AND IMPLICATIONS TO CANCER PREVENTION AND IMMUNOTHERAPY. 2021 13 3811 28 INTRATUMORAL HETEROGENEITY: CLONAL COOPERATION IN EPITHELIAL-TO-MESENCHYMAL TRANSITION AND METASTASIS. ALTHOUGH PHENOTYPIC INTRATUMORAL HETEROGENEITY WAS FIRST DESCRIBED MANY DECADES AGO, THE ADVENT OF NEXT-GENERATION SEQUENCING HAS PROVIDED CONCLUSIVE EVIDENCE THAT IN ADDITION TO PHENOTYPIC DIVERSITY, SIGNIFICANT GENOTYPIC DIVERSITY EXISTS WITHIN TUMORS. TUMOR HETEROGENEITY LIKELY ARISES BOTH FROM CLONAL EXPANSIONS, AS WELL AS FROM DIFFERENTIATION HIERARCHIES EXISTENT IN THE TUMOR, SUCH AS THAT ESTABLISHED BY CANCER STEM CELLS (CSCS) AND NON-CSCS. THESE DIFFERENTIATION HIERARCHIES MAY ARISE DUE TO GENETIC MUTATIONS, EPIGENETIC ALTERATIONS, OR MICROENVIRONMENTAL INFLUENCES. AN ADDITIONAL DIFFERENTIATION HIERARCHY WITHIN EPITHELIAL TUMORS MAY ARISE WHEN ONLY A FEW TUMOR CELLS TRANS-DIFFERENTIATE INTO MESENCHYMAL-LIKE CELLS, A PROCESS KNOWN AS EPITHELIAL-TO-MESENCHYMAL TRANSITION (EMT). AGAIN, THIS PROCESS CAN BE INFLUENCED BY BOTH GENETIC AND NON-GENETIC FACTORS. IN THIS REVIEW WE DISCUSS THE EVIDENCE FOR CLONAL INTERACTION AND COOPERATION FOR TUMOR MAINTENANCE AND PROGRESSION, PARTICULARLY WITH RESPECT TO EMT, AND FURTHER ADDRESS THE FAR-REACHING EFFECTS THAT TUMOR HETEROGENEITY MAY HAVE ON CANCER THERAPY. 2015 14 3688 34 INFLAMMATION: GEARING THE JOURNEY TO CANCER. CHRONIC INFLAMMATION PLAYS A MULTIFACETED ROLE IN CARCINOGENESIS. MOUNTING EVIDENCE FROM PRECLINICAL AND CLINICAL STUDIES SUGGESTS THAT PERSISTENT INFLAMMATION FUNCTIONS AS A DRIVING FORCE IN THE JOURNEY TO CANCER. THE POSSIBLE MECHANISMS BY WHICH INFLAMMATION CAN CONTRIBUTE TO CARCINOGENESIS INCLUDE INDUCTION OF GENOMIC INSTABILITY, ALTERATIONS IN EPIGENETIC EVENTS AND SUBSEQUENT INAPPROPRIATE GENE EXPRESSION, ENHANCED PROLIFERATION OF INITIATED CELLS, RESISTANCE TO APOPTOSIS, AGGRESSIVE TUMOR NEOVASCULARIZATION, INVASION THROUGH TUMOR-ASSOCIATED BASEMENT MEMBRANE AND METASTASIS, ETC. INFLAMMATION-INDUCED REACTIVE OXYGEN AND NITROGEN SPECIES CAUSE DAMAGE TO IMPORTANT CELLULAR COMPONENTS (E.G., DNA, PROTEINS AND LIPIDS), WHICH CAN DIRECTLY OR INDIRECTLY CONTRIBUTE TO MALIGNANT CELL TRANSFORMATION. OVEREXPRESSION, ELEVATED SECRETION, OR ABNORMAL ACTIVATION OF PROINFLAMMATORY MEDIATORS, SUCH AS CYTOKINES, CHEMOKINES, CYCLOOXYGENASE-2, PROSTAGLANDINS, INDUCIBLE NITRIC OXIDE SYNTHASE, AND NITRIC OXIDE, AND A DISTINCT NETWORK OF INTRACELLULAR SIGNALING MOLECULES INCLUDING UPSTREAM KINASES AND TRANSCRIPTION FACTORS FACILITATE TUMOR PROMOTION AND PROGRESSION. WHILE INFLAMMATION PROMOTES DEVELOPMENT OF CANCER, COMPONENTS OF THE TUMOR MICROENVIRONMENT, SUCH AS TUMOR CELLS, STROMAL CELLS IN SURROUNDING TISSUE AND INFILTRATED INFLAMMATORY/IMMUNE CELLS GENERATE AN INTRATUMORAL INFLAMMATORY STATE BY ABERRANT EXPRESSION OR ACTIVATION OF SOME PROINFLAMMATORY MOLECULES. MANY OF PROINFLAMMATORY MEDIATORS, ESPECIALLY CYTOKINES, CHEMOKINES AND PROSTAGLANDINS, TURN ON THE ANGIOGENIC SWITCHES MAINLY CONTROLLED BY VASCULAR ENDOTHELIAL GROWTH FACTOR, THEREBY INDUCING INFLAMMATORY ANGIOGENESIS AND TUMOR CELL-STROMA COMMUNICATION. THIS WILL END UP WITH TUMOR ANGIOGENESIS, METASTASIS AND INVASION. MOREOVER, CELLULAR MICRORNAS ARE EMERGING AS A POTENTIAL LINK BETWEEN INFLAMMATION AND CANCER. THE PRESENT ARTICLE HIGHLIGHTS THE ROLE OF VARIOUS PROINFLAMMATORY MEDIATORS IN CARCINOGENESIS AND THEIR PROMISE AS POTENTIAL TARGETS FOR CHEMOPREVENTION OF INFLAMMATION-ASSOCIATED CARCINOGENESIS. 2008 15 459 47 APPLYING SINGLE-CELL TECHNOLOGIES TO CLINICAL PATHOLOGY: PROGRESS IN NEPHROPATHOLOGY. CELLS REPRESENT THE BASIC BUILDING BLOCKS OF LIVING ORGANISMS. ACCURATE CHARACTERISATION OF CELLULAR PHENOTYPE, INTERCELLULAR SIGNALLING NETWORKS, AND THE SPATIAL ORGANISATION OF CELLS WITHIN ORGANS IS CRUCIAL TO DELIVER A BETTER UNDERSTANDING OF THE PROCESSES UNDERPINNING PHYSIOLOGY, AND THE PERTURBATIONS THAT LEAD TO DISEASE. SINGLE-CELL METHODOLOGIES HAVE INCREASED RAPIDLY IN SCALE AND SCOPE IN RECENT YEARS AND ARE SET TO GENERATE IMPORTANT INSIGHTS INTO HUMAN DISEASE. HERE, WE REVIEW CURRENT PRACTICES IN NEPHROPATHOLOGY, WHICH ARE DOMINATED BY RELATIVELY SIMPLE MORPHOLOGICAL DESCRIPTIONS OF TISSUE BIOPSIES BASED ON THEIR APPEARANCE USING LIGHT MICROSCOPY. BULK TRANSCRIPTOMICS HAVE MORE RECENTLY BEEN USED TO EXPLORE GLOMERULAR AND TUBULOINTERSTITIAL KIDNEY DISEASE, RENAL CANCER, AND THE RESPONSES TO INJURY AND ALLOIMMUNITY IN KIDNEY TRANSPLANTATION, GENERATING NOVEL DISEASE INSIGHTS AND PROGNOSTIC BIOMARKERS. THESE STUDIES SET THE STAGE FOR SINGLE-CELL TRANSCRIPTOMIC APPROACHES THAT REVEAL CELL-TYPE-SPECIFIC GENE EXPRESSION PATTERNS IN HEALTH AND DISEASE. THESE TECHNOLOGIES ALLOW GENOME-WIDE DISEASE SUSCEPTIBILITY GENES TO BE INTERPRETED WITH THE KNOWLEDGE OF THE SPECIFIC CELL POPULATIONS WITHIN ORGANS THAT EXPRESS THEM, IDENTIFYING CANDIDATE CELL TYPES FOR FURTHER STUDY. SINGLE-CELL TECHNOLOGIES ARE ALSO MOVING BEYOND ASSAYING INDIVIDUAL CELLULAR TRANSCRIPTOMES, TO MEASURING THE EPIGENETIC LANDSCAPE OF SINGLE CELLS. SINGLE-CELL ANTIGEN-RECEPTOR GENE SEQUENCING ALSO ENABLES SPECIFIC T- AND B-CELL CLONES TO BE TRACKED IN DIFFERENT TISSUES AND DISEASE STATES. IN THE COMING YEARS THESE RICH 'MULTI-OMIC' DESCRIPTIONS OF KIDNEY DISEASE WILL ENABLE HISTOPATHOLOGICAL DESCRIPTIONS TO BE COMPREHENSIVELY INTEGRATED WITH MOLECULAR PHENOTYPES, ENABLING BETTER DISEASE CLASSIFICATION AND PROGNOSTICATION AND THE APPLICATION OF PERSONALISED TREATMENT STRATEGIES. (C) 2020 THE AUTHORS. THE JOURNAL OF PATHOLOGY PUBLISHED BY JOHN WILEY & SONS LTD ON BEHALF OF PATHOLOGICAL SOCIETY OF GREAT BRITAIN AND IRELAND. 2020 16 1701 41 DYNAMIC IMMUNE/INFLAMMATION PRECISION MEDICINE: THE GOOD AND THE BAD INFLAMMATION IN INFECTION AND CANCER. NORMAL OR "GOOD" INFLAMMATION PROCESS STARTS FROM A LOCAL CELLULAR RESPONSE AGAINST INJURY OR ANY INFECTIOUS AGENT, WITH THE ACTIVATION OF NEUTROPHILS, MACROPHAGES, LANGERHANS CELLS, DENDRITIC CELLS, AND INNATE IMMUNE CELLS. CYTOKINES AND CHEMOKINES ARE PRODUCED TO AMPLIFY THE LOCAL INFLAMMATORY PROCESS FOLLOWED BY THE MIGRATION OF IMMUNE CELLS TO THE REGIONAL LYMPH NODES WHERE ADAPTIVE IMMUNE RESPONSE IS INITIATED. SYSTEMIC INFLAMMATION ENHANCES THE BIOLOGICAL RESPONSE TO MOBILIZE ADDITIONAL CELLS FROM CENTRAL AND PERIPHERAL IMMUNE/HEMATOPOIETIC SYSTEM. LOCAL MECHANISMS TO LIMIT INFLAMMATION ARE INITIATED AND LEAD TO HEALING. DURING THE NORMAL INFLAMMATORY PROCESS, THERE IS A BALANCE BETWEEN THE PRODUCTION OF INFLAMMATORY CHEMOKINES/CYTOKINES SUCH AS TUMOR NECROSIS FACTOR (TNF)-ALPHA, INTERLEUKIN (IL)-6 AND IL-1 AND THE PRODUCTION OF COMPOUNDS THAT LIMIT INFLAMMATION AND HAVE AN IMMUNE SUPPRESSIVE EFFECT, SUCH AS IL-10 AND TRANSFORMING FACTOR (TGF) BETA. IL-6 AND IL-6/SOLUBLE IL-6 RECEPTOR (R) COMPLEX STIMULATE LIVER CELLS TO PRODUCE INFLAMMATORY PROTEINS, WHICH REPRESENTS THE SYSTEMIC INFLAMMATION RESPONSE. THE MAGNITUDE AND THE DURATION OF THE SYSTEMIC INFLAMMATORY RESPONSE ARE LINKED TO THE CAUSE, UNDER GENETIC AND EPIGENETIC CONTROL. SIGNIFICANT INFLAMMATION AS SEEN IN SEPTIC SHOCK, IN SEVERE FORMS OF INFECTIONS OR IN CERTAIN ACTIVE CANCERS, REPRESENTS THE "BAD INFLAMMATION", CORRELATED WITH A POOR PROGNOSIS. IN ADDITION, THE PERSISTENCE OF A CHRONIC SMOLDERING INFLAMMATION MAY LEAD TO PATHOLOGICAL SITUATIONS WHICH ARE OBSERVED IN THE MAJORITY OF INFLAMMATORY, DEGENERATIVE, DYSMETABOLIC, OR DYSIMMUNE DISEASES AND CANCER. CHRONIC SMOLDERING INFLAMMATION IS A CROSS BETWEEN DIFFERENT PATHOLOGICAL SITUATIONS POSSIBLY LINKED. IN ADDITION, WITHIN THE TUMOR MICROENVIRONMENT, INFLAMMATORY PROCESS RESULTS FROM DIFFERENT CELLULAR MECHANISMS MODULATED BY METABOLIC AND VASCULAR CHANGES. ON THE CONTRARY, A LIMITED AND BALANCED INFLAMMATION INITIATES THE NORMAL IMMUNE RESPONSE, INCLUDING THE ADAPTIVE RESPONSE WHICH AMPLIFIES ANY IMMUNOTHERAPY, INCLUDING VACCINES. IMMUNE CHECKPOINT INHIBITORS AND CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELLS ARE ASSOCIATED WITH CYTOKINE RELEASE SYNDROME, A CLINICAL RISK LEADING TO THE USE OF ANTI-CYTOKINE DRUGS. NOWADAYS, IT IS TIME TO MONITOR THE DYNAMIC INFLAMMATORY PROCESS FOR A BETTER IMMUNE PRECISION MEDICINE IN BOTH INFECTIONS AND CANCER. 2021 17 9 45 'TRAINED IMMUNITY': CONSEQUENCES FOR LYMPHOID MALIGNANCIES. IN HEMATOLOGICAL MALIGNANCIES COMPLEX INTERACTIONS EXIST BETWEEN THE IMMUNE SYSTEM, MICROORGANISMS AND MALIGNANT CELLS. ON ONE HAND, MICROORGANISMS CAN INDUCE CANCER, AS ILLUSTRATED BY SPECIFIC INFECTION-INDUCED LYMPHOPROLIFERATIVE DISEASES SUCH AS HELICOBACTER PYLORI-ASSOCIATED GASTRIC MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMA. ON THE OTHER HAND, MALIGNANT CELLS CREATE AN IMMUNOSUPPRESSIVE ENVIRONMENT FOR THEIR OWN BENEFIT, BUT THIS ALSO RESULTS IN AN INCREASED RISK OF INFECTIONS. DISRUPTED INNATE IMMUNITY CONTRIBUTES TO THE NEOPLASTIC TRANSFORMATION OF BLOOD CELLS BY SEVERAL MECHANISMS, INCLUDING THE UNCONTROLLED CLEARANCE OF MICROBIAL AND AUTOANTIGENS RESULTING IN CHRONIC IMMUNE STIMULATION AND PROLIFERATION, CHRONIC INFLAMMATION, AND DEFECTIVE IMMUNE SURVEILLANCE AND ANTI-CANCER IMMUNITY. RESTORING DYSFUNCTION OR ENHANCING RESPONSIVENESS OF THE INNATE IMMUNE SYSTEM MIGHT THEREFORE REPRESENT A NEW ANGLE FOR THE PREVENTION AND TREATMENT OF HEMATOLOGICAL MALIGNANCIES, IN PARTICULAR LYMPHOID MALIGNANCIES AND ASSOCIATED INFECTIONS. RECENTLY, IT HAS BEEN SHOWN THAT CELLS OF THE INNATE IMMUNE SYSTEM, SUCH AS MONOCYTES/MACROPHAGES AND NATURAL KILLER CELLS, HARBOR FEATURES OF IMMUNOLOGICAL MEMORY AND DISPLAY ENHANCED FUNCTIONALITY LONG-TERM AFTER STIMULATION WITH CERTAIN MICROORGANISMS AND VACCINES. THESE FUNCTIONAL CHANGES RELY ON EPIGENETIC REPROGRAMMING AND HAVE BEEN TERMED 'TRAINED IMMUNITY'. IN THIS REVIEW THE CONCEPT OF 'TRAINED IMMUNITY' IS DISCUSSED IN THE SETTING OF LYMPHOID MALIGNANCIES. AMELIORATION OF INFECTIOUS COMPLICATIONS AND HEMATOLOGICAL DISEASE PROGRESSION CAN BE ENVISIONED TO RESULT FROM THE INDUCTION OF TRAINED IMMUNITY, BUT FUTURE STUDIES ARE REQUIRED TO PROVE THIS EXCITING NEW HYPOTHESIS. 2016 18 3795 36 INTERLEUKIN-6 CONTRIBUTES TO GROWTH IN CHOLANGIOCARCINOMA CELLS BY ABERRANT PROMOTER METHYLATION AND GENE EXPRESSION. THE ASSOCIATION BETWEEN CHRONIC INFLAMMATION AND THE DEVELOPMENT AND PROGRESSION OF MALIGNANCY IS EXEMPLIFIED IN THE BILIARY TRACT WHERE PERSISTENT INFLAMMATION STRONGLY PREDISPOSES TO CHOLANGIOCARCINOMA. THE INFLAMMATORY CYTOKINE INTERLEUKIN-6 (IL-6) ENHANCES TUMOR GROWTH IN CHOLANGIOCARCINOMA BY ALTERED GENE EXPRESSION VIA AUTOCRINE MECHANISMS. IL-6 CAN REGULATE THE ACTIVITY OF DNA METHYLTRANSFERASES, AND MOREOVER, ABERRANT DNA METHYLATION CAN CONTRIBUTE TO CARCINOGENESIS. WE THEREFORE INVESTIGATED THE EFFECT OF CHRONIC EXPOSURE TO IL-6 ON METHYLATION-DEPENDENT GENE EXPRESSION AND TRANSFORMED CELL GROWTH IN HUMAN CHOLANGIOCARCINOMA. THE RELATIONSHIP BETWEEN AUTOCRINE IL-6 PATHWAYS, DNA METHYLATION, AND TRANSFORMED CELL GROWTH WAS ASSESSED USING MALIGNANT CHOLANGIOCYTES STABLY TRANSFECTED TO OVEREXPRESS IL-6. TREATMENT WITH THE DNA METHYLATION INHIBITOR 5-AZA-2'-DEOXYCYTIDINE DECREASED CELL PROLIFERATION, GROWTH IN SOFT AGAR, AND METHYLCYTOSINE CONTENT OF MALIGNANT CHOLANGIOCYTES. HOWEVER, THIS EFFECT WAS NOT OBSERVED IN IL-6-OVEREXPRESSING CELLS. IL-6 OVEREXPRESSION RESULTED IN THE ALTERED EXPRESSION AND PROMOTER METHYLATION OF SEVERAL GENES, INCLUDING THE EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR). EGFR PROMOTER METHYLATION WAS DECREASED AND GENE AND PROTEIN EXPRESSION WAS INCREASED BY IL-6. THUS, EPIGENETIC REGULATION OF GENE EXPRESSION BY IL-6 CAN CONTRIBUTE TO TUMOR PROGRESSION BY ALTERING PROMOTER METHYLATION AND GENE EXPRESSION OF GROWTH-REGULATORY PATHWAYS, SUCH AS THOSE INVOLVING EGFR. MOREOVER, ENHANCED IL-6 EXPRESSION MAY DECREASE THE SENSITIVITY OF TUMOR CELLS TO THERAPEUTIC TREATMENTS USING METHYLATION INHIBITORS. THESE OBSERVATIONS HAVE IMPORTANT IMPLICATIONS FOR CANCER TREATMENT AND PROVIDE A MECHANISM BY WHICH PERSISTENT CYTOKINE STIMULATION CAN PROMOTE TUMOR GROWTH. 2006 19 4769 35 NUCLEAR MORPHOMETRY, NUCLEOMICS AND PROSTATE CANCER PROGRESSION. PROSTATE CANCER (PCA) RESULTS FROM A MULTISTEP PROCESS. THIS PROCESS INCLUDES INITIATION, WHICH OCCURS THROUGH VARIOUS AGING EVENTS AND MULTIPLE INSULTS (SUCH AS CHRONIC INFECTION, INFLAMMATION AND GENETIC INSTABILITY THROUGH REACTIVE OXYGEN SPECIES CAUSING DNA DOUBLE-STRAND BREAKS), FOLLOWED BY A MULTISTEP PROCESS OF PROGRESSION. THESE STEPS INCLUDE SEVERAL GENETIC AND EPIGENETIC ALTERATIONS, AS WELL AS ALTERATIONS TO THE CHROMATIN STRUCTURE, WHICH OCCUR IN RESPONSE TO THE CARCINOGENIC STRESS-RELATED EVENTS THAT SUSTAIN PROLIFERATIVE SIGNALING. EVENTS SUCH AS EVADING GROWTH SUPPRESSORS, RESISTING CELL DEATH, ENABLING REPLICATIVE IMMORTALITY, INDUCING ANGIOGENESIS, AND ACTIVATING INVASION AND METASTASIS ARE READILY OBSERVED. IN ADDITION, IN CONJUNCTION WITH THESE CRITICAL DRIVERS OF CARCINOGENESIS, OTHER FACTORS RELATED TO THE ETIOPATHOGENESIS OF PCA, INVOLVING ENERGY METABOLISM AND EVASION OF THE IMMUNE SURVEILLANCE SYSTEM, APPEAR TO BE INVOLVED. IN ADDITION, WHEN CANCER SPREAD AND METASTASIS OCCUR, THE 'TUMOR MICROENVIRONMENT' IN THE BONE OF PCA PATIENTS MAY PROVIDE A WAY TO SUSTAIN DORMANCY OR SENESCENCE AND EVENTUALLY ESTABLISH A 'SEED AND SOIL' SITE WHERE PCA PROLIFERATION AND GROWTH MAY OCCUR OVER TIME. WHEN PCA IS INITIATED AND PROGRESSION ENSUES, SIGNIFICANT ALTERATIONS IN NUCLEAR SIZE, SHAPE AND HETEROCHROMATIN (DNA TRANSCRIPTION) ORGANIZATION ARE FOUND, AND KEY NUCLEAR TRANSCRIPTIONAL AND STRUCTURAL PROTEINS, AS WELL AS MULTIPLE NUCLEAR BODIES CAN LEAD TO PRECANCEROUS AND MALIGNANT CHANGES. THESE SERIES OF CELLULAR AND TISSUE-RELATED MALIGNANCY-ASSOCIATED EVENTS CAN BE QUANTIFIED TO ASSESS DISEASE PROGRESSION AND MANAGEMENT. 2012 20 6621 32 UNDERSTANDING FIBROSIS IN SYSTEMIC SCLEROSIS: SHIFTING PARADIGMS, EMERGING OPPORTUNITIES. FIBROSIS IN MULTIPLE ORGANS IS A PROMINENT PATHOLOGICAL FINDING AND DISTINGUISHING HALLMARK OF SYSTEMIC SCLEROSIS (SSC). FINDINGS DURING THE PAST 5 YEARS HAVE CONTRIBUTED TO A MORE COMPLETE UNDERSTANDING OF THE COMPLEX CELLULAR AND MOLECULAR UNDERPINNING OF FIBROSIS IN SSC. FIBROBLASTS, THE PRINCIPAL EFFECTOR CELLS, ARE ACTIVATED IN THE PROFIBROTIC CELLULAR MILIEU BY CYTOKINES AND GROWTH FACTORS, DEVELOPMENTAL PATHWAYS, ENDOTHELIN 1 AND THROMBIN. INNATE IMMUNE SIGNALING VIA TOLL-LIKE RECEPTORS, MATRIX-GENERATED BIOMECHANICAL STRESS SIGNALING VIA INTEGRINS, HYPOXIA AND OXIDATIVE STRESS SEEM TO BE IMPLICATED IN PERPETUATING THE PROCESS. BEYOND CHRONIC FIBROBLAST ACTIVATION, FIBROSIS REPRESENTS A FAILURE TO TERMINATE TISSUE REPAIR, COUPLED WITH AN EXPANDED POPULATION OF MESENCHYMAL CELLS ORIGINATING FROM BONE MARROW AND TRANSDIFFERENTIATION OF EPITHELIAL CELLS, ENDOTHELIAL CELLS AND PERICYTES. IN ADDITION, STUDIES HAVE IDENTIFIED INTRINSIC ALTERATIONS IN SSC FIBROBLASTS RESULTING FROM EPIGENETIC CHANGES, AS WELL AS ALTERED MICRORNA EXPRESSION THAT MIGHT UNDERLIE THE CELL-AUTONOMOUS, PERSISTENT ACTIVATION PHENOTYPE OF THESE CELLS. PRECISE CHARACTERIZATION OF THE DEREGULATED EXTRACELLULAR AND INTRACELLULAR SIGNALING PATHWAYS, MEDIATORS AND CELLULAR DIFFERENTIATION PROGRAMS THAT CONTRIBUTE TO FIBROSIS IN SSC WILL FACILITATE THE DEVELOPMENT OF SELECTIVE, TARGETED THERAPEUTIC STRATEGIES. EFFECTIVE ANTIFIBROTIC THERAPY WILL ULTIMATELY INVOLVE NOVEL COMPOUNDS AND REPURPOSING OF DRUGS THAT ARE ALREADY APPROVED FOR OTHER INDICATIONS. 2011