1 6820 161 [GASTRIC CARCINOMA AND CHRONIC GASTRITIS: EPIGENETIC REGULATION OF CDH1 (E-CADHERIN), CDKN2A (P16INK4A), PTGS2 (COX-2) AND EGFR GENES THROUGH METHYLATION]. THE GENETIC AND EPIGENETIC ALTERATIONS ARE BEING STUDIED AS ONE OF THE CAUSES OF GASTRIC CANCER (GC) PROGRESSION AND DEVELOPMENT. DNA METHYLATION IS AN EPIGENETIC ALTERATION WHICH LEADS TO SUPPRESSOR GENE SILENCING AND PROTO-ONCOGENE ACTIVATION, PLAYING AN IMPORTANT ROLE IN CARCINOGENESIS. THE HISTOLOGICAL TYPES OF GASTRIC CARCINOMA HAVE DIFFERENT GENETIC PATHS AND THE KNOWLEDGE OF THE MOLECULAR BASES OF TUMORAL PROGRESSION LEADS TO DIAGNOSTIC ACCURACY AND ATTEMPTED THERAPY. CDH1 (E-CADHERIN) AND CDKN2A (P16(INK4A)) GENES ARE THOUGHT TO BE TUMORAL SUPPRESSOR GENES AND PTGS2 (COX-2) AND GENES ARE INVOLVED IN TUMOUR REGULATION AND GROWTH. IN ONE HAND, GENE SILENCING AS AN EPIGENETIC PHENOMENON, AND IN THE OTHER HAND, GENE EXPRESSION ENHANCEMENT DUE TO POSSIBLE DEMETHYLATION, SIMULTANEOUSLY, CAN FACILITATE CARCINOGENESIS AND TUMORAL PROGRESSION. OUR AIM WAS TO RELATE CDH1, P16(INK4A), COX-2 AND EGFR GENES DNA METHYLATION WITH THE SEVERAL HISTOLOGICAL TYPES OF GASTRIC CARCINOMA AND CHRONIC GASTRITIS. WE STUDIED 55 FORMALIN FIXED PARAFFIN EMBEDDED GASTRIC BIOPSIES: 35 WERE GC SPECIMENS (12 DIFFUSE TYPE, 15 INTESTINAL TYPE AND 8 INDETERMINATE TYPE, ACCORDING TO LAUREN'S CLASSIFICATION) AND 20 SAMPLES HAD CHRONIC GASTRITIS (CG). THE DNA WAS TREATED WITH SODIUM BISULFITE AFTER EXTRACTION AND THEN PERFORMED METHYLATION SPECIFIC PCR (MSP). STATISTICAL ANALYSIS WAS BASED ON CHI-SQUARE TEST AND EXACT FISHER'S TEST. CPG ISLAND METHYLATION WAS DETECTED IN 94% OF THE GC SAMPLES FOR CDH1, 91% FOR COX-2, 80% FOR P16(INK4A) AND NO METHYLATION WAS DETECTED IN EGFR GENE (0%). IN CG, CPG ISLAND METHYLATION WAS FOUND IN 100% FOR CDH1 AND COX-2 GENES, 90% FOR P16(INK4A) AND 20% FOR EGFR. THESE RESULTS REVEAL SIGNIFICANT DIFFERENCES IN EGFR GENE METHYLATION DISTINGUISHING GC FROM CG (P < 0, 01), SUGGESTING THAT GENE DEMETHYLATION LEADS TO MALIGNANT TRANSFORMATION AND FAVOURS THE USE OF TYROSINE-KINASE INHIBITORS IN ITS TREATMENT. GENES COX2 E P16INK4A LOWER METHYLATION IN INTESTINAL AND DIFFUSE TYPES OF GC, FAVOURS THEIR DIFFERENT ROLE IN RESPECTIVE HISTOGENESIS. 2010 2 1489 32 DNA DAMAGE SIGNALLING GUARDS AGAINST ACTIVATED ONCOGENES AND TUMOUR PROGRESSION. DNA DAMAGE RESPONSE (DDR), THE GUARDIAN OF GENOMIC INTEGRITY, EMERGES AS AN ONCOGENE-INDUCIBLE BIOLOGICAL BARRIER AGAINST PROGRESSION OF CANCER BEYOND ITS EARLY STAGES. RECENT EVIDENCE FROM BOTH CELL CULTURE AND ANIMAL MODELS AS WELL AS ANALYSES OF CLINICAL SPECIMENS SHOW THAT ACTIVATION OF NUMEROUS ONCOGENES AND LOSS OF SOME TUMOUR SUPPRESSORS RESULT IN DNA REPLICATION STRESS AND DNA DAMAGE THAT ALARM THE CELLULAR DDR MACHINERY, A MULTIFACETED RESPONSE ORCHESTRATED BY THE ATR-CHK1 AND ATM-CHK2 KINASE SIGNALLING PATHWAYS. SUCH ACTIVATION OF THE DDR NETWORK LEADS TO CELLULAR SENESCENCE OR DEATH OF ONCOGENE-TRANSFORMED CELLS, RESULTING IN DELAY OR PREVENTION OF TUMORIGENESIS. AT THE SAME TIME, THE ONGOING CHRONIC DDR ACTIVATION CREATES SELECTIVE PRESSURE THAT EVENTUALLY FAVOURS OUTGROWTH OF MALIGNANT CLONES WITH GENETIC OR EPIGENETIC DEFECTS IN THE GENOME MAINTENANCE MACHINERY, SUCH AS ABERRATIONS IN THE ATM-CHK2-P53 CASCADE AND OTHER DDR COMPONENTS. FURTHERMORE, THE EXECUTIVE DDR MACHINERY IS SHARED BY AT LEAST TWO ANTICANCER BARRIERS, AS BOTH THE ONCOGENE-INDUCED DNA REPLICATION STRESS AND TELOMERE SHORTENING IMPACT THE CELL FATE DECISIONS THROUGH CONVERGENCE ON DNA DAMAGE SIGNALLING. IN THIS STUDY, WE HIGHLIGHT RECENT ADVANCES IN THIS RAPIDLY EVOLVING AREA OF CANCER RESEARCH, WITH PARTICULAR EMPHASIS ON MECHANISTIC INSIGHTS, EMERGING ISSUES OF SPECIAL CONCEPTUAL SIGNIFICANCE AND DISCUSSION OF MAJOR REMAINING CHALLENGES AND IMPLICATIONS OF THE CONCEPT OF DDR AS A TUMORIGENESIS BARRIER FOR EXPERIMENTAL AND CLINICAL ONCOLOGY. 2007 3 6206 25 THE INFLUENCE OF TISSUE SPATIAL GEOMETRY AND FUNCTIONAL ORGANISATION ON LIVER REGENERATION. THE ADULT LIVER EXERTS CRUCIAL FUNCTIONS, INCLUDING NUTRIENT METABOLISM AND STORAGE, BILE PRODUCTION AND DRUG DETOXIFICATION. THESE COMPLEX FUNCTIONS EXPOSE THE LIVER TO CONSTANT DAMAGE INDUCED BY TOXINS, METABOLIC INTERMEDIATES AND OXIDATIVE STRESS. HOWEVER, THE ADULT LIVER EXHIBITS AN EXCEPTIONAL REGENERATIVE POTENTIAL, WHICH ALLOWS FAST AND EFFICIENT RESTORATION OF TISSUE ARCHITECTURE AND FUNCTION BOTH AFTER TISSUE RESECTION AND TOXIC DAMAGE. TO ACCOMPLISH ITS VITAL ROLE, THE LIVER SHOWS A PECULIAR TISSUE ARCHITECTURE INTO FUNCTIONAL UNITS, WHICH FOLLOW THE GRADIENT OF OXYGEN AND NUTRIENTS WITHIN THE PARENCHYMA. MUCH LESS IS KNOWN ABOUT THE INFLUENCE OF TISSUE SPATIAL GEOMETRY AND FUNCTIONAL ORGANISATION ON ADULT LIVER REGENERATION. HERE I EXAMINE THE EXPERIMENTAL EVIDENCE IN MOUSE MODELS SHOWING THAT THE SPATIAL ORGANISATION OF THE EPITHELIAL AND MESENCHYMAL COMPARTMENTS PLAYS A KEY ROLE IN LIVER REGENERATION AND FAVOURS THE ESTABLISHMENT OF REGENERATIVE ADULT LIVER PROGENITORS FOLLOWING LIVER INJURY. I ALSO DISCUSS THE ADVANTAGES AND LIMITATIONS OF HUMAN AND MOUSE 3D HEPATIC ORGANOID SYSTEMS, WHICH RECAPITULATE KEY ASPECTS OF LIVER FUNCTION AND ARCHITECTURE, AS MODELS OF LIVER REGENERATION AND DISEASE. FINALLY, I ANALYSE THE ROLE OF THE YAP/TAZ TRANSCRIPTIONAL CO-ACTIVATORS AS A CENTRAL HUB SENSING THE EXTRA-CELLULAR MATRIX (ECM), METABOLIC AND EPIGENETIC REMODELLING THAT REGULATE LIVER REGENERATION AND PROMOTE LIVER DISEASE, SUCH AS FIBROSIS, CHRONIC LIVER DISEASE AND LIVER CANCER. TOGETHER, THE FINDINGS SUMMARISED HERE DEMONSTRATE THAT LOCAL PHYSICAL AND FUNCTIONAL CELLULAR INTERACTIONS DETERMINED BY THE LIVER PECULIAR SPATIAL GEOMETRY, PLAY A CRUCIAL ROLE IN LIVER REGENERATION, AND THAT THEIR ALTERATIONS HAVE IMPORTANT IMPLICATIONS FOR HUMAN LIVER DISEASE. 2022 4 1641 36 DOES GUT-BREAST MICROBIOTA AXIS ORCHESTRATES CANCER PROGRESSION? BREAST CANCER, EVEN TODAY, CAN CAUSE DEATH. THEREFORE, PREVENTION AND EARLY DETECTION ARE FUNDAMENTAL FACTORS. THE MECHANISMS THAT FAVOUR IT ARE GENETIC AND EPIGENETIC, AND SEEM TO PLAY A SIGNIFICANT ROLE; ALSO, THE MICROBIOTA CAN CHANGE ESTROGEN LEVELS AND CAN INDUCE CHRONIC INFLAMMATION IN THE NEOPLASTIC SITE, ALTERNATING THE BALANCE BETWEEN PROLIFERATION AND CELL DEATH. ACTIVATED STEROID HORMONE RECEPTORS INDUCE TRANSCRIPTION OF GENES THAT ENCODE FOR PROTEINS INVOLVED IN CELL PROLIFERATION AND ACTIVATE ANOTHER TRANSDUCTION PATHWAY, INDUCING CELL CYCLE PROGRESSION AND CELL MIGRATION. THESE IMPORTANT STUDIES HAVE ALLOWED TO DEVELOP THERAPIES WITH SELECTIVE MODULATORS OF ESTROGEN RECEPTORS (SERMS), ABLE TO BLOCK THEIR PROLIFERATIVE AND PRO-TUMORIGENIC ACTION. OF FUNDAMENTAL IMPORTANCE IS ALSO THE ROLE PLAYED BY THE MICROBIOTA IN REGULATING THE METABOLISM OF ESTROGENS AND THEIR LEVELS IN THE BLOOD. THERE ARE MICROBIAL POPULATIONS THAT ARE ABLE TO PROMOTE THE DEVELOPMENT OF BREAST CANCER, THROUGH THE PRODUCTION OF ENZYMES RESPONSIBLE FOR THE DECONJUGATION OF ESTROGENS, THE INCREASE OF THESE IN THE INTESTINE, SUBSEQUENT CIRCULATION AND MIGRATION TO OTHER LOCATIONS, SUCH AS THE UDDER. OTHER MICROBIAL POPULATIONS ARE, INSTEAD, ABLE TO SYNTHESIZE ESTROGEN COMPOUNDS OR MIMIC ESTROGENIC ACTION, AND INTERFERE WITH THE METABOLISM OF DRUGS, AFFECTING THE OUTCOME OF THERAPIES. THE MICROBIAL COMPOSITION OF THE INTESTINE AND HORMONAL METABOLISM DEPEND LARGELY ON EATING HABITS; THE CONSUMPTION OF FATS AND PROTEINS FAVOURS THE INCREASE OF ESTROGEN IN THE BLOOD, UNLIKE A DIET RICH IN FIBER. THEREFORE, IN-DEPTH KNOWLEDGE OF THE MICROBIOTA PRESENT IN THE INTESTINE-BREAST AXIS COULD, IN THE FUTURE, ENCOURAGE THE DEVELOPMENT OF NEW DIAGNOSTIC AND THERAPEUTIC APPROACHES TO BREAST CANCERS. 2022 5 5057 23 PHENOBARBITAL MECHANISTIC DATA AND RISK ASSESSMENT: ENZYME INDUCTION, ENHANCED CELL PROLIFERATION, AND TUMOR PROMOTION. CHRONIC EXPOSURE TO HIGH DOSES OF PHENOBARBITAL (PB) CAUSES HEPATOCELLULAR ADENOMAS IN BOTH MICE AND RATS AND HEPATOCELLULAR CARCINOMAS IN SOME STRAINS OF MICE. LONG-TERM PB THERAPY HAS NOT BEEN FOUND TO CAUSE HUMAN TUMORS. PB IS NOT DNA REACTIVE, AND MOST GENOTOXICITY TESTS HAVE YIELDED NEGATIVE RESULTS. PB HAS BEEN EXTENSIVELY STUDIED AS AN EPIGENETIC, RODENT LIVER TUMOR PROMOTER. AT EXPOSURES CAUSING RODENT LIVER TUMORS, PB HAS MEASURABLE EFFECTS ON HEPATOCYTES: PB INHIBITS CELL-TO-CELL COMMUNICATION; PB INDUCES ENZYMES, INCLUDING P450 CYTOCHROMES; PB STIMULATES PROLIFERATION AND INHIBITS APOPTOSIS OF HEPATOCYTES IN NEOPLASTIC FOCI. THRESHOLD EXPOSURES FOR SOME OF THESE ENDPOINTS COINCIDE WITH THE THRESHOLD EXPOSURE FOR TUMORIGENESIS. 1996 6 3571 33 IMPACT OF LOCAL ANESTHETICS ON EPIGENETICS IN CANCER. DEFECTIVE SILENCING OF TUMOR SUPPRESSOR GENES THROUGH EPIGENETIC ALTERATIONS CONTRIBUTES TO ONCOGENESIS BY PERTURBING CELL CYCLE REGULATION, DNA REPAIR OR CELL DEATH MECHANISMS. REVERSAL OF SUCH EPIGENETIC CHANGES INCLUDING DNA HYPERMETHYLATION PROVIDES A PROMISING ANTICANCER STRATEGY. UNTIL NOW, THE NUCLEOSIDE DERIVATIVES 5-AZACYTIDINE AND DECITABINE ARE THE SOLE DNA METHYLTRANSFERASE (DNMT) INHIBITORS APPROVED BY THE FDA FOR THE TREATMENT OF SPECIFIC HEMATOLOGICAL CANCERS. NEVERTHELESS, DUE TO THEIR NUCLEOSIDE STRUCTURE, THESE INHIBITORS DIRECTLY INCORPORATE INTO DNA, WHICH LEADS TO SEVERE SIDE EFFECTS AND COMPROMISES GENOMIC STABILITY. MUCH EMPHASIS HAS BEEN PLACED ON THE DEVELOPMENT OF LESS TOXIC EPIGENETIC MODIFIERS. RECENTLY, SEVERAL PRECLINICAL STUDIES DEMONSTRATED THE POTENT EPIGENETIC EFFECTS OF LOCAL ANESTHETICS, WHICH ARE ROUTINELY USED DURING PRIMARY TUMOR RESECTION TO RELIEF SURGICAL PAIN. THESE NON-NUCLEOSIDE MOLECULES INHIBIT DNMT ACTIVITY, AFFECT THE EXPRESSION OF MICRO-RNAS AND REPRESS HISTONE ACETYLATION, THUS EXERTING CYTOTOXIC EFFECTS ON MALIGNANT CELLS. THE IN-DEPTH MECHANISTIC COMPREHENSION OF THESE EPIGENETIC EFFECTS MIGHT PROMOTE THE USE OF LOCAL ANESTHETICS AS ANTICANCER DRUGS. 2022 7 6369 31 THE ROLE OF MICRORNAS IN HELICOBACTER PYLORI PATHOGENESIS AND GASTRIC CARCINOGENESIS. GASTRIC CARCINOGENESIS IS A MULTISTEP PROCESS ORCHESTRATED BY ABERRANCIES IN THE GENETIC AND EPIGENETIC REGULATION OF ONCOGENES AND TUMOR SUPPRESSOR GENES. CHRONIC INFECTION WITH HELICOBACTER PYLORI IS THE STRONGEST KNOWN RISK FACTOR FOR THE DEVELOPMENT OF GASTRIC CANCER. H. PYLORI EXPRESSES A SPECTRUM OF VIRULENCE FACTORS THAT DYSREGULATE HOST INTRACELLULAR SIGNALING PATHWAYS THAT LOWER THE THRESHOLD FOR NEOPLASTIC TRANSFORMATION. IN ADDITION TO BACTERIAL DETERMINANTS, NUMEROUS HOST AND ENVIRONMENTAL FACTORS INCREASE THE RISK OF GASTRIC CARCINOGENESIS. RECENT DISCOVERIES HAVE SHED NEW LIGHT ON THE INVOLVEMENT OF MICRORNAS (MIRNAS) IN GASTRIC CARCINOGENESIS. MIRNAS REPRESENT AN ABUNDANT CLASS OF SMALL, NON-CODING RNAS INVOLVED IN GLOBAL POST-TRANSCRIPTIONAL REGULATION AND, CONSEQUENTLY, PLAY AN INTEGRAL ROLE AT MULTIPLE STEPS IN CARCINOGENESIS, INCLUDING CELL CYCLE PROGRESSION, PROLIFERATION, APOPTOSIS, INVASION, AND METASTASIS. EXPRESSION LEVELS OF MIRNAS ARE FREQUENTLY ALTERED IN MALIGNANCIES, WHERE THEY FUNCTION AS EITHER ONCOGENIC MIRNAS OR TUMOR SUPPRESSOR MIRNAS. THIS REVIEW FOCUSES ON MIRNAS DYSREGULATED BY H. PYLORI AND POTENTIAL ETIOLOGIC ROLES THEY PLAY IN H. PYLORI-MEDIATED GASTRIC CARCINOGENESIS. 2011 8 2800 29 FEEDBACK REGULATORS OF HYPOXIA-INDUCIBLE FACTORS AND THEIR ROLE IN CANCER BIOLOGY. MALIGNANT TUMORS ARE CHARACTERIZED BY REGIONS OF LOW OXYGEN CONCENTRATION (HYPOXIA). THE HYPOXIC TUMOR MICROENVIRONMENT CONTRIBUTES TO TUMOR PROGRESSION BY ACTIVATING A SET OF ADAPTIVE RESPONSES VIA THE KEY TRANSCRIPTIONAL REGULATORS HIF-1ALPHA AND HIF-2ALPHA. THESE FACTORS HAVE BEEN TRADITIONALLY LINKED TO AN AGGRESSIVE TUMOR PHENOTYPE BY PROMOTING PROCESSES ESSENTIAL FOR TUMOR GROWTH, SUCH AS ANGIOGENESIS, GLYCOLYSIS, METASTASIS AND INVASION, AS WELL AS DIFFERENTIATION AND SELF RENEWAL. NOTABLY, THE COMPLEX HIF PATHWAY ALSO INITIATES ANTI-TUMORIGENIC MECHANISMS THAT LEAD TO CELL CYCLE ARREST OR CELL DEATH, INDICATING THE NEED FOR A STRINGENT CONTROL OF THE EXTENT AND THE DIRECTION OF THE HYPOXIA RESPONSE. THE IMPORTANCE OF THIS CONTROL FOR TUMOR CELL SURVIVAL IS ILLUSTRATED BY THE INTRICATE REGULATION OF HIF ACTIVITY AT THE MRNA, PROTEIN AND EPIGENETIC LEVEL BY A COMPLEX NETWORK OF POSITIVE AND NEGATIVE FEEDBACK REGULATORS. WE PROPOSE THAT THESE FEEDBACK REGULATORS HELP TO FLEXIBLY ADJUST AND ADAPT HIF ACTIVATED RESPONSES TO THE FLUCTUATING OXYGEN CONCENTRATIONS WITHIN TUMORS DURING ACUTE AND CHRONIC HYPOXIA AND TO CURTAIL THE TUMOR-SUPPRESSING COMPONENTS OF THE HIF PATHWAY. MOREOVER, FEEDBACK REGULATION OF HIF INDUCES A SWITCH FROM HIF-1ALPHA TO HIF-2ALPHA DRIVEN RESPONSES UNDER CHRONIC HYPOXIA WHICH MAY HAVE ESSENTIAL FUNCTIONS IN THE REGULATION OF TUMOR CELL DIFFERENTIATION AND TUMOR STEM CELL MAINTENANCE. GIVEN THEIR CENTRAL ROLE IN CANCER BIOLOGY, HIF FEEDBACK REGULATORS MAY REPRESENT AN ATTRACTIVE AND NOVEL ANTI-TUMOR THERAPY TARGET TO OVERCOME CELL DEATH RESISTANCE IN TUMORS. 2010 9 3226 34 HELICOBACTER PYLORI INFECTION, ONCOGENIC PATHWAYS AND EPIGENETIC MECHANISMS IN GASTRIC CARCINOGENESIS. CHRONIC COLONIZATION OF THE HUMAN STOMACH BY HELICOBACTER PYLORI, A GRAM-NEGATIVE BACTERIUM, IS THE MAJOR CAUSE OF CHRONIC GASTRITIS, PEPTIC ULCERS AND GASTRIC CANCER. RECENT PROGRESS HAS ELUCIDATED IMPORTANT BACTERIAL AND HOST FACTORS THAT ARE RESPONSIBLE FOR H. PYLORI-INDUCED GASTRIC INFLAMMATION AND GASTRIC MALIGNANCY. H. PYLORI CYTOTOXIN-ASSOCIATED ANTIGEN A IS THE MAJOR ONCOGENIC FACTOR INJECTED INTO HOST CELLS FROM BACTERIA AND IT DISRUPTS EPITHELIAL CELL FUNCTIONS. TOGETHER WITH H. PYLORI CAG PATHOGENICITY ISLAND, IT CAUSES GENERAL INFLAMMATORY STRESS WITHIN GASTRIC MUCOSA AND ACTIVATES MULTIPLE ONCOGENIC PATHWAYS IN EPITHELIAL CELLS. A GROWING LIST OF THESE PATHWAYS INCLUDES NF-KAPPAB, ACTIVATOR PROTEIN-1, PI3K, SIGNAL TRANSDUCERS AND ACTIVATORS OF TRANSCRIPTION 3, WNT/BETA-CATENIN AND CYCLOOXYGENASE 2. H. PYLORI INDUCES EPIGENETIC ALTERATIONS, SUCH AS DNA METHYLATION AND HISTONE MODIFICATION, WHICH PLAY CRITICAL ROLES IN ONCOGENIC TRANSFORMATION. IN ADDITION, INVESTIGATIONS INTO GASTRIC STEM CELL OR PROGENITOR CELL BIOLOGY HAVE SHED LIGHT ON THE MECHANISMS THROUGH WHICH GASTRIC CANCER MAY ORIGINATE. CONTINUED INVESTIGATION IN THESE AREAS WILL YIELD NOVEL INSIGHTS AND HELP TO ELUCIDATE THE MECHANISMS OF BACTERIA-INDUCED CARCINOGENESIS. 2010 10 767 35 CD24 MEDIATES GASTRIC CARCINOGENESIS AND PROMOTES GASTRIC CANCER PROGRESSION VIA STAT3 ACTIVATION. THE DEVELOPMENT OF GASTRIC CANCER (GC) IS A COMPLEX MULTISTEP PROCESS, INCLUDING NUMEROUS GENETIC AND EPIGENETIC CHANGES. CD24 IS ASSOCIATED WITH ENHANCED INVASIVENESS OF GC AND A POOR PROGNOSIS. HOWEVER, THE MECHANISM BY WHICH CD24 INDUCES GC PROGRESSION REMAINS POORLY CHARACTERIZED. HERE, WE FOUND THAT THE EXPRESSION OF CD24 GRADUALLY INCREASED IN SAMPLES OF NORMAL GASTRIC MUCOSA, NON-ATROPHIC CHRONIC GASTRITIS, CHRONIC ATROPHIC GASTRITIS (CAG), CAG WITH INTESTINAL METAPLASIA, DYSPLASIA AND GC. MOREOVER, THE KNOCKDOWN OF CD24 INDUCED SIGNIFICANT LEVELS OF APOPTOSIS IN GC CELLS VIA THE MITOCHONDRIAL APOPTOTIC PATHWAY. CD24 MAY ALSO PROMOTE CELLULAR INVASION AND REGULATE THE EXPRESSION OF E-CADHERIN, FIBRONECTIN AND VITAMIN D RECEPTOR IN GC CELLS. THE ACTIVATION OF SIGNAL TRANSDUCER AND ACTIVATOR OF TRANSCRIPTION 3 (STAT3) MAY MEDIATE CD24-INDUCED GC SURVIVAL AND INVASION IN VITRO. FURTHERMORE, CD24-INDUCED GC PROGRESSION AND STAT3 ACTIVATION COULD ALSO BE DETECTED IN VIVO AND IN CLINICAL GC TISSUES SAMPLES. TAKEN TOGETHER, OUR RESULTS INDICATE THAT CD24 MEDIATES GASTRIC CARCINOGENESIS AND MAY PROMOTE GC PROGRESSION BY SUPPRESSING APOPTOSIS AND PROMOTING INVASION, WITH THE ACTIVATION OF STAT3 PLAYING A CRITICAL ROLE. 2014 11 3685 32 INFLAMMATION-ASSOCIATED CANCER DEVELOPMENT IN DIGESTIVE ORGANS: MECHANISMS AND ROLES FOR GENETIC AND EPIGENETIC MODULATION. CHRONIC INFLAMMATION, REGARDLESS OF INFECTIOUS AGENTS, PLAYS IMPORTANT ROLES IN THE DEVELOPMENT OF VARIOUS CANCERS, PARTICULARLY IN DIGESTIVE ORGANS, INCLUDING HELICOBACTER PYLORI-ASSOCIATED GASTRIC CANCER, HEPATITIS C VIRUS-POSITIVE HEPATOCELLULAR CARCINOMA, AND COLITIS-ASSOCIATED COLON CANCERS. CANCER DEVELOPMENT IS CHARACTERIZED BY STEPWISE ACCUMULATION OF GENETIC AND EPIGENETIC ALTERATIONS OF VARIOUS PROTO-ONCOGENES AND TUMOR-SUPPRESSOR GENES. DURING CHRONIC INFLAMMATION, INFECTIOUS AGENTS SUCH AS H PYLORI AND HEPATITIS C VIRUS AS WELL AS INTRINSIC MEDIATORS OF INFLAMMATORY RESPONSES, INCLUDING PROINFLAMMATORY CYTOKINES AND REACTIVE OXYGEN AND NITROGEN SPECIES, CAN INDUCE GENETIC AND EPIGENETIC CHANGES, INCLUDING POINT MUTATIONS, DELETIONS, DUPLICATIONS, RECOMBINATIONS, AND METHYLATION OF VARIOUS TUMOR-RELATED GENES THROUGH VARIOUS MECHANISMS. FURTHERMORE, INFLAMMATION ALSO MODULATES THE EXPRESSIONS OF MICRORNAS THAT INFLUENCE THE PRODUCTION OF SEVERAL TUMOR-RELATED MESSENGER RNAS OR PROTEINS. THESE MOLECULAR EVENTS INDUCED BY CHRONIC INFLAMMATION WORK IN CONCERT TO ALTER IMPORTANT PATHWAYS INVOLVED IN NORMAL CELLULAR FUNCTION, AND HENCE ACCELERATE INFLAMMATION-ASSOCIATED CANCER DEVELOPMENT. AMONG THESE, RECENT STUDIES HIGHLIGHTED AN IMPORTANT ROLE OF ACTIVATION-INDUCED CYTIDINE DEAMINASE, A NUCLEOTIDE-EDITING ENZYME ESSENTIAL FOR SOMATIC HYPERMUTATION AND CLASS-SWITCH RECOMBINATION OF THE IMMUNOGLOBULIN GENE, AS A GENOMIC MODULATOR IN INFLAMMATION-ASSOCIATED CANCER DEVELOPMENT. 2012 12 4960 34 PATHOGENESIS OF PRE-NEOPLASTIC LESIONS OF THE STOMACH: TARGETS FOR PREVENTION. GASTRIC ATROPHY AND INTESTINAL METAPLASIA ARE GENERALLY CONSIDERED TO BE PRECANCEROUS LESIONS OF THE STOMACH. CHRONIC HELICOBACTER PYLORI INFECTION IS ONE THE MOST IMPORTANT FACTORS IN THE DEVELOPMENT OF THESE PRE-MALIGNANT GASTRIC LESIONS. IN ADDITION TO BACTERIAL FACTORS, POLYMORPHISMS IN THE CYTOKINE GENES OF THE HOST THAT MODULATE INFLAMMATORY RESPONSES ARE FOUND TO HAVE A SYNERGISTIC EFFECT IN THE DEVELOPMENT OF GASTRIC CANCER AS WELL AS PRE-NEOPLASTIC LESIONS. RECENTLY, INAPPROPRIATE ACTIVATION OF THE INTESTINE-SPECIFIC TRANSCRIPTION FACTOR LIKE THE HOMEOBOX GENE COMPLEX CDX1 AND CDX2 ARE FOUND TO BE AN IMPORTANT CONTRIBUTING FACTOR IN THE INDUCTION OF INTESTINAL METAPLASIA IN THE STOMACH. ABERRANT EXPRESSION OF CYCLOOXYGENASE-2 AND EPIGENETIC CHANGES ARE ALSO FREQUENTLY DETECTED IN PRE-NEOPLASTIC GASTRIC LESIONS. ONE OF THE MOST IMPORTANT QUESTIONS RELATING TO THESE PRE-NEOPLASTIC GASTRIC LESIONS IS THAT WHETHER H. PYLORI ERADICATION COULD REVERSE THESE CHANGES. HOWEVER, MOST CONTROLLED STUDIES SHOWED NO OR JUST MODEST IMPROVEMENT IN INTESTINAL METAPLASIA AFTER H. PYLORI ERADICATION. FURTHER STUDIES SHOULD EVALUATE THE ROLE OF OTHER CHEMOPREVENTIVE AGENTS, PARTICULARLY CYCLOOXYGENASE-2 INHIBITOR, ON REGRESSION OF PRE-NEOPLASTIC LESIONS. 2004 13 4769 34 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 14 2943 33 GENETIC AND EPIGENETIC ALTERATIONS OF TUMOR SUPPRESSOR AND TUMOR-RELATED GENES IN GASTRIC CANCER. BOTH GENETIC AND EPIGENETIC ALTERATIONS OF TUMOR SUPPRESSOR AND TUMOR-RELATED GENES INVOLVED IN THE PATHOGENESIS OF GASTRIC CANCER ARE REVIEWED HERE, AND MOLECULAR PATHWAYS OF GASTRIC CARCINOGENESIS ARE PROPOSED. GASTRIC CARCINOMAS ARE BELIEVED TO EVOLVE FROM NATIVE GASTRIC MUCOSA OR INTESTINAL METAPLASTIC MUCOSA THAT UNDERGOES GENETIC AND EPIGENETIC ALTERATIONS INVOLVING EITHER THE SUPPRESSOR PATHWAY (DEFECTS IN TUMOR SUPPRESSOR GENES) OR MUTATOR PATHWAY (DEFECTS IN DNA MISMATCH REPAIR GENES). METHYLATION OF E-CADHERIN IN NATIVE GASTRIC MUCOSA RESULTS IN UNDIFFERENTIATED CARCINOMAS (SUPPRESSOR PATHWAY), WHILE METHYLATION OF HMLHI RESULTS IN DIFFERENTIATED FOVEOLAR-TYPE CARCINOMAS (MUTATOR PATHWAY). THE MAJORITY OF DIFFERENTIATED GASTRIC CARCINOMAS HOWEVER, ARISE FROM INTESTINAL METAPLASTIC MUCOSA AND EXHIBIT STRUCTURAL ALTERATIONS OF TUMOR SUPPRESSOR GENES, ESPECIALLY P53. THEY APPEAR TO BE RELATED TO CHRONIC INJURY, PERHAPS DUE TO HELICOBACTER PYLORI INFECTION. APPROXIMATELY 20% OF DIFFERENTIATED CARCINOMAS (ORDINARY-TYPE) HAVE EVIDENCE OF MUTATOR PATHWAY TUMORIGENESIS. MUTATIONS OF E-CADHERIN ARE MAINLY INVOLVED IN THE PROGRESSION OF DIFFERENTIATED CARCINOMAS TO UNDIFFERENTIATED TUMORS. THE MOLECULAR PATHWAYS OF GASTRIC CARCINOGENESIS DEPEND ON THE HISTOLOGICAL BACKGROUND, AND GASTRIC CARCINOMAS SHOW DISTINCT BIOLOGICAL BEHAVIORS AS A RESULT OF DISCERNIBLE CELLULAR GENETIC AND EPIGENETIC ALTERATIONS. 2002 15 2894 24 GASTRIC CANCER AS A STEM-CELL DISEASE: DATA AND HYPOTHESES. THE MAIN FUNCTION OF GASTRIC STEM CELLS IS TO MAINTAIN THE INTEGRITY OF THE GASTROINTESTINAL EPITHELIUM AND REPLENISH ALL THE MATURE CELL LINEAGES. IN ORDER TO ACCOMPLISH THIS, GASTRIC STEM CELLS PROLIFERATE AND SELF-RENEW, GIVING RISE TO TRANSIENT AMPLIFYING CELLS WHICH REPLACE THE CONSTANTLY RENEWING EPITHELIUM, ESPECIALLY AFTER INJURY INDUCED BY LONG-TERM INFLAMMATION. GASTRIC CANCER (GC) REMAINS THE FOURTH MOST COMMON CANCER AND THE SECOND LEADING CAUSE OF DEATH FOR CANCER IN THE WORLD. THE MOST ACCEPTED MODEL OF GASTRIC CARCINOGENESIS PROVIDES A MULTIFACTORIAL AND MULTISTEP PATHOGENESIS, INVOLVING A NUMBER OF INITIATORS AND OTHER CONTINUATOR AGENTS. HELICOBACTER PYLORI INFECTION IS RECOGNIZED AS A NECESSARY BUT INSUFFICIENT CAUSE OF GC. RECENT ADVANCES IN GASTRIC STEM CELL BIOLOGY POINT OUT TO TWO HYPOTHESES. IN THE FIRST, IT IS POSTULATED THAT RESIDENT STEM CELLS MAY, IN A CHRONICALLY INFLAMED ENVIRONMENT, AS IN THE CASE OF HELICOBACTER PYLORI-INDUCED GASTRITIS, ACCUMULATE OVER TIME A SERIES OF GENETIC AND EPIGENETIC CHANGES THAT LEAD TO THE EMERGENCE OF GC STEM CELLS. ALTERNATIVELY, THE SETTING OF CHRONIC INFLAMMATORY STRESS MAY LEAD TO LOSS OF THE INDIGENOUS GASTRIC STEM CELLS FROM THEIR NICHES, FOLLOWED BY RECRUITMENT AND ENGRAFTMENT OF BONE MARROW DERIVED STEM CELLS (BMDCS) INTO THE GASTRIC EPITHELIUM. IN THE MOUSE MODEL, INCREASING EVIDENCE SUPPORTS THE HYPOTHESIS THAT BMDCS ARE IMPORTANT CELLULAR SOURCE OF HELICOBACTER-INDUCED GC. THIS REVIEW HIGHLIGHTS DATA AND HYPOTHESES ABOUT GC AS A MODEL OF STEM-CELL DISEASE. 2014 16 835 33 CHEMICAL CARCINOGEN MECHANISMS OF ACTION AND IMPLICATIONS FOR TESTING METHODOLOGY. CHEMICAL CARCINOGENS ARE OF TWO DISTINCT TYPES, DNA-REACTIVE AND EPIGENETIC. TESTING METHODOLOGY CAN BE DIRECTED TOWARD DETECTING EFFECTS OF BOTH TYPES OF CARCINOGEN. CARCINOGENS OF THE DNA-REACTIVE TYPE ARE DEFINED BY THE FORMATION OF COVALENTLY BOUND DNA ADDUCTS. THESE CHEMICALS HAVE STRUCTURES THAT YIELD ELECTROPHILIC REACTANTS EITHER DIRECTLY OR AFTER BIOACTIVATION. THESE AGENTS CAUSE GENOMIC ALTERATION IN THE STRUCTURE OR FUNCTION OF DNA IN THE TARGET CELL. IN ADDITION, THESE COMPOUNDS CAN EXERT OTHER CELLULAR AND TISSUE EPIGENETIC EFFECTS, SUCH AS CELL PROLIFERATION AND GROWTH PROMOTION. CARCINOGENS OF THE EPIGENETIC (PARAGENETIC) TYPE, IN CONTRAST, DO NOT REACT WITH DNA, BUT RATHER DISPLAY CELLULAR EFFECTS SUCH AS NEOPLASM GROWTH PROMOTION, CYTOTOXICITY, INHIBITION OF TISSUE GROWTH REGULATION, PEROXISOME PROLIFERATION, ENDOCRINE MODIFICATION, IMMUNOSUPPRESSION AND/OR SUSTAINED TISSUE ISCHEMIA THAT CAN BE THE BASIS FOR INCREASES IN NEOPLASIA. THEIR CHEMICAL STRUCTURE IS SUCH THAT THEY DO NOT GIVE RISE TO A REACTIVE ELECTROPHILE. THE TESTING METHODOLOGIES TO IDENTIFY EITHER TYPE FOLLOW A DECISION POINT APPROACH DESIGNED TO IDENTIFY POTENTIAL CARCINOGENICITY AND YIELD MECHANISTIC INFORMATION ON THE PRODUCTION OF EFFECTS THAT UNDERLIE CARCINOGENICITY. IT HAS 5 STAGES FOCUSING ON THE CHEMICAL STRUCTURE, DNA-REACTIVITY, EPIGENETIC EFFECTS, LIMITED BIOASSAYS AND FINALLY THE APPLICATION OF THE ACCELERATED BIOASSAY (ABA). ABA REQUIRES 40 WEEKS AND APPLIES THE USE OF SENSITIVE MARKERS FOR INDUCTION OF NEOPLASIA IN COMPARISON TO POSITIVE CONTROL COMPOUNDS FOR IMPORTANT ORGANS IN HUMAN CARCINOGENESIS. IT ENABLES DATA ACQUISITION OF THE ENTIRE CARCINOGENIC PROCESS DIRECTED TOWARD DEVELOPING MECHANISTIC INFORMATION. THE ABA HAS THE POTENTIAL TO REPLACE THE CHRONIC BIOASSAY IN RODENTS IN SOME CIRCUMSTANCES AND CAN SERVE AS AN ALTERNATIVE TO A CHRONIC BIOASSAY IN A SECOND SPECIES. 1996 17 5939 35 TARGETING MECHANOTRANSDUCTION AT THE TRANSCRIPTIONAL LEVEL: YAP AND BRD4 ARE NOVEL THERAPEUTIC TARGETS FOR THE REVERSAL OF LIVER FIBROSIS. LIVER FIBROSIS IS THE RESULT OF A DEREGULATED WOUND HEALING PROCESS CHARACTERIZED BY THE EXCESSIVE DEPOSITION OF EXTRACELLULAR MATRIX. HEPATIC STELLATE CELLS (HSCS), WHICH ARE ACTIVATED IN RESPONSE TO LIVER INJURY, ARE THE MAJOR SOURCE OF EXTRACELLULAR MATRIX AND DRIVE THE WOUND HEALING PROCESS. HOWEVER, CHRONIC LIVER DAMAGE LEADS TO PERPETUAL HSC ACTIVATION, PROGRESSIVE FORMATION OF PATHOLOGICAL SCAR TISSUE AND ULTIMATELY, CIRRHOSIS AND ORGAN FAILURE. HSC ACTIVATION IS TRIGGERED LARGELY IN RESPONSE TO MECHANOSIGNALING FROM THE MICROENVIRONMENT, WHICH INDUCES A PROFIBROTIC NUCLEAR TRANSCRIPTION PROGRAM THAT PROMOTES HSC PROLIFERATION AND EXTRACELLULAR MATRIX SECRETION THEREBY SETTING UP A POSITIVE FEEDBACK LOOP LEADING TO MATRIX STIFFENING AND SELF-SUSTAINED, PATHOLOGICAL, HSC ACTIVATION. DESPITE THE SIGNIFICANT PROGRESS IN OUR UNDERSTANDING OF LIVER FIBROSIS, THE MOLECULAR MECHANISMS THROUGH WHICH THE EXTRACELLULAR MATRIX PROMOTES HSC ACTIVATION ARE NOT WELL UNDERSTOOD AND NO EFFECTIVE THERAPIES HAVE BEEN APPROVED TO DATE THAT CAN TARGET THIS EARLY, REVERSIBLE, STAGE IN LIVER FIBROSIS. SEVERAL NEW LINES OF INVESTIGATION NOW PROVIDE IMPORTANT INSIGHT INTO THIS AREA OF STUDY AND IDENTIFY TWO NUCLEAR TARGETS WHOSE INHIBITION HAS THE POTENTIAL OF REVERSING LIVER FIBROSIS BY INTERFERING WITH HSC ACTIVATION: YES-ASSOCIATED PROTEIN (YAP), A TRANSCRIPTIONAL CO-ACTIVATOR AND EFFECTOR OF THE MECHANOSENSITIVE HIPPO PATHWAY, AND BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4), AN EPIGENETIC REGULATOR OF GENE EXPRESSION. YAP AND BRD4 ACTIVITY IS INDUCED IN RESPONSE TO MECHANICAL STIMULATION OF HSCS AND EACH PROTEIN INDEPENDENTLY CONTROLS WAVES OF EARLY GENE EXPRESSION NECESSARY FOR HSC ACTIVATION. SIGNIFICANTLY, INHIBITION OF EITHER PROTEIN CAN REVERT THE CHRONIC ACTIVATION OF HSCS AND IMPEDE PATHOLOGICAL PROGRESSION OF LIVER FIBROSIS IN CLINICALLY RELEVANT MODEL SYSTEMS. IN THIS REVIEW WE WILL DISCUSS THE ROLES OF THESE NUCLEAR CO-ACTIVATORS IN HSC ACTIVATION, THEIR MECHANISM OF ACTION IN THE FIBROTIC PROCESS IN THE LIVER AND OTHER ORGANS, AND THE POTENTIAL OF TARGETING THEIR ACTIVITY WITH SMALL MOLECULE DRUGS FOR FIBROSIS REVERSAL. 2016 18 4501 22 MORPHOGENS AND HEPATIC STELLATE CELL FATE REGULATION IN CHRONIC LIVER DISEASE. HEPATIC STELLATE CELLS (HSC) ARE THE LIVER MESENCHYMAL CELL TYPE WHICH RESPONDS TO HEPATOCELLULAR DAMAGE AND PARTICIPATES IN WOUND HEALING. ALTHOUGH HSC MYOFIBROBLASTIC TRANS-DIFFERENTIATION (ACTIVATION) IS IMPLICATED IN EXCESSIVE EXTRACELLULAR MATRIX DEPOSITION, MOLECULAR UNDERSTANDING OF THIS PHENOTYPIC SWITCH FROM THE VIEWPOINT OF CELL FATE REGULATION IS LIMITED. RECENT STUDIES DEMONSTRATE THE ROLES OF ANTI-ADIPOGENIC MORPHOGENS (WNT, NECDIN, SHH) IN EPIGENETIC REPRESSION OF THE HSC DIFFERENTIATION GENE PPARGAMMA AS A CAUSAL EVENT IN HSC ACTIVATION. THESE MORPHOGENS HAVE POSITIVE CROSS-INTERACTIONS WHICH CONVERGE TO EPIGENETIC REPRESSION OF PPARGAMMA INVOLVING THE METHYL-CPG BINDING PROTEIN MECP2. HOWEVER, THESE MORPHOGENS EXPRESSED BY ACTIVATED HSC MAY ALSO PARTICIPATE IN CROSS-TALK BETWEEN HSC AND HEPATOBLASTS/HEPATOCYTES TO SUPPORT LIVER REGENERATION, AND THEIR ABERRANT REGULATION MAY CONTRIBUTE TO LIVER TUMORIGENESIS. IMPLICATIONS OF HSC-DERIVED MORPHOGENS IN THESE POSSIBILITIES ARE DISCUSSED. 2012 19 3224 30 HELICOBACTER PYLORI INFECTION AND STEM CELLS AT THE ORIGIN OF GASTRIC CANCER. HELICOBACTER PYLORI INFECTION IS NOW RECOGNIZED AS THE MAIN AND SPECIFIC INFECTIOUS CAUSE OF CANCER IN THE WORLD. IT IS RESPONSIBLE FOR GASTRIC ADENOCARCINOMAS OF BOTH INTESTINAL AND DIFFUSE TYPES, WHICH ARE THE LONG-TERM CONSEQUENCES OF THE CHRONIC INFECTION OF THE GASTRIC MUCOSA. CASE-CONTROL STUDIES HAVE SHOWN AN ASSOCIATION BETWEEN THE TWO, RECOGNIZED AS EARLY AS 1994 AND FURTHER SUBSTANTIATED BY INTERVENTIONAL STUDIES IN WHICH H. PYLORI ERADICATION HAS LED TO THE PREVENTION OF AT LEAST PART OF THE GASTRIC CANCERS. EXPERIMENTAL STUDIES HAVE HIGHLIGHTED THE ROLE OF BONE MARROW-DERIVED CELLS (BMDCS) AND PARTICULARLY MESENCHYMAL STEM CELLS, IN THE NEOPLASTIC PROCESS IN ABOUT A QUARTER OF THE CASES AND POSSIBLY AN EPITHELIAL-MESENCHYMAL TRANSITION (EMT) IN THE OTHER CASES. DIFFERENT STUDIES HAVE CONFIRMED THAT CHRONIC INFECTION WITH H. PYLORI INDUCES A CHRONIC INFLAMMATION AND SUBSEQUENT DAMAGE OF THE GASTRIC EPITHELIAL MUCOSA, LEADING TO BMDC RECRUITMENT. ONCE RECRUITED, THESE CELLS HOME AND DIFFERENTIATE BY CELL-CELL FUSION WITH LOCAL GASTRIC EPITHELIAL CELLS, BEARING LOCAL STEM CELL FAILURE AND PARTICIPATING IN TISSUE REGENERATION. THE CONTEXT OF CHRONIC INFECTION AND INFLAMMATION LEADS TO AN EMT AND ALTERED TISSUE REGENERATION AND DIFFERENTIATION FROM BOTH LOCAL EPITHELIAL STEM CELLS AND BMDC. EMT INDUCES THE EMERGENCE OF CD44+ CELLS POSSESSING MESENCHYMAL AND STEM CELL PROPERTIES, RESULTING IN METAPLASTIC AND DYSPLASTIC LESIONS TO GIVE RISE, AFTER ADDITIONAL EPIGENETIC AND MUTATIONAL EVENTS, TO THE EMERGENCE OF CANCER STEM CELLS (CSCS) AND ADENOCARCINOMA. 2015 20 3232 25 HELICOBACTER PYLORI-INDUCED SIGNALING PATHWAYS CONTRIBUTE TO INTESTINAL METAPLASIA AND GASTRIC CARCINOGENESIS. HELICOBACTER PYLORI (H. PYLORI) INDUCES CHRONIC GASTRIC INFLAMMATION, ATROPHIC GASTRITIS, INTESTINAL METAPLASIA, AND CANCER. ALTHOUGH THE RISK OF GASTRIC CANCER INCREASES EXPONENTIALLY WITH THE EXTENT OF ATROPHIC GASTRITIS, THE PRECISE MECHANISMS OF GASTRIC CARCINOGENESIS HAVE NOT BEEN FULLY ELUCIDATED. H. PYLORI INDUCES GENETIC AND EPIGENETIC CHANGES IN GASTRIC EPITHELIAL CELLS THROUGH ACTIVATING INTRACELLULAR SIGNALING PATHWAYS IN A CAGPAI-DEPENDENT MANNER. H. PYLORI EVENTUALLY INDUCES GASTRIC CANCER WITH CHROMOSOMAL INSTABILITY (CIN) OR MICROSATELLITE INSTABILITY (MSI), WHICH ARE CLASSIFIED AS TWO MAJOR SUBTYPES OF GASTRIC CANCER. ELUCIDATION OF THE PRECISE MECHANISMS OF GASTRIC CARCINOGENESIS WILL ALSO BE IMPORTANT FOR CANCER THERAPY. 2015