1 40 182 A COMPARISON OF HERPES SIMPLEX VIRUS TYPE 1 AND VARICELLA-ZOSTER VIRUS LATENCY AND REACTIVATION. HERPES SIMPLEX VIRUS TYPE 1 (HSV-1; HUMAN HERPESVIRUS 1) AND VARICELLA-ZOSTER VIRUS (VZV; HUMAN HERPESVIRUS 3) ARE HUMAN NEUROTROPIC ALPHAHERPESVIRUSES THAT CAUSE LIFELONG INFECTIONS IN GANGLIA. FOLLOWING PRIMARY INFECTION AND ESTABLISHMENT OF LATENCY, HSV-1 REACTIVATION TYPICALLY RESULTS IN HERPES LABIALIS (COLD SORES), BUT CAN OCCUR FREQUENTLY ELSEWHERE ON THE BODY AT THE SITE OF PRIMARY INFECTION (E.G. WHITLOW), PARTICULARLY AT THE GENITALS. RARELY, HSV-1 REACTIVATION CAN CAUSE ENCEPHALITIS; HOWEVER, A THIRD OF THE CASES OF HSV-1 ENCEPHALITIS ARE ASSOCIATED WITH HSV-1 PRIMARY INFECTION. PRIMARY VZV INFECTION CAUSES VARICELLA (CHICKENPOX) FOLLOWING WHICH LATENT VIRUS MAY REACTIVATE DECADES LATER TO PRODUCE HERPES ZOSTER (SHINGLES), AS WELL AS AN INCREASINGLY RECOGNIZED NUMBER OF SUBACUTE, ACUTE AND CHRONIC NEUROLOGICAL CONDITIONS. FOLLOWING PRIMARY INFECTION, BOTH VIRUSES ESTABLISH A LATENT INFECTION IN NEURONAL CELLS IN HUMAN PERIPHERAL GANGLIA. HOWEVER, THE DETAILED MECHANISMS OF VIRAL LATENCY AND REACTIVATION HAVE YET TO BE UNRAVELLED. IN BOTH CASES LATENT VIRAL DNA EXISTS IN AN 'END-LESS' STATE WHERE THE ENDS OF THE VIRUS GENOME ARE JOINED TO FORM STRUCTURES CONSISTENT WITH UNIT LENGTH EPISOMES AND CONCATEMERS, FROM WHICH VIRAL GENE TRANSCRIPTION IS RESTRICTED. IN LATENTLY INFECTED GANGLIA, THE MOST ABUNDANTLY DETECTED HSV-1 RNAS ARE THE SPLICED PRODUCTS ORIGINATING FROM THE PRIMARY LATENCY ASSOCIATED TRANSCRIPT (LAT). THIS PRIMARY LAT IS AN 8.3 KB UNSTABLE TRANSCRIPT FROM WHICH TWO STABLE (1.5 AND 2.0 KB) INTRONS ARE SPLICED. TRANSCRIPTS MAPPING TO 12 VZV GENES HAVE BEEN DETECTED IN HUMAN GANGLIA REMOVED AT AUTOPSY; HOWEVER, IT IS DIFFICULT TO ASCRIBE THESE AS TRANSCRIPTS PRESENT DURING LATENT INFECTION AS EARLY-STAGE VIRUS REACTIVATION MAY HAVE TRANSPIRED IN THE POST-MORTEM TIME PERIOD IN THE GANGLIA. NONETHELESS, LOW-LEVEL TRANSCRIPTION OF VZV ORF63 HAS BEEN REPEATEDLY DETECTED IN MULTIPLE GANGLIA REMOVED AS CLOSE TO DEATH AS POSSIBLE. THERE IS INCREASING EVIDENCE THAT HSV-1 AND VZV LATENCY IS EPIGENETICALLY REGULATED. IN VITRO MODELS THAT PERMIT PATHWAY ANALYSIS AND IDENTIFICATION OF BOTH EPIGENETIC MODULATIONS AND GLOBAL TRANSCRIPTIONAL MECHANISMS OF HSV-1 AND VZV LATENCY HOLD MUCH PROMISE FOR OUR FUTURE UNDERSTANDING IN THIS COMPLEX AREA. THIS REVIEW SUMMARIZES THE MOLECULAR BIOLOGY OF HSV-1 AND VZV LATENCY AND REACTIVATION, AND ALSO PRESENTS FUTURE DIRECTIONS FOR STUDY. 2015 2 6697 67 VARICELLA-ZOSTER VIRUS HUMAN GANGLIONIC LATENCY: A CURRENT SUMMARY. VARICELLA-ZOSTER VIRUS (VZV) IS A UBIQUITOUS HUMAN HERPES VIRUS TYPICALLY ACQUIRED IN CHILDHOOD WHEN IT CAUSES VARICELLA (CHICKENPOX), FOLLOWING WHICH THE VIRUS ESTABLISHES A LATENT INFECTION IN TRIGEMINAL AND DORSAL ROOT GANGLIA THAT LASTS FOR THE LIFE OF THE INDIVIDUAL. VZV SUBSEQUENTLY REACTIVATES, SPONTANEOUSLY OR AFTER SPECIFIC TRIGGERING FACTORS, TO CAUSE HERPES ZOSTER (SHINGLES), WHICH MAY BE COMPLICATED BY POSTHERPETIC NEURALGIA AND SEVERAL OTHER NEUROLOGICAL COMPLICATIONS INCLUDING VASCULOPATHY. OUR UNDERSTANDING OF VZV LATENCY LAGS BEHIND OUR KNOWLEDGE OF HERPES SIMPLEX VIRUS TYPE 1 (HSV-1) LATENCY PRIMARILY DUE TO THE DIFFICULTY IN PROPAGATING THE VIRUS TO HIGH TITERS IN A CELL-FREE STATE, AND THE LACK OF A SUITABLE SMALL-ANIMAL MODEL FOR STUDYING VIRUS LATENCY AND REACTIVATION. IT IS NOW ESTABLISHED BEYOND DOUBT THAT LATENT VZV IS PREDOMINANTLY LOCATED IN HUMAN GANGLIONIC NEURONS. VIRUS GENE TRANSCRIPTION DURING LATENCY IS EPIGENETICALLY REGULATED, AND APPEARS TO BE RESTRICTED TO EXPRESSION OF AT LEAST SIX GENES, WITH EXPRESSION OF GENE 63 BEING THE HALLMARK OF LATENCY. HOWEVER, VIRAL GENE TRANSCRIPTION MAY BE MORE EXTENSIVE THAN PREVIOUSLY THOUGHT. THERE IS ALSO EVIDENCE FOR SEVERAL VZV GENES BEING EXPRESSED AT THE PROTEIN LEVEL, INCLUDING VZV GENE 63-ENCODED PROTEIN, BUT RECENT EVIDENCE SUGGESTS THAT THIS MAY NOT BE A COMMON EVENT. THE NATURE AND EXTENT OF THE CHRONIC INFLAMMATORY RESPONSE IN LATENTLY INFECTED GANGLIA IS ALSO OF CURRENT INTEREST. THERE REMAIN SEVERAL QUESTIONS CONCERNING THE VZV LATENCY PROCESS THAT STILL NEED TO BE RESOLVED UNAMBIGUOUSLY AND IT IS LIKELY THAT THIS WILL REQUIRE THE USE OF NEWLY DEVELOPED MOLECULAR TECHNOLOGIES, SUCH AS GEXPS MULTIPLEX POLYMERASE CHAIN REACTION (PCR) FOR VIRUS TRANSCRIPTIONAL ANALYSIS AND CHIP-SEQ TO STUDY THE EPIGENETIC OF LATENT VIRUS GENOME ( LIU ET AL, 2010 , BMC BIOL 8: 56). 2010 3 2143 40 EPIGENETIC LANDSCAPE OF HIV-1 INFECTION IN PRIMARY HUMAN MACROPHAGE. HUMAN IMMUNODEFICIENCY VIRUS (HIV)-INFECTED MACROPHAGES ARE LONG-LIVED CELLS THAT SUSTAIN PERSISTENT VIRUS EXPRESSION, WHICH IS BOTH A BARRIER TO VIRAL ERADICATION AND CONTRIBUTOR TO NEUROLOGICAL COMPLICATIONS IN PATIENTS DESPITE ANTIRETROVIRAL THERAPY (ART). TO BETTER UNDERSTAND THE REGULATION OF HIV-1 IN MACROPHAGES, WE COMPARED HIV-INFECTED PRIMARY HUMAN MONOCYTE-DERIVED MACROPHAGES (MDM) TO ACUTELY INFECTED PRIMARY CD4 T CELLS AND JURKAT CELLS LATENTLY INFECTED WITH HIV (JLAT 8.4). HIV GENOMES IN MDM WERE ACTIVELY TRANSCRIBED DESPITE ENRICHMENT WITH HETEROCHROMATIN-ASSOCIATED H3K9ME3 ACROSS THE COMPLETE HIV GENOME IN COMBINATION WITH ELEVATED ACTIVATION MARKS OF H3K9AC AND H3K27AC AT THE LONG TERMINAL REPEAT (LTR). MACROPHAGE PATTERNS CONTRASTED WITH JLAT CELLS, WHICH SHOWED CONVENTIONAL BIVALENT H3K4ME3/H3K27ME3, AND ACUTELY INFECTED CD4 T CELLS, WHICH SHOWED AN INTERMEDIATE EPIGENOTYPE. 5'-METHYLCYTOSINE (5MC) WAS ENRICHED ACROSS THE HIV GENOME IN LATENTLY INFECTED JLAT CELLS, WHILE 5'-HYDROXYMETHYLCYTOSINE (5HMC) WAS ENRICHED IN CD4 CELLS AND MDMS. HIV INFECTION INDUCED MULTINUCLEATION OF MDMS ALONG WITH DNA DAMAGE-ASSOCIATED P53 PHOSPHORYLATION, AS WELL AS LOSS OF TET2 AND THE NUCLEAR REDISTRIBUTION OF 5-HYDOXYMETHYLATION. TAKEN TOGETHER, OUR FINDINGS SUGGEST THAT HIV INDUCES A UNIQUE MACROPHAGE NUCLEAR AND TRANSCRIPTIONAL PROFILE, AND VIRAL GENOMES ARE MAINTAINED IN A NONCANONICAL BIVALENT EPIGENETIC STATE. IMPORTANCE MACROPHAGES SERVE AS A RESERVOIR FOR LONG-TERM PERSISTENCE AND CHRONIC PRODUCTION OF HIV. WE FOUND AN ATYPICAL EPIGENETIC CONTROL OF HIV IN MACROPHAGES MARKED BY HETEROCHROMATIC H3K9ME3 DESPITE ACTIVE VIRAL TRANSCRIPTION. HIV INFECTION INDUCED CHANGES IN MACROPHAGE NUCLEAR MORPHOLOGY AND EPIGENETIC REGULATORY FACTORS. THESE FINDINGS MAY IDENTIFY NEW MECHANISMS TO CONTROL CHRONIC HIV EXPRESSION IN INFECTED MACROPHAGES. 2022 4 3938 36 LNC(ING)RNAS TO THE "SHOCK AND KILL" STRATEGY FOR HIV-1 CURE. THE ADVENT OF ANTIRETROVIRAL THERAPY ALMOST 25 YEARS AGO HAS TRANSFORMED HIV-1 INFECTION INTO A MANAGEABLE CHRONIC CONDITION, ALBEIT STILL INCURABLE. THE INABILITY OF THE TREATMENT REGIMEN TO ELIMINATE LATENTLY INFECTED CELLS THAT HARBOR THE VIRUS IN AN EPIGENETICALLY SILENT STATE POSES A MAJOR HURDLE. CURRENT CURE APPROACHES ARE FOCUSED ON A "SHOCK AND KILL" STRATEGY THAT USES LATENCY-REVERSING AGENTS TO CHEMICALLY REVERSE THE PROVIRAL QUIESCENCE IN LATENTLY INFECTED CELLS, FOLLOWED BY IMMUNE-MEDIATED CLEARANCE OF REACTIVATED CELLS. TO DATE, HUNDREDS OF COMPOUNDS HAVE BEEN INVESTIGATED FOR VIRAL REACTIVATION, YET NONE HAS RESULTED IN A FUNCTIONAL CURE. THE INSUFFICIENCY OF THESE LATENCY-REVERSING AGENTS (LRAS) ALONE INDICATES A CRITICAL NEED FOR ADDITIONAL, ALTERNATE APPROACHES SUCH AS GENETIC MANIPULATION. LONG NON-CODING RNAS (LNCRNAS) ARE AN EMERGING CLASS OF REGULATORY RNAS WITH FUNCTIONAL ROLES IN MANY CELLULAR PROCESSES, INCLUDING EPIGENETIC MODULATION. A NUMBER OF LNCRNAS HAVE ALREADY BEEN IMPLICATED TO PLAY IMPORTANT ROLES IN HIV-1 LATENCY AND, AS SUCH, PHARMACOLOGICAL MODULATION OF LNCRNAS CONSTITUTES A RATIONAL ALTERNATIVE APPROACH IN HIV-1 CURE RESEARCH. IN THIS REVIEW, WE DISCUSS THE CURRENT STATE OF KNOWLEDGE OF THE ROLE OF LNCRNAS IN HIV-1 INFECTION AND EXPLORE THE SCOPE FOR A LNCRNA-MEDIATED GENETIC APPROACH WITHIN THE SHOCK AND KILL STRATEGY OF HIV-1 CURE. 2021 5 2115 37 EPIGENETIC HETEROGENEITY IN HIV-1 LATENCY ESTABLISHMENT. DESPITE PROLONGED ANTIRETROVIRAL THERAPY, HIV-1 PERSISTS AS TRANSCRIPTIONALLY INACTIVE PROVIRUSES. THE HIV-1 LATENCY REMAINS A PRINCIPAL OBSTACLE IN CURING AIDS. IT IS IMPORTANT TO UNDERSTAND MECHANISMS BY WHICH HIV-1 LATENCY IS ESTABLISHED TO MAKE THE LATENT RESERVOIR SMALLER. WE PRESENT A MOLECULAR CHARACTERIZATION OF DISTINCT POPULATIONS AT AN EARLY PHASE OF INFECTION. WE DEVELOPED AN ORIGINAL DUAL-COLOR REPORTER VIRUS TO MONITOR LTR KINETICS FROM ESTABLISHMENT TO MAINTENANCE STAGE. WE FOUND THAT THERE ARE TWO WAYS OF LATENCY ESTABLISHMENT I.E., BY IMMEDIATE SILENCING AND SLOW INACTIVATION FROM ACTIVE INFECTION. HISTONE COVALENT MODIFICATIONS, PARTICULARLY POLYCOMB REPRESSIVE COMPLEX 2 (PRC2)-MEDIATED H3K27 TRIMETHYLATION, APPEARED TO DOMINATE VIRAL TRANSCRIPTION AT THE EARLY PHASE. PRC2 ALSO CONTRIBUTES TO TIME-DEPENDENT LTR DORMANCY IN THE CHRONIC PHASE OF THE INFECTION. SIGNIFICANT DIFFERENCES IN SENSITIVITY AGAINST SEVERAL STIMULI WERE OBSERVED BETWEEN THESE TWO DISTINCT POPULATIONS. THESE RESULTS WILL EXPAND OUR UNDERSTANDING OF HETEROGENEOUS ESTABLISHMENT OF HIV-1 LATENCY POPULATIONS. 2015 6 3379 33 HIV LATENCY AND THE NONCODING RNA THERAPEUTIC LANDSCAPE. THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) BELONGS TO THE SUBFAMILY OF LENTIVIRUSES THAT ARE CHARACTERIZED BY LONG INCUBATION PERIODS AND CHRONIC, PERSISTENT INFECTION. THE VIRUS INTEGRATES INTO THE GENOME OF INFECTED CD4+ CELLS AND, IN A SUBPOPULATION OF CELLS, ADOPTS A TRANSCRIPTIONALLY SILENT STATE, A PROCESS REFERRED TO A VIRAL LATENCY. THIS PROPERTY MAKES IT EXCEEDINGLY DIFFICULT TO THERAPEUTICALLY TARGET THE VIRUS AND ERADICATE INFECTION. IF LEFT UNTREATED, THE INEXORABLE DEMISE OF THE INFECTED INDIVIDUAL'S IMMUNE SYSTEM ENSUES, A CAUSAL RESULT OF ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS). LATENTLY INFECTED CELLS PROVIDE A RESERVOIR THAT MAINTAINS VIRAL INFECTION INDEFINITELY. IN THIS CHAPTER WE EXPLORE THE ROLE OF NONCODING RNAS IN HIV INFECTION AND IN THE ESTABLISHMENT AND MAINTENANCE OF VIRAL LATENCY. BOTH SHORT AND LONG NONCODING RNAS ARE ENDOGENOUS MODULATORS OF EPIGENETIC REGULATION IN HUMAN CELLS AND PLAY AN ACTIVE ROLE IN GENE EXPRESSION. LASTLY, WE EXPLORE THERAPEUTIC MODALITIES BASED ON EXPRESSED RNAS THAT ARE CAPABLE OF COUNTERING INFECTION, TRANSCRIPTIONALLY REGULATING THE VIRUS, AND SUPPRESSING OR ACTIVATING THE LATENT STATE. 2015 7 6077 35 THE EFFECT OF CD4 RECEPTOR DOWNREGULATION AND ITS DOWNSTREAM SIGNALING MOLECULES ON HIV-1 LATENCY. HIV-1 CAN ESTABLISH A LATENT INFECTION IN MEMORY CD4+T CELLS TO EVADE THE HOST IMMUNE RESPONSE. CD4 MOLECULES CAN ACT NOT ONLY AS THE HIV-1 RECEPTOR FOR ENTRY BUT ALSO AS THE TRIGGER IN AN INTRACELLULAR SIGNALING CASCADE FOR T-CELL ACTIVATION AND PROLIFERATION VIA PROTEIN TYROSINE KINASES. NOVEL CHRONIC HIV-1-INFECTED A3.01-DERIVED (NCHA) CELLS WERE USED TO EXAMINE THE INVOLVEMENT OF CD4 DOWNSTREAM SIGNALING IN HIV-1 LATENCY. CD4 RECEPTORS IN NCHA CELLS WERE DRAMATICALLY DOWNREGULATED ON ITS SURFACE BUT WERE SLIGHTLY DECREASED IN WHOLE-CELL LYSATES. THE EXPRESSION LEVELS OF CD4 DOWNSTREAM SIGNALING MOLECULES, INCLUDING P56(LCK), ZAP-70, LAT, AND C-JUN, WERE SHARPLY DECREASED IN NCHA CELLS. THE LOWERED HISTONE MODIFICATIONS OF H3K4ME3 AND H3K9AC CORRELATED WITH THE DOWNREGULATION OF P56(LCK), ZAP-70, AND LAT IN NCHA CELLS. AP-1 BINDING ACTIVITY WAS ALSO REDUCED IN NCHA CELLS. LAT AND C-JUN SUPPRESSED IN NCHA CELLS WERE HIGHLY INDUCED AFTER PMA TREATMENT. IN EPIGENETIC ANALYSIS, OTHER SIGNAL TRANSDUCTION MOLECULES WHICH ARE ASSOCIATED WITH ACTIVE AND/OR LATENT HIV-1 INFECTION SHOWED NORMAL STATES IN HIV-1 LATENTLY INFECTED CELLS COMPARED TO A3.01 CELLS. IN CONCLUSION, WE DEMONSTRATED THAT THE HIV-1 LATENT STATE IS SUSTAINED BY THE REDUCTION OF DOWNSTREAM SIGNALING MOLECULES VIA THE DOWNREGULATION OF CD4 AND THE ATTENUATED ACTIVITY OF TRANSCRIPTION FACTOR AS AP-1. THE HIV-1 LATENCY MODEL VIA T-CELL DEACTIVATION MAY PROVIDE SOME CLUES FOR THE DEVELOPMENT OF THE NEW ANTIRESERVOIR THERAPY. 2011 8 6209 39 THE INTERFERON-STIMULATED GENE TRIM22: A DOUBLE-EDGED SWORD IN HIV-1 INFECTION. INFECTION OF TARGET CELLS BY THE HUMAN IMMUNODEFICIENCY VIRUS TYPE-1 (HIV-1) IS HAMPERED BY CONSTITUTIVELY EXPRESSED HOST CELL PROTEINS PREVENTING OR CURTAILING VIRUS REPLICATION AND THEREFORE DEFINED AS "RESTRICTION FACTORS". AMONG THEM, MEMBERS OF THE TRIPARTITE MOTIF (TRIM) FAMILY HAVE EMERGED AS IMPORTANT PLAYERS ENDOWED WITH BOTH ANTIVIRAL EFFECTS AND MODULATORY CAPACITY OF THE INNATE IMMUNE RESPONSE. TRIM5ALPHA AND TRIM19 (I.E. PROMYELOCYTIC LEUKEMIA, PML) ARE AMONG THE BEST-CHARACTERIZED FAMILY MEMBERS; HOWEVER, IN THIS REVIEW WE WILL FOCUS ON THE POTENTIAL ROLE OF ANOTHER FAMILY MEMBER, I.E. TRIM22, A FACTOR STRONGLY INDUCED BY INTERFERON STIMULATION, IN HIV INFECTION IN VIVO AND IN VITRO IN THE CONTEXT OF ITS BROADER ANTIVIRAL EFFECTS. WE WILL ALSO FOCUS ON THE POTENTIAL ROLE OF TRIM22 IN HIV-1-INFECTED INDIVIDUALS SPECULATING ON ITS DUAL ROLE IN CONTROLLING VIRUS REPLICATION AND MORE COMPLEX ROLE IN CHRONIC INFECTION. AT THE MOLECULAR LEVELS, WE WILL REVIEW THE EVIDENCE IN FAVOR OF A RELEVANT ROLE OF TRIM22 AS EPIGENETIC INHIBITOR OF HIV-1 TRANSCRIPTION ACTING BY PREVENTING THE BINDING OF THE HOST CELL TRANSCRIPTION FACTOR SP1 TO THE VIRAL PROMOTER. THESE EVIDENCES SUGGEST THAT TRIM22 SHOULD BE CONSIDERED A POTENTIAL NEW PLAYER IN EITHER THE ESTABLISHMENT OR MAINTENANCE OF HIV-1 RESERVOIRS OF LATENTLY INFECTED CELLS UNAFFECTED BY COMBINATION ANTIRETROVIRAL THERAPY. 2018 9 6706 37 VIRAL GENE PRODUCTS ACTIVELY PROMOTE LATENT INFECTION BY EPIGENETIC SILENCING MECHANISMS. MANY VIRUSES UNDERGO AN ACUTE INFECTION IN THE HOST ORGANISM AND THEN ARE CLEARED BY THE ENSUING HOST IMMUNE RESPONSE, BUT OTHER VIRUSES ESTABLISH A PERSISTENT INFECTION INVOLVING A LATENT INFECTION OR A CHRONIC INFECTION. LATENT INFECTION BY THE HERPESVIRUSES OR HUMAN IMMUNODEFICIENCY VIRUS INVOLVES EPIGENETIC SILENCING OF THE DNA GENOME OR PROVIRAL GENOME, RESPECTIVELY. LATENT INFECTION WAS PREVIOUSLY THOUGHT TO BE A DEFAULT PATHWAY RESULTING FROM INFECTION OF A NONPERMISSIVE CELL, BUT RECENT STUDIES HAVE SHOWN THAT VIRAL GENE PRODUCTS CAN PROMOTE EPIGENETIC SILENCING AND LATENT INFECTION. THIS REVIEW WILL SUMMARIZE THE VIRAL GENE PRODUCTS THAT HAVE BEEN SHOWN TO PROMOTE EPIGENETIC SILENCING OF THE GENOMES AND THEIR POTENTIAL FOR THERAPEUTICS TO TARGET THESE VIRAL GENE PRODUCTS AND DISRUPT OR LOCK IN LATENT INFECTION. 2017 10 64 40 A HIGH-THROUGHPUT SCREENING ASSAY FOR SILENCING ESTABLISHED HIV-1 MACROPHAGE INFECTION IDENTIFIES NUCLEOSIDE ANALOGS THAT PERTURB H3K9ME3 ON PROVIRAL GENOMES. HIV-INFECTED MACROPHAGES ARE LONG-LIVED CELLS THAT REPRESENT A BARRIER TO FUNCTIONAL CURE. ADDITIONALLY, LOW-LEVEL VIRAL EXPRESSION BY CENTRAL NERVOUS SYSTEM (CNS) MACROPHAGES CONTRIBUTES TO NEUROCOGNITIVE DEFICITS THAT DEVELOP DESPITE ANTIRETROVIRAL THERAPY (ART). WE RECENTLY IDENTIFIED H3K9ME3 AS AN ATYPICAL EPIGENETIC MARK ASSOCIATED WITH CHRONIC HIV INFECTION IN MACROPHAGES. THUS, STRATEGIES ARE NEEDED TO SUPPRESS HIV-1 EXPRESSION IN MACROPHAGES, BUT THE UNIQUE MYELOID ENVIRONMENT AND THE RESPONSIBLE MACROPHAGE/CNS-TROPIC STRAINS REQUIRE CELL/STRAIN-SPECIFIC APPROACHES. HERE, WE GENERATED AN HIV-1 REPORTER VIRUS FROM A CNS-DERIVED STRAIN WITH INTACT AUXILIARY GENES EXPRESSING DESTABILIZED LUCIFERASE. WE EMPLOYED THIS REPORTER VIRUS IN POLYCLONAL INFECTION OF PRIMARY HUMAN MONOCYTE-DERIVED MACROPHAGES (MDM) FOR A HIGH-THROUGHPUT SCREEN (HTS) TO IDENTIFY COMPOUNDS THAT SUPPRESS VIRUS EXPRESSION FROM ESTABLISHED MACROPHAGE INFECTION. SCREENING ~6,000 KNOWN DRUGS AND COMPOUNDS YIELDED 214 HITS. A SECONDARY SCREEN WITH 10-DOSE TITRATION IDENTIFIED 24 MEETING CRITERIA FOR HIV-SELECTIVE ACTIVITY. USING THREE REPLICATION-COMPETENT CNS-DERIVED MACROPHAGE-TROPIC HIV-1 ISOLATES AND VIRAL GENE EXPRESSION READOUT IN MDM, WE CONFIRMED THE EFFECT OF THREE PURINE ANALOGS, NELARABINE, FLUDARABINE, AND ENTECAVIR, SHOWING THE SUPPRESSION OF HIV-1 EXPRESSION FROM ESTABLISHED MACROPHAGE INFECTION. NELARABINE INHIBITED THE FORMATION OF H3K9ME3 ON HIV GENOMES IN MACROPHAGES. THUS, THIS NOVEL HTS ASSAY CAN IDENTIFY SUPPRESSORS OF HIV-1 TRANSCRIPTION IN ESTABLISHED MACROPHAGE INFECTION, SUCH AS NUCLEOSIDE ANALOGS AND HDAC INHIBITORS, WHICH MAY BE LINKED TO H3K9ME3 MODIFICATION. THIS SCREEN MAY BE USEFUL TO IDENTIFY NEW METABOLIC AND EPIGENETIC AGENTS THAT AMELIORATE HIV-DRIVEN NEUROINFLAMMATION IN PEOPLE ON ART OR PREVENT VIRAL RECRUDESCENCE FROM MACROPHAGE RESERVOIRS IN STRATEGIES TO ACHIEVE ART-FREE REMISSION. IMPORTANCE MACROPHAGES INFECTED BY HIV-1 ARE A LONG-LIVED RESERVOIR AND A BARRIER IN CURRENT EFFORTS TO ACHIEVE HIV CURE AND ALSO CONTRIBUTE TO NEUROCOGNITIVE COMPLICATIONS IN PEOPLE DESPITE ANTIRETROVIRAL THERAPY (ART). SILENCING HIV EXPRESSION IN THESE CELLS WOULD BE OF GREAT VALUE, BUT THE REGULATION OF HIV-1 IN MACROPHAGES DIFFERS FROM T CELLS. WE DEVELOPED A NOVEL HIGH-THROUGHPUT SCREEN FOR COMPOUNDS THAT CAN SILENCE ESTABLISHED INFECTION OF PRIMARY MACROPHAGES, AND IDENTIFIED AGENTS THAT DOWNREGULATE VIRUS EXPRESSION AND ALTER PROVIRUS EPIGENETIC PROFILES. THE SIGNIFICANCE OF THIS ASSAY IS THE POTENTIAL TO IDENTIFY NEW DRUGS THAT ACT IN THE UNIQUE MACROPHAGE ENVIRONMENT ON RELEVANT VIRAL STRAINS, WHICH MAY CONTRIBUTE TO ADJUNCTIVE TREATMENT FOR HIV-ASSOCIATED NEUROCOGNITIVE DISORDERS AND/OR PREVENT VIRAL REBOUND IN EFFORTS TO ACHIEVE ART-FREE REMISSION OR CURE. 2023 11 1239 33 CURE AND LONG-TERM REMISSION STRATEGIES. THE MAJORITY OF VIRALLY SUPPRESSED INDIVIDUALS WILL EXPERIENCE RAPID VIRAL REBOUND UPON ANTIRETROVIRAL THERAPY (ART) INTERRUPTION, PROVIDING A STRONG RATIONALE FOR THE DEVELOPMENT OF CURE STRATEGIES. MOREOVER, DESPITE ART VIROLOGICAL CONTROL, HIV INFECTION IS STILL ASSOCIATED WITH CHRONIC IMMUNE ACTIVATION, INFLAMMATION, COMORBIDITIES, AND ACCELERATED AGING. THESE EFFECTS ARE BELIEVED TO BE DUE, IN PART, TO LOW-GRADE PERSISTENT TRANSCRIPTION AND TRICKLING PRODUCTION OF VIRAL PROTEINS FROM THE POOL OF LATENT PROVIRUSES CONSTITUTING THE VIRAL RESERVOIR. IN RECENT YEARS THERE HAS BEEN AN INCREASING INTEREST IN DEVELOPING WHAT HAS BEEN TERMED A FUNCTIONAL CURE FOR HIV. THIS APPROACH ENTAILS THE LONG-TERM, DURABLE CONTROL OF VIRAL EXPRESSION IN THE ABSENCE OF THERAPY, PREVENTING DISEASE PROGRESSION AND TRANSMISSION, DESPITE THE PRESENCE OF DETECTABLE INTEGRATED PROVIRUSES. ONE SUCH STRATEGY, THE BLOCK-AND-LOCK APPROACH FOR A FUNCTIONAL CURE, PROPOSES THE EPIGENETIC SILENCING OF PROVIRAL EXPRESSION, LOCKING THE VIRUS IN A PROFOUND LATENT STATE, FROM WHICH REACTIVATION IS VERY UNLIKELY. THE PROOF-OF-CONCEPT FOR THIS APPROACH WAS DEMONSTRATED WITH THE USE OF A SPECIFIC SMALL MOLECULE TARGETING HIV TRANSCRIPTION. HERE WE REVIEW THE PRINCIPLES BEHIND THE BLOCK-AND-LOCK APPROACH AND SOME OF THE ADDITIONAL STRATEGIES PROPOSED TO SILENCE HIV EXPRESSION. 2022 12 6523 41 TRANSCRIPTIONAL AND EPIGENETIC REGULATORY MECHANISMS AFFECTING HTLV-1 PROVIRUS. HUMAN T-CELL LEUKEMIA VIRUS TYPE 1 (HTLV-1) IS A RETROVIRUS ASSOCIATED WITH HUMAN DISEASES, SUCH AS ADULT T-CELL LEUKEMIA (ATL) AND HTLV-1-ASSOCIATED MYELOPATHY/TROPIC SPASTIC PARAPARESIS (HAM/TSP). AS A RETROVIRUS, ITS LIFE CYCLE INCLUDES A STEP WHERE HTLV-1 IS INTEGRATED INTO THE HOST GENOMIC DNA AND FORMS PROVIRAL DNA. IN THE CHRONIC PHASE OF THE INFECTION, HTLV?1 IS KNOWN TO PROLIFERATE AS A PROVIRUS VIA THE MITOTIC DIVISION OF THE INFECTED HOST CELLS. THERE ARE GENERALLY TENS OF THOUSANDS OF INFECTED CLONES WITHIN AN INFECTED INDIVIDUAL. THEY EXIST NOT ONLY IN PERIPHERAL BLOOD, BUT ALSO IN VARIOUS LYMPHOID ORGANS. VIRAL PROTEINS ENCODED IN HTLV-1 GENOME PLAY A ROLE IN THE PROLIFERATION AND SURVIVAL OF THE INFECTED CELLS. AS IS THE CASE WITH OTHER CHRONIC VIRAL INFECTIONS, HTLV-1 GENE EXPRESSION INDUCES THE ACTIVATION OF THE HOST IMMUNITY AGAINST THE VIRUS. THUS, THE TRANSCRIPTION FROM HTLV-1 PROVIRUS NEEDS TO BE CONTROLLED IN ORDER TO EVADE THE HOST IMMUNE SURVEILLANCE. THERE SHOULD BE A DYNAMIC AND COMPLEX REGULATION IN VIVO, WHERE AN EQUILIBRIUM BETWEEN VIRAL ANTIGEN EXPRESSION AND HOST IMMUNE SURVEILLANCE IS ACHIEVED. THE MECHANISMS REGULATING VIRAL GENE EXPRESSION FROM THE PROVIRUS ARE A KEY TO UNDERSTANDING THE PERSISTENT/LATENT INFECTION WITH HTLV-1 AND ITS PATHOGENESIS. IN THIS ARTICLE, WE WOULD LIKE TO REVIEW OUR CURRENT UNDERSTANDING ON THIS TOPIC. 2016 13 3779 47 INTERFERON ALPHA INDUCES MULTIPLE CELLULAR PROTEINS THAT COORDINATELY SUPPRESS HEPADNAVIRAL COVALENTLY CLOSED CIRCULAR DNA TRANSCRIPTION. COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) OF HEPADNAVIRUSES EXISTS AS AN EPISOMAL MINICHROMOSOME IN THE NUCLEUS OF AN INFECTED HEPATOCYTE AND SERVES AS THE TEMPLATE FOR THE TRANSCRIPTION OF VIRAL MRNAS. IT HAD BEEN DEMONSTRATED BY OTHERS AND US THAT INTERFERON ALPHA (IFN-ALPHA) TREATMENT OF HEPATOCYTES INDUCED A PROLONGED SUPPRESSION OF HUMAN AND DUCK HEPATITIS B VIRUS CCCDNA TRANSCRIPTION, WHICH IS ASSOCIATED WITH THE REDUCTION OF CCCDNA-ASSOCIATED HISTONE MODIFICATIONS SPECIFYING ACTIVE TRANSCRIPTION (H3K9(AC) OR H3K27(AC)), BUT NOT THE HISTONE MODIFICATIONS MARKING CONSTITUTIVE (H3K9(ME3)) OR FACULTATIVE (H3K27(ME3)) HETEROCHROMATIN FORMATION. IN OUR EFFORTS TO IDENTIFY IFN-INDUCED CELLULAR PROTEINS THAT MEDIATE THE SUPPRESSION OF CCCDNA TRANSCRIPTION BY THE CYTOKINE, WE FOUND THAT DOWNREGULATING THE EXPRESSION OF SIGNAL TRANSDUCER AND ACTIVATOR OF TRANSCRIPTION 1 (STAT1), STRUCTURAL MAINTENANCE OF CHROMOSOMES FLEXIBLE HINGE DOMAIN CONTAINING 1 (SMCHD1), OR PROMYELOCYTIC LEUKEMIA (PML) PROTEIN INCREASED BASAL LEVEL OF CCCDNA TRANSCRIPTION ACTIVITY AND PARTIALLY ATTENUATED IFN-ALPHA SUPPRESSION OF CCCDNA TRANSCRIPTION. IN CONTRAST, ECTOPIC EXPRESSION OF STAT1, SMCHD1, OR PML SIGNIFICANTLY REDUCED CCCDNA TRANSCRIPTION ACTIVITY. SMCHD1 IS A NONCANONICAL SMC FAMILY PROTEIN AND IMPLICATED IN EPIGENETIC SILENCING OF GENE EXPRESSION. PML IS A COMPONENT OF NUCLEAR DOMAIN 10 (ND10) AND IS INVOLVED IN SUPPRESSING THE REPLICATION OF MANY DNA VIRUSES. MECHANISTIC ANALYSES DEMONSTRATED THAT STAT1, SMCHD1, AND PML WERE RECRUITED TO CCCDNA MINICHROMOSOMES AND PHENOCOPIED THE IFN-ALPHA-INDUCED POSTTRANSLATIONAL MODIFICATIONS OF CCCDNA-ASSOCIATED HISTONES. WE THUS CONCLUDE THAT STAT1, SMCHD1, AND PML MAY PARTLY MEDIATE THE SUPPRESSIVE EFFECT OF IFN-ALPHA ON HEPADNAVIRAL CCCDNA TRANSCRIPTION.IMPORTANCE PEGYLATED IFN-ALPHA IS THE ONLY THERAPEUTIC REGIMEN THAT CAN INDUCE A FUNCTIONAL CURE OF CHRONIC HEPATITIS B IN A SMALL, BUT SIGNIFICANT, FRACTION OF TREATED PATIENTS. UNDERSTANDING THE MECHANISMS UNDERLYING THE ANTIVIRAL FUNCTIONS OF IFN-ALPHA IN HEPADNAVIRAL INFECTION MAY REVEAL MOLECULAR TARGETS FOR DEVELOPMENT OF NOVEL ANTIVIRAL AGENTS TO IMPROVE THE THERAPEUTIC EFFICACY OF IFN-ALPHA. BY A LOSS-OF-FUNCTION GENETIC SCREENING OF INDIVIDUAL IFN-STIMULATED GENES (ISGS) ON HEPADNAVIRAL MRNAS TRANSCRIBED FROM CCCDNA, WE FOUND THAT DOWNREGULATING THE EXPRESSION OF STAT1, SMCHD1, OR PML SIGNIFICANTLY INCREASED THE LEVEL OF VIRAL RNAS WITHOUT ALTERING THE LEVEL OF CCCDNA. MECHANISTIC ANALYSES INDICATED THAT THOSE CELLULAR PROTEINS ARE RECRUITED TO CCCDNA MINICHROMOSOMES AND INDUCE THE POSTTRANSLATIONAL MODIFICATIONS OF CCCDNA-ASSOCIATED HISTONES SIMILAR TO THOSE INDUCED BY IFN-ALPHA TREATMENT. WE HAVE THUS IDENTIFIED THREE IFN-ALPHA-INDUCED CELLULAR PROTEINS THAT SUPPRESS CCCDNA TRANSCRIPTION AND MAY PARTLY MEDIATE IFN-ALPHA SILENCING OF HEPADNAVIRAL CCCDNA TRANSCRIPTION. 2020 14 2073 37 EPIGENETIC CROSSTALK IN CHRONIC INFECTION WITH HIV-1. HUMAN IMMUNODEFICIENCY VIRUS 1 (HIV-1) REPLICATES THROUGH THE INTEGRATION OF ITS VIRAL DNA INTO THE GENOME OF HUMAN IMMUNE TARGET CELLS. CHRONICALLY INFECTED INDIVIDUALS THUS CARRY A GENOMIC BURDEN OF VIRUS-DERIVED SEQUENCES THAT PERSISTS THROUGH ANTIRETROVIRAL THERAPY. THIS BURDEN CONSISTS OF A SMALL FRACTION OF INTACT, BUT TRANSCRIPTIONALLY SILENCED, I.E. LATENT, VIRAL GENOMES AND A DOMINANT FRACTION OF DEFECTIVE SEQUENCES. REMARKABLY, ALL VIRAL-DERIVED SEQUENCES ARE SUBJECT TO INTERACTION WITH HOST CELLULAR PHYSIOLOGY AT VARIOUS LEVELS. IN THIS REVIEW, WE FOCUS ON EPIGENETIC ASPECTS OF THIS INTERACTION. WE PROVIDE A COMPREHENSIVE OVERVIEW OF HOW EPIGENETIC MECHANISMS CONTRIBUTE TO ESTABLISHMENT AND MAINTENANCE OF HIV-1 GENE REPRESSION DURING LATENCY. WE FURTHERMORE SUMMARIZE FINDINGS INDICATING THAT HIV-1 INFECTION LEADS TO CHANGES IN THE EPIGENOME OF TARGET AND BYSTANDER IMMUNE CELLS. FINALLY, WE DISCUSS HOW AN IMPROVED UNDERSTANDING OF EPIGENETIC FEATURES AND MECHANISMS INVOLVED IN HIV-1 INFECTION COULD BE EXPLOITED FOR CLINICAL USE. 2020 15 6044 48 THE COMPLEX BIOLOGY OF HUMAN CYTOMEGALOVIRUS LATENCY. WHILE MANY VIRAL INFECTIONS ARE LIMITED AND EVENTUALLY RESOLVED BY THE HOST IMMUNE RESPONSE OR BY DEATH OF THE HOST, OTHER VIRUSES ESTABLISH LONG-TERM RELATIONSHIPS WITH THE HOST BY WAY OF A PERSISTENT INFECTION, THAT RANGE FROM CHRONIC VIRUSES THAT MAY BE EVENTUALLY CLEARED TO THOSE THAT ESTABLISH LIFE-LONG PERSISTENT OR LATENT INFECTION. VIRUSES INFECTING HOSTS FROM BACTERIA TO HUMANS ESTABLISH QUIESCENT INFECTIONS THAT MUST BE REACTIVATED TO PRODUCE PROGENY. FOR MAMMALIAN VIRUSES, MOST NOTABLY HERPESVIRUSES, THIS QUIESCENT MAINTENANCE OF VIRAL GENOMES IN THE ABSENCE OF VIRUS REPLICATION IS REFERRED TO AS LATENCY. THE LATENT STRATEGY ALLOWS THE VIRUS TO PERSIST QUIESCENTLY WITHIN A SINGLE HOST UNTIL CONDITIONS INDICATE A NEED TO REACTIVATE TO REACH A NEW HOST OR, TO RE-SEED A RESERVOIR WITHIN THE HOST. HERE, I REVIEW COMMON THEMES IN VIRAL STRATEGIES TO REGULATE THE LATENT CYCLE AND REACTIVATE FROM IT RANGING FROM BACTERIOPHAGE TO HERPESVIRUSES WITH A FOCUS ON HUMAN CYTOMEGALOVIRUS (HCMV). THEMES CENTRAL TO HERPESVIRUS LATENCY INCLUDE, EPIGENETIC REPRESSION OF VIRAL GENE EXPRESSION AND MECHANISMS TO REGULATE HOST SIGNALING AND SURVIVAL. CRITICAL TO THE SUCCESS OF A LATENT PROGRAM ARE MECHANISMS BY WHICH THE VIRUS CAN "SENSE" FLUCTUATIONS IN HOST BIOLOGY (WITHIN THE HOST) OR ENVIRONMENT (OUTSIDE THE HOST) AND MAKE APPROPRIATE "DECISIONS" TO MAINTAIN LATENCY OR RE-INITIATE THE REPLICATIVE PROGRAM. THE SIGNALS OR ENVIRONMENTS THAT INDICATE THE ESTABLISHMENT OF A LATENT STATE, THE VERY NATURE OF THE LATENT STATE, AS WELL AS THE SIGNALS DRIVING REACTIVATION HAVE BEEN TOPICS OF INTENSE STUDY FROM BACTERIOPHAGE TO HUMAN VIRUSES, AS THESE QUESTIONS ENCOMPASS THE HEIGHT OF COMPLEXITY IN VIRUS-HOST INTERACTIONS-WHERE THE HOST AND THE VIRUS COEXIST. 2022 16 3340 43 HISTONE DEACETYLASE MEDIATED TRANSCRIPTIONAL ACTIVATION REDUCES PROVIRAL LOADS IN HTLV-1 ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS PATIENTS. EPIGENETIC MODIFICATIONS OF CHROMATIN MAY PLAY A ROLE IN MAINTAINING VIRAL LATENCY AND THUS PERSISTENCE OF THE HUMAN T-LYMPHOTROPIC VIRUS TYPE 1 (HTLV-1), WHICH IS RESPONSIBLE FOR HTLV-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS (HAM/TSP). A MAJOR DETERMINANT OF DISEASE PROGRESSION IS INCREASED PERIPHERAL BLOOD PROVIRAL LOAD (PVL), POSSIBLY VIA THE ACCUMULATION OF INFECTED CELLS IN THE CENTRAL NERVOUS SYSTEM (CNS) CREATING A DAMAGING INFLAMMATORY RESPONSE. CURRENT THERAPEUTIC APPROACHES THAT FOCUS ON REDUCING EITHER CELL PROLIFERATION, VIRAL REPLICATION, OR TISSUE INVASION ARE STILL UNSATISFACTORY. CONTRASTING WITH THESE INHIBITORY STRATEGIES, WE EVALUATED THE EFFICACY OF A NOVEL APPROACH AIMED, PARADOXICALLY, AT ACTIVATING VIRAL GENE EXPRESSION TO EXPOSE VIRUS-POSITIVE CELLS TO THE HOST IMMUNE RESPONSE. WE USED VALPROATE (VPA), A HISTONE DEACETYLASE INHIBITOR THAT HAS BEEN USED FOR DECADES AS A CHRONIC, SAFE TREATMENT FOR EPILEPTIC DISORDERS. BASED ON IN VITRO AND IN VIVO DATA, WE PROVIDE EVIDENCE THAT TRANSIENT ACTIVATION OF THE LATENT VIRAL RESERVOIR CAUSES ITS COLLAPSE, A PROCESS THAT MAY ALLEVIATE THE CONDITION OF HAM/TSP. THIS REPRESENTS THE FIRST SUCH APPROACH TO TREATING HAM/TSP, USING GENE ACTIVATION THERAPY TO TILT THE HOST-PATHOGEN BALANCE IN FAVOR OF AN EXISTING ANTIVIRAL RESPONSE. THIS TRIAL IS REGISTERED AT HTTP://CLINICALTRIALS.GOV/AS NO. NCT00519181. 2007 17 4849 29 OPIOID-MEDIATED HIV-1 IMMUNOPATHOGENESIS. DESPITE THE ABILITY OF COMBINATION ANTIRETROVIRAL THERAPY TO DRAMATICALLY SUPPRESS VIREMIA, THE BRAIN CONTINUES TO BE A RESERVOIR OF HIV-1 LOW-LEVEL REPLICATION. ADDING FURTHER COMPLEXITY TO THIS IS THE COMORBIDITY OF DRUG ABUSE WITH HIV-1 ASSOCIATED NEUROCOGNITIVE DISORDERS AND NEUROHIV. AMONG SEVERAL ABUSED DRUGS, THE USE OF OPIATES IS HIGHLY PREVALENT IN HIV-1 INFECTED INDIVIDUALS, BOTH AS AN ABUSED DRUG AS WELL AS FOR PAIN MANAGEMENT. OPIOIDS AND THEIR RECEPTORS HAVE ATTAINED NOTABLE ATTENTION OWING TO THEIR ABILITY TO MODULATE IMMUNE FUNCTIONS, IN TURN, IMPACTING DISEASE PROGRESSION. VARIOUS CELL CULTURE, ANIMAL AND HUMAN STUDIES HAVE IMPLICATED THE ROLE OF OPIOIDS AND THEIR RECEPTORS IN MODULATING VIRAL REPLICATION AND VIRUS-MEDIATED PATHOLOGY BOTH POSITIVELY AND NEGATIVELY. FURTHER, THE COMBINATORIAL EFFECTS OF HIV-1/HIV-1 PROTEINS AND MORPHINE HAVE DEMONSTRATED ACTIVATION OF INFLAMMATORY SIGNALING IN THE HOST SYSTEM. HEREIN, WE SUMMARIZED THE CURRENT KNOWLEDGE ON THE ROLE OF OPIOIDS ON PERIPHERAL IMMUNOPATHOGENESIS, VIRAL IMMUNOPATHOGENESIS, EPIGENETIC PROFILES OF THE HOST AND VIRAL GENOME, NEUROPATHOGENESIS OF SIV/SHIV-INFECTED NON-HUMAN PRIMATES, BLOOD-BRAIN-BARRIER, HIV-1 VIRAL LATENCY, AND VIRAL REBOUND. OVERALL, THIS REVIEW PROVIDES RECENT INSIGHTS INTO THE ROLE OF OPIOIDS IN HIV-1 IMMUNOPATHOGENESIS. GRAPHICAL ABSTRACT. 2020 18 5368 30 RECENT ADVANCES IN THE STUDY OF HEPATITIS B VIRUS COVALENTLY CLOSED CIRCULAR DNA. CHRONIC HEPATITIS B INFECTION IS CAUSED BY HEPATITIS B VIRUS (HBV) AND A TOTAL CURE IS YET TO BE ACHIEVED. THE VIRAL COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) IS THE KEY TO ESTABLISH A PERSISTENT INFECTION WITHIN HEPATOCYTES. CURRENT ANTIVIRAL STRATEGIES HAVE NO EFFECT ON THE PRE-EXISTING CCCDNA RESERVOIR. THEREFORE, THE STUDY OF THE MOLECULAR MECHANISM OF CCCDNA FORMATION IS BECOMING A MAJOR FOCUS OF HBV RESEARCH. THIS REVIEW SUMMARIZES THE CURRENT ADVANCES IN CCCDNA MOLECULAR BIOLOGY AND THE LATEST STUDIES ON THE ELIMINATION OR INACTIVATION OF CCCDNA, INCLUDING THREE MAJOR AREAS: (1) EPIGENETIC REGULATION OF CCCDNA BY HBV X PROTEIN, (2) IMMUNE-MEDIATED DEGRADATION, AND (3) GENOME-EDITING NUCLEASES. ALL THESE ASPECTS PROVIDE CLUES ON HOW TO FINALLY ATTAIN A CURE FOR CHRONIC HEPATITIS B INFECTION. 2017 19 3280 39 HERPES ZOSTER OPHTHALMICUS FOLLOWING ONABOTULINUMTOXINA ADMINISTRATION FOR CHRONIC MIGRAINE: A CASE REPORT AND LITERATURE REVIEW. BACKGROUND: THERE IS A GROWING BODY OF LITERATURE DOCUMENTING LOCAL HERPES ZOSTER OUTBREAK FOLLOWING PROCEDURES. THE MECHANISM UNDERLYING THESE OUTBREAKS REMAINS ELUSIVE. WE PRESENT A CASE OF ZOSTER FOLLOWING ONABOTULINUMTOXINA (BTX) FOR MIGRAINE AND A LITERATURE REVIEW. METHODS: CHART AND LITERATURE REVIEW. CASE: A 72-YEAR-OLD WOMAN WITH CHRONIC MIGRAINE RECEIVED BTX INJECTIONS FOR 3 YEARS WITHOUT INCIDENT. SHE HAD A HISTORY OF THORACIC ZOSTER WITH SUBSEQUENT POST-HERPETIC NEURALGIA. IN AUGUST 2013, 48 HOURS AFTER RECEIVING BTX INJECTIONS, SHE DEVELOPED A PAINFUL RASH IN THE RIGHT V1 DISTRIBUTION CONSISTENT WITH HERPES ZOSTER OPHTHALMICUS. ONE WEEK LATER THE RASH HAD RESOLVED WITHOUT TREATMENT. LITERATURE REVIEW: WE IDENTIFIED 65 (INCLUDING 2 FROM JUEL-JENSON) CASES OF ZOSTER REACTIVATION FOLLOWING MINOR PROCEDURES. THESE CASES TEND TO BE IN YOUNG PATIENTS WITHOUT SPECIFIC RISK FACTORS. OUTBREAKS CHARACTERISTICALLY OCCUR AT THE LEVEL OF EXPOSURE TO LOCAL TRAUMA. DISCUSSION: OUR REVIEW SUGGESTS THAT LOCAL TRAUMA, REGARDLESS OF THE NATURE OF STIMULI, MAY BE SUFFICIENT FOR ZOSTER REACTIVATION. WE HYPOTHESIZE THAT THE STRESSORS IN THESE REPORTED CASES EXERT A LOCAL EPIGENETIC INFLUENCE ON VIRAL TRANSCRIPTION, ALLOWING FOR VIRAL REACTIVATION. CONCLUSION: ZOSTER IS A POTENTIAL COMPLICATION OF BTX ADMINISTRATION FOR CHRONIC MIGRAINE IN ADULTS. PHYSICIAN AWARENESS CAN REDUCE THE SIGNIFICANT MORBIDITY ASSOCIATED WITH THIS DISEASE. 2015 20 2915 36 GENE THERAPY FOR CHRONIC HBV-CAN WE ELIMINATE CCCDNA? CHRONIC INFECTION WITH THE HEPATITIS B VIRUS (HBV) IS A GLOBAL HEALTH CONCERN AND ACCOUNTS FOR APPROXIMATELY 1 MILLION DEATHS ANNUALLY. AMONGST OTHER LIMITATIONS OF CURRENT ANTI-HBV TREATMENT, FAILURE TO ELIMINATE THE VIRAL COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) AND EMERGENCE OF RESISTANCE REMAIN THE MOST WORRISOME. VIRAL REBOUND FROM LATENT EPISOMAL CCCDNA RESERVOIRS OCCURS FOLLOWING CESSATION OF THERAPY, PATIENT NON-COMPLIANCE, OR THE DEVELOPMENT OF ESCAPE MUTANTS. SIMULTANEOUS VIRAL CO-INFECTIONS, SUCH AS BY HIV-1, FURTHER COMPLICATE THERAPEUTIC INTERVENTIONS. THESE CHALLENGES HAVE PROMPTED DEVELOPMENT OF NOVEL TARGETED HEPATITIS B THERAPIES. GIVEN THE EASE WITH WHICH HIGHLY SPECIFIC AND POTENT NUCLEIC ACID THERAPEUTICS CAN BE RATIONALLY DESIGNED, GENE THERAPY HAS GENERATED INTEREST FOR ANTIVIRAL APPLICATION. GENE THERAPY STRATEGIES DEVELOPED FOR HBV INCLUDE GENE SILENCING BY HARNESSING RNA INTERFERENCE, TRANSCRIPTIONAL INHIBITION THROUGH EPIGENETIC MODIFICATION OF TARGET DNA, GENOME EDITING BY DESIGNER NUCLEASES, AND IMMUNE MODULATION WITH CYTOKINES. DNA-BINDING DOMAINS AND EFFECTORS BASED ON THE ZINC FINGER (ZF), TRANSCRIPTION ACTIVATOR-LIKE EFFECTOR (TALE), AND CLUSTERED REGULARLY INTERSPACED SHORT PALINDROMIC REPEAT (CRISPR) SYSTEMS ARE REMARKABLY WELL SUITED TO TARGETING EPISOMAL CCCDNA. THIS REVIEW DISCUSSES RECENT DEVELOPMENTS AND CHALLENGES FACING THE FIELD OF ANTI-HBV GENE THERAPY, ITS POTENTIAL CURATIVE SIGNIFICANCE AND THE PROGRESS TOWARDS CLINICAL APPLICATION. 2018