1 1390 59 DIAGNOSING NOCIPLASTIC PAIN IN CANCER SURVIVORS: A MAJOR STEP FORWARD. NOCIPLASTIC PAIN SYNDROMES INCLUDE PARTICULAR FIBROMYALGIA, IRRITABLE BOWEL SYNDROME, HEADACHE, COMPLEX REGIONAL PAIN SYNDROME, AND IDIOPATHIC OROFACIAL PAIN. SEVERAL MECHANISMS HAVE BEEN PROPOSED TO ACCOUNT FOR NOCIPLASTIC PAIN INCLUDING CENTRAL SENSITISATION, ALTERATIONS OF PAIN MODULATORY CONTROLS, EPIGENETIC CHANGES, AND PERIPHERAL MECHANISMS. IMPORTANTLY, NOCIPLASTIC PAIN MIGHT ALSO BE PRESENT IN PATIENTS WITH CANCER PAIN, PARTICULARLY THOSE WITH PAIN RELATED TO COMPLICATIONS OF CANCER TREATMENT. INCREASED AWARENESS OF NOCIPLASTIC PAIN ASSOCIATED WITH CANCER SHOULD HAVE IMPORTANT IMPLICATIONS FOR MONITORING AND MANAGING SUCH PATIENTS. 2023 2 1969 18 EPIGENETIC ALTERATIONS AND AN INCREASED FREQUENCY OF MICRONUCLEI IN WOMEN WITH FIBROMYALGIA. FIBROMYALGIA (FM), CHARACTERIZED BY CHRONIC WIDESPREAD PAIN, FATIGUE, AND COGNITIVE/MOOD DISTURBANCES, LEADS TO REDUCED WORKPLACE PRODUCTIVITY AND INCREASED HEALTHCARE EXPENSES. TO DETERMINE IF ACQUIRED EPIGENETIC/GENETIC CHANGES ARE ASSOCIATED WITH FM, WE COMPARED THE FREQUENCY OF SPONTANEOUSLY OCCURRING MICRONUCLEI (MN) AND GENOME-WIDE METHYLATION PATTERNS IN WOMEN WITH FM (N = 10) TO THOSE SEEN IN COMPARABLY AGED HEALTHY CONTROLS (N = 42 (MN); N = 8 (METHYLATION)). THE MEAN (SD) MN FREQUENCY OF WOMEN WITH FM (51.4 (21.9)) WAS SIGNIFICANTLY HIGHER THAN THAT OF CONTROLS (15.8 (8.5)) (CHI (2) = 45.552; DF = 1; P = 1.49 X 10(-11)). SIGNIFICANT DIFFERENCES (N = 69 SITES) IN METHYLATION PATTERNS WERE OBSERVED BETWEEN CASES AND CONTROLS CONSIDERING A 5% FALSE DISCOVERY RATE. THE MAJORITY OF DIFFERENTIALLY METHYLATED (DM) SITES (91%) WERE ATTRIBUTABLE TO INCREASED VALUES IN THE WOMEN WITH FM. THE DM SITES INCLUDED SIGNIFICANT BIOLOGICAL CLUSTERS INVOLVED IN NEURON DIFFERENTIATION/NERVOUS SYSTEM DEVELOPMENT, SKELETAL/ORGAN SYSTEM DEVELOPMENT, AND CHROMATIN COMPACTION. GENES ASSOCIATED WITH DM SITES WHOSE FUNCTION HAS PARTICULAR RELEVANCE TO FM INCLUDED BDNF, NAT15, HDAC4, PRKCA, RTN1, AND PRKG1. RESULTS SUPPORT THE NEED FOR FUTURE RESEARCH TO FURTHER EXAMINE THE POTENTIAL ROLE OF EPIGENETIC AND ACQUIRED CHROMOSOMAL ALTERATIONS AS A POSSIBLE BIOLOGICAL MECHANISM UNDERLYING FM. 2013 3 1601 21 DNA METHYLATION SIGNATURES OF FUNCTIONAL SOMATIC SYNDROMES: SYSTEMATIC REVIEW. OBJECTIVE: FUNCTIONAL SOMATIC SYNDROMES (FSS) ARE HIGHLY PREVALENT ACROSS ALL LEVELS OF HEALTHCARE. THE FACT THAT THEY ARE CHARACTERISED BY MEDICALLY UNEXPLAINED SYMPTOMS, SUCH AS FATIGUE AND PAIN, RAISES THE IMPORTANT QUESTION OF THEIR UNDERLYING PATHOPHYSIOLOGY. PSYCHOSOCIAL STRESS REPRESENTS A SIGNIFICANT FACTOR IN THE DEVELOPMENT OF FSS AND CAN INDUCE LONG-TERM MODIFICATIONS AT THE EPIGENETIC LEVEL. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY REVIEW, FOR THE FIRST TIME, WHETHER INDIVIDUALS WITH FSS ARE CHARACTERISED BY SPECIFIC ALTERATIONS IN DNA METHYLATION. METHODS: MEDLINE AND PSYCINFO WERE SEARCHED FROM THE FIRST AVAILABLE DATE UNTIL SEPTEMBER 2022. THE INCLUSION CRITERIA WERE: 1) ADULTS FULFILLING RESEARCH DIAGNOSTIC CRITERIA FOR CHRONIC FATIGUE SYNDROME, FIBROMYALGIA SYNDROME, AND/OR IRRITABLE BOWEL SYNDROME, 2) HEALTHY CONTROL GROUP, AND 3) CANDIDATE-GENE OR GENOME-WIDE STUDY OF DNA METHYLATION. RESULTS: SIXTEEN STUDIES (N = 957) WERE INCLUDED. IN CANDIDATE-GENE STUDIES, SPECIFIC SITES WITHIN NR3C1 WERE IDENTIFIED, WHICH WERE HYPOMETHYLATED IN INDIVIDUALS WITH CHRONIC FATIGUE SYNDROME COMPARED TO HEALTHY CONTROLS. IN GENOME-WIDE STUDIES IN CHRONIC FATIGUE SYNDROME, A HYPOMETHYLATED SITE LOCATED TO LY86 AND HYPERMETHYLATED SITES WITHIN HLA-DQB1 WERE FOUND. IN GENOME-WIDE STUDIES IN FIBROMYALGIA SYNDROME, DIFFERENTIAL METHYLATION IN SITES RELATED TO HDAC4 , TMEM44 , KCNQ1 , SLC17A9 , PRKG1 , ALPK3 , TFAP2A , AND LY6G5C WAS FOUND. CONCLUSIONS: INDIVIDUALS WITH CHRONIC FATIGUE SYNDROME AND FIBROMYALGIA SYNDROME APPEAR TO BE CHARACTERISED BY ALTERED DNA METHYLATION OF GENES REGULATING CELLULAR SIGNALLING AND IMMUNE FUNCTIONING. IN CHRONIC FATIGUE SYNDROME, THERE IS PRELIMINARY EVIDENCE FOR THESE TO BE IMPLICATED IN KEY PATHOPHYSIOLOGICAL ALTERATIONS, SUCH AS HYPOCORTISOLISM AND LOW-GRADE INFLAMMATION, AND TO CONTRIBUTE TO THE DEBILITATING SYMPTOMS THESE INDIVIDUALS EXPERIENCE.PREREGISTRATION PROSPERO IDENTIFIER: CRD42022364720. 2023 4 2815 22 FIBROMYALGIA: GENETICS AND EPIGENETICS INSIGHTS MAY PROVIDE THE BASIS FOR THE DEVELOPMENT OF DIAGNOSTIC BIOMARKERS. FIBROMYALGIA IS A DISEASE CHARACTERIZED BY CHRONIC WIDESPREAD PAIN WITH ADDITIONAL SYMPTOMS, SUCH AS JOINT STIFFNESS, FATIGUE, SLEEP DISTURBANCE, COGNITIVE DYSFUNCTION, AND DEPRESSION. CURRENTLY, FIBROMYALGIA DIAGNOSIS IS BASED EXCLUSIVELY ON A COMPREHENSIVE CLINICAL ASSESSMENT, ACCORDING TO 2016 ACR CRITERIA, BUT VALIDATED BIOLOGICAL BIOMARKERS ASSOCIATED WITH FIBROMYALGIA HAVE NOT YET BEEN IDENTIFIED. GENOME-WIDE ASSOCIATION STUDIES INVESTIGATED GENES POTENTIALLY INVOLVED IN FIBROMYALGIA PATHOGENESIS HIGHLIGHTING THAT GENETIC FACTORS ARE POSSIBLY RESPONSIBLE FOR UP TO 50% OF THE DISEASE SUSCEPTIBILITY. POTENTIAL CANDIDATE GENES FOUND ASSOCIATED TO FIBROMYALGIA ARE SLC64A4, TRPV2, MYT1L, AND NRXN3. FURTHERMORE, A GENE-ENVIRONMENTAL INTERACTION HAS BEEN PROPOSED AS TRIGGERING MECHANISM, THROUGH EPIGENETIC ALTERATIONS: IN PARTICULAR, FIBROMYALGIA APPEARS TO BE CHARACTERIZED BY A HYPOMETHYLATED DNA PATTERN, IN GENES IMPLICATED IN STRESS RESPONSE, DNA REPAIR, AUTONOMIC SYSTEM RESPONSE, AND SUBCORTICAL NEURONAL ABNORMALITIES. DIFFERENCES IN THE GENOME-WIDE EXPRESSION PROFILE OF MICRORNAS WERE FOUND AMONG MULTIPLE TISSUES, INDICATING THE INVOLVEMENT OF DISTINCT PROCESSES IN FIBROMYALGIA PATHOGENESIS. FURTHER STUDIES SHOULD BE DEDICATED TO STRENGTH THESE PRELIMINARY FINDINGS, IN LARGER MULTICENTER COHORTS, TO IDENTIFY RELIABLE DIRECTIONS FOR BIOMARKER RESEARCH AND CLINICAL PRACTICE. 2019 5 43 9 A COMPREHENSIVE REVIEW OF THE GENETIC AND EPIGENETIC CONTRIBUTIONS TO THE DEVELOPMENT OF FIBROMYALGIA. THIS NARRATIVE REVIEW SUMMARIZES THE CURRENT KNOWLEDGE OF THE GENETIC AND EPIGENETIC CONTRIBUTIONS TO THE DEVELOPMENT OF FIBROMYALGIA (FM). ALTHOUGH THERE IS NO SINGLE GENE THAT RESULTS IN THE DEVELOPMENT OF FM, THIS STUDY REVEALS THAT CERTAIN POLYMORPHISMS IN GENES INVOLVED IN THE CATECHOLAMINERGIC PATHWAY, THE SEROTONERGIC PATHWAY, PAIN PROCESSING, OXIDATIVE STRESS, AND INFLAMMATION MAY INFLUENCE SUSCEPTIBILITY TO FM AND THE SEVERITY OF ITS SYMPTOMS. FURTHERMORE, EPIGENETIC CHANGES AT THE DNA LEVEL MAY LEAD TO THE DEVELOPMENT OF FM. LIKEWISE, MICRORNAS MAY IMPACT THE EXPRESSION OF CERTAIN PROTEINS THAT LEAD TO THE WORSENING OF FM-ASSOCIATED SYMPTOMS. 2023 6 1525 24 DNA METHYLATION CHANGES IN GENES INVOLVED IN INFLAMMATION AND DEPRESSION IN FIBROMYALGIA: A PILOT STUDY. OBJECTIVES: THE PRESENT PILOT STUDY AIMS TO INVESTIGATE DNA METHYLATION CHANGES OF GENES RELATED TO FIBROMYALGIA (FM) DEVELOPMENT AND ITS MAIN COMORBID SYMPTOMS, INCLUDING SLEEP IMPAIRMENT, INFLAMMATION, DEPRESSION AND OTHER PSYCHIATRIC DISORDERS. EPIGENETIC MODIFICATIONS MIGHT TRIGGER OR PERPETUATE COMPLEX INTERPLAY BETWEEN PAIN TRANSDUCTION/TRANSMISSION, CENTRAL PAIN PROCESSING AND EXPERIENCED STRESSORS IN VULNERABLE INDIVIDUALS. METHODS: WE CONDUCTED DNA METHYLATION ANALYSIS BY TARGETED BISULFITE NGS SEQUENCING TESTING DIFFERENTIAL METHYLATION IN 112 GENOMIC REGIONS FROM LEUKOCYTES OF EIGHT WOMEN WITH FM AND THEIR EIGHT HEALTHY SISTERS AS CONTROLS. RESULTS: TESTS FOR DIFFERENTIALLY METHYLATED REGIONS AND CYTOSINES BROUGHT FOCUS ON THE GRM2 GENE, ENCODING THE METABOTROPIC GLUTAMATE RECEPTOR2. THE SLIGHTLY INCREASED DNA METHYLATION OBSERVED IN THE GRM2 REGION OF FM PATIENTS MAY CONFIRM THE INVOLVEMENT OF THE GLUTAMATE PATHWAY IN THIS PATHOLOGICAL CONDITION. LOGISTIC REGRESSION HIGHLIGHTED THE SIMULTANEOUS ASSOCIATION OF METHYLATION LEVELS OF DEPRESSION AND INFLAMMATION-RELATED GENES WITH FM. CONCLUSIONS: ALTOGETHER, THE RESULTS EVIDENCE THE GLUTAMATE PATHWAY INVOLVEMENT IN FM AND SUPPORT THE IDEA THAT A COMBINATION OF METHYLATED AND UNMETHYLATED GENES COULD REPRESENT A RISK FACTOR TO FM OR ITS CONSEQUENCE, MORE THAN SINGLE GENES. FURTHER STUDIES ON THE IDENTIFIED BIOMARKERS COULD CONTRIBUTE TO UNRAVEL THE CAUSATIVE UNDERLYING FM MECHANISMS, GIVING RELIABLE DIRECTIONS TO RESEARCH, IMPROVING THE DIAGNOSIS AND EFFECTIVE THERAPIES. 2021 7 2816 24 FIBROMYALGIA: PATHOGENESIS, MECHANISMS, DIAGNOSIS AND TREATMENT OPTIONS UPDATE. FIBROMYALGIA IS A SYNDROME CHARACTERIZED BY CHRONIC AND WIDESPREAD MUSCULOSKELETAL PAIN, OFTEN ACCOMPANIED BY OTHER SYMPTOMS, SUCH AS FATIGUE, INTESTINAL DISORDERS AND ALTERATIONS IN SLEEP AND MOOD. IT IS ESTIMATED THAT TWO TO EIGHT PERCENT OF THE WORLD POPULATION IS AFFECTED BY FIBROMYALGIA. FROM A MEDICAL POINT OF VIEW, THIS PATHOLOGY STILL PRESENTS INEXPLICABLE ASPECTS. IT IS KNOWN THAT FIBROMYALGIA IS CAUSED BY A CENTRAL SENSITIZATION PHENOMENON CHARACTERIZED BY THE DYSFUNCTION OF NEURO-CIRCUITS, WHICH INVOLVES THE PERCEPTION, TRANSMISSION AND PROCESSING OF AFFERENT NOCICEPTIVE STIMULI, WITH THE PREVALENT MANIFESTATION OF PAIN AT THE LEVEL OF THE LOCOMOTOR SYSTEM. IN RECENT YEARS, THE PATHOGENESIS OF FIBROMYALGIA HAS ALSO BEEN LINKED TO OTHER FACTORS, SUCH AS INFLAMMATORY, IMMUNE, ENDOCRINE, GENETIC AND PSYCHOSOCIAL FACTORS. A RHEUMATOLOGIST TYPICALLY MAKES A DIAGNOSIS OF FIBROMYALGIA WHEN THE PATIENT DESCRIBES A HISTORY OF PAIN SPREADING IN ALL QUADRANTS OF THE BODY FOR AT LEAST THREE MONTHS AND WHEN PAIN IS CAUSED BY DIGITAL PRESSURE IN AT LEAST 11 OUT OF 18 ALLOGENIC POINTS, CALLED TENDER POINTS. FIBROMYALGIA DOES NOT INVOLVE ORGANIC DAMAGE, AND SEVERAL DIAGNOSTIC APPROACHES HAVE BEEN DEVELOPED IN RECENT YEARS, INCLUDING THE ANALYSIS OF GENETIC, EPIGENETIC AND SEROLOGICAL BIOMARKERS. SYMPTOMS OFTEN BEGIN AFTER PHYSICAL OR EMOTIONAL TRAUMA, BUT IN MANY CASES, THERE APPEARS TO BE NO OBVIOUS TRIGGER. WOMEN ARE MORE PRONE TO DEVELOPING THE DISEASE THAN MEN. UNFORTUNATELY, THE CONVENTIONAL MEDICAL THERAPIES THAT TARGET THIS PATHOLOGY PRODUCE LIMITED BENEFITS. THEY REMAIN LARGELY PHARMACOLOGICAL IN NATURE AND TEND TO TREAT THE SYMPTOMATIC ASPECTS OF VARIOUS DISORDERS REPORTED BY THE PATIENT. THE STATISTICS, HOWEVER, HIGHLIGHT THE FACT THAT 90% OF PEOPLE WITH FIBROMYALGIA ALSO TURN TO COMPLEMENTARY MEDICINE TO MANAGE THEIR SYMPTOMS. 2021 8 6438 20 THERAPEUTIC AND PREVENTIVE INTERVENTIONS FOR POSTULATED VASOACTIVE NEUROPEPTIDE AUTOIMMUNE FATIGUE-RELATED DISORDERS. MAJOR ADVANCES HAVE BEEN MADE IN UNDERSTANDING THE RELATIVELY NOVEL GROUP OF VASOACTIVE (VASODILATORY) NEUROPEPTIDES (VNS) IN HUMANS. VNS COMPRISE A NOVEL BUT EXPANDING GROUP OF SUBSTANCES HAVING IMMUNOREGULATION, INFLAMMATION MODULATION, NEUROTRANSMITTER, NEUROTROPHIC, HORMONAL AND METABOLIC FUNCTIONS. THESE SUBSTANCES MAY CONTROL GENE EXPRESSION FOR MRNA FOR THEMSELVES AND THEIR RECEPTORS. THEY HAVE COMPLEX RELATIONSHIPS WITH GASEOUS AND OTHER NEUROTRANSMITTERS AND XENOBIOTIC SUBSTANCES. THEORETICAL ARGUMENTS HAVE IMPLICATED THESE SUBSTANCES IN AUTOIMMUNE PHENOMENA RESULTING IN FATIGUE-RELATED CONDITIONS SUCH AS CHRONIC FATIGUE SYNDROME (CFS), SUDDEN INFANT DEATH SYNDROME (SIDS), FIBROMYALGIA (FM) AND GULF WAR SYNDROME (GWS) BUT REMAIN UNPROVEN. AS WELL AS POSSIBLY SPONTANEOUS ONSET, THE PRECIPITATING CAUSES OF VN AUTOIMMUNE DYSFUNCTION ARE LIKELY TO BE A COMBINATION OF GENETIC PREDISPOSITION, INFECTION AND XENOBIOTIC SUBSTANCES. THERAPEUTIC AND PREVENTIVE POSSIBILITIES FOR POSTULATED VN AUTOIMMUNE CONDITIONS WILL BE INFLUENCED BY THE COMPLEX PATHOLOPHYSIOLOGY UNDERPINNING THEM. SOME SPECULATIVE POSSIBILITIES ARE VN SUBSTITUTION/REPLACEMENT, PRESERVATION OF BIOLOGICAL EFFECT, EPIGENETIC DNA MODIFICATIONS, PLASMA EXCHANGE, ANTI-CHOLINESTERASES, E.G., PYRIDOSTIGMINE, CORTICOSTEROIDS AND OTHER DRUG TREATMENTS, THYMECTOMY, INTRAVENOUS IMMUNOGLOBULIN AND ANTI-IDIOTYPE ANTIBODIES, AND CPG/DNA VACCINES. PREVENTION AND TREATMENT OF POSSIBLE VN AUTOIMMUNE FATIGUE-RELATED DISORDERS MAY PROVE TO BE IMPORTANT AREAS FOR FUTURE RESEARCH AND DEVELOPMENT. 2005 9 1745 15 EARLY LIFE ADVERSITY AS A RISK FACTOR FOR FIBROMYALGIA IN LATER LIFE. THE IMPACT OF EARLY LIFE EVENTS IS INCREASINGLY BECOMING APPARENT, AS STUDIES INVESTIGATE HOW EARLY CHILDHOOD CAN SHAPE LONG-TERM PHYSIOLOGY AND BEHAVIOUR. FIBROMYALGIA (FM), WHICH IS CHARACTERISED BY INCREASED PAIN SENSITIVITY AND A NUMBER OF AFFECTIVE CO-MORBIDITIES, HAS AN UNCLEAR ETIOLOGY. THIS PAPER DISCUSSES RISK FACTORS FROM EARLY LIFE THAT MAY INCREASE THE OCCURRENCE OR SEVERITY OF FM IN LATER LIFE: PAIN EXPERIENCE DURING NEONATAL LIFE CAUSES LONG-LASTING CHANGES IN NOCICEPTIVE CIRCUITRY AND INCREASES PAIN SENSITIVITY IN THE OLDER ORGANISM; PREMATURE BIRTH AND RELATED STRESSOR EXPOSURE CAUSE LASTING CHANGES IN STRESS RESPONSIVITY; MATERNAL DEPRIVATION AFFECTS ANXIETY-LIKE BEHAVIOURS THAT MAY BE PARTIALLY MEDIATED BY EPIGENETIC MODULATION OF THE GENOME-ALL THESE ADULT PHENOTYPES ARE STRIKINGLY SIMILAR TO SYMPTOMS DISPLAYED BY FM SUFFERERS. IN ADDITION, CHILDHOOD TRAUMA AND EXPOSURE TO SUBSTANCES OF ABUSE MAY CAUSE LASTING CHANGES IN DEVELOPING NEUROTRANSMITTER AND ENDOCRINE CIRCUITS THAT ARE LINKED TO ANXIETY AND STRESS RESPONSES. 2012 10 6406 20 THE SEARCH FOR RELIABLE BIOMARKERS OF DISEASE IN MULTIPLE CHEMICAL SENSITIVITY AND OTHER ENVIRONMENTAL INTOLERANCES. WHILST FACING A WORLDWIDE FAST INCREASE OF FOOD AND ENVIRONMENTAL ALLERGIES, THE MEDICAL COMMUNITY IS ALSO CONFRONTED WITH ANOTHER INHOMOGENEOUS GROUP OF ENVIRONMENT-ASSOCIATED DISABLING CONDITIONS, INCLUDING MULTIPLE CHEMICAL SENSITIVITY (MCS), FIBROMYALGIA, CHRONIC FATIGUE SYNDROME, ELECTRIC HYPERSENSITIVITY, AMALGAM DISEASE AND OTHERS. THESE SHARE THE FEATURES OF POLY-SYMPTOMATIC MULTI-ORGAN CUTANEOUS AND SYSTEMIC MANIFESTATIONS, WITH POSTULATED INHERITED/ACQUIRED IMPAIRED METABOLISM OF CHEMICAL/PHYSICAL/NUTRITIONAL XENOBIOTICS, TRIGGERING ADVERSE REACTIONS AT EXPOSURE LEVELS FAR BELOW TOXICOLOGICALLY-RELEVANT VALUES, OFTEN IN THE ABSENCE OF CLEAR-CUT ALLERGOLOGIC AND/OR IMMUNOLOGIC INVOLVEMENT. DUE TO THE LACK OF PROVEN PATHOGENIC MECHANISMS GENERATING MEASURABLE DISEASE BIOMARKERS, THESE ENVIRONMENTAL HYPERSENSITIVITIES ARE GENERALLY IGNORED BY SANITARY AND SOCIAL SYSTEMS, AS PSYCHOGENIC OR "MEDICALLY UNEXPLAINED SYMPTOMS". THE UNCONTROLLED APPLICATION OF DIAGNOSTIC AND TREATMENT PROTOCOLS NOT CORRESPONDING TO ACCEPTABLE LEVELS OF VALIDATION, SAFETY, AND CLINICAL EFFICACY, TO A STEADILY INCREASING NUMBER OF PATIENTS DEMANDING ASSISTANCE, OCCURS IN MANY COUNTRIES IN THE ABSENCE OF EVIDENCE-BASED GUIDELINES. HERE WE REVISE AVAILABLE INFORMATION SUPPORTING THE ORGANIC NATURE OF THESE CLINICAL CONDITIONS. FOLLOWING INTENSE RESEARCH ON GENE POLYMORPHISMS OF PHASE I/II DETOXIFICATION ENZYME GENES, SO FAR STATISTICALLY INCONCLUSIVE, EPIGENETIC AND METABOLIC FACTORS ARE UNDER INVESTIGATION, IN PARTICULAR FREE RADICAL/ANTIOXIDANT HOMEOSTASIS DISTURBANCES. THE FINDING OF RELEVANT ALTERATIONS OF CATALASE, GLUTATHIONE-TRANSFERASE AND PEROXIDASE DETOXIFYING ACTIVITIES SIGNIFICANTLY CORRELATING WITH CLINICAL MANIFESTATIONS OF MCS, HAS RECENTLY REGISTERED SOME PROGRESS TOWARDS THE IDENTIFICATION OF RELIABLE BIOMARKERS OF DISEASE ONSET, PROGRESSION, AND TREATMENT OUTCOMES. 2011 11 2564 20 EPIGENETICS INSIGHTS INTO CHRONIC PAIN: DNA HYPOMETHYLATION IN FIBROMYALGIA-A CONTROLLED PILOT-STUDY. TO EVALUATE CHANGES IN DNA METHYLATION PROFILES IN PATIENTS WITH FIBROMYALGIA (FM) COMPARED TO MATCHED HEALTHY CONTROLS (HCS). ALL INDIVIDUALS UNDERWENT FULL CLINICAL AND NEUROPHYSIOLOGICAL ASSESSMENT BY CORTICAL EXCITABILITY (CE) PARAMETERS MEASURED BY TRANSCRANIAL MAGNETIC STIMULATION. DNA FROM THE PERIPHERAL BLOOD OF PATIENTS WITH FM (N = 24) AND HC (N = 24) WERE ASSESSED USING THE ILLUMINA-HUMANMETHYLATION450 BEADCHIPS. WE IDENTIFIED 1610 DIFFERENTIALLY METHYLATED POSITIONS (DMPS) IN PATIENTS WITH FM DISPLAYING A NONRANDOM DISTRIBUTION IN REGIONS OF THE GENOME. SIXTY-NINE PERCENT OF DMP IN FM WERE HYPOMETHYLATED COMPARED TO HC. DIFFERENTIALLY METHYLATED POSITIONS WERE ENRICHED IN 5 GENOMIC REGIONS (1P34; 6P21; 10Q26; 17Q25; 19Q13). THE FUNCTIONAL CHARACTERIZATION OF 960 GENES RELATED TO DMPS REVEALED AN ENRICHMENT FOR MAPK SIGNALING PATHWAY (N = 18 GENES), REGULATION OF ACTIN CYTOSKELETON (N = 15 GENES), AND FOCAL ADHESION (N = 13 GENES). A GENE-GENE INTERACTION NETWORK ENRICHMENT ANALYSIS REVEALED THE PARTICIPATION OF DNA REPAIR PATHWAYS, MITOCHONDRIA-RELATED PROCESSES, AND SYNAPTIC SIGNALING. EVEN THOUGH DNA WAS EXTRACTED FROM PERIPHERAL BLOOD, THIS SET OF GENES WAS ENRICHED FOR DISORDERS SUCH AS SCHIZOPHRENIA, MOOD DISORDERS, BULIMIA, HYPERPHAGIA, AND OBESITY. REMARKABLY, THE HIERARCHICAL CLUSTERIZATION BASED ON THE METHYLATION LEVELS OF THE 1610 DMPS SHOWED AN ASSOCIATION WITH NEUROPHYSIOLOGICAL MEASUREMENTS OF CE IN FM AND HC. FIBROMYALGIA HAS A HYPOMETHYLATION DNA PATTERN, WHICH IS ENRICHED IN GENES IMPLICATED IN STRESS RESPONSE AND DNA REPAIR/FREE RADICAL CLEARANCE. THESE CHANGES OCCURRED PARALLEL TO CHANGES IN CE PARAMETERS. NEW EPIGENETIC INSIGHTS INTO THE PATHOPHYSIOLOGY OF FM MAY PROVIDE THE BASIS FOR THE DEVELOPMENT OF BIOMARKERS OF THIS DISORDER. 2017 12 404 22 ANALYSIS OF EPIGENETIC AGE PREDICTORS IN PAIN-RELATED CONDITIONS. CHRONIC PAIN PREVALENCE IS HIGH WORLDWIDE AND INCREASES AT OLDER AGES. SIGNS OF PREMATURE AGING HAVE BEEN ASSOCIATED WITH CHRONIC PAIN, BUT FEW STUDIES HAVE INVESTIGATED AGING BIOMARKERS IN PAIN-RELATED CONDITIONS. A SET OF DNA METHYLATION (DNAM)-BASED ESTIMATES OF AGE, CALLED "EPIGENETIC CLOCKS," HAS BEEN PROPOSED AS BIOLOGICAL MEASURES OF AGE-RELATED ADVERSE PROCESSES, MORBIDITY, AND MORTALITY. THE AIM OF THIS STUDY IS TO ASSESS IF DIFFERENT PAIN-RELATED PHENOTYPES SHOW ALTERATIONS IN DNAM AGE. IN OUR ANALYSIS, WE CONSIDERED THREE COHORTS FOR WHICH WHOLE-BLOOD DNAM DATA WERE AVAILABLE: HEAT PAIN SENSITIVITY (HPS), INCLUDING 20 MONOZYGOTIC TWIN PAIRS DISCORDANT FOR HEAT PAIN TEMPERATURE THRESHOLD; FIBROMYALGIA (FM), INCLUDING 24 CASES AND 20 CONTROLS; AND HEADACHE, INCLUDING 22 CHRONIC MIGRAINE AND MEDICATION OVERUSE HEADACHE PATIENTS (MOH), 18 EPISODIC MIGRAINEURS (EM), AND 13 HEALTHY SUBJECTS. WE USED THE HORVATH'S EPIGENETIC AGE CALCULATOR TO OBTAIN DNAM-BASED ESTIMATES OF EPIGENETIC AGE, TELOMERE LENGTH, LEVELS OF 7 PROTEINS IN PLASMA, NUMBER OF SMOKED PACKS OF CIGARETTES PER YEAR, AND BLOOD CELL COUNTS. WE DID NOT FIND DIFFERENCES IN EPIGENETIC AGE ACCELERATION, CALCULATED USING FIVE DIFFERENT EPIGENETIC CLOCKS, BETWEEN SUBJECTS DISCORDANT FOR PAIN-RELATED PHENOTYPES. TWINS WITH HIGH HPS HAD INCREASED CD8+ T CELL COUNTS (NOMINAL P = 0.028). HPS THRESHOLDS WERE NEGATIVELY ASSOCIATED WITH ESTIMATED LEVELS OF GDF15 (NOMINAL P = 0.008). FM PATIENTS SHOWED DECREASED NAIVE CD4+ T CELL COUNTS COMPARED WITH CONTROLS (NOMINAL P = 0.015). THE SEVERITY OF FM MANIFESTATIONS EXPRESSED THROUGH VARIOUS EVALUATION TESTS WAS ASSOCIATED WITH DECREASED LEVELS OF LEPTIN, SHORTER LENGTH OF TELOMERES, AND REDUCED CD8+ T AND NATURAL KILLER CELL COUNTS (NOMINAL P < 0.05), WHILE THE DURATION OF PAINFUL SYMPTOMS WAS POSITIVELY ASSOCIATED WITH TELOMERE LENGTH (NOMINAL P = 0.034). NO DIFFERENCES IN DNAM-BASED ESTIMATES WERE DETECTED FOR MOH OR EM COMPARED WITH CONTROLS. IN SUMMARY, OUR STUDY SUGGESTS THAT HPS, FM, AND MOH/EM DO NOT SHOW SIGNS OF EPIGENETIC AGE ACCELERATION IN WHOLE BLOOD, WHILE HPS AND FM ARE ASSOCIATED WITH DNAM-BASED ESTIMATES OF IMMUNOLOGICAL PARAMETERS, PLASMA PROTEINS, AND TELOMERE LENGTH. FUTURE STUDIES SHOULD EXTEND THESE OBSERVATIONS IN LARGER COHORTS. 2020 13 6375 27 THE ROLE OF NEURO-IMMUNE INTERACTION IN CHRONIC PAIN CONDITIONS; FUNCTIONAL SOMATIC SYNDROME, NEUROGENIC INFLAMMATION, AND PERIPHERAL NEUROPATHY. FUNCTIONAL SOMATIC SYNDROMES ARE INCREASINGLY DIAGNOSED IN CHRONICALLY ILL PATIENTS PRESENTING WITH AN ARRAY OF SYMPTOMS NOT ATTRIBUTED TO PHYSICAL AILMENTS. CONDITIONS SUCH AS CHRONIC FATIGUE SYNDROME, FIBROMYALGIA SYNDROME, OR IRRITABLE BOWEL SYNDROME ARE COMMON DISORDERS THAT BELONG IN THIS BROAD CATEGORY. SUCH SYNDROMES ARE CHARACTERISED BY THE PRESENCE OF ONE OR MULTIPLE CHRONIC SYMPTOMS INCLUDING WIDESPREAD MUSCULOSKELETAL PAIN, FATIGUE, SLEEP DISORDERS, AND ABDOMINAL PAIN, AMONGST OTHER ISSUES. SYMPTOMS ARE BELIEVED TO RELATE TO A COMPLEX INTERACTION OF BIOLOGICAL AND PSYCHOSOCIAL FACTORS, WHERE A DEFINITE AETIOLOGY HAS NOT BEEN ESTABLISHED. THEORIES SUGGEST CAUSATIVE PATHWAYS BETWEEN THE IMMUNE AND NERVOUS SYSTEMS OF AFFECTED INDIVIDUALS WITH SEVERAL RISK FACTORS IDENTIFIED IN PATIENTS PRESENTING WITH ONE OR MORE FUNCTIONAL SYNDROMES. RISK FACTORS INCLUDING STRESS AND CHILDHOOD TRAUMA ARE NOW RECOGNISED AS IMPORTANT CONTRIBUTORS TO CHRONIC PAIN CONDITIONS. EMOTIONAL, PHYSICAL, AND SEXUAL ABUSE DURING CHILDHOOD IS CONSIDERED A SEVERE STRESSOR HAVING A HIGH PREVALENCE IN FUNCTIONAL SOMATIC SYNDROME SUFFERS. SUCH TRAUMA PERMANENTLY ALTERS THE BIOLOGICAL STRESS RESPONSE OF THE SUFFERS LEADING TO NEUROEXCITATORY AND OTHER NERVE ISSUES ASSOCIATED WITH CHRONIC PAIN IN ADULTS. TRAUMATIC AND CHRONIC STRESS RESULTS IN EPIGENETIC CHANGES IN STRESS RESPONSE GENES, WHICH ULTIMATELY LEADS TO DYSREGULATION OF THE HYPOTHALAMIC-PITUITARY AXIS, THE AUTONOMIC NERVOUS SYSTEM, AND THE IMMUNE SYSTEM MANIFESTING IN A BROAD ARRAY OF SYMPTOMS. IMPORTANTLY, THESE SYSTEMS ARE KNOWN TO BE DYSREGULATED IN PATIENTS SUFFERING FROM FUNCTIONAL SOMATIC SYNDROME. FUNCTIONAL SOMATIC SYNDROMES ARE ALSO HIGHLY PREVALENT CO-MORBIDITIES OF PSYCHIATRIC CONDITIONS, MOOD DISORDERS, AND ANXIETY. CONSEQUENTLY, THIS REVIEW AIMS TO PROVIDE INSIGHT INTO THE ROLE OF THE NERVOUS SYSTEM AND IMMUNE SYSTEM IN CHRONIC PAIN DISORDERS ASSOCIATED WITH THE MUSCULOSKELETAL SYSTEM, AND CENTRAL AND PERIPHERAL NERVOUS SYSTEMS. 2022 14 849 18 CHILDHOOD TRAUMATIZATION IS ASSOCIATED WITH DIFFERENCES IN TRPA1 PROMOTER METHYLATION IN FEMALE PATIENTS WITH MULTISOMATOFORM DISORDER WITH PAIN AS THE LEADING BODILY SYMPTOM. BACKGROUND: THE CONSTRUCT OF MULTISOMATOFORM DISORDER (MSD) IS A COMMON POINT OF REFERENCE FOR PATIENTS IN DIFFERENT SOMATIC AND PSYCHOSOMATIC SPECIALTIES AND THEREFORE USEFUL IN STUDYING LARGE WELL-CHARACTERIZED COHORTS OF A PROTOTYPE OF A SOMATOFORM DISORDER AND IN PARALLEL AS A FUNCTIONAL SOMATIC SYNDROME (FSS). THIS DISORDER IS CHARACTERIZED BY DISTRESSING AND FUNCTIONALLY DISABLING SOMATIC SYMPTOMS WITH CHRONIC PAIN AS THE MOST FREQUENT AND CLINICALLY RELEVANT COMPLAINT. PAIN IS PERCEIVED BY NOCICEPTIVE NERVE FIBERS AND TRANSFERRED THROUGH THE GENERATION OF ACTION POTENTIALS BY DIFFERENT RECEPTOR MOLECULES KNOWN TO DETERMINE PAIN SENSITIVITY IN PATHOPHYSIOLOGICAL PROCESSES. PREVIOUS STUDIES HAVE SHOWN THAT FOR THE TRANSIENT RECEPTOR POTENTIAL ANKYRIN 1 (TRPA1), RECEPTOR METHYLATION OF A PARTICULAR CPG DINUCLEOTIDE IN THE PROMOTER REGION IS INVERSELY ASSOCIATED WITH BOTH HEAT PAIN AND PRESSURE PAIN THRESHOLDS. IN THIS STUDY, WE HYPOTHESIZED THAT TRPA1 PROMOTER METHYLATION REGULATES PAIN SENSITIVITY OF PATIENTS WITH MULTISOMATOFORM DISORDER (MSD). A COHORT OF 151 PATIENTS WITH MSD AND 149 MATCHED HEALTHY VOLUNTEERS WERE EVALUATED USING QUANTITATIVE SENSORY TESTING, CLINICAL AND PSYCHOMETRIC ASSESSMENT, AND METHYLATION ANALYSIS USING DNA ISOLATED FROM WHOLE BLOOD. RESULTS: WE FOUND CPG -628 TO BE CORRELATED WITH MECHANICAL PAIN THRESHOLD AND CPG -411 TO BE CORRELATED WITH MECHANICAL PAIN THRESHOLD IN FEMALE VOLUNTEERS, I.E., HIGHER METHYLATION LEVELS LEAD TO HIGHER PAIN THRESHOLDS. A NOVEL FINDING IS THAT METHYLATION LEVELS WERE SIGNIFICANTLY DIFFERENT BETWEEN PATIENTS WITH NO AND SEVERE LEVELS OF CHILDHOOD TRAUMA. CPG METHYLATION ALSO CORRELATED WITH PSYCHOMETRIC ASSESSMENT OF PAIN AND PAIN LEVELS RATED ON A VISUAL ANALOG SCALE. CONCLUSION: OUR FINDINGS SUPPORT THE HYPOTHESIS THAT EPIGENETIC REGULATION OF TRPA1 PLAYS A ROLE IN MECHANICAL PAIN SENSITIVITIES IN HEALTHY VOLUNTEERS. THEY FURTHER PROVIDE EVIDENCE FOR THE POSSIBLE INFLUENCE OF CHILDHOOD TRAUMATIC EXPERIENCES ON THE EPIGENETIC REGULATION OF TRPA1 IN PATIENTS WITH MSD. 2019 15 6779 14 [BIO-PSYCHO-SOCIAL THERAPY FOR STRESS-INDUCED CHRONIC PAIN]. BIO-PSYCHO-SOCIAL THERAPY FOR STRESS-INDUCED CHRONIC PAIN ABSTRACT. AGAINST THE BACKGROUND OF LATEST NEUROBIOLOGICAL AND EPIGENETIC FINDINGS THE BIO-PSYCHO-SOCIAL MODEL OF DISEASE IS OUTLINED OFTEN MISINTERPRETED IN THE CONTEXT OF CHRONIC PAIN. IT REPRESENTS THE BASIC PRINCIPLE FOR A PERSONALIZED TREATMENT OF STRESS-INDUCED CHRONIC PAIN. CONSEQUENCES FOR DIAGNOSTIC PROCEDURES ARE DELINEATED TO DETECT THIS PATHOGENETIC SUBGROUP OF CHRONIC PAIN PATIENTS (E.G. FIBROMYALGIA, BACK PAIN, TEMPOROMANDIBULAR DYSFUNCTION, TENSION HEADACHE). FINALLY, THE PRINCIPLES OF A BIO-PSYCHO-SOCIAL TREATMENT PROGRAM WITH HIGH EFFICIENCY ARE PRESENTED. 2020 16 189 21 ACETYL-L-CARNITINE IN CHRONIC PAIN: A NARRATIVE REVIEW. ACETYL-L-CARNITINE (ALC) IS AN ENDOGENOUS MOLECULE THAT NOT ONLY PLAYS A ROLE IN ENERGY METABOLISM, BUT ALSO HAS ANTIOXIDANT PROPERTIES, PROTECTS FROM OXIDATIVE STRESS, MODULATES BRAIN NEUROTRANSMITTERS SUCH AS ACETYLCHOLINE, SEROTONIN AND DOPAMINE, AND ACTS ON NEUROTROPHIC FACTORS SUCH AS NERVE GROWTH FACTOR (NGF) AND METABOTROPIC GLUTAMATE (MGLU) RECEPTORS BY MEANS OF EPIGENETIC MECHANISMS. IMPORTANTLY, IT INDUCES MGLU2 EXPRESSION AT NERVE TERMINALS, THUS GIVING RISE TO ANALGESIA AND PREVENTING SPINAL SENSITISATION. IT HAS ALSO BEEN FOUND TO HAVE EVEN LONG-TERM NEUROTROPHIC AND ANALGESIC ACTIVITY IN EXPERIMENTAL MODELS OF CHRONIC INFLAMMATORY AND NEUROPATHIC PAIN. THE AIM OF THIS NARRATIVE REVIEW IS TO SUMMARISE THE CURRENT EVIDENCE REGARDING THE USE OF ALC IN PATIENTS WITH CHRONIC PAIN, AND COGNITIVE AND MOOD DISORDERS, AND INVESTIGATE THE RATIONALE UNDERLYING ITS USE IN PATIENTS WITH FIBROMYALGIA SYNDROME, WHICH IS CHARACTERISED BY NOCIPLASTIC CHANGES THAT INCREASE THE SENSITIVITY OF THE NERVOUS SYSTEM TO PAIN. 2021 17 1998 21 EPIGENETIC AND MIRNA EXPRESSION CHANGES IN PEOPLE WITH PAIN: A SYSTEMATIC REVIEW. ACCUMULATING EVIDENCE SUGGESTS THAT EPIGENETIC MECHANISMS MAY HOLD GREAT POTENTIAL IN THE FIELD OF PAIN. WE SYSTEMATICALLY REVIEWED THE LITERATURE EXPLORING EPIGENETIC MECHANISMS IN PEOPLE WITH PAIN. FOUR DATABASES HAVE BEEN INTERROGATED: MEDLINE, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIAL, SCOPUS, AND WEB OF SCIENCE, FOLLOWING PRISMA GUIDELINES IN CONDUCTING STUDY SELECTION AND ASSESSMENT. THIRTY-SEVEN STUDIES WERE INCLUDED. STUDIES EXPLORED EPIGENETICS IN CONDITIONS SUCH AS FIBROMYALGIA, CRPS, NEUROPATHIES, OR OSTEOARTHRITIS. RESEARCH FOCUSSED ON GENOME-WIDE AND GENE-SPECIFIC DNA METHYLATION, AND MIRNA EXPRESSION. BIOINFORMATICS ANALYSES EXPLORING MIRNA-ASSOCIATED MOLECULAR PATHWAYS WERE ALSO PERFORMED. SEVERAL GENES ALREADY KNOWN FOR THEIR ROLE IN PAIN (BDNF, HDAC4, PRKG1, IL-17, TNFRSF13B, ETC.), AND SEVERAL MIRNAS LINKED TO INFLAMMATORY REGULATION, NOCICEPTIVE SIGNALLING AND PROTEIN KINASES FUNCTIONS HAVE BEEN FOUND TO DIFFER SIGNIFICANTLY BETWEEN PEOPLE WITH CHRONIC PAIN AND HEALTHY CONTROLS. ALTHOUGH THE STUDIES INCLUDED WERE CROSS-SECTIONAL IN NATURE, AND NO CONCLUSION ON CAUSAL LINKS BETWEEN EPIGENETIC CHANGES AND PAIN COULD BE DRAWN, WE SUMMARISED THE LARGE AMOUNT OF DATA AVAILABLE IN LITERATURE ON THE TOPIC, HIGHLIGHTING RESULTS THAT HAVE BEEN REPLICATED BY INDEPENDENT INVESTIGATIONS. THE FIELD OF PAIN EPIGENETICS APPEARS VERY EXCITING AND HAS ALL THE POTENTIAL TO LEAD TO REMARKABLE SCIENTIFIC ADVANCES. HOWEVER, HIGH-QUALITY, WELL-POWERED, LONGITUDINAL STUDIES ARE WARRANTED. PERSPECTIVE: THOUGH MORE HIGH-QUALITY RESEARCH IS NEEDED, AVAILABLE RESEARCH EXPLORING EPIGENETIC MECHANISMS OR MIRNAS IN PEOPLE WITH PAIN SHOWS THAT GENES REGULATING SYNAPTIC PLASTICITY AND EXCITABILITY, PROTEIN KINASES, AND ELEMENTS OF THE IMMUNE SYSTEM MIGHT HOLD GREAT POTENTIAL IN UNDERSTANDING THE PATHOPHYSIOLOGY OF DIFFERENT CONDITIONS. 2020 18 4428 17 MOLECULAR BASIS OF THE IRRITABLE BOWEL SYNDROME. IRRITABLE BOWEL SYNDROME (IBS) IS A FUNCTIONAL DISORDER CHARACTERIZED BY ABDOMINAL PAIN, DISCOMFORT AND BLOATING. THE PATHOPHYSIOLOGY OF IBS IS POORLY UNDERSTOOD, BUT THE PRESENCE OF PSYCHOSOCIAL BASIS IS NOW KNOWN. THERE IS AN INCREASING NUMBER OF PUBLICATIONS SUPPORTING THE ROLE OF GENETICS IN IBS. MOST OF THE VARIATIONS ARE FOUND IN GENES ASSOCIATED WITH THE BRAIN-GUT AXIS, REVEALING THE STRONG CORRELATION OF BRAIN-GUT AXIS AND IBS. MIRNAS, WHICH PLAY CRITICAL ROLES IN PHYSIOLOGICAL PROCESSES, ARE NOT WELL STUDIED IN IBS. HOWEVER, SO FAR THERE IS FOUND AN INVOLVEMENT OF ALTERATIONS IN MIRNA EXPRESSION OR SEQUENCE, IN IBS SYMPTOMS. IBS PHENOTYPE IS AFFECTED BY EPIGENETIC ALTERATION AND ENVIRONMENT. CHANGES IN DNA AND HISTONE METHYLATION ARE OBSERVED IN PATIENTS WHO SUFFERED CHILDHOOD TRAUMA OR ABUSE, RESULTING IN ALTERED GENE EXPRESSION, SUCH AS THE GLUCOCORTICOID RECEPTOR GENE. FINALLY, DIET IS ANOTHER FACTOR ASSOCIATED WITH IBS, WHICH MAY CONTRIBUTE TO SYMPTOM ONSET. CERTAIN FOODS MAY AFFECT ON BACTERIAL METABOLISM AND EPIGENETIC MODIFICATIONS, PREDISPOSING TO IBS. 2014 19 2646 11 EPIGENOMIC LINKS BETWEEN SOCIAL DETERMINANTS OF HEALTH AND SYMPTOMS: A SCOPING REVIEW. SOCIAL DETERMINANTS OF HEALTH (SDOH) IMPACT HEALTH AND WELLNESS. THE LINK BETWEEN SDOH AND ADVERSE HEALTH OUTCOMES, INCLUDING SYMPTOM OCCURRENCE AND SEVERITY, MAY BE EXPLAINED BY AN INDIVIDUAL'S PHYSIOLOGIC RESPONSE TO ONE OR MORE SDOH. ONE POTENTIAL MECHANISM UNDERLYING THIS PHYSIOLOGIC RESPONSE LINKING SDOH AND SYMPTOMS IS THE DYNAMIC EPIGENOME. THE PURPOSE OF THIS SCOPING REVIEW OF THE LITERATURE WAS TO EXAMINE DIFFERENTIAL SUSCEPTIBILITY FOR SYMPTOMS BY IDENTIFYING AND SUMMARIZING RESEARCH LINKING SDOH AND SYMPTOMS THROUGH EPIGENOMIC MECHANISMS. PUBMED WAS SEARCHED TO IDENTIFY EMPIRICAL RESEARCH WHERE AT LEAST ONE SDOH WAS AN INDEPENDENT OR DEPENDENT VARIABLE, AT LEAST ONE SYMPTOM WAS INVESTIGATED, AND THE INVESTIGATION INCLUDED AN EPIGENOMIC MEASURE. OF THE 484 ARTICLES INITIALLY RETRIEVED, AFTER THOROUGH VETTING, 41 ARTICLES MET ELIGIBILITY. THE MOST STUDIED SYMPTOM WAS DEPRESSIVE SYMPTOMS FOLLOWED BY ANXIETY, COGNITIVE FUNCTION, SLEEP DYSFUNCTION, AND PAIN. THE MOST FREQUENTLY STUDIED SDOH WERE: 1) STRESS, PARTICULARLY EARLY LIFE STRESS AND ACCULTURATIVE STRESS; AND 2) TRAUMA, PREDOMINANTLY CHILDHOOD TRAUMA. DNA METHYLATION AND TELOMERE LENGTH WERE THE MOST STUDIED EPIGENOMIC MEASURES. FOUR GENES (SLC6A4, BDNF, NR3C1, OXTR) HAD EVIDENCE FROM MULTIPLE STUDIES AND ACROSS METHODOLOGICAL APPROACHES LINKING SDOH TO SYMPTOMS. THIS REVIEW SUPPORTS THE INCLUSION OF EPIGENOMIC APPROACHES TO BETTER UNDERSTAND THE LINK BETWEEN SDOH AND SYMPTOMS AND PROVIDES EVIDENCE THAT SDOH IMPACT TELOMERE LENGTH AND THE METHYLATION OF GENES INVOLVED IN NEUROTRANSMITTER SIGNALING, NEURONAL SURVIVAL, BEHAVIOR, INFLAMMATION AND STRESS RESPONSE. 2023 20 3905 16 LEPTIN PROMOTER METHYLATION IN FEMALE PATIENTS WITH PAINFUL MULTISOMATOFORM DISORDER AND CHRONIC WIDESPREAD PAIN. BACKGROUND: DIFFERENT FUNCTIONAL SOMATIC SYNDROMES (FSS), FIBROMYALGIA (FMS) AND OTHER UNEXPLAINED PAINFUL CONDITIONS SHARE MANY COMMON CLINICAL TRAITS AND ARE CHARACTERIZED BY TROUBLING AND FUNCTIONALLY DISABLING SOMATIC SYMPTOMS. CHRONIC PAIN IS MOST FREQUENTLY REPORTED AND AT THE CENTER OF PATIENTS' LEVEL OF DISEASE BURDEN. THE CONSTRUCT OF MULTISOMATOFORM DISORDER (MSD) ALLOWS TO SUBSUME SEVERELY IMPAIRED PATIENTS SUFFERING FROM FSS, FMS AND OTHER UNEXPLAINED PAINFUL CONDITIONS TO BE EXAMINED FOR COMMON UNDERLYING PROCESSES. ALTERED LEPTIN LEVELS AND A PATHOLOGICAL RESPONSE OF THE HPA-AXIS AS A RESULT OF CHRONIC STRESS AND CHILDHOOD TRAUMA HAVE BEEN SUGGESTED AS ONE OF THE DRIVING FACTORS OF DISEASE DEVELOPMENT AND SEVERITY. PREVIOUS STUDIES HAVE DEMONSTRATED THAT METHYLATION OF THE LEPTIN PROMOTER CAN PLAY A REGULATORY ROLE IN ADDICTION. IN THIS STUDY, WE HYPOTHESIZED THAT METHYLATION OF THE LEPTIN PROMOTER IS INFLUENCED BY THE DEGREE OF CHILDHOOD TRAUMATIZATION AND DIFFERS BETWEEN PATIENTS WITH MSD AND CONTROLS. A COHORT OF 151 PATIENTS WITH MSD AND 149 MATCHED HEALTHY VOLUNTEERS WERE EVALUATED USING CLINICAL AND PSYCHOMETRIC ASSESSMENT WHILE METHYLATION LEVEL ANALYSIS OF THE LEPTIN PROMOTER WAS PERFORMED USING DNA ISOLATED FROM WHOLE BLOOD. RESULTS: IN FEMALE CONTROLS, WE FOUND CPG C-167 TO BE NEGATIVELY CORRELATED WITH LEPTIN LEVELS, WHEREAS IN FEMALE PATIENTS CPG C-289, C-255, C-193, C-167 AND METHYLATION CLUSTER (C-291 TO C-167) AT PUTATIVE BINDINGS SITES FOR TRANSCRIPTION FACTORS SP1 AND C/EBPALPHA WERE NEGATIVELY CORRELATED WITH LEPTIN LEVELS. METHYLATION LEVELS WERE SIGNIFICANTLY LOWER IN FEMALE PATIENTS CPG C-289 COMPARED WITH CONTROLS. WHEN LOOKING AT FEMALE PATIENTS WITH CHRONIC WIDESPREAD PAIN METHYLATION LEVELS WERE SIGNIFICANTLY LOWER AT CPG C-289, C-255 AND METHYLATION CLUSTER (C-291 TO C-167). CONCLUSION: OUR FINDINGS SUPPORT THE HYPOTHESIS THAT EPIGENETIC REGULATION OF LEPTIN PLAYS A ROLE IN THE REGULATION OF LEPTIN LEVELS IN PATIENTS WITH MSD. THIS EFFECT IS MORE PRONOUNCED IN PATIENTS WITH CHRONIC WIDESPREAD PAIN. 2022