1 1460 147 DISORDERS OF CONSCIOUSNESS AND PHARMACEUTICALS THAT ACT ON OXYGEN BASED AMINO ACID AND MONOAMINE NEUROTRANSMITTER PATHWAYS OF THE BRAIN. OXYGEN BASED NEUROTRANSMITTERS IN THE SYNAPSES OF THE BRAIN ARE PROPOSED TO PLAY AN IMPORTANT ROLE IN THE GENERATION OF CONSCIOUSNESS. THEY INCLUDE THE AMINO ACIDS GLUTAMATE AND GABA WHICH USE KREBS CYCLE PRECURSORS FOR THEIR SYNTHESIS, AND THE MONOAMINES DOPAMINE, NORADRENALIN, ADRENALIN AND SEROTONIN, WHICH ARE DERIVED FROM TYROSINE AND TRYPTOPHAN. DURING ISCHEMIA AFTER AN ACUTE BRAIN INJURY, A GABA SURGE OFTEN INITIATES BRAIN SUPPRESSION. IT HAS BEEN PROPOSED THAT WITH CHRONIC ISCHEMIA, A SECONDARY, POSSIBLY EPIGENETIC RESPONSE OCCURS WHEN NEUROTRANSMITTERS DEPLETE, A GLUCOSE AND OXYGEN SAVING MECHANISM TERMED NEURODORMANCY THAT MAY INVOKE ALTERNATIVE LONG TERM LOW ENERGY METABOLIC PATHWAYS IN THE BRAIN, ENCOUNTERED IN DISORDERS OF CONSCIOUSNESS. SOME MEDICATIONS CAN REVERSE DISORDERS OF CONSCIOUSNESS IN SOME PATIENTS. VIRTUALLY ALL OF THEM ACT ON NEUROTRANSMITTER SYSTEMS THAT USE OXYGEN AS A BUILDING BLOCK OR AS AN ENERGY SOURCE WITHIN THE BRAIN. PHARMACEUTICALS THAT ACT IN THE OXYGEN BASED AMINO ACID SYSTEMS OF THE BRAIN INCLUDE THE GABAERGIC MEDICATIONS ZOLPIDEM AND BACLOFEN, WHILE THOSE THAT ACT IN THE MONOAMINE AXES INCLUDE THE DOPAMINERGIC MEDICATIONS L DOPA, AMANTADINE, BROMOCRIPTINE, APOMORPHINE AND METHYLPHENIDATE, AND THE NORADRENERGIC AND SEROTONERGIC MEDICATIONS DESIPRAMINE, AMITRIPTYLINE, PROTRIPTYLINE AND FLUOXETINE. ANOTHER GROUP ARE THE CHOLINESTERASE INHIBITORS, RESPONSIBLE FOR INCREASING ACETYLCHOLINE, WHICH IS SYNTHESIZED FROM THE KREBS CYCLE INITIATOR, ACETYL COA. IT APPEARS THAT PHARMACEUTICALS THAT ARE ACTIVE IN THE OXYGEN BASED NEUROTRANSMITTER PATHWAYS OF THE BRAIN ARE SUCCESSFUL TO AROUSE TO CONSCIOUSNESS PATIENTS THAT SUFFER FROM ITS DISORDERS. RESEARCH NEEDS TO BE SUPPORTED AS FOUNDATION TO UNDERSTAND THE BIOCHEMICAL MECHANISMS THAT ARE INVOLVED IN CONSCIOUSNESS DISORDERS AND TO EXPLORE FURTHER THE PHARMACOLOGICAL TREATMENT POSSIBILITIES FOR THESE DEVASTATING NEUROLOGICAL CONDITIONS. 2014 2 604 32 BEYOND BROODING ON ONCOMETABOLIC HAVOC IN IDH-MUTANT GLIOMAS AND AML: CURRENT AND FUTURE THERAPEUTIC STRATEGIES. ISOCITRATE DEHYDROGENASES 1 AND 2 (IDH1,2), THE KEY KREBS CYCLE ENZYMES THAT GENERATE NADPH REDUCING EQUIVALENTS, UNDERGO HETEROZYGOUS MUTATIONS IN >70% OF LOW- TO MID-GRADE GLIOMAS AND ~20% OF ACUTE MYELOID LEUKEMIAS (AMLS) AND GAIN AN UNUSUAL NEW ACTIVITY OF REDUCING THE ALPHA-KETOGLUTARATE (ALPHA-KG) TO D-2 HYDROXYGLUTARATE (D-2HG) IN A NADPH-CONSUMING REACTION. THE ONCOMETABOLITE D-2HG, WHICH ACCUMULATES >35 MM, IS WIDELY ACCEPTED TO DRIVE A PROGRESSIVE ONCOGENESIS BESIDES EXACERBATING THE ALREADY INCREASED OXIDATIVE STRESS IN THESE CANCERS. MORE IMPORTANTLY, D-2HG COMPETES WITH ALPHA-KG AND INHIBITS A LARGE NUMBER OF ALPHA-KG-DEPENDENT DIOXYGENASES SUCH AS TET (TEN-ELEVEN TRANSLOCATION), JMJC DOMAIN-CONTAINING KDMS (HISTONE LYSINE DEMETHYLASES), AND THE ALKBH DNA REPAIR PROTEINS THAT ULTIMATELY LEAD TO HYPERMETHYLATION OF THE CPG ISLANDS IN THE GENOME. THE RESULTING CPG ISLAND METHYLATOR PHENOTYPE (CIMP) ACCOUNTS FOR MAJOR GENE EXPRESSION CHANGES INCLUDING THE SILENCING OF THE MGMT (O(6)-METHYLGUANINE DNA METHYLTRANSFERASE) REPAIR PROTEIN IN GLIOMAS. GLIOMA PATIENTS WITH IDH1 MUTATIONS ALSO SHOW BETTER THERAPEUTIC RESPONSES AND LONGER SURVIVAL, THE REASONS FOR WHICH ARE YET UNCLEAR. THERE HAS BEEN A GREAT SURGE IN DRUG DISCOVERY FOR CURTAILING THE MUTANT IDH ACTIVITIES, AND ARRESTING TUMOR PROLIFERATION; HOWEVER, GIVEN THE UNIQUE AND CHRONIC METABOLIC EFFECTS OF D-2HG, THE PROMISE OF THESE COMPOUNDS FOR GLIOMA TREATMENT IS UNCERTAIN. THIS COMPREHENSIVE REVIEW DISCUSSES THE BIOLOGY, CURRENT DRUG DESIGN AND OPPORTUNITIES FOR IMPROVED THERAPIES THROUGH EXPLOITABLE SYNTHETIC LETHALITY PATHWAYS, AND AN INTRIGUING ONCOMETABOLITE-INSPIRED STRATEGY FOR PRIMARY GLIOBLASTOMA. 2018 3 2899 31 GC-MS-BASED URINARY ORGANIC ACID PROFILING REVEALS MULTIPLE DYSREGULATED METABOLIC PATHWAYS FOLLOWING EXPERIMENTAL ACUTE ALCOHOL CONSUMPTION. METABOLOMICS STUDIES OF DISEASES ASSOCIATED WITH CHRONIC ALCOHOL CONSUMPTION PROVIDE COMPELLING EVIDENCE OF SEVERAL PERTURBED METABOLIC PATHWAYS. MOREOVER, THE HOLISTIC APPROACH OF SUCH STUDIES GIVES INSIGHTS INTO THE PATHOPHYSIOLOGICAL RISK FACTORS ASSOCIATED WITH CHRONIC ALCOHOL-INDUCED DISABILITY, MORBIDITY AND MORTALITY. HERE, WE REPORT ON A GC-MS-BASED ORGANIC ACID PROFILING STUDY ON ACUTE ALCOHOL CONSUMPTION. OUR INVESTIGATION - INVOLVING 12 HEALTHY, MODERATE-DRINKING YOUNG MEN - SIMULATED A SINGLE BINGE DRINKING EVENT, AND INDICATED ITS METABOLIC CONSEQUENCES. WE GENERATED TIME-DEPENDENT DATA THAT PREDICTED THE METABOLIC PATHOPHYSIOLOGY OF THE ALCOHOL INTERVENTION. MULTIVARIATE STATISTICAL MODELLING WAS APPLIED TO THE LONGITUDINAL DATA OF 120 BIOLOGICALLY RELEVANT ORGANIC ACIDS, OF WHICH 13 PROVIDED STATISTICAL EVIDENCE OF THE ALCOHOL EFFECT. THE KNOWN ALCOHOL-INDUCED INCREASED NADH:NAD(+) RATIO IN THE CYTOSOL OF HEPATOCYTES CONTRIBUTED TO THE GLOBAL DYSREGULATION OF SEVERAL METABOLIC REACTIONS OF GLYCOLYSIS, KETOGENESIS, THE KREBS CYCLE AND GLUCONEOGENESIS. THE SIGNIFICANT PRESENCE OF 2-HYDROXYISOBUTYRIC ACID SUPPORTS THE EMERGING PARADIGM THAT THIS COMPOUND IS AN IMPORTANT ENDOGENOUS METABOLITE. ITS METABOLIC ORIGIN REMAINS ELUSIVE, BUT RECENT EVIDENCE INDICATED 2-HYDROXYISOBUTYRYLATION AS A NOVEL REGULATORY MODIFIER OF HISTONES. METABOLOMICS HAS THUS OPENED AN AVENUE FOR FURTHER RESEARCH ON THE REPROGRAMMING OF METABOLIC PATHWAYS AND EPIGENETIC NETWORKS IN RELATION TO THE SEVERE EFFECTS OF ALCOHOL CONSUMPTION. 2018 4 3115 34 GEROMETABOLITES: THE PSEUDOHYPOXIC AGING SIDE OF CANCER ONCOMETABOLITES. ONCOMETABOLITES ARE DEFINED AS SMALL-MOLECULE COMPONENTS (OR ENANTIOMERS) OF NORMAL METABOLISM WHOSE ACCUMULATION CAUSES SIGNALING DYSREGULATION TO ESTABLISH A MILIEU THAT INITIATES CARCINOGENESIS. IN A SIMILAR MANNER, WE PROPOSE THE TERM "GEROMETABOLITES" TO REFER TO SMALL-MOLECULE COMPONENTS OF NORMAL METABOLISM WHOSE DEPLETION CAUSES SIGNALING DYSREGULATION TO ESTABLISH A MILIEU THAT DRIVES AGING. IN AN INVESTIGATION OF THE PATHOGENIC ACTIVITIES OF THE CURRENTLY RECOGNIZED ONCOMETABOLITES R(-)-2-HYDROXYGLUTARATE (2-HG), FUMARATE, AND SUCCINATE, WHICH ACCUMULATE DUE TO MUTATIONS IN ISOCITRATE DEHYDROGENASES (IDH), FUMARATE HYDRATASE (FH), AND SUCCINATE DEHYDROGENASE (SDH), RESPECTIVELY, WE ILLUSTRATE THE FACT THAT METABOLIC PSEUDOHYPOXIA, THE ACCUMULATION OF HYPOXIA-INDUCIBLE FACTOR (HIFALPHA) UNDER NORMOXIC CONDITIONS, AND THE SUBSEQUENT WARBURG-LIKE REPROGRAMMING THAT SHIFTS GLUCOSE METABOLISM FROM THE OXIDATIVE PATHWAY TO AEROBIC GLYCOLYSIS ARE THE SAME MECHANISMS THROUGH WHICH THE DECLINE OF THE "GEROMETABOLITE" NICOTINAMIDE ADENINE DINUCLEOTIDE (NAD)(+) REVERSIBLY DISRUPTS NUCLEAR-MITOCHONDRIAL COMMUNICATION AND CONTRIBUTES TO THE DECLINE IN MITOCHONDRIAL FUNCTION WITH AGE. FROM AN EVOLUTIONARY PERSPECTIVE, IT IS REASONABLE TO VIEW NAD(+)-DRIVEN MITOCHONDRIAL HOMEOSTASIS AS A CONSERVED RESPONSE TO CHANGES IN ENERGY SUPPLIES AND OXYGEN LEVELS. SIMILARLY, THE NATURAL ABILITY OF 2-HG TO SIGNIFICANTLY ALTER EPIGENETICS MIGHT REFLECT AN EVOLUTIONARILY ANCIENT ROLE OF CERTAIN METABOLITES TO SIGNAL FOR ELEVATED GLUTAMINE/GLUTAMATE METABOLISM AND/OR OXYGEN DEFICIENCY. HOWEVER, WHEN CHRONICALLY ALTERED, THESE RESPONSES BECOME CONSERVED CAUSES OF AGING AND CANCER. BECAUSE HIFALPHA-DRIVEN PSEUDOHYPOXIA MIGHT DRIVE THE OVERPRODUCTION OF 2-HG, THE INTRIGUING POSSIBILITY EXISTS THAT THE DECLINE OF GEROMETABOLITES SUCH AS NAD(+) COULD PROMOTE THE CHRONIC ACCUMULATION OF ONCOMETABOLITES IN NORMAL CELLS DURING AGING. IF THE SOLE ACTIVATION OF A WARBURG-LIKE METABOLIC REPROGRAMMING IN NORMAL TISSUES MIGHT BE ABLE TO SIGNIFICANTLY INCREASE THE ENDOGENOUS PRODUCTION OF BONA FIDE ETIOLOGICAL DETERMINANTS IN CANCER, SUCH AS ONCOMETABOLITES, THIS UNDESIRABLE TRADE-OFF BETWEEN MITOCHONDRIAL DYSFUNCTION AND ACTIVATION OF ONCOMETABOLITES PRODUCTION MIGHT THEN PAVE THE WAY FOR THE EPIGENETIC INITIATION OF CARCINOGENESIS IN A STRICTLY METABOLIC-DEPENDENT MANNER. PERHAPS IT IS TIME TO DEFINITELY ADOPT THE VIEW THAT AGING AND AGING DISEASES INCLUDING CANCER ARE GOVERNED BY A PIVOTAL REGULATORY ROLE OF METABOLIC REPROGRAMMING IN CELL FATE DECISIONS. 2014 5 329 26 ALPHA-OXOGLUTARATE INHIBITS THE PROLIFERATION OF IMMORTALIZED NORMAL BLADDER EPITHELIAL CELLS VIA AN EPIGENETIC SWITCH INVOLVING ARID1A. INTERSTITIAL CYSTITIS (IC) IS A CHRONIC URINARY TRACT DISEASE THAT IS CHARACTERIZED BY UNPLEASANT SENSATIONS, SUCH AS PERSISTENT PELVIC PAIN, IN THE ABSENCE OF INFECTION OR OTHER IDENTIFIABLE CAUSES. WE PREVIOUSLY PERFORMED COMPREHENSIVE METABOLOMICS PROFILING OF URINE SAMPLES FROM IC PATIENTS USING NUCLEAR MAGNETIC RESONANCE AND GAS-CHROMATOGRAPHY/MASS SPECTROMETRY AND FOUND THAT URINARY ALPHA-OXOGLUTARATE (ALPHA-OG), WAS SIGNIFICANTLY ELEVATED. ALPHA-OG, A TRICARBOXYLIC ACID (TCA) CYCLE INTERMEDIATE, REPORTEDLY FUNCTIONS TO SUPPRESS THE PROLIFERATION OF IMMORTALIZED NORMAL HUMAN BLADDER EPITHELIAL CELLS. HERE, WE IDENTIFIED AT-RICH INTERACTIVE DOMAIN 1 A (ARID1A), A KEY CHROMATIN REMODELER, AS BEING HYPOMETHYLATED AND UPREGULATED BY ALPHA-OG TREATMENT. THIS WAS DONE THROUGH EPIC DNA METHYLATION PROFILING AND SUBSEQUENT BIOCHEMICAL APPROACHES, INCLUDING QUANTITATIVE RT-PCR AND WESTERN BLOT ANALYSES. FURTHERMORE, WE FOUND THAT ALPHA-OG ALMOST COMPLETELY SUPPRESSES TEN-ELEVEN TRANSLOCATION (TET) ACTIVITY, BUT DOES NOT AFFECT DNA METHYLTRANSFERASE (DNMT) ACTIVITY. ALTOGETHER, OUR STUDIES REVEAL THE POTENTIAL ROLE OF ALPHA-OG IN EPIGENETIC REMODELING THROUGH ITS EFFECTS ON ARID1A AND TET EXPRESSION IN THE BLADDER. THIS MAY PROVIDE A NEW POSSIBLE THERAPEUTIC STRATEGY IN TREATING IC. 2018 6 6166 31 THE GLUTATHIONE SYSTEM: A NEW DRUG TARGET IN NEUROIMMUNE DISORDERS. GLUTATHIONE (GSH) HAS A CRUCIAL ROLE IN CELLULAR SIGNALING AND ANTIOXIDANT DEFENSES EITHER BY REACTING DIRECTLY WITH REACTIVE OXYGEN OR NITROGEN SPECIES OR BY ACTING AS AN ESSENTIAL COFACTOR FOR GSH S-TRANSFERASES AND GLUTATHIONE PEROXIDASES. GSH ACTING IN CONCERT WITH ITS DEPENDENT ENZYMES, KNOWN AS THE GLUTATHIONE SYSTEM, IS RESPONSIBLE FOR THE DETOXIFICATION OF REACTIVE OXYGEN AND NITROGEN SPECIES (ROS/RNS) AND ELECTROPHILES PRODUCED BY XENOBIOTICS. ADEQUATE LEVELS OF GSH ARE ESSENTIAL FOR THE OPTIMAL FUNCTIONING OF THE IMMUNE SYSTEM IN GENERAL AND T CELL ACTIVATION AND DIFFERENTIATION IN PARTICULAR. GSH IS A UBIQUITOUS REGULATOR OF THE CELL CYCLE PER SE. GSH ALSO HAS CRUCIAL FUNCTIONS IN THE BRAIN AS AN ANTIOXIDANT, NEUROMODULATOR, NEUROTRANSMITTER, AND ENABLER OF NEURON SURVIVAL. DEPLETION OF GSH LEADS TO EXACERBATION OF DAMAGE BY OXIDATIVE AND NITROSATIVE STRESS; HYPERNITROSYLATION; INCREASED LEVELS OF PROINFLAMMATORY MEDIATORS AND INFLAMMATORY POTENTIAL; DYSFUNCTIONS OF INTRACELLULAR SIGNALING NETWORKS, E.G., P53, NUCLEAR FACTOR-KAPPAB, AND JANUS KINASES; DECREASED CELL PROLIFERATION AND DNA SYNTHESIS; INACTIVATION OF COMPLEX I OF THE ELECTRON TRANSPORT CHAIN; ACTIVATION OF CYTOCHROME C AND THE APOPTOTIC MACHINERY; BLOCKADE OF THE METHIONINE CYCLE; AND COMPROMISED EPIGENETIC REGULATION OF GENE EXPRESSION. AS SUCH, GSH DEPLETION HAS MARKED CONSEQUENCES FOR THE HOMEOSTATIC CONTROL OF THE IMMUNE SYSTEM, OXIDATIVE AND NITROSATIVE STRESS (O&NS) PATHWAYS, REGULATION OF ENERGY PRODUCTION, AND MITOCHONDRIAL SURVIVAL AS WELL. GSH DEPLETION AND CONCOMITANT INCREASE IN O&NS AND MITOCHONDRIAL DYSFUNCTIONS PLAY A ROLE IN THE PATHOPHYSIOLOGY OF DIVERSE NEUROIMMUNE DISORDERS, INCLUDING DEPRESSION, MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME AND PARKINSON'S DISEASE, SUGGESTING THAT DEPLETED GSH IS AN INTEGRAL PART OF THESE DISEASES. THERAPEUTICAL INTERVENTIONS THAT AIM TO INCREASE GSH CONCENTRATIONS IN VIVO INCLUDE N-ACETYL CYSTEINE; NRF-2 ACTIVATION VIA HYPERBARIC OXYGEN THERAPY; DIMETHYL FUMARATE; PHYTOCHEMICALS, INCLUDING CURCUMIN, RESVERATROL, AND CINNAMON; AND FOLATE SUPPLEMENTATION. 2014 7 6775 31 [ALCOHOL DEPENDENCE MEDIATED BY MONOAMINE NEUROTRANSMITTERS IN THE CENTRAL NERVOUS SYSTEM]. ALCOHOL DEPENDENCE, A CHRONIC RELAPSING BRAIN DISEASE WITH THE CHARACTERISTICS OF DRINKING ALCOHOL OUT OF CONTROL, HAS BECOME A SERIOUS SOCIAL PROBLEM. MONOAMINE NEUROTRANSMITTERS, MAINLY INCLUDING DOPAMINE AND 5-HYDROXYTRYP NOTTAMINE, PLAY IMPORTANT ROLES IN THE OCCURRENCE, DEVELOPMENT AND NEURAL DYSFUNCTION OF ALCOHOL DEPENDENCE SYNDROME. IN THIS REVIEW, THE ROLES OF KEY FACTORS OF THE MONOAMINE SYSTEM (DOPAMINE RECEPTOR GENES, 5-HYDROXYTRYPTAMINE RECEPTOR GENES, TRANSPORTER GENES, TYROSINE HYDROXYLASE GENE, TRYPTOPHANHYDROXYLASE GENE AND MONOAMINE OXIDASE GENE) IN ALCOHOL DEPENDENCE WERE DISCUSSED, AND STRATEGIES FOR FURTHER STUDIES OF MOLECULAR MECHANISMS WERE PROPOSED BASED ON GENE KNOCKOUT MICE MODELS GENERATED IN OUR LABORATORY. THEN, COMBINING WITH STUDIES ON TYROSINE HYDROXYLASE ACTIVATOR CAMKII IN OUR LAB, THERAPEUTIC TARGETS WERE DISCUSSED. BESIDES, EPIGENETIC STRATEGIES FOR PREVENTION AND TREATMENT OF ALCOHOL DEPENDENCE SYNDROME WERE PROPOSED. FURTHERMORE, MANIPULATING METHYLATION LEVELS IN GENE REGULATORY REGIONS AND ALTERNATIVE SPLICING OF PRE-MRNAS MIGHT ALSO HAVE CLINICAL IMPLICATIONS. FINALLY, BASED ON NEW FINDINGS ON GENETIC POLYMORPHISM, IT IS OF GREAT POTENTIAL TO CARRY OUT INDIVIDUAL PREVENTION AND TREATMENT FOR PATIENTS SUFFERING FROM ALCOHOL DEPENDENCE. 2014 8 1091 38 COGNITIVE ENHANCERS AS A TREATMENT FOR HEROIN RELAPSE AND ADDICTION. HEROIN ADDICTION IS A DISORDER THAT STEMS FROM MALADAPTIVE PLASTICITY WITHIN NEURAL CIRCUITS AND PRODUCES BROAD COGNITIVE DEFICITS. DESPITE CONSIDERABLE ADVANCES IN PSYCHOTHERAPY AND PHARMACOTHERAPY FOR HEROIN RELAPSE AND ADDICTION, EFFECTIVE TREATMENTS FOR HEROIN USE DISORDER ARE STILL LACKING. INCREASING PRECLINICAL EVIDENCE INDICATES THAT HEROIN SEEKING BEHAVIOR IS PERSISTENT AFTER WITHDRAWAL, WHILE COGNITIVE DYSFUNCTIONS ASSOCIATED WITH CHRONIC HEROIN USE ARE AN IMPORTANT CONTRIBUTING FACTOR TO RISK OF HEROIN RELAPSE AND ADDICTION. COGNITIVE ENHANCERS MAY BE USED TO STIMULATE TREATMENT SUCCESS AND ENHANCE TREATMENT EFFICACY. THE PURPOSE OF THIS REVIEW IS TO OUTLINE THE LITERATURE THAT DEMONSTRATES THE COGNITIVE DEFICITS DURING THE DEVELOPMENT OF HEROIN ADDICTION AND WITHDRAWAL PROCESS, AND SEVERAL FACTORS THAT UNDERLINE THE EFFICACY OF COGNITIVE ENHANCERS FOR HEROIN USE DISORDERS. THE REVIEW, THEN, EXAMINES THE POTENTIAL USE AND PHARMACOLOGICAL MECHANISMS OF COGNITIVE ENHANCERS THAT ACT ON CHOLINERGIC, GLUTAMATERGIC, DOPAMINERGIC OR ADRENERGIC PATHWAYS. IT ALSO EXAMINES THE EFFECTS OF COMPOUNDS THAT ALTER CREB SIGNALING AND EPIGENETIC MECHANISMS IN ANIMAL MODEL OF HEROIN RELAPSE. THE CURRENT BODY OF RESEARCH REVEALS THE NEW INSIGHTS INTO THE PHARMACOLOGICAL MECHANISMS UNDERLYING HEROIN ADDICTION AND HOLDS A SIGNIFICANT PROMISE FOR COGNITIVE ENHANCERS AS AN IMPROVED APPROACH TO TREAT HEROIN USE DISORDER IN A MORE EFFICIENT AND PERSISTENT WAY. 2019 9 6743 45 WHITHER THE ETIOPATHOGENESIS (AND SCOLIOGENY) OF ADOLESCENT IDIOPATHIC SCOLIOSIS? INCORPORATING PRESENTATIONS ON SCOLIOGENY AT THE 2012 IRSSD AND SRS MEETINGS. THIS PAPER AIMS TO INTEGRATE INTO CURRENT UNDERSTANDING OF AIS CAUSATION, ETIOPATHOGENETIC INFORMATION PRESENTED AT TWO MEETINGS DURING 2012 NAMELY, THE INTERNATIONAL RESEARCH SOCIETY OF SPINAL DEFORMITIES (IRSSD) AND THE SCOLIOSIS RESEARCH SOCIETY (SRS). THE ULTIMATE HOPE IS TO PREVENT THE OCCURRENCE OR PROGRESSION OF THE SPINAL DEFORMITY OF AIS WITH NON-INVASIVE TREATMENT, POSSIBLY MEDICAL. THIS MIGHT BE ATTAINED BY PERSONALISED POLYMECHANISTIC PREVENTIVE THERAPY TARGETING THE APPROPRIATE ETIOLOGY AND/OR ETIOPATHOGENETIC PATHWAYS, TO AVOID FUSION AND MAINTAIN SPINAL MOBILITY. ALTHOUGH CONSIDERABLE PROGRESS HAD BEEN MADE IN THE PAST TWO DECADES IN UNDERSTANDING THE ETIOPATHOGENESIS OF ADOLESCENT IDIOPATHIC SCOLIOSIS (AIS), IT STILL LACKS AN AGREED THEORY OF ETIOPATHOGENESIS. ONE PROBLEM MAY BE THAT AIS RESULTS NOT FROM ONE CAUSE, BUT SEVERAL THAT INTERACT WITH VARIOUS GENETIC PREDISPOSING FACTORS. THERE IS A VIEW THERE ARE TWO OTHER PATHOGENIC PROCESSES FOR IDIOPATHIC SCOLIOSIS NAMELY, INITIATING (OR INDUCING), AND THOSE THAT CAUSE CURVE PROGRESSION. TWIN STUDIES AND OBSERVATIONS OF FAMILY AGGREGATION HAVE REVEALED SIGNIFICANT GENETIC CONTRIBUTIONS TO IDIOPATHIC SCOLIOSIS, THAT PLACE AIS AMONG OTHER COMMON DISEASE OR COMPLEX TRAITS WITH A HIGH HERITABILITY INTERPRETED BY THE GENETIC VARIANT HYPOTHESIS OF DISEASE. WE SUMMARIZE ETIOPATHOGENETIC KNOWLEDGE OF AIS AS THEORIES OF PATHOGENESIS INCLUDING RECENT MULTIPLE CONCEPTS, AND BLOOD TESTS FOR AIS BASED ON PREDICTIVE BIOMARKERS AND GENETIC VARIANTS THAT SIGNIFY DISEASE RISK. THERE IS INCREASING EVIDENCE FOR THE POSSIBILITY OF AN UNDERLYING NEUROLOGICAL DISORDER FOR AIS, RESEARCH WHICH HOLDS PROMISE. LIKE BRAIN RESEARCH, MOST AIS WORKERS FOCUS ON THEIR OWN CORNER AND THERE IS A NEED FOR GREATER INTEGRATION OF RESEARCH EFFORT. EPIGENETICS, A RELATIVELY RECENT FIELD, EVALUATES FACTORS CONCERNED WITH GENE EXPRESSION IN RELATION TO ENVIRONMENT, DISEASE, NORMAL DEVELOPMENT AND AGING, WITH A COMPLEX REGULATION ACROSS THE GENOME DURING THE FIRST DECADE OF LIFE. RESEARCH ON THE ROLE OF ENVIRONMENTAL FACTORS, EPIGENETICS AND CHRONIC NON-COMMUNICABLE DISEASES (NCDS) INCLUDING ADIPOSITY, AFTER A SLOW START, HAS EXPLODED IN THE LAST DECADE. NOT SO FOR AIS RESEARCH AND THE ENVIRONMENT WHERE, EXCEPT FOR MONOZYGOTIC TWIN STUDIES, THERE ARE ONLY SPORADIC REPORTS TO SUGGEST THAT ENVIRONMENTAL FACTORS ARE AT WORK IN ETIOLOGY. HERE, WE EXAMINE EPIGENETIC CONCEPTS AS THEY MAY RELATE TO HUMAN DEVELOPMENT, NORMAL LIFE HISTORY PHASES AND AIS PATHOGENESIS. ALTHOUGH AIS IS NOT REGARDED AS AN NCD, LIKE THEM, IT IS ASSOCIATED WITH WHOLE ORGANISM METABOLIC PHENOMENA, INCLUDING LOWER BODY MASS INDEX, LOWER CIRCULATING LEPTIN LEVELS AND OTHER SYSTEMIC DISORDERS. SOME EPIGENETIC RESEARCH APPLIED TO SILVER-RUSSELL SYNDROME AND ADIPOSITY IS EXAMINED, FROM WHICH SUGGESTIONS ARE MADE FOR CONSIDERATION OF AIS EPIGENETIC RESEARCH, CROSS-SECTIONAL AND LONGITUDINAL. THE WORD SCOLIOGENY IS SUGGESTED TO INCLUDE ETIOLOGY, PATHOGENESIS AND PATHOMECHANISM. 2013 10 1651 36 DOPAMINE AND GLUCOSE, OBESITY, AND REWARD DEFICIENCY SYNDROME. OBESITY AS A RESULT OF OVEREATING AS WELL AS A NUMBER OF WELL DESCRIBED EATING DISORDERS HAS BEEN ACCURATELY CONSIDERED TO BE A WORLD-WIDE EPIDEMIC. RECENTLY A NUMBER OF THEORIES BACKED BY A PLETHORA OF SCIENTIFICALLY SOUND NEUROCHEMICAL AND GENETIC STUDIES PROVIDE STRONG EVIDENCE THAT FOOD ADDICTION IS SIMILAR TO PSYCHOACTIVE DRUG ADDICTION. OUR LABORATORY HAS PUBLISHED ON THE CONCEPT KNOWN AS REWARD DEFICIENCY SYNDROME (RDS) WHICH IS A GENETIC AND EPIGENETIC PHENOMENA LEADING TO IMPAIRMENT OF THE BRAIN REWARD CIRCUITRY RESULTING IN A HYPO-DOPAMINERGIC FUNCTION. RDS INVOLVES THE INTERACTIONS OF POWERFUL NEUROTRANSMITTERS AND RESULTS IN ABNORMAL CRAVING BEHAVIOR. A NUMBER OF IMPORTANT FACTS WHICH COULD HELP TRANSLATE TO POTENTIAL THERAPEUTIC TARGETS ESPOUSED IN THIS FOCUSED REVIEW INCLUDE: (1) CONSUMPTION OF ALCOHOL IN LARGE QUANTITIES OR CARBOHYDRATES BINGING STIMULATES THE BRAIN'S PRODUCTION OF AND UTILIZATION OF DOPAMINE; (2) IN THE MESO-LIMBIC SYSTEM THE ENKEPHALINERGIC NEURONS ARE IN CLOSE PROXIMITY, TO GLUCOSE RECEPTORS; (3) HIGHLY CONCENTRATED GLUCOSE ACTIVATES THE CALCIUM CHANNEL TO STIMULATE DOPAMINE RELEASE FROM P12 CELLS; (4) A SIGNIFICANT CORRELATION BETWEEN BLOOD GLUCOSE AND CEREBROSPINAL FLUID CONCENTRATIONS OF HOMOVANILLIC ACID THE DOPAMINE METABOLITE; (5) 2-DEOXYGLUCOSE (2DG), THE GLUCOSE ANALOG, IN PHARMACOLOGICAL DOSES IS ASSOCIATED WITH ENHANCED DOPAMINE TURNOVER AND CAUSES ACUTE GLUCOPRIVATION. EVIDENCE FROM ANIMAL STUDIES AND FMRI IN HUMANS SUPPORT THE HYPOTHESIS THAT MULTIPLE, BUT SIMILAR BRAIN CIRCUITS ARE DISRUPTED IN OBESITY AND DRUG DEPENDENCE AND FOR THE MOST PART, IMPLICATE THE INVOLVEMENT OF DA-MODULATED REWARD CIRCUITS IN PATHOLOGIC EATING BEHAVIORS. BASED ON A CONSENSUS OF NEUROSCIENCE RESEARCH TREATMENT OF BOTH GLUCOSE AND DRUG LIKE COCAINE, OPIATES SHOULD INCORPORATE DOPAMINE AGONIST THERAPY IN CONTRAST TO CURRENT THEORIES AND PRACTICES THAT UTILIZES DOPAMINE ANTAGONISTIC THERAPY. CONSIDERING THAT UP UNTIL NOW CLINICAL UTILIZATION OF POWERFUL DOPAMINE D2 AGONISTS HAVE FAILED DUE TO CHRONIC DOWN REGULATION OF D2 RECEPTORS NEWER TARGETS BASED ON NOVEL LESS POWERFUL D2 AGONISTS THAT UP-REGULATE D2 RECEPTORS SEEMS PRUDENT. WE ENCOURAGE NEW STRATEGIES TARGETED AT IMPROVING DA FUNCTION IN THE TREATMENT AND PREVENTION OF OBESITY A SUBTYPE OF REWARD DEFICIENCY. 2014 11 4625 41 NEUROBIOLOGY OF VITAMIN C: EXPANDING THE FOCUS FROM ANTIOXIDANT TO ENDOGENOUS NEUROMODULATOR. ASCORBIC ACID (AA) IS A WATER-SOLUBLE VITAMIN (C) FOUND IN ALL BODILY ORGANS. MOST MAMMALS SYNTHESIZE IT, HUMANS ARE REQUIRED TO EAT IT, BUT ALL MAMMALS NEED IT FOR HEALTHY FUNCTIONING. AA REACHES ITS HIGHEST CONCENTRATION IN THE BRAIN WHERE BOTH NEURONS AND GLIA RELY ON TIGHTLY REGULATED UPTAKE FROM BLOOD VIA THE GLUCOSE TRANSPORT SYSTEM AND SODIUM-COUPLED ACTIVE TRANSPORT TO ACCUMULATE AND MAINTAIN AA AT MILLIMOLAR LEVELS. AS A PROTOTYPE ANTIOXIDANT, AA IS NOT ONLY NEUROPROTECTIVE, BUT ALSO FUNCTIONS AS A COFACTOR IN REDOX-COUPLED REACTIONS ESSENTIAL FOR THE SYNTHESIS OF NEUROTRANSMITTERS (E.G., DOPAMINE AND NOREPINEPHRINE) AND PARACRINE LIPID MEDIATORS (E.G., EPOXIECOISATRIENOIC ACIDS) AS WELL AS THE EPIGENETIC REGULATION OF DNA. ALTHOUGH REDOX CAPACITY LED TO THE PROMOTION OF AA IN HIGH DOSES AS POTENTIAL TREATMENT FOR VARIOUS NEUROPATHOLOGICAL AND PSYCHIATRIC CONDITIONS, AMPLE EVIDENCE HAS NOT SUPPORTED THIS THERAPEUTIC STRATEGY. HERE, WE FOCUS ON SOME LONG-NEGLECTED ASPECTS OF AA NEUROBIOLOGY, INCLUDING ITS MODULATORY ROLE IN SYNAPTIC TRANSMISSION AS DEMONSTRATED BY THE LONG-ESTABLISHED LINK BETWEEN RELEASE OF ENDOGENOUS AA IN BRAIN EXTRACELLULAR FLUID AND THE CLEARANCE OF GLUTAMATE, AN EXCITATORY AMINO ACID. EVIDENCE THAT THIS LINK CAN BE DISRUPTED IN ANIMAL MODELS OF HUNTINGTON S DISEASE IS REVEALING OPPORTUNITIES FOR NEW RESEARCH PATHWAYS AND THERAPEUTIC APPLICATIONS (E.G., EPILEPSY AND PAIN MANAGEMENT). IN FACT, WE SUGGEST THAT IMPROVED UNDERSTANDING OF THE REGULATION OF ENDOGENOUS AA AND ITS INTERACTION WITH KEY BRAIN NEUROTRANSMITTER SYSTEMS, RATHER THAN ADMINISTRATION OF AA IN EXCESS, SHOULD BE THE TARGET OF FUTURE BRAIN-BASED THERAPIES. 2019 12 5331 39 PUTTING THE PIECES TOGETHER IN GILLES DE LA TOURETTE SYNDROME: EXPLORING THE LINK BETWEEN CLINICAL OBSERVATIONS AND THE BIOLOGICAL BASIS OF DYSFUNCTION. GILLES DE LA TOURETTE SYNDROME IS A COMPLEX, IDIOPATHIC NEUROPSYCHIATRIC DISORDER WHOSE PATHOPHYSIOLOGICAL MECHANISMS HAVE YET TO BE ELUCIDATED. IT IS PHENOTYPICALLY HETEROGENEOUS AND MANIFESTS MORE OFTEN THAN NOT WITH BOTH MOTOR AND BEHAVIORAL IMPAIRMENT, ALTHOUGH TICS ARE ITS CLINICAL HALLMARK. TICS THEMSELVES PRESENT WITH A COMPLEX PROFILE AS THEY CHARACTERISTICALLY WAX AND WANE AND ARE OFTEN PRECEDED BY PREMONITORY SOMATOSENSORY SENSATIONS TO WHICH IT IS SAID A TIC IS THE RESPONSE. HIGHLY COMORBID WITH OBSESSIVE-COMPULSIVE DISORDER AND ATTENTION DEFICIT-HYPERACTIVITY DISORDER, IT IS PURPORTED TO BE AN EPIGENETIC, NEURODEVELOPMENTAL SPECTRUM DISORDER WITH A COMPLEX GENETIC PROFILE. IT HAS A CHILDHOOD ONSET, OCCURS DISPROPORTIONATELY IN MALES, AND SHOWS SPONTANEOUS SYMPTOMATIC ATTENUATION BY ADULTHOOD IN THE MAJORITY OF THOSE AFFLICTED. ALTHOUGH NOT FULLY UNDERSTOOD, ITS NEUROBIOLOGICAL BASIS IS LINKED TO DYSFUNCTION IN THE CORTICO-BASAL GANGLIA-THALAMO-CORTICAL NETWORK. TREATMENT MODALITIES FOR TOURETTE SYNDROME INCLUDE BEHAVIORAL, PHARMACOLOGICAL AND SURGICAL INTERVENTIONS, BUT THERE IS PRESENTLY NO CURE FOR THE DISORDER. FOR THOSE SEVERELY AFFECTED, DEEP BRAIN STIMULATION (DBS) HAS RECENTLY BECOME A VIABLE THERAPEUTIC OPTION. A KEY FACTOR TO ATTAINING OPTIMAL RESULTS FROM THIS SURGERY IS TARGET SELECTION, A TOPIC STILL UNDER DEBATE DUE TO THE COMPLEX CLINICAL PROFILE PRESENTED BY GTS PATIENTS. DEPENDING ON ITS PHENOTYPIC EXPRESSION AND THE MOST PROBLEMATIC ASPECT OF THE DISORDER FOR THE INDIVIDUAL, ONE OF THREE BRAIN REGIONS IS MOST COMMONLY CHOSEN FOR STIMULATION: THE THALAMUS, GLOBUS PALLIDUS, OR NUCLEUS ACCUMBENS. NEUROPHYSIOLOGICAL ANALYSES OF INTRA- AND POST-OPERATIVE HUMAN ELECTROPHYSIOLOGICAL RECORDINGS FROM CLINICAL DBS STUDIES SUGGEST A LINK BETWEEN TIC BEHAVIOR AND ACTIVITY IN BOTH THE THALAMUS AND GLOBUS PALLIDUS. IN PARTICULAR, CHRONIC RECORDINGS FROM THE THALAMUS HAVE SHOWN A CORRELATION BETWEEN SYMPTOMATOLOGY AND (1) SPECTRAL ACTIVITY IN GAMMA BAND POWER AND (2) THETA/GAMMA CROSS FREQUENCY COHERENCE. THESE RESULTS SUGGEST GAMMA OSCILLATIONS AND THETA/GAMMA CROSS CORRELATION DYNAMICS MAY SERVE AS BIOMARKERS FOR DYSFUNCTION. WHILE ACUTE AND CHRONIC RECORDINGS FROM HUMAN SUBJECTS UNDERGOING DBS HAVE PROVIDED BETTER INSIGHT INTO TIC GENESIS AND THE NEUROPATHOPHYSIOLOGICAL MECHANISMS UNDERLYING TOURETTE SYNDROME, THESE STUDIES ARE STILL SPARSE AND THE FIELD WOULD GREATLY BENEFIT FROM FURTHER INVESTIGATIONS. THIS REVIEW REPORTS DATA AND DISCOVERIES OF SCIENTIFIC AND CLINICAL RELEVANCE FROM A WIDE VARIETY OF METHODS AND PROVIDES UP-TO-DATE INFORMATION ABOUT OUR CURRENT UNDERSTANDING OF THE PATHOMECHANISMS UNDERLYING TOURETTE SYNDROME. IT GIVES A COMPREHENSIVE OVERVIEW OF THE CURRENT STATE OF KNOWLEDGE AND ADDRESSES OPEN QUESTIONS IN THE FIELD. 2017 13 6538 28 TRANSCRIPTIONAL REGULATORS AS TARGETS FOR ALCOHOL PHARMACOTHERAPIES. ALCOHOL USE DISORDER (AUD) IS A CHRONIC RELAPSING BRAIN DISEASE THAT CURRENTLY AFFLICTS OVER 15 MILLION ADULTS IN THE UNITED STATES. DESPITE ITS PREVALENCE, THERE ARE ONLY THREE FDA-APPROVED MEDICATIONS FOR AUD TREATMENT, ALL OF WHICH SHOW LIMITED EFFICACY. BECAUSE OF THEIR ABILITY TO ALTER EXPRESSION OF A LARGE NUMBER OF GENES, OFTEN WITH GREAT CELL-TYPE AND BRAIN-REGION SPECIFICITY, TRANSCRIPTION FACTORS AND EPIGENETIC MODIFIERS SERVE AS PROMISING NEW TARGETS FOR THE DEVELOPMENT OF AUD TREATMENTS AIMED AT THE NEURAL CIRCUITRY THAT UNDERLIES CHRONIC ALCOHOL ABUSE. IN THIS CHAPTER, WE WILL DISCUSS TRANSCRIPTIONAL REGULATORS THAT CAN BE TARGETED PHARMACOLOGICALLY AND HAVE SHOWN SOME EFFICACY IN ATTENUATING ALCOHOL CONSUMPTION WHEN TARGETED. SPECIFICALLY, THE TRANSCRIPTION FACTORS CYCLIC AMP-RESPONSIVE ELEMENT BINDING PROTEIN (CREB), PEROXISOME PROLIFERATOR-ACTIVATED RECEPTORS (PPARS), NUCLEAR FACTOR KAPPA-LIGHT-CHAIN-ENHANCER OF ACTIVATED B CELLS (NF-KAPPAB), AND GLUCOCORTICOID RECEPTOR (GR), AS WELL AS THE EPIGENETIC ENZYMES, THE DNA METHYLTRANSFERASES (DNMTS) AND HISTONE DEACETYLASES (HDACS), WILL BE DISCUSSED. 2018 14 1856 28 ELEVATION OF N-ACETYLTRANSFERASE 10 IN HIPPOCAMPAL NEURONS MEDIATES DEPRESSION- AND ANXIETY-LIKE BEHAVIORS. MAJOR DEPRESSIVE DISORDER (MDD) IS ONE OF THE MOST DEBILITATING AND SEVERE MENTAL DISEASES GLOBALLY. INCREASING EVIDENCE HAS SHOWN THAT EPIGENETICS IS CRITICAL FOR UNDERSTANDING BRAIN FUNCTION AND BRAIN DISORDERS, INCLUDING MDD. N-ACETYLTRANSFERASE 10 (NAT10), ACTING ON HISTONES, MRNA AND OTHER SUBSTRATES, HAS BEEN REPORTED TO BE INVOLVED IN EPIGENETIC EVENTS, INCLUDING HISTONE ACETYLATION AND MRNA MODIFICATIONS. NAT10 IS HIGHLY EXPRESSED IN THE BRAIN. HOWEVER, THE POTENTIAL EFFECTS OF NAT10 ON MDD ARE STILL UNKNOWN. HERE, WE EXPLOITED CHRONIC MILD STRESS (CMS) TO INDUCE ANXIETY- AND DEPRESSION-LIKE BEHAVIORS IN MICE AND FOUND THAT THE EXPRESSION OF NAT10 IN THE MOUSE HIPPOCAMPUS WAS UPREGULATED AFTER CMS TREATMENT. INHIBITION OF NAT10 BY PHARMACOLOGICAL METHODS PRODUCED ANXIOLYTIC- AND ANTIDEPRESSANT-LIKE EFFECTS. NEURON-SPECIFIC OVEREXPRESSION OF NAT10 IN THE HIPPOCAMPUS RESULTED IN ANXIETY- AND DEPRESSION-LIKE BEHAVIORS, ACCOMPANIED BY HIGHER SIRT1 PROTEIN LEVELS, AND LOWER DENDRITIC SPINE DENSITIES. OVERALL, IT WAS FOUND THAT ELEVATION OF NAT10 IN HIPPOCAMPAL NEURONS IS INVOLVED IN THE OCCURRENCE OF ANXIETY- AND DEPRESSION-LIKE BEHAVIORS, SUGGESTING THAT NAT10 COULD BE A POTENTIAL NEW TARGET FOR DEVELOPING ANXIOLYTICS AND ANTIDEPRESSANTS. 2022 15 5580 32 ROLE OF NEUROTOXICANTS IN THE PATHOGENESIS OF ALZHEIMER'S DISEASE: A MECHANISTIC INSIGHT. ALZHEIMER'S DISEASE (AD) IS THE MOST CONSPICUOUS CHRONIC NEURODEGENERATIVE SYNDROME, WHICH HAS BECOME A SIGNIFICANT CHALLENGE FOR THE GLOBAL HEALTHCARE SYSTEM. MULTIPLE STUDIES HAVE CORROBORATED A CLEAR ASSOCIATION OF NEUROTOXICANTS WITH AD PATHOGENICITY, SUCH AS AMYLOID BETA (ABETA) PROTEINS AND NEUROFIBRILLARY TANGLES (NFTS), SIGNALLING PATHWAY MODIFICATIONS, CELLULAR STRESS, COGNITIVE DYSFUNCTIONS, NEURONAL APOPTOSIS, NEUROINFLAMMATION, EPIGENETIC MODIFICATION, AND SO ON. THIS REVIEW, THEREFORE, AIMED TO ADDRESS SEVERAL ESSENTIAL MECHANISMS AND SIGNALLING CASCADES, INCLUDING WNT (WINGLESS AND INT.) SIGNALLING PATHWAY, AUTOPHAGY, MAMMALIAN TARGET OF RAPAMYCIN (MTOR), PROTEIN KINASE C (PKC) SIGNALLING CASCADES, CELLULAR REDOX STATUS, ENERGY METABOLISM, GLUTAMATERGIC NEUROTRANSMISSIONS, IMMUNE CELL STIMULATIONS (E.G. MICROGLIA, ASTROCYTES) AS WELL AS AN AMYLOID PRECURSOR PROTEIN (APP), PRESENILIN-1 (PSEN1), PRESENILIN-2 (PSEN2) AND OTHER AD-RELATED GENE EXPRESSIONS THAT HAVE BEEN PRETENTIOUS AND MODULATED BY THE VARIOUS NEUROTOXICANTS. THIS REVIEW CONCLUDED THAT NEUROTOXICANTS PLAY A MOMENTOUS ROLE IN DEVELOPING AD THROUGH MODULATING VARIOUS SIGNALLING CASCADES. NEVERTHELESS, COMPREHENSION OF THIS RISK AGENT-INDUCED NEUROTOXICITY IS FAR TOO LITTLE. MORE IN-DEPTH EPIDEMIOLOGICAL AND SYSTEMATIC INVESTIGATIONS ARE NEEDED TO UNDERSTAND THE POTENTIAL MECHANISMS BETTER TO ADDRESS THESE NEUROTOXICANTS AND IMPROVE APPROACHES TO THEIR RISK EXPOSURE THAT AID IN AD PATHOGENESIS.KEY MESSAGESINEVITABLE CASCADE MECHANISMS OF HOW ALZHEIMER'S DISEASE-RELATED (AD-RELATED) GENE EXPRESSIONS ARE MODULATED BY NEUROTOXICANTS HAVE BEEN DISCUSSED.INVOLVEMENT OF THE NEUROTOXICANTS-INDUCED PATHWAYS CAUSED AN EXTENDED RISK OF AD IS EXPLICITED.INTEGRATION OF CELL CULTURE, ANIMALS AND POPULATION-BASED ANALYSIS ON THE CLINICAL SEVERITY OF AD IS ADDRESSED. 2021 16 4207 27 METABOTROPIC GLUTAMATE RECEPTORS AND THE CONTROL OF CHRONIC PAIN. OVER THE PAST TWO DECADES METABOTROPIC GLUTAMATE (MGLU) RECEPTOR LIGANDS HAVE BEEN INVESTIGATED FOR THEIR POTENTIAL THERAPEUTIC EFFECTS IN DIFFERENT DISORDERS OF THE CENTRAL NERVOUS SYSTEM (CNS), INCLUDING ANXIETY, DEPRESSION, SCHIZOPHRENIA, AND NEURODEGENERATIVE DISEASES. IN ADDITION, IT HAS BEEN WIDELY DEMONSTRATED THAT MGLU RECEPTORS ARE ABLE TO MODULATE PAIN TRANSMISSION BOTH IN INFLAMMATORY AND NEUROPATHIC PAIN MODELS. A LARGE NUMBER OF PRECLINICAL STUDIES COMBINING THE USE OF SELECTIVE LIGANDS WITH THE KNOCKOUT STRATEGY HAVE REVEALED MORE DETAILS ABOUT THE ROLE OF THE DIFFERENT MGLU RECEPTOR SUBTYPES IN THE MODULATION OF PAIN INFORMATION. THIS REVIEW WILL ADDRESS THE ROLE OF MGLU RECEPTORS IN PAIN SENSITIVITY FOCUSING ON DIFFERENT STRATEGIES TO ACHIEVE PAIN CONTROL BY TARGETING SPECIFIC MGLU RECEPTOR SUBTYPES. SPECIFICALLY, PHARMACOLOGICAL INTERVENTIONS AIMED AT INHIBITING GROUP I MGLU RECEPTOR-MEDIATED SIGNALING AND/OR POTENTIATING GROUPS II AND III MGLU RECEPTOR SIGNALING TOGETHER WITH AN EPIGENETIC APPROACH LEADING TO AN INCREASED EXPRESSION OF MGLU2 RECEPTORS WILL BE DISCUSSED. 2012 17 6617 30 UNDERPINNING THE NEUROBIOLOGICAL INTRICACIES ASSOCIATED WITH OPIOID TOLERANCE. THE OPIOID CRISIS IS A MAJOR THREAT OF THE 21ST CENTURY, WITH A REMARKABLE JUXTAPOSITION OF USE AND ABUSE. OPIOIDS ARE THE MOST POTENT AND EFFICACIOUS CLASS OF ANALGESICS, BUT DESPITE THEIR PROVEN THERAPEUTIC EFFICACY, THEY HAVE RECENTLY BEEN DEGRADED TO THIRD-LINE THERAPY FOR THE MANAGEMENT OF CHRONIC PAIN IN CLINICS. THE REASON BEHIND THIS IS THE DEVELOPMENT OF POTENTIAL SIDE EFFECTS AND TOLERANCE AFTER REPEATED DOSING. OPIOID TOLERANCE IS THE MAJOR LIMITING FACTOR LEADING TO THE WITHDRAWAL OF TREATMENT, SEVERE SIDE EFFECTS DUE TO DOSE ESCALATION, AND SOMETIMES EVEN DEATH OF THE PATIENTS. EVERY DAY MORE THAN 90 PEOPLE DIE DUE TO OPIOIDS OVERDOSE IN AMERICA, AND A SIMILAR TREND HAS BEEN SEEN ACROSS THE GLOBE. OVER THE PAST TWO DECADES, RESEARCHERS HAVE BEEN TRYING TO DISSECT THE NEUROBIOLOGICAL MECHANISM OF OPIOID TOLERANCE. RESEARCH ON OPIOID TOLERANCE SHIFTED TOWARD CENTRAL NERVOUS SYSTEM-BASED ADAPTATIONS BECAUSE TOLERANCE IS MUCH MORE THAN JUST A CELLULAR PHENOMENON. THUS, NEUROBIOLOGICAL ADAPTATIONS ASSOCIATED WITH OPIOID TOLERANCE ARE IMPORTANT TO UNDERSTAND IN ORDER TO FIND NEWER PAIN THERAPEUTICS. THESE ADAPTATIONS ARE ASSOCIATED WITH ALTERATIONS IN ASCENDING AND DESCENDING PAIN PATHWAYS, REWARD CIRCUITRY MODULATIONS, RECEPTOR DESENSITIZATION AND DOWN-REGULATION, RECEPTOR INTERNALIZATION, HETERODIMERIZATION, AND ALTERED EPIGENETIC REGULATION. THE PRESENT REVIEW IS FOCUSED ON NOVEL CIRCUITRIES ASSOCIATED WITH OPIOID TOLERANCE IN DIFFERENT AREAS OF THE BRAIN, SUCH AS PERIAQUEDUCTAL GRAY, ROSTRAL VENTROMEDIAL MEDULLA, DORSAL RAPHE NUCLEUS, VENTRAL TEGMENTAL AREA, AND NUCLEUS ACCUMBENS. UNDERSTANDING THE NEUROBIOLOGICAL MODULATIONS ASSOCIATED WITH CHRONIC OPIOID EXPOSURE AND TOLERANCE WILL PAVE THE WAY FOR THE DEVELOPMENT OF NOVEL PHARMACOLOGICAL TOOLS FOR SAFER AND BETTER MANAGEMENT OF CHRONIC PAIN IN PATIENTS. 2020 18 5837 28 STRESSED MITOCHONDRIA: A TARGET TO INTRUDE ALZHEIMER'S DISEASE. ALZHEIMER'S DISEASE (AD) IS THE INOPERABLE, INCAPACITATING, NEUROPSYCHIATRIC, AND DEGENERATIVE MANIFESTATION THAT DRASTICALLY AFFECTS HUMAN LIFE QUALITY. THE CURRENT MEDICATIONS TARGET EXTRA-NEURONAL SENILE PLAQUES, OXIDATIVE STRESS, NEUROINFLAMMATION, INTRANEURONAL NEUROFIBRILLARY TANGLES, CHOLINERGIC DEFICITS, AND EXCITOTOXICITY. AMONG NOVEL PATHWAYS AND TARGETS, BIOENERGETIC AND RESULTANT MITOCHONDRIAL DYSFUNCTION HAS BEEN RECOGNIZED AS ESSENTIAL FACTORS THAT DECIDE THE NEURONAL FATE AND CONSEQUENT NEURODEGENERATION IN AD. THE CRUCIAL ATTRIBUTES OF MITOCHONDRIA, INCLUDING BIOENERGESIS, SIGNALING, SENSING, INTEGRATING, AND TRANSMITTING BIOLOGICAL SIGNALS CONTRIBUTE TO OPTIMUM NETWORKING OF NEURONAL DYNAMICS AND MAKE THEM INDISPENSABLE FOR CELL SURVIVAL. IN AD, MITOCHONDRIAL DYSFUNCTION AND MITOPHAGY ARE A PRELIMINARY AND CRITICAL EVENT THAT AGGRAVATES THE PATHOLOGICAL CASCADE. STRESS IS KNOWN TO PROMOTE AND EXAGGERATE THE NEUROPATHOLOGICAL ALTERATION DURING NEURODEGENERATION AND METABOLIC IMPAIRMENTS, ESPECIALLY IN THE CORTICO-LIMBIC SYSTEM, BESIDES ADVERSELY AFFECTING THE NORMAL PHYSIOLOGY AND MITOCHONDRIAL DYNAMICS. STRESS INVOLVES THE ALLOCATION OF ENERGY RESOURCES FOR NEURONAL SURVIVAL. CHRONIC AND AGGRAVATED STRESS RESPONSE LEADS TO EXCESSIVE RELEASE OF GLUCOCORTICOIDS BY ACTIVATION OF THE HYPOTHALAMIC-PITUITARYADRENAL (HPA) AXIS. BY ACTING THROUGH THEIR RECEPTORS, GLUCOCORTICOIDS INFLUENCE ADVERSE MITOCHONDRIAL CHANGES AND ALTER MTDNA TRANSCRIPTION, MTRNA EXPRESSION, HIPPOCAMPAL MITOCHONDRIAL NETWORK, AND ULTIMATELY MITOCHONDRIAL PHYSIOLOGY. CHRONIC STRESS ALSO AFFECTS MITOCHONDRIAL DYNAMICS BY CHANGING METABOLIC AND NEURO-ENDOCRINAL SIGNALLING, AGGRAVATING OXIDATIVE STRESS, PROVOKING INFLAMMATORY MEDIATORS, ALTERING TROPIC FACTORS, INFLUENCING GENE EXPRESSION, AND MODIFYING EPIGENETIC PATHWAYS. THUS, EXPLORING CHRONIC STRESS-INDUCED GLUCOCORTICOID DYSREGULATION AND RESULTANT BIO-BEHAVIORAL AND PSYCHOSOMATIC MITOCHONDRIAL ALTERATIONS MAY BE A FEASIBLE NARRATIVE TO INVESTIGATE AND UNRAVEL THE MYSTERIOUS PATHOBIOLOGY OF AD. 2021 19 189 34 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 20 5541 23 ROLE OF DIETARY PHENOLS IN MITIGATING MICROGLIA-MEDIATED NEUROINFLAMMATION. CHRONIC NEUROINFLAMMATION IS A PATHOLOGICAL FEATURE OF A NUMBER OF CENTRAL NERVOUS SYSTEM (CNS) DISEASES AND IS MEDIATED BY SUSTAINED ACTIVATION OF MICROGLIAL CELLS, THE INNATE IMMUNE CELLS OF THE CNS. STUDIES HAVE MAINLY FOCUSED ON IDENTIFYING THE MOLECULAR AND EPIGENETIC MECHANISMS OF MICROGLIAL ACTIVATION. THIS IS CRUCIAL IN DESIGNING THERAPEUTIC STRATEGIES FOR NEUROPATHOLOGIES IN WHICH PROLONGED MICROGLIAL ACTIVATION IS KNOWN TO EXACERBATE DISEASE CONDITION. IN RECENT YEARS, INCREASING EVIDENCE SHOW THAT NATURALLY OCCURRING COMPOUNDS PRESENT IN REGULAR DIET COULD FUNCTION AS "NUTRACEUTICALS," ARRESTING MICROGLIAL ACTIVATION, AND THUS CONFERRING NEUROPROTECTION. THIS REVIEW SUMMARIZES OUR UNDERSTANDING OF THE ROLE OF DIETARY PHENOLIC NUTRACEUTICALS IN MITIGATING MICROGLIA-MEDIATED NEUROINFLAMMATION. STUDIES SHOW THAT THESE NATURAL PHENOLS INHIBIT KEY SIGNALING PATHWAYS IN ACTIVATED MICROGLIA SUCH AS THE NFKAPPAB, MAPK AND JAK-STAT THAT TRIGGER MICROGLIA-MEDIATED INFLAMMATION IN VARIOUS NEUROPATHOLOGICAL CONDITIONS SUCH AS INJURY, INFECTION, STROKE, AUTISM AND NEURODEGENERATIVE DISEASES, I.E., ALZHEIMER'S DISEASE AND PARKINSON'S DISEASE. THE ANTI-INFLAMMATORY AND ANTIOXIDANT EFFECT EXERTED BY THESE NATURAL PHENOLS HAVE SHOWN CONSIDERABLE SUCCESS IN IMPROVING DISEASE CONDITION IN ANIMAL MODELS OF NEUROPATHOLOGIES, AND THUS SEEM TO BE SUITABLE CANDIDATES FOR DEVELOPING THERAPEUTIC STRATEGIES. 2016