1 6304 147 THE QUEBEC LOW BACK PAIN STUDY: A PROTOCOL FOR AN INNOVATIVE 2-TIER PROVINCIAL COHORT. INTRODUCTION: THE NEUROBIOLOGICAL MECHANISMS UNDERLYING RECOVERY FROM OR PERSISTENCE OF LOW BACK PAIN (LBP) REMAIN MISUNDERSTOOD, LIMITING PROGRESS TOWARD EFFECTIVE MANAGEMENT. WE HAVE DEVELOPED AN INNOVATIVE TWO-TIER DESIGN TO STUDY THE TRANSITION FROM ACUTE TO CHRONIC LBP. THE OBJECTIVE OF THE FIRST TIER IS TO CREATE A PROVINCIAL WEB-BASED INFRASTRUCTURE TO RECRUIT AND MONITOR THE TRAJECTORY OF INDIVIDUALS WITH ACUTE LBP. THE OBJECTIVE OF THE SECOND TIER IS TO FUEL HYPOTHESIS-DRIVEN SATELLITE DATA COLLECTION CENTERS WITH SPECIALIZED EXPERTISE TO STUDY THE ROLE OF BIOMECHANICAL, EPIGENETIC, GENETIC, NEUROANATOMICAL, ONTOLOGICAL, PHYSIOLOGICAL, PSYCHOLOGICAL, AND SOCIOECONOMIC FACTORS IN LBP CHRONICITY. METHODS: THIS ARTICLE DESCRIBES THE FIRST TIER OF THE PROTOCOL: ESTABLISHMENT OF THE CORE DATASET AND COHORT. ADULTS WITH ACUTE LBP WILL BE RECRUITED THROUGH NETWORKS, MEDIA, AND HEALTH CARE SETTINGS. A WEB-BASED INTERFACE WILL BE USED TO COLLECT SELF-REPORTED VARIABLES AT BASELINE AND AT 3, 6, 12, AND 24 MONTHS. ACUTE LBP WILL BE DEFINED ACCORDING TO THE DIONNE 2008 CONSENSUS. MEASUREMENTS WILL INCLUDE THE CANADIAN MINIMUM DATA SET FOR CHRONIC LBP RESEARCH, DN4 FOR NEUROPATHIC PAIN, COMORBIDITIES, EQ-5D-5L FOR QUALITY OF LIFE, AND LINKAGE WITH PROVINCIAL MEDICO-ADMINISTRATIVE DATABASES. THE PRIMARY OUTCOME WILL BE THE TRANSITION TO CHRONIC LBP, AS DEFINED BY DEYO 2014. SECONDARY OUTCOMES INCLUDE HEALTH CARE RESOURCE UTILIZATION, DISABILITY, SICK LEAVE, MOOD, AND QUALITY OF LIFE. PERSPECTIVE: THIS STUDY BRINGS TOGETHER DIVERSE RESEARCH EXPERTISE TO INVESTIGATE THE TRANSITION FROM ACUTE TO CHRONIC LBP, CHARACTERIZE THE PROGRESSION TO RECOVERY OR CHRONICITY, AND IDENTIFY PATTERNS ASSOCIATED WITH THAT PROGRESSION. 2020 2 2706 43 EXERCISE ATTENUATES LOW BACK PAIN AND ALTERS EPIGENETIC REGULATION IN INTERVERTEBRAL DISCS IN A MOUSE MODEL. BACKGROUND CONTEXT: CHRONIC LOW BACK PAIN (LBP) IS A MULTIFACTORIAL DISORDER WITH COMPLEX UNDERLYING MECHANISMS, INCLUDING ASSOCIATIONS WITH INTERVERTEBRAL DISC (IVD) DEGENERATION IN SOME INDIVIDUALS. IT HAS BEEN DEMONSTRATED THAT EPIGENETIC PROCESSES ARE INVOLVED IN THE PATHOLOGY OF IVD DEGENERATION. EPIGENETICS REFERS TO SEVERAL MECHANISMS, INCLUDING DNA METHYLATION, THAT HAVE THE ABILITY TO CHANGE GENE EXPRESSION WITHOUT INDUCING ANY CHANGE IN THE UNDERLYING DNA SEQUENCE. DNA METHYLATION CAN ALTER THE ENTIRE STATE OF A TISSUE FOR AN EXTENDED PERIOD OF TIME AND THUS COULD POTENTIALLY BE HARNESSED FOR LONG-TERM PAIN RELIEF. LIFESTYLE FACTORS, SUCH AS PHYSICAL ACTIVITY, HAVE A STRONG INFLUENCE ON EPIGENETIC REGULATION. EXERCISE IS A COMMONLY PRESCRIBED TREATMENT FOR CHRONIC LBP, AND SEX-SPECIFIC EPIGENETIC ADAPTATIONS IN RESPONSE TO ENDURANCE EXERCISE HAVE BEEN REPORTED. HOWEVER, WHETHER EXERCISE INTERVENTIONS THAT ATTENUATE LBP ARE ASSOCIATED WITH EPIGENETIC ALTERATIONS IN DEGENERATING IVDS HAS NOT BEEN EVALUATED. PURPOSE: WE HYPOTHESIZE THAT THE THERAPEUTIC EFFICACY OF PHYSICAL ACTIVITY IS MEDIATED, AT LEAST IN PART, AT THE EPIGENETIC LEVEL. THE PURPOSE OF THIS STUDY WAS TO USE THE SPARC-NULL MOUSE MODEL OF LBP ASSOCIATED WITH IVD DEGENERATION TO CLARIFY (1) IF IVD DEGENERATION IS ASSOCIATED WITH ALTERED EXPRESSION OF EPIGENETIC REGULATORY GENES IN THE IVDS, (2) IF EPIGENETIC REGULATORY MACHINERY IS SENSITIVE TO THERAPEUTIC ENVIRONMENTAL INTERVENTION, AND (3) IF THERE ARE SEX-SPECIFIC DIFFERENCES IN (1) AND/OR (2). STUDY DESIGN: EIGHT-MONTH-OLD MALE AND FEMALE SPARC-NULL AND AGE-MATCHED CONTROL (WT) MICE (N=108) WERE ASSIGNED TO EXERCISE (N=56) OR SEDENTARY (N=52) GROUPS. DELETION OF SPARC IS ASSOCIATED WITH PROGRESSIVE IVD DEGENERATION AND BEHAVIORAL SIGNS OF LBP. THE EXERCISE GROUP RECEIVED A CIRCULAR PLASTIC HOME CAGE RUNNING WHEEL ON WHICH THEY COULD RUN FREELY. THE SEDENTARY GROUP RECEIVED AN IDENTICAL WHEEL SECURED IN PLACE TO PREVENT ROTATION. AFTER 6 MONTHS, THE RESULTS OBTAINED IN EACH GROUP WERE COMPARED. METHODS: AFTER 6 MONTHS OF EXERCISE, LBP-RELATED BEHAVIORAL INDICES WERE DETERMINED, AND GLOBAL DNA METHYLATION (5-METHYLCYTOSINE) AND EPIGENETIC REGULATORY GENE MRNA EXPRESSION IN IVDS WERE ASSESSED. THIS PROJECT WAS SUPPORTED BY THE CANADIAN INSTITUTES FOR HEALTH RESEARCH. THE AUTHORS HAVE NO CONFLICTS OF INTEREST. RESULTS: LUMBAR IVDS FROM WT SEDENTARY AND SPARC-NULL SEDENTARY MICE HAD SIMILAR LEVELS OF GLOBAL DNA METHYLATION (%5-MC) AND COMPARABLE MRNA EXPRESSION OF EPIGENETIC REGULATORY GENES (DNMT1,3A,B, MECP2, MBD2A,B, TET1-3) IN BOTH SEXES. EXERCISE ATTENUATED LBP-RELATED BEHAVIORS, DECREASED GLOBAL DNA METHYLATION IN BOTH WT (P<.05) AND SPARC-NULL MICE (P<.01) AND REDUCED MRNA EXPRESSION OF MECP2 IN SPARC-NULL MICE (P<.05). SEX-SPECIFIC EFFECTS OF EXERCISE ON EXPRESSION OF MRNA WERE ALSO OBSERVED. CONCLUSIONS: EXERCISE ALLEVIATES LBP IN A MOUSE MODEL. THIS MAY BE MEDIATED, IN PART, BY CHANGES IN THE EPIGENETIC REGULATORY MACHINERY IN DEGENERATING IVDS. EPIGENETIC ALTERATIONS DUE TO A LIFESTYLE CHANGE COULD HAVE A LONG-LASTING THERAPEUTIC IMPACT BY CHANGING TISSUE HOMEOSTASIS IN IVDS. CLINICAL SIGNIFICANCE: THIS STUDY CONFIRMED THE THERAPEUTIC BENEFITS OF EXERCISE ON LBP AND SUGGESTS THAT EXERCISE RESULTS IN SEX-SPECIFIC ALTERATIONS IN EPIGENETIC REGULATION IN IVDS. ELUCIDATING THE EFFECTS OF EXERCISE ON EPIGENETIC REGULATION MAY ENABLE THE DISCOVERY OF NOVEL GENE TARGETS OR NEW STRATEGIES TO IMPROVE THE TREATMENT OF CHRONIC LBP. 2021 3 2418 33 EPIGENETIC SIGNATURE OF CHRONIC LOW BACK PAIN IN HUMAN T CELLS. OBJECTIVE: DETERMINE IF CHRONIC LOW BACK PAIN (LBP) IS ASSOCIATED WITH DNA METHYLATION SIGNATURES IN HUMAN T CELLS THAT WILL REVEAL NOVEL MECHANISMS AND POTENTIAL THERAPEUTIC TARGETS AND EXPLORE THE FEASIBILITY OF EPIGENETIC DIAGNOSTIC MARKERS FOR PAIN-RELATED PATHOPHYSIOLOGY. METHODS: GENOME-WIDE DNA METHYLATION ANALYSIS OF 850,000 CPG SITES IN WOMEN AND MEN WITH CHRONIC LBP AND PAIN-FREE CONTROLS WAS PERFORMED. T CELLS WERE ISOLATED (DISCOVERY COHORT, N = 32) AND USED TO IDENTIFY DIFFERENTIALLY METHYLATED CPG SITES, AND GENE ONTOLOGIES AND MOLECULAR PATHWAYS WERE IDENTIFIED. A POLYGENIC DNA METHYLATION SCORE FOR LBP WAS GENERATED IN BOTH WOMEN AND MEN. VALIDATION WAS PERFORMED IN AN INDEPENDENT COHORT (VALIDATION COHORT, N = 63) OF CHRONIC LBP AND HEALTHY CONTROLS. RESULTS: ANALYSIS WITH THE DISCOVERY COHORT REVEALED A TOTAL OF 2,496 AND 419 DIFFERENTIALLY METHYLATED CPGS IN WOMEN AND MEN, RESPECTIVELY. IN WOMEN, MOST OF THESE SITES WERE HYPOMETHYLATED AND ENRICHED IN GENES WITH FUNCTIONS IN THE EXTRACELLULAR MATRIX, IN THE IMMUNE SYSTEM (IE, CYTOKINES), OR IN EPIGENETIC PROCESSES. IN MEN, A UNIQUE CHRONIC LBP DNA METHYLATION SIGNATURE WAS IDENTIFIED CHARACTERIZED BY SIGNIFICANT ENRICHMENT FOR GENES FROM THE MAJOR HISTOCOMPATIBILITY COMPLEX. SEX-SPECIFIC POLYGENIC DNA METHYLATION SCORES WERE GENERATED TO ESTIMATE THE PAIN STATUS OF EACH INDIVIDUAL AND CONFIRMED IN THE VALIDATION COHORT USING PYROSEQUENCING. CONCLUSION: THIS STUDY REVEALS SEX-SPECIFIC DNA METHYLATION SIGNATURES IN HUMAN T CELLS THAT DISCRIMINATES CHRONIC LBP PARTICIPANTS FROM HEALTHY CONTROLS. 2021 4 112 41 A ROLE FOR GLOBAL DNA METHYLATION LEVEL AND IL2 EXPRESSION IN THE TRANSITION FROM ACUTE TO CHRONIC LOW BACK PAIN. OBJECTIVES: THE TRANSITION FROM ACUTE LOW BACK PAIN (ALBP) TO CHRONIC LBP (CLBP) RESULTS FROM A VARIETY OF FACTORS, INCLUDING EPIGENETIC MODIFICATIONS OF DNA. THE AIM OF THIS STUDY WAS TO (1) COMPARE GLOBAL DNA (GDNA) METHYLATION AND HISTONE ACETYLATION AT LBP ONSET BETWEEN THE ALBP AND CLBP PARTICIPANTS, (2) COMPARE MRNA EXPRESSION OF GENES WITH KNOWN ROLES IN THE TRANSDUCTION, MAINTENANCE, AND/OR MODULATION OF PAIN BETWEEN THE ALBP AND CLBP PARTICIPANTS, (3) COMPARE SOMATOSENSORY FUNCTION AND PAIN RATINGS IN OUR PARTICIPANTS, AND (4) DETERMINE IF THE AFOREMENTIONED MEASUREMENTS WERE ASSOCIATED. METHODS: A TOTAL OF 220 PARTICIPANTS WERE RECRUITED FOR THIS PROSPECTIVE OBSERVATIONAL STUDY FOLLOWING RECENT ONSET OF AN EPISODE OF LBP. WE RETAINED 45 INDIVIDUALS WHOSE GDNA WAS OF SUFFICIENT QUALITY FOR ANALYSIS. THE FINAL SAMPLE INCLUDED 14 PARTICIPANTS WHOSE PAIN RESOLVED WITHIN 6 WEEKS OF ONSET (ALBP),15 PARTICIPANTS THAT REPORTED PAIN FOR 6 MONTHS (CLBP), AND 16 HEALTHY CONTROLS. PARTICIPANTS WERE SUBJECTED TO QUANTITATIVE SENSORY TESTING (QST), BLOOD WAS DRAWN VIA VENIPUNCTURE, GDNA ISOLATED, AND GLOBAL DNA METHYLATION AND HISTONE ACETYLATION, AS WELL AS MRNA EXPRESSION OF 84 CANDIDATE GENES, WERE MEASURED. RESULTS: INDIVIDUALS THAT DEVELOP CLBP DISPLAY MULTIMODAL SOMATOSENSORY HYPERSENSITIVITY RELATIVE TO ALBP PARTICIPANTS. CLBP PARTICIPANTS ALSO HAD SIGNIFICANTLY LOWER GLOBAL DNA METHYLATION, WHICH WAS NEGATIVELY CORRELATED WITH INTERLEUKIN-2 (IL2) MRNA EXPRESSION. DISCUSSION: CLBP IS CHARACTERIZED BY SOMATOSENSORY HYPERSENSITIVITY, LOWER GLOBAL DNA METHYLATION, AND HIGHER IL2 EXPRESSION LEVEL COMPARED TO THOSE WHOSE PAIN WILL RESOLVE QUICKLY (ALBP). THESE RESULTS SUGGEST POTENTIAL DIAGNOSTIC AND THERAPEUTIC RELEVANCE FOR GLOBAL DNA METHYLATION AND IL2 EXPRESSION IN THE PATHOLOGY UNDERLYING THE TRANSITION FROM ACUTE TO CHRONIC LBP. 2021 5 2108 30 EPIGENETIC FACTORS RELATED TO LOW BACK PAIN: A SYSTEMATIC REVIEW OF THE CURRENT LITERATURE. LOW BACK PAIN (LBP) IS ONE OF THE MOST COMMON CAUSES OF PAIN AND DISABILITY. AT PRESENT, TREATMENT AND INTERVENTIONS FOR ACUTE AND CHRONIC LOW BACK PAIN OFTEN FAIL TO PROVIDE SUFFICIENT LEVELS OF PAIN RELIEF, AND FULL FUNCTIONAL RESTORATION CAN BE CHALLENGING. CONSIDERING THE SIGNIFICANT SOCIO-ECONOMIC BURDEN AND RISK-TO-BENEFIT RATIO OF MEDICAL AND SURGICAL INTERVENTION IN LOW BACK PAIN PATIENTS, THE IDENTIFICATION OF RELIABLE BIOMARKERS SUCH AS EPIGENETIC FACTORS ASSOCIATED WITH LOW BACK PAIN COULD BE USEFUL IN CLINICAL PRACTICE. THE AIM OF THIS STUDY WAS TO REVIEW THE AVAILABLE LITERATURE REGARDING THE EPIGENETIC FACTORS ASSOCIATED WITH LOW BACK PAIN. THIS REVIEW WAS CARRIED OUT IN ACCORDANCE WITH PREFERENTIAL REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND META-ANALYSES (PRISMA) GUIDELINES. THE SEARCH WAS CARRIED OUT IN OCTOBER 2022. ONLY PEER-REVIEWED ARTICLES WERE CONSIDERED FOR INCLUSION. FOURTEEN STUDIES WERE INCLUDED AND SHOWED PROMISING RESULTS IN TERMS OF RELIABLE MARKERS. EPIGENETIC MARKERS FOR LBP HAVE THE POTENTIAL TO SIGNIFICANTLY MODIFY DISEASE MANAGEMENT. MOST RECENT EVIDENCE SUGGESTS THAT EPIGENETICS IS A MORE PROMISING FIELD FOR THE IDENTIFICATION OF FACTORS ASSOCIATED WITH LBP, OFFERING A RATIONALE FOR FURTHER INVESTIGATION IN THIS FIELD WITH THE LONG-TERM GOAL OF FINDING EPIGENETIC BIOMARKERS THAT COULD CONSTITUTE BIOLOGICAL TARGETS FOR DISEASE MANAGEMENT AND TREATMENT. 2023 6 2284 11 EPIGENETIC REGULATION IN INTERVERTEBRAL DISC DEGENERATION. INTERVERTEBRAL DISC (IVD) DEGENERATION IS THE LEADING CAUSE OF LOW BACK PAIN, WHICH HAS A STRIKING IMPACT ON NUMEROUS PATIENTS. THEREFORE, COMPREHENSIVELY ILLUMINATING THE REGULATORY MECHANISMS OF IVD DEGENERATION IS OF GREAT SIGNIFICANCE. HERE, WE DISCUSS THE LATEST ADVANCES IN UNDERSTANDING THE MAIN EPIGENETIC MECHANISMS REGULATING IVD DEGENERATION. 2022 7 5740 25 SMOKING AND TETRAMER TRYPTASE ACCELERATE INTERVERTEBRAL DISC DEGENERATION BY INDUCING METTL14-MEDIATED DIXDC1 M(6) MODIFICATION. ALTHOUGH CIGARETTE SMOKING (CS) AND LOW BACK PAIN (LBP) ARE COMMON WORLDWIDE, THEIR CORRELATIONS AND THE MECHANISMS OF ACTION REMAIN UNCLEAR. WE HAVE SHOWN THAT EXCESSIVE ACTIVATION OF MAST CELLS (MCS) AND THEIR PROTEASES PLAY KEY ROLES IN CS-ASSOCIATED DISEASES, LIKE ASTHMA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), BLOOD COAGULATION, AND LUNG CANCER. PREVIOUS STUDIES HAVE ALSO SHOWN THAT MCS AND THEIR PROTEASES INDUCE DEGENERATIVE MUSCULOSKELETAL DISEASE. BY USING A CUSTOM-DESIGNED SMOKE-EXPOSURE MOUSE SYSTEM, WE DEMONSTRATED THAT CS RESULTS IN INTERVERTEBRAL DISC (IVD) DEGENERATION AND RELEASE OF MC-RESTRICTED TETRAMER TRYPTASES (TTS) IN THE IVDS. TTS WERE FOUND TO REGULATE THE EXPRESSION OF METHYLTRANSFERASE 14 (METTL14) AT THE EPIGENETIC LEVEL BY INDUCING N6-METHYLADENOSINE (M(6)A) DEPOSITION IN THE 3' UNTRANSLATED REGION (UTR) OF THE TRANSCRIPT THAT ENCODES DISHEVELLED-AXIN (DIX) DOMAIN-CONTAINING 1 (DIXDC1). THAT REACTION INCREASES THE MRNA STABILITY AND EXPRESSION OF DIXDC1. DIXDC1 FUNCTIONALLY INTERACTS WITH DISRUPTED IN SCHIZOPHRENIA 1 (DISC1) TO ACCELERATE THE DEGENERATION AND SENESCENCE OF NUCLEUS PULPOSUS (NP) CELLS BY ACTIVATING A CANONICAL WNT PATHWAY. OUR STUDY DEMONSTRATES THE ASSOCIATION BETWEEN CS, MC-DERIVED TTS, AND LBP. THESE FINDINGS RAISE THE POSSIBILITY THAT METTL14-MEDICATED DIXDC1 M(6)A MODIFICATION COULD SERVE AS A POTENTIAL THERAPEUTIC TARGET TO BLOCK THE DEVELOPMENT OF DEGENERATION OF THE NP IN LBP PATIENTS. 2023 8 500 21 ASSOCIATION BETWEEN NEUROPATHIC PAIN CHARACTERISTICS AND DNA METHYLATION OF TRANSIENT RECEPTOR POTENTIAL ANKYRIN 1 IN HUMAN PERIPHERAL BLOOD. ELUCIDATION OF EPIGENETIC MECHANISMS CORRELATING WITH NEUROPATHIC PAIN IN HUMANS IS CRUCIAL FOR THE PREVENTION AND TREATMENT OF THIS TREATMENT-RESISTANT PAIN STATE. IN THE PRESENT STUDY, ASSOCIATIONS BETWEEN NEUROPATHIC PAIN CHARACTERISTICS AND DNA METHYLATION OF THE TRANSIENT RECEPTOR POTENTIAL ANKYRIN 1 (TRPA1) GENE WERE EVALUATED IN CHRONIC PAIN PATIENTS AND PREOPERATIVE PATIENTS. PAIN AND PSYCHOLOGICAL STATES WERE PROSPECTIVELY ASSESSED IN PATIENTS WHO SUFFERED CHRONIC PAIN OR WERE SCHEDULED FOR THORACIC SURGERY. NEUROPATHIC CHARACTERISTICS WERE ASSESSED USING THE DOULEUR NEUROPATHIQUE 4 (DN4) QUESTIONNAIRE. DNA METHYLATION LEVELS OF THE CPG ISLANDS IN THE TRPA1 GENE WERE EXAMINED USING WHOLE BLOOD. FORTY-EIGHT ADULT PATIENTS WERE ENROLLED IN THIS STUDY. INCREASES IN DNA METHYLATION RATES AT CPG -51 SHOWED POSITIVE CORRELATIONS WITH INCREASES IN THE DN4 SCORE BOTH IN PREOPERATIVE AND CHRONIC PAIN PATIENTS. COMBINED METHYLATION RATES AT CPG -51 IN THESE PATIENTS ALSO SIGNIFICANTLY INCREASED TOGETHER WITH INCREASE IN DN4 SCORES. NEUROPATHIC PAIN CHARACTERISTICS ARE LIKELY ASSOCIATED WITH METHYLATION RATES AT THE PROMOTER REGION OF THE TRPA1 GENE IN HUMAN PERIPHERAL BLOOD. 2020 9 3850 30 IS GENDER A FACTOR AFFECTING LONG-TERM HETEROTOPIC OSSIFICATION INCIDENCE AFTER SINGLE-LEVEL CERVICAL DISC ARTHROPLASTY? BACKGROUND: CERVICAL DISC DISEASES HAVE BEEN TREATED BY CERVICAL DISC ARTHROPLASTY (CDA). NEVERTHELESS, SOME PATIENTS WILL EXPERIENCE A MOBILITY FAILURE IN THEIR CERVICAL PROSTHESES OVER TIME BECAUSE OF HETEROTOPIC OSSIFICATION. THE AIM OF THIS STUDY WAS TO INVESTIGATE THE ROLE OF GENDER IN LONG-TERM OUTCOMES AFTER CDA. METHODS: A RETROSPECTIVE, SINGLE-CENTER STUDY OF PATIENTS WHO UNDERWENT SINGLE-LEVEL CDA WITH A BRYAN CERVICAL DISC PROSTHESIS WAS PERFORMED, INCLUDING A NARRATIVE REVIEW ABOUT GENDER DIFFERENCES IN BOTH STRUCTURAL AND BIOMECHANICAL FEATURES OF THE CERVICAL SPINE. RESULTS: STUDY PATIENTS (14 MEN, 30 WOMEN) HAD AN AVERAGE FOLLOW-UP OF 9.8 +/- 3.2 YEARS. SIGNIFICANT DIFFERENCES EMERGED BETWEEN GENDERS FOR SPECIFIC ITEMS IN NECK DISABILITY INDEX PREOPERATIVE EVALUATION, WITH WOMEN REPORTING WORSE PAIN SCORES (P = 0.05). AFTER STRATIFICATION BY AGE, WE FOUND A HIGHER PREOPERATIVE OVERALL NECK DISABILITY INDEX SCORE FOR FEMALE PATIENTS <36 YEARS OF AGE (P = 0.03). IN AN INTERGENDER, BODY MASS INDEX-SPECIFIC COMPARISON, WE ALSO FOUND A SIGNIFICANT DIFFERENCE IN NECK DISABILITY INDEX PREOPERATIVE SCORE WITH NORMAL-WEIGHT MALE PATIENTS FARING WORSE THAN OVERWEIGHT MALE PATIENTS (P = 0.05). AT A RADIOLOGICAL LEVEL, WE FOUND A TENDENCY TOWARD A HIGHER HETEROTOPIC OSSIFICATION INCIDENCE IN MALE PATIENTS (62% IN MEN, 17% IN WOMEN, P = 0.06). THE FEMALE CERVICAL SPINE HAS DISTINCTIVE FEATURES, INCLUDING BONE STRUCTURE, MUSCULAR ACTION, SOFT TISSUE RESPONSE, AND GENETIC AND EPIGENETIC RESPONSE TO OSTEOARTHRITIS. CONCLUSIONS: THE INCIDENCE OF MOBILITY FAILURE IN OUR SERIES OF SINGLE-LEVEL CDA WAS LOWER IN FEMALE PATIENTS. SEVERAL GENDER-SPECIFIC FACTORS BOTH IN STATIC AND IN DYNAMIC FEATURES MAY PLAY A SIGNIFICANT ROLE IN SPINAL PATHOLOGY AND CDA LONG-TERM RADIOLOGICAL OUTCOME. 2022 10 2634 32 EPIGENOME-WIDE DNA METHYLATION PROFILING OF CONDITIONED PAIN MODULATION IN INDIVIDUALS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN. BACKGROUND: THE PATHOANATOMIC CAUSE OF CHRONIC LOW BACK PAIN (CLBP) CANNOT BE IDENTIFIED FOR UP TO 90% OF INDIVIDUALS. HOWEVER, DYSFUNCTIONAL PROCESSING OF ENDOGENOUS NOCICEPTIVE INPUT, MEASURED AS CONDITIONED PAIN MODULATION (CPM), HAS BEEN ASSOCIATED WITH CLBP AND MAY INVOLVE CHANGES IN NEURONAL GENE EXPRESSION. EPIGENETIC-INDUCED CHANGES SUCH AS DNA METHYLATION (DNAM) HAVE BEEN ASSOCIATED WITH CLBP. METHODS: IN THE PRESENT STUDY, THE RELATIONSHIP BETWEEN CPM AND DNAM CHANGES IN A SAMPLE OF COMMUNITY-DWELLING ADULTS WITH NONSPECIFIC CLBP (N = 48) AND PAIN-FREE CONTROLS (PFC; N = 50) WAS EXAMINED USING REDUCED REPRESENTATION BISULFITE SEQUENCING. GENE ONTOLOGY (GO) TERM ENRICHMENT AND KYOTO ENCYCLOPEDIA OF GENES AND GENOMES (KEGG) PATHWAY ANALYSIS WERE APPLIED TO IDENTIFY KEY PATHWAYS INVOLVED IN EFFICIENT VERSUS DEFICIENT CPM. RESULTS: BASED ON CPM EFFICIENCY, WE IDENTIFIED 6006 AND 18,305 DIFFERENTIALLY METHYLATED CPG SITES (DMCS) WITH Q VALUES < 0.01 AMONG INDIVIDUALS WITH CLBP AND PFCS, RESPECTIVELY. MOST OF THE DMCS WERE HYPOMETHYLATED AND ANNOTATED TO GENES OF RELEVANCE TO PAIN, INCLUDING OPRM1, ADRB2, CACNA2D3, GNA12, LPL, NAXD, AND ASPHD1. IN BOTH CLBP AND PFC GROUPS, THE DMCS ANNOTATED GENES ENRICHED MANY GO TERMS RELEVANT TO PAIN PROCESSING, INCLUDING TRANSCRIPTION REGULATION BY RNA POLYMERASE II, NERVOUS SYSTEM DEVELOPMENT, GENERATION OF NEURONS, NEURON DIFFERENTIATION, AND NEUROGENESIS. BOTH GROUPS ALSO ENRICHED THE PATHWAYS INVOLVED IN RAP1-SIGNALING, CANCER, AND DOPAMINERGIC NEUROGENESIS. HOWEVER, MAPK-RAS SIGNALING PATHWAYS WERE ENRICHED IN THE CLBP, NOT THE PFC GROUP. CONCLUSIONS: THIS IS THE FIRST STUDY TO INVESTIGATE THE GENOME-SCALE DNA METHYLATION PROFILES OF CPM PHENOTYPE IN ADULTS WITH CLBP AND PFCS. BASED ON CPM EFFICIENCY, FEWER DMC ENRICHMENT PATHWAYS WERE UNIQUE TO THE CLBP THAN THE PFCS GROUP. OUR RESULTS SUGGEST THAT EPIGENETICALLY INDUCED MODIFICATION OF NEURONAL DEVELOPMENT/DIFFERENTIATION PATHWAYS MAY AFFECT CPM EFFICIENCY, SUGGESTING NOVEL POTENTIAL THERAPEUTIC TARGETS FOR CENTRAL SENSITIZATION. HOWEVER, CPM EFFICIENCY AND THE EXPERIENCE OF NONSPECIFIC CLBP MAY BE INDEPENDENT. FURTHER MECHANISTIC STUDIES ARE REQUIRED TO CONFIRM THE RELATIONSHIP BETWEEN CPM, CENTRAL SENSITIZATION, AND NONSPECIFIC CLBP. 2022 11 5882 30 SYSTEMATIC REVIEW OF LUNG FUNCTION AND COPD WITH PERIPHERAL BLOOD DNA METHYLATION IN POPULATION BASED STUDIES. BACKGROUND: EPIGENETIC VARIATIONS IN PERIPHERAL BLOOD HAVE POTENTIAL AS BIOMARKERS FOR DISEASE. THIS SYSTEMATIC REVIEW ASSESSES THE ASSOCIATION OF LUNG FUNCTION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) WITH DNA METHYLATION PROFILES IN PERIPHERAL BLOOD FROM POPULATION-BASED STUDIES. METHODS: ONLINE DATABASES MEDLINE, EMBASE, AND WEB OF SCIENCE WERE SEARCHED. GOOGLE SCHOLAR WAS SEARCHED TO IDENTIFY GREY LITERATURE. AFTER REMOVING DUPLICATE ARTICLES, 1155 ARTICLES WERE INDEPENDENTLY SCREENED BY TWO INVESTIGATORS. PEER REVIEWED REPORTS ON POPULATION-BASED STUDIES THAT EXAMINED PERIPHERAL BLOOD DNA METHYLATION IN PARTICIPANTS WITH MEASURED LUNG FUNCTION (FEV1, FEV1/FVC RATIO) OR KNOWN COPD STATUS WERE SELECTED FOR FULL-TEXT REVIEW. SIX ARTICLES WERE SUITABLE FOR INCLUSION. INFORMATION REGARDING STUDY CHARACTERISTICS, DESIGNS, METHODOLOGIES AND CONCLUSIONS WAS EXTRACTED. A NARRATIVE SYNTHESIS WAS PERFORMED BASED ON PUBLISHED RESULTS. RESULTS: THREE OF THE SIX ARTICLES ASSESSED THE ASSOCIATION OF COPD WITH DNA METHYLATION, AND TWO OF THESE ALSO INCLUDED ASSOCIATIONS WITH LUNG FUNCTION. OVERALL, FIVE REPORTS EXAMINED THE ASSOCIATION OF LUNG FUNCTION WITH DNA METHYLATION PROFILES. FIVE OF THE SIX ARTICLES REPORTED 'SIGNIFICANT' RESULTS. HOWEVER, NO CONSISTENT CPG SITES WERE IDENTIFIED ACROSS STUDIES FOR COPD STATUS OR LUNG FUNCTION VALUES. CONCLUSIONS: DNA METHYLATION PATTERNS IN PERIPHERAL BLOOD FROM INDIVIDUALS WITH REDUCED LUNG FUNCTION OR COPD MAY BE DIFFERENT TO THOSE IN PEOPLE WITH NORMAL LUNG FUNCTION. HOWEVER, THIS SYSTEMATIC REVIEW DID NOT FIND ANY CONSISTENT ASSOCIATIONS OF LUNG FUNCTION OR COPD WITH DIFFERENTIALLY METHYLATED CPG SITES. LARGE STUDIES WITH A LONGITUDINAL DESIGN TO ADDRESS REVERSE CAUSALITY MAY PROVE A MORE FRUITFUL AREA OF RESEARCH. TRIAL REGISTRATION: PROSPERO 2016: CRD42016037352 . 2017 12 1956 31 EPIGENETIC AGE IN PERIPHERAL BLOOD AMONG CHILDREN, ADOLESCENT, AND ADULT SURVIVORS OF CHILDHOOD CANCER. IMPORTANCE: CERTAIN CANCER THERAPIES ARE RISK FACTORS FOR EPIGENETIC AGE ACCELERATION (EAA) AMONG SURVIVORS OF CHILDHOOD CANCER, AND EAA IS ASSOCIATED WITH CHRONIC HEALTH CONDITIONS (CHCS). HOWEVER, SMALL NUMBERS OF YOUNGER SURVIVORS (AGED <20 YEARS) PREVIOUSLY EVALUATED HAVE LIMITED THE ABILITY TO CALCULATE EAA AMONG THIS AGE GROUP. OBJECTIVE: TO EVALUATE THE CHANGE RATE OF EPIGENETIC AGE (EA) AND EAA IN YOUNGER COMPARED WITH OLDER SURVIVORS AND THE POSSIBLE ASSOCIATION OF EAA WITH EARLY-ONSET OBESITY (AGED <20 YEARS), SEVERITY/BURDEN OF CHCS, AND LATE MORTALITY (>5 YEARS FROM CANCER DIAGNOSIS). DESIGN, SETTING, AND PARTICIPANTS: STUDY PARTICIPANTS WERE FROM THE ST JUDE LIFETIME COHORT, INITIATED IN 2007 WITH ONGOING FOLLOW-UP. THE PRESENT STUDY WAS CONDUCTED FROM APRIL 17, 2022, TO MARCH 23, 2023. SURVIVORS IN THIS COHORT OF EUROPEAN ANCESTRY WITH DNA METHYLATION DATA WERE INCLUDED. CROSS-SECTIONAL ANNUAL CHANGES IN EA AND EAA WERE COMPARED ACROSS 5 DIFFERENT CHRONOLOGIC AGE GROUPS: AGE 0 TO 9 (CHILDREN), 10 TO 19 (ADOLESCENTS), 20 TO 34 (YOUNGER ADULTS), 35 TO 49 (MIDDLE-AGED ADULTS), AND GREATER THAN OR EQUAL TO 50 (OLDER ADULTS) YEARS. LOGISTIC REGRESSION EVALUATED THE ASSOCIATION BETWEEN EAA AND EARLY-ONSET OBESITY OR SEVERITY/BURDEN OF CHCS. COX PROPORTIONAL HAZARDS REGRESSION ASSESSED THE ASSOCIATION BETWEEN EAA AND LATE MORTALITY. MAIN OUTCOMES AND MEASURES: EARLY-ONSET OBESITY, SEVERITY/BURDEN OF CHCS (GRADED USING THE COMMON TERMINOLOGY CRITERIA FOR ADVERSE EVENTS (GRADE 1, MILD; 2, MODERATE; 3, SEVERE/DISABLING; 4, LIFE-THREATENING) AND WERE COMBINED INTO HIGH VS LOW SEVERITY/BURDEN BASED ON FREQUENCY AND GRADE), AND LATE MORTALITY WERE THE OUTCOMES BASED ON FOLLOW-UP UNTIL APRIL 2020. EXPANDED DNA METHYLATION PROFILING INCREASED THE NUMBER OF SURVIVORS YOUNGER THAN 20 YEARS (N = 690). EPIGENETIC AGE WAS CALCULATED PRIMARILY USING THE LEVINE CLOCK, AND EAA WAS DERIVED FROM LEAST SQUARES REGRESSION OF EA AGAINST CHRONOLOGIC AGE AND WAS STANDARDIZED TO A Z SCORE (LEVINE EEA). RESULTS: AMONG 2846 PARTICIPANTS (MEDIAN AGE, 30.3 [IQR, 9.3-41.5] YEARS; 53% MALES), THE CROSS-SECTIONAL ANNUAL CHANGE IN EA_LEVINE WAS HIGHER IN CHILDREN (1.63 YEARS) AND ADOLESCENTS (1.14 YEARS), AND THE ADJUSTED LEAST-SQUARES MEAN OF LEVINE EEA WAS LOWER IN CHILDREN (-0.22 YEARS) AND OLDER ADULTS (-1.70 YEARS). EACH 1-SD INCREASE IN LEVINE EEA WAS ASSOCIATED WITH INCREASED RISK OF DEVELOPING EARLY-ONSET OBESITY (ODDS RATIO [OR], 1.46; 95% CI, 1.19-1.78), HIGH SEVERITY/BURDEN OF CHCS (OR, 1.13; 95% CI, 1.03-1.24), AND LATE MORTALITY (HAZARD RATIO, 1.75; 95% CI, 1.35-2.26). CONCLUSIONS AND RELEVANCE: THE FINDINGS OF THIS STUDY SUGGEST THAT EAA MEASURED IN CHILDREN AND ADOLESCENT SURVIVORS OF CHILDHOOD CANCER IS ASSOCIATED WITH EARLY-ONSET OBESITY, SEVERITY/BURDEN OF ALL CHCS, AND LATE MORTALITY. EVALUATING EAA MAY HELP IDENTIFY SURVIVORS OF CHILDHOOD CANCER AT INCREASED RISK FOR EARLY-ONSET OBESITY, MORBIDITY IN GENERAL, AND MORTALITY. 2023 13 4825 20 OCULAR FUNDUS ABNORMALITIES IN PATIENTS WITH BALKAN ENDEMIC NEPHROPATHY AND OTHER CHRONIC KIDNEY DISEASES. AIM: THE AIM OF THIS STUDY WAS TO EXAMINE THE OCULAR FUNDUS PATHOLOGY IN PATIENTS WITH BALKAN ENDEMIC NEPHROPATHY (BN) AND CHRONIC KIDNEY DISEASES (CKD). METHODS: THE STUDY INCLUDED 51 PATIENTS WITH BN FROM THE SOUTH MORAVA RIVER REGION IN SERBIA, AND 102 SUBJECTS WITH DIFFERENT STAGES OF CHRONIC RENAL DISEASES, MATCHED ACCORDING TO AGE AND GENDER, OBTAINED FROM A DATABASE USED IN A RECENTLY PUBLISHED STUDY. ALL PATIENTS HAD VISITED OUTPATIENT DEPARTMENT OF THE CLINIC OF NEPHROLOGY, CLINICAL CENTER NIS. ALL PATIENTS UNDERWENT ROUTINE OPHTHALMIC EXAMINATIONS. RESULTS: THERE WERE SIGNIFICANTLY MORE (P < 0.001) PATIENTS WITH AGE-RELATED MACULAR DEGENERATION (AMD) IN THE GROUP WITH BN (31.37 %) THAN IN THOSE WITH CKD (5.88 %). MULTIVARIATE LOGISTIC REGRESSION ANALYSIS CONFIRMED THAT THE SIGNIFICANT FACTORS RELATED TO AMD IN THE GROUP WITH BN WERE ALBUMINURIA (P < 0.05) AND PROTEINURIA (P < 0.05); IN CKD PATIENTS, THE LEVEL OF HDL (P < 0.05), WHILE NEGATIVE CORRELATION WITH THE LEVEL OF TRIGLYCERIDE WAS REGISTERED (P < 0.05). THERE WAS NO ASSOCIATION BETWEEN ESTIMATED GLOMERULAR FILTRATION RATE AND AMD. THE SIGNIFICANT FACTORS RELATED TO RETINOPATHY IN THE GROUP WITH BN ARE AGE (P < 0.05) AND SERUM CREATININE VALUES (P < 0.05), IN PATIENTS WITH CKD INCREASING AGE (P < 0.001) AND DM (P < 0.05). CONCLUSION: OCULAR FUNDUS PATHOLOGY IN PATIENTS WITH BN IS SIMILAR TO THE PATHOLOGY OF OTHER CKD, BUT WITH SIGNIFICANTLY MORE AMD (ABOUT FOUR TIMES), PROBABLY RELATED TO THE GENETIC/EPIGENETIC FACTORS. 2015 14 6418 28 THE TEMPORAL EXPRESSION OF CIRCULATING MICRORNAS AFTER ACUTE EXPERIMENTAL PAIN IN HUMANS. BACKGROUND: MICRORNAS (MIRNAS) CAN MODULATE SEVERAL BIOLOGICAL SYSTEMS, INCLUDING THE PAIN SYSTEM. THIS STUDY AIMED TO EVALUATE THE TEMPORAL EXPRESSION OF CIRCULATING MIRNAS IN THE PLASMA OF HEALTHY VOLUNTEERS AS A MARKER FOR EPIGENETIC CHANGES BEFORE AND AFTER AN ACUTE, EXPERIMENTAL, PAIN PROVOCATION BY INTRAMUSCULAR HYPERTONIC SALINE INJECTION. METHODS: TWENTY VOLUNTEERS WERE RANDOMLY ALLOCATED INTO TWO GROUPS AND RECEIVED EITHER HYPERTONIC (PAIN) OR ISOTONIC (CONTROL) SALINE INJECTION IN THE FIRST DORSAL INTEROSSEOUS MUSCLE OF THEIR DOMINANT HAND. PAIN INTENSITY WAS CONTINUOUSLY RECORDED FOR 20 MINUTES AFTER INJECTION ON A VAS SCALE FROM 0 TO 100 (0 INDICATES NO PAIN AND 100 THE WORST IMAGINABLE PAIN). BLOOD SAMPLES WERE TAKEN AT BASELINE, 30 MINUTES, 3 HOURS, AND 24 HOURS POST-INJECTION, AND PLASMA WAS SEPARATED. MIRNA EXTRACTS WERE USED FOR RNA SEQUENCING WITH THE ILLUMINA NEXTSEQ PLATFORM. MIRNA TRANSCRIPTS WERE COMPARED BETWEEN THE PAIN AND THE NO-PAIN, CONTROL GROUP AT EVERY TIME POINT. SIGNIFICANT DIFFERENCES WERE CONSIDERED WHEN FOLDS WERE >2 AND THE FALSE DISCOVERY RATE WAS P < 0.05. RESULTS: AFTER 30 MINUTES, 4 MIRNAS WERE SIGNIFICANTLY ALTERED IN THE PAIN GROUP COMPARED TO CONTROLS, WHICH INCREASED TO 24 AFTER 3 HOURS AND TO 42 AFTER 24 HOURS FROM BASELINE (P < 0.0001). TWO MIRNAS WERE CONSISTENTLY UPREGULATED THROUGHOUT THE EXPERIMENT. ENRICHMENT ANALYSIS SHOWED SIGNIFICANT MIRNAS INVOLVED IN BRAIN PERCEPTION OF PAIN, BRAIN SIGNALLING AND RESPONSE TO STIMULI. CONCLUSIONS: THIS EXPLORATORY STUDY IS THE FIRST TO REPORT ON THE TEMPORAL EXPRESSION OF CIRCULATING MIRNAS AFTER AN ACUTE, HUMAN EXPERIMENTAL MUSCLE PAIN MODEL. SIGNIFICANCE: THIS EXPLORATORY STUDY EVALUATED THE TEMPORAL PROFILE OF CIRCULATING MIRNAS IN THE PLASMA OF HEALTHY SUBJECTS AFTER ACUTE EXPERIMENTAL PAIN. SEVERAL MIRNAS WERE ALTERED IN SUBJECTS AT THE TIMES OF FOLLOW-UP AFTER THE ACUTE PAIN MODEL WHEN COMPARED TO CONTROLS. MIRNAS PREVIOUSLY ASSOCIATED WITH PAIN PROCESSES WERE ALTERED IN THE PAIN GROUP. OUR RESULTS, BY SHOWING THE FAST AND PROLONGED MODIFICATIONS OF MIRNA ELICITED BY THE ACUTE EXPERIMENTAL PAIN MODEL, ADD NEW PERSPECTIVES TO THE TOPIC OF EPIGENETICS AND PAIN. 2023 15 404 27 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 16 3488 29 IDENTIFICATION OF DNA METHYLATION ASSOCIATED ENRICHMENT PATHWAYS IN ADULTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN. CHRONIC LOW BACK PAIN (CLBP) THAT CANNOT BE ATTRIBUTABLE TO A SPECIFIC PATHOANATOMICAL CHANGE IS ASSOCIATED WITH HIGH PERSONAL AND SOCIETAL COSTS. STILL, THE UNDERLYING MECHANISM THAT CAUSES AND SUSTAINS SUCH A PHENOTYPE IS LARGELY UNKNOWN. EMERGING EVIDENCE SUGGESTS THAT EPIGENETIC CHANGES PLAY A ROLE IN CHRONIC PAIN CONDITIONS. USING REDUCED REPRESENTATION BISULFITE SEQUENCING (RRBS), WE EVALUATED DNA METHYLATION PROFILES OF ADULTS WITH NON-SPECIFIC CLBP (N = 50) AND PAIN-FREE CONTROLS (N = 48). WE IDENTIFIED 28,325 HYPERMETHYLATED AND 36,936 HYPOMETHYLATED CPG SITES (P < 0.05). AFTER CORRECTING FOR MULTIPLE TESTING, WE IDENTIFIED 159 DMRS (Q < 0.01AND METHYLATION DIFFERENCE > 10%), THE MAJORITY OF WHICH WERE LOCATED IN CPG ISLAND (50%) AND PROMOTER REGIONS (48%) ON THE ASSOCIATED GENES. THE GENES ASSOCIATED WITH THE DIFFERENTIALLY METHYLATED REGIONS WERE HIGHLY ENRICHED IN BIOLOGICAL PROCESSES THAT HAVE PREVIOUSLY BEEN IMPLICATED IN IMMUNE SIGNALING, ENDOCHONDRAL OSSIFICATION, AND G-PROTEIN COUPLED TRANSMISSIONS. OUR FINDINGS SUPPORT INFLAMMATORY ALTERATIONS AND THE ROLE OF BONE MATURATION IN CLBP. THIS STUDY SUGGESTS THAT EPIGENETIC REGULATION HAS AN IMPORTANT ROLE IN THE PATHOPHYSIOLOGY OF NON-SPECIFIC CLBP AND A BASIS FOR FUTURE STUDIES IN BIOMARKER DEVELOPMENT AND TARGETED INTERVENTIONS. 2020 17 4522 43 MULTIDIMENSIONAL EVALUATION OF THE PAIN PROFILE AS PROGNOSTIC FACTOR IN INDIVIDUALS WITH HIP OR KNEE OSTEOARTHRITIS RECEIVING TOTAL JOINT REPLACEMENT: PROTOCOL OF A 2-YEAR LONGITUDINAL PROGNOSTIC COHORT STUDY. INTRODUCTION: KNEE AND HIP OSTEOARTHRITIS ARE TWO HIGHLY PREVALENT MUSCULOSKELETAL PAIN CONDITIONS. UNSUCCESSFUL RATES AFTER HIP/KNEE REPLACEMENT RANGE FROM 10% TO 20%. SUBJECTS WITH SENSITISATION MANIFESTATIONS ARE VULNERABLE TO WORSE CLINICAL OUTCOMES. MOST STUDIES HAVE ANALYSED OUTCOMES UP TO 1 YEAR AFTER SURGERY. THE AIM OF THIS 2-YEAR LONGITUDINAL STUDY WILL BE TO EVALUATE SENSORY-RELATED, PSYCHOLOGICAL AND PSYCHOPHYSICAL PAIN SENSITISATION MANIFESTATIONS AND A POTENTIAL EPIGENETIC BIOMARKER AS PROGNOSTIC CLINICAL OUTCOMES FOR THE DEVELOPMENT OF CHRONIC POSTOPERATIVE PAIN AFTER KNEE OR HIP REPLACEMENT. METHODS AND ANALYSIS: A PROSPECTIVE LONGITUDINAL STUDY WITH A 2-YEAR FOLLOW-UP PERIOD WILL BE CONDUCTED. THE PROGNOSTIC VARIABLES WILL INCLUDE PAIN, FUNCTION, RELATED-DISABILITY, ANXIETY, DEPRESSION, QUALITY OF LIFE, SENSITISATION-ASSOCIATED SYMPTOMS, KINESIOPHOBIA, NEUROPATHIC PAIN AND CATASTROPHISING, AND EXPECTATIVE OF THE INTERVENTION WILL BE ASSESSED BEFORE SURGERY. WE WILL ALSO EVALUATE THE PRESENCE OF THE VAL158MET POLYMORPHISM AS A POSSIBLE EPIGENETIC MARKER. CLINICAL OUTCOMES INCLUDING PAIN, RELATED-DISABILITY AND SELF-PERCEIVED SATISFACTION, SENSITISATION-ASSOCIATED SYMPTOMS AND NEUROPATHIC PAIN WILL BE ASSESSED 3, 6, 12, 18 AND 24 MONTHS AFTER SURGERY. THESE VARIABLES WILL BE USED TO CONSTRUCT THREE PREDICTION MODELS: (1) PAIN AND FUNCTION, (2) SENSITISATION-ASSOCIATED SYMPTOMATOLOGY AND (3) NEUROPATHIC PAIN FEATURES CLASSIFYING THOSE PATIENTS IN RESPONDERS AND NON-RESPONDERS. DATA FROM KNEE OR HIP OSTEOARTHRITIS WILL BE ANALYSED SEPARATELY. STATISTICAL ANALYSES WILL BE CONDUCTED WITH LOGISTIC REGRESSIONS. ETHICS AND DISSEMINATION: THE STUDY HAS BEEN APPROVED BY THE ETHICS COMMITTEE OF BOTH INSTITUTIONS INVOLVED (HOSPITAL UNIVERSITARIO FUNDACION ALCORCON (HUFA) 19-141 AND UNIVERSIDAD REY JUAN CARLOS (URJC) 0312201917319). PARTICIPANTS WILL SIGN THE WRITTEN INFORMED CONSENT BEFORE THEIR INCLUSION. STUDY RESULTS WILL BE DISSEMINATED THROUGH PEER-REVIEWED PUBLICATIONS AND PRESENTATIONS AT SCIENTIFIC MEETINGS. 2023 18 849 29 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 19 3063 31 GENOME-WIDE DNA METHYLATION AND LONG-TERM AMBIENT AIR POLLUTION EXPOSURE IN KOREAN ADULTS. BACKGROUND: AMBIENT AIR POLLUTION IS ASSOCIATED WITH NUMEROUS ADVERSE HEALTH OUTCOMES, BUT THE UNDERLYING MECHANISMS ARE NOT WELL UNDERSTOOD; EPIGENETIC EFFECTS INCLUDING ALTERED DNA METHYLATION COULD PLAY A ROLE. TO EVALUATE ASSOCIATIONS OF LONG-TERM AIR POLLUTION EXPOSURE WITH DNA METHYLATION IN BLOOD, WE CONDUCTED AN EPIGENOME-WIDE ASSOCIATION STUDY IN A KOREAN CHRONIC OBSTRUCTIVE PULMONARY DISEASE COHORT (N = 100 INCLUDING 60 CASES) USING ILLUMINA'S INFINIUM HUMANMETHYLATION450K BEADCHIP. ANNUAL AVERAGE CONCENTRATIONS OF PARTICULATE MATTER