1 4598 94 NATURAL PRODUCTS: THE ROLE AND MECHANISM IN LOW-DENSITY LIPOPROTEIN OXIDATION AND ATHEROSCLEROSIS. ATHEROSCLEROSIS IS A CHRONIC INFLAMMATORY, METABOLIC, AND EPIGENETIC DISEASE, WHICH LEADS TO THE LIFE-THREATENING CORONARY ARTERY DISEASE. EMERGING STUDIES FROM BENCH TO BEDSIDE HAVE DEMONSTRATED THE PIVOTAL ROLE OF LOW-DENSITY LIPOPROTEIN (LDL) OXIDATION IN THE INITIATION AND PROGRESSION OF ATHEROSCLEROSIS. THIS ARTICLE HEREBY REVIEWS OXIDATION MECHANISM OF LDL, AND THE PRO-ATHEROGENIC AND BIOMARKER ROLE OF OXIDIZED LDL IN ATHEROSCLEROSIS. WE ALSO REVIEW THE PHARMACOLOGICAL EFFECTS OF SEVERAL REPRESENTATIVE NATURAL PRODUCTS (VITAMIN E, RESVERATROL, QUERCETIN, PROBUCOL, TANSHINONE IIA, EPIGALLOCATECHIN GALLATE, AND LYCOPENE) IN PROTECTING AGAINST LDL OXIDATION AND ATHEROSCLEROSIS. CLINICAL AND BASIC RESEARCH SUPPORTS THE BENEFICIAL EFFECTS OF THESE NATURAL PRODUCTS IN INHIBITING LDL OXIDATION AND PREVENTING ATHEROSCLEROSIS, BUT THE DATA ARE STILL CONTROVERSIAL. THIS MAY BE RELATED TO FACTORS SUCH AS THE POPULATION AND THE DOSAGE AND TIME OF TAKING NATURAL PRODUCTS INVOLVED IN DIFFERENT STUDIES. UNDERSTANDING THE MECHANISM OF LDL OXIDATION AND EFFECT OF OXIDIZED LDL HELP RESEARCHERS TO FIND NOVEL THERAPIES AGAINST ATHEROSCLEROSIS. 2021 2 5285 27 PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9 (PCSK9) IN THE BRAIN AND RELEVANCE FOR NEUROPSYCHIATRIC DISORDERS. PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9 (PCSK9) HAS LONG BEEN STUDIED IN THE LIVER DUE TO ITS REGULATION OF PLASMA LOW-DENSITY LIPOPROTEIN CHOLESTEROL (LDL-C) AND ITS CAUSAL ROLE IN FAMILIAL HYPERCHOLESTEROLEMIA. ALTHOUGH PCSK9 WAS FIRST DISCOVERED IN CEREBELLAR NEURONS UNDERGOING APOPTOSIS, ITS FUNCTION IN THE CENTRAL NERVOUS SYSTEM (CNS) IS LESS CLEAR. PCSK9 HAS BEEN SHOWN TO BE INVOLVED IN NEURONAL DIFFERENTIATION, LDL RECEPTOR FAMILY METABOLISM, APOPTOSIS, AND INFLAMMATION IN THE BRAIN, BUT IN VITRO AND IN VIVO STUDIES OFFER CONTRADICTORY FINDINGS. PCSK9 EXPRESSION IN THE ADULT BRAIN IS LOW BUT IS HIGHLY UPREGULATED DURING DISEASE STATES. CEREBRAL SPINAL FLUID (CSF) PCSK9 CONCENTRATIONS ARE CORRELATED WITH NEURAL TUBE DEFECTS AND NEURODEGENERATIVE DISEASES IN HUMAN PATIENTS. EPIGENETIC STUDIES REVEAL THAT CHRONIC ALCOHOL USE MAY MODULATE METHYLATION OF THE PCSK9 GENE AND GENETIC STUDIES SHOW THAT PATIENTS WITH GAIN-OF-FUNCTION PCSK9 VARIANTS HAVE HIGHER LDL-C AND AN INCREASED RISK OF ISCHEMIC STROKE. EARLY SAFETY STUDIES OF THE PCSK9 INHIBITORS EVOLOCUMAB AND ALIROCUMAB, USED TO TREAT HYPERCHOLESTEROLEMIA, HINTED THAT PCSK9 INHIBITION MAY NEGATIVELY IMPACT COGNITION BUT MORE RECENT, LONGER-TERM CLINICAL TRIALS FOUND NO ADVERSE NEUROCOGNITIVE EVENTS. THE PURPOSE OF THIS REVIEW IS TO ELUCIDATE THE ROLE OF PCSK9 IN THE BRAIN, PARTICULARLY ITS ROLE IN DISEASE PATHOGENESIS. 2020 3 445 31 APABETALONE (RVX-208) REDUCES VASCULAR INFLAMMATION IN VITRO AND IN CVD PATIENTS BY A BET-DEPENDENT EPIGENETIC MECHANISM. BACKGROUND: APABETALONE (RVX-208) IS A BROMODOMAIN AND EXTRATERMINAL PROTEIN INHIBITOR (BETI) THAT IN PHASE II TRIALS REDUCED THE RELATIVE RISK (RR) OF MAJOR ADVERSE CARDIAC EVENTS (MACE) IN PATIENTS WITH CARDIOVASCULAR DISEASE (CVD) BY 44% AND IN DIABETIC CVD PATIENTS BY 57% ON TOP OF STATINS. A PHASE III TRIAL, BETONMACE, IS CURRENTLY ASSESSING APABETALONE'S ABILITY TO REDUCE MACE IN STATIN-TREATED POST-ACUTE CORONARY SYNDROME TYPE 2 DIABETIC CVD PATIENTS WITH LOW HIGH-DENSITY LIPOPROTEIN C. THE LEADING CAUSE OF MACE IS ATHEROSCLEROSIS, DRIVEN BY DYSFUNCTIONAL LIPID METABOLISM AND CHRONIC VASCULAR INFLAMMATION (VI). IN VITRO STUDIES HAVE IMPLICATED THE BET PROTEIN BRD4 AS AN EPIGENETIC DRIVER OF INFLAMMATION AND ATHEROGENESIS, SUGGESTING THAT BETI MAY BE CLINICALLY EFFECTIVE IN COMBATING VI. HERE, WE ASSESSED APABETALONE'S ABILITY TO REGULATE INFLAMMATION-DRIVEN GENE EXPRESSION AND CELL ADHESION IN VITRO AND INVESTIGATED THE MECHANISM BY WHICH APABETALONE SUPPRESSES EXPRESSION. THE CLINICAL IMPACT OF APABETALONE ON MEDIATORS OF VI WAS ASSESSED WITH PROTEOMIC ANALYSIS OF PHASE II CVD PATIENT PLASMA. RESULTS: IN VITRO, APABETALONE PREVENTED INFLAMMATORY (TNFALPHA, LPS, OR IL-1BETA) INDUCTION OF KEY FACTORS THAT DRIVE ENDOTHELIAL ACTIVATION, MONOCYTE RECRUITMENT, ADHESION, AND PLAQUE DESTABILIZATION. BRD4 ABUNDANCE ON INFLAMMATORY AND ADHESION GENE PROMOTERS AND ENHANCERS WAS REDUCED BY APABETALONE. BRD2-4 DEGRADATION BY MZ-1 ALSO PREVENTED TNFALPHA-INDUCED TRANSCRIPTION OF MONOCYTE AND ENDOTHELIAL CELL ADHESION MOLECULES AND INFLAMMATORY MEDIATORS, CONFIRMING BET-DEPENDENT REGULATION. TRANSCRIPTIONAL REGULATION BY APABETALONE TRANSLATED INTO A REDUCTION IN MONOCYTE ADHESION TO AN ENDOTHELIAL MONOLAYER. IN A PHASE II TRIAL, APABETALONE TREATMENT REDUCED THE ABUNDANCE OF MULTIPLE VI MEDIATORS IN THE PLASMA OF CVD PATIENTS (SOMASCAN(R) 1.3 K). THESE PROTEINS CORRELATE WITH CVD RISK AND INCLUDE ADHESION MOLECULES, CYTOKINES, AND METALLOPROTEINASES. INGENUITY(R) PATHWAY ANALYSIS (IPA(R)) PREDICTED THAT APABETALONE INHIBITS PRO-ATHEROGENIC REGULATORS AND PATHWAYS AND PREVENTS DISEASE STATES ARISING FROM LEUKOCYTE RECRUITMENT. CONCLUSIONS: APABETALONE SUPPRESSED GENE EXPRESSION OF VI MEDIATORS IN MONOCYTES AND ENDOTHELIAL CELLS BY INHIBITING BET-DEPENDENT TRANSCRIPTION INDUCED BY MULTIPLE INFLAMMATORY STIMULI. IN CVD PATIENTS, APABETALONE TREATMENT REDUCED CIRCULATING LEVELS OF VI MEDIATORS, AN OUTCOME CONDUCIVE WITH ATHEROSCLEROTIC PLAQUE STABILIZATION AND MACE REDUCTION. INHIBITION OF INFLAMMATORY AND ADHESION MOLECULE GENE EXPRESSION BY APABETALONE IS PREDICTED TO CONTRIBUTE TO MACE REDUCTION IN THE PHASE III BETONMACE TRIAL. 2019 4 4332 33 MICRORNAS: IMPORTANT MODULATORS OF OXLDL-MEDIATED SIGNALING IN ATHEROSCLEROSIS. OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL) IS KNOWN TO BE A MAJOR RISK FACTOR FOR THE INITIATION AND DEVELOPMENT OF ATHEROSCLEROSIS. IT CAN ELICIT AN ARRAY OF ATHEROGENIC RESPONSES IN MULTIPLE TYPES OF CELLS RESIDING IN THE ARTERIAL WALL, SUCH AS ENDOTHELIAL CELLS (ECS), MACROPHAGES, DENDRITIC CELLS (DCS), AND VASCULAR SMOOTH MUSCLE CELLS (VSMCS). ALTHOUGH THEY HAVE BEEN STUDIED FOR MANY YEARS, THE DETAILED MECHANISMS MODULATING OXLDL-INDUCED INFLAMMATION HAVE NOT BEEN FULLY ELUCIDATED. EPIGENETIC MECHANISMS CONSIST OF DNA METHYLATION, HISTONE POST-TRANSLATIONAL MODIFICATIONS (PTMS), AND MICRORNA (MIRNA) ALTERATIONS. RECENTLY, EPIGENETIC FACTORS, ESPECIALLY MIRNAS, HAVE EMERGED AS NOVEL COMPONENTS OF THE GENE EXPRESSION REGULATING OXLDL-TRIGGERED SIGNAL TRANSDUCTION. IN ADDITION TO THEIR REGULATORY ROLES IN SIGNALING MOLECULES, INCREASING EVIDENCE SUGGESTS THAT THE DIFFERENT GENETIC STABILITY AND CROSS-TALK REGULATION AMONG THESE EPIGENETIC FACTORS MAY BE PARTICULARLY IMPORTANT TO THE SUSTAINED INFLAMMATION INITIATED BY TEMPORAL OXLDL STIMULATION. THEREFORE, IN THIS REVIEW, WE PRIMARILY FOCUSED ON THE FUNCTIONAL ROLE OF MIRNAS, AS WELL AS OTHER EPIGENETIC FACTORS, ON MODULATING OXLDL-INDUCED SIGNAL TRANSDUCTION IN DIFFERENT VASCULAR CELLS, WITH A SPECIAL EMPHASIS ON THE CROSSTALK INTERACTIONS BETWEEN MIRNAS AND OTHER EPIGENETIC PLAYERS THAT HELP TRANSLATE TRANSIENT ENVIRONMENT INSULTS INTO CHRONIC INFLAMMATION. MOREOVER, WE EXTENSIVELY DISCUSSED THE POTENTIAL APPLICABILITY OF MIRNAS AS DISEASE BIOMARKERS AND THERAPEUTIC TARGETS IN DIAGNOSING AND TREATING ATHEROSCLEROSIS. 2013 5 4257 23 METHYLOMIC PROFILING AND REPLICATION IMPLICATES DEREGULATION OF PCSK9 IN ALCOHOL USE DISORDER. ALCOHOL USE DISORDER (AUD) IS A COMMON AND CHRONIC DISORDER WITH SUBSTANTIAL EFFECTS ON PERSONAL AND PUBLIC HEALTH. THE UNDERLYING PATHOPHYSIOLOGY IS POORLY UNDERSTOOD BUT STRONG EVIDENCE SUGGESTS SIGNIFICANT ROLES OF BOTH GENETIC AND EPIGENETIC COMPONENTS. GIVEN THAT ALCOHOL AFFECTS MANY ORGAN SYSTEMS, WE PERFORMED A CROSS-TISSUE AND CROSS-PHENOTYPIC ANALYSIS OF GENOME-WIDE METHYLOMIC VARIATION IN AUD USING SAMPLES FROM 3 DISCOVERY, 4 REPLICATION, AND 2 TRANSLATIONAL COHORTS. WE IDENTIFIED A DIFFERENTIALLY METHYLATED REGION IN THE PROMOTER OF THE PROPROTEIN CONVERTASE SUBTILISIN/KEXIN 9 (PCSK9) GENE THAT WAS ASSOCIATED WITH DISEASE PHENOTYPES. BIOLOGICAL VALIDATION SHOWED THAT PCSK9 PROMOTER METHYLATION IS CONSERVED ACROSS TISSUES AND POSITIVELY CORRELATED WITH EXPRESSION. REPLICATION IN AUD DATASETS CONFIRMED PCSK9 HYPOMETHYLATION AND A TRANSLATIONAL MOUSE MODEL OF AUD SHOWED THAT ALCOHOL EXPOSURE LEADS TO PCSK9 DOWNREGULATION. PCSK9 IS PRIMARILY EXPRESSED IN THE LIVER AND REGULATES LOW-DENSITY LIPOPROTEIN CHOLESTEROL (LDL-C). OUR FINDING OF ALCOHOL-INDUCED EPIGENETIC REGULATION OF PCSK9 REPRESENTS ONE OF THE UNDERLYING MECHANISMS BETWEEN THE WELL-KNOWN EFFECTS OF ALCOHOL ON LIPID METABOLISM AND CARDIOVASCULAR RISK, WITH LIGHT ALCOHOL USE GENERALLY BEING PROTECTIVE WHILE CHRONIC HEAVY USE HAS DETRIMENTAL HEALTH OUTCOMES. 2018 6 4510 35 MTOR-DEPENDENT OXIDATIVE STRESS REGULATES OXLDL-INDUCED TRAINED INNATE IMMUNITY IN HUMAN MONOCYTES. INTRODUCTION: CELLS OF THE INNATE IMMUNE SYSTEM PARTICULARLY MONOCYTES AND MACROPHAGES HAVE BEEN RECOGNIZED AS PIVOTAL PLAYERS BOTH DURING THE INITIAL INSULT AS WELL AS THE CHRONIC PHASE OF ATHEROSCLEROSIS. IT HAS RECENTLY BEEN SHOWN THAT OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL) INDUCES A LONG-TERM PRO-INFLAMMATORY RESPONSE IN MONOCYTES DUE TO EPIGENETIC AND METABOLIC REPROGRAMMING, AN EMERGING NEW CONCEPT CALLED TRAINED INNATE IMMUNITY. CHANGES IN THE CELLULAR REDOX STATE ARE CRUCIAL EVENTS IN THE REGULATION OF MANY PHYSIOLOGIC FUNCTIONS IN MACROPHAGES INCLUDING TRANSCRIPTION, DIFFERENTIATION AND INFLAMMATORY RESPONSE. HERE WE HAVE ANALYZED THE ROLE OF REACTIVE OXYGEN SPECIES (ROS) IN REGULATING THIS PROINFLAMMATORY MONOCYTE PRIMING IN RESPONSE TO OXLDL-TREATMENT. METHODS AND RESULTS: HUMAN MONOCYTES WERE ISOLATED AND INCUBATED WITH OXLDL FOR 24 H. AFTER 5 DAYS OF RESTING, OXLDL TREATED CELLS PRODUCED SIGNIFICANTLY MORE INFLAMMATORY CYTOKINES UPON RESTIMULATION WITH THE TLR2-AGONIST PAM3CYS. FURTHERMORE, OXLDL INCUBATION INDUCED PERSISTENT MTOR ACTIVATION, ROS FORMATION, HIF1ALPHA ACCUMULATION AND HIF1ALPHA TARGET GENE EXPRESSION, WHILE PHARMACOLOGIC MTOR INHIBITION OR SIRNA MEDIATED INHIBITION OF THE MTORC1 SUBUNIT RAPTOR PREVENTED ROS FORMATION AND PROINFLAMMATORY PRIMING. MTOR DEPENDENT ROS FORMATION WAS ASSOCIATED WITH INCREASED EXPRESSION OF NAPDH OXIDASES AND NECESSARY FOR THE EMERGENCE OF THE PRIMED PHENOTYPE AS ANTIOXIDANT TREATMENT BLOCKED OXLDL PRIMING. INHIBITION OF CYTOSOLIC ROS FORMATION COULD ALSO BLOCK MTOR ACTIVATION AND HIF1ALPHA ACCUMULATION SUGGESTING A POSITIVE FEEDBACK LOOP BETWEEN MTOR AND CYTOSOLIC ROS. ALTHOUGH MITOCHONDRIAL ROS SCAVENGING DID NOT BLOCK HIF1ALPHA-ACCUMULATION AT AN EARLY TIME POINT (24 H), IT WAS PERSISTENTLY REDUCED ON DAY 6. THEREFORE, MITOCHONDRIAL ROS FORMATION APPEARS TO OCCUR INITIALLY DOWNSTREAM OF THE MTOR-CYTOROS-HIF1ALPHA FEEDBACK LOOP BUT SEEMS TO BE A CRUCIAL FACTOR THAT CONTROLS THE LONG-TERM ACTIVATION OF THE MTOR-HIF1ALPHA-AXIS. CONCLUSION: IN SUMMARY, OUR DATA DEMONSTRATE THAT MTOR DEPENDENT ROS PRODUCTION CONTROLS THE OXLDL-INDUCED TRAINED INNATE IMMUNITY PHENOTYPE IN HUMAN MONOCYTE DERIVED MACROPHAGES. PHARMACOLOGIC MODULATION OF THESE PATHWAYS MIGHT PROVIDE A POTENTIAL APPROACH TO MODULATE INFLAMMATION, ASSOCIATED WITH ABERRANT MONOCYTE ACTIVATION, DURING ATHEROSCLEROSIS DEVELOPMENT. 2018 7 6493 33 TRAINED IMMUNITY AND REACTIVITY OF MACROPHAGES AND ENDOTHELIAL CELLS. INNATE IMMUNE CELLS CAN DEVELOP EXACERBATED IMMUNOLOGIC RESPONSE AND LONG-TERM INFLAMMATORY PHENOTYPE FOLLOWING BRIEF EXPOSURE TO ENDOGENOUS OR EXOGENOUS INSULTS, WHICH LEADS TO AN ALTERED RESPONSE TOWARDS A SECOND CHALLENGE AFTER THE RETURN TO A NONACTIVATED STATE. THIS PHENOMENON IS KNOWN AS TRAINED IMMUNITY (TI). TI IS NOT ONLY IMPORTANT FOR HOST DEFENSE AND VACCINE RESPONSE BUT ALSO FOR CHRONIC INFLAMMATIONS SUCH AS CARDIOVASCULAR AND METABOLIC DISEASES SUCH AS ATHEROSCLEROSIS. TI CAN OCCUR IN INNATE IMMUNE CELLS SUCH AS MONOCYTES/MACROPHAGES, NATURAL KILLER CELLS, ENDOTHELIAL CELLS (ECS), AND NONIMMUNE CELLS, SUCH AS FIBROBLAST. IN THIS BRIEF REVIEW, WE ANALYZE THE SIGNIFICANCE OF TI IN ECS, WHICH ARE ALSO CONSIDERED AS INNATE IMMUNE CELLS IN ADDITION TO MACROPHAGES. TI CAN BE INDUCED BY A VARIETY OF STIMULI, INCLUDING LIPOPOLYSACCHARIDES, BCG (BACILLUS CALMETTE-GUERIN), AND OXLDL (OXIDIZED LOW-DENSITY LIPOPROTEIN), WHICH ARE DEFINED AS RISK FACTORS FOR CARDIOVASCULAR AND METABOLIC DISEASES. FURTHERMORE, TI IN ECS IS FUNCTIONAL FOR INFLAMMATION EFFECTIVENESS AND TRANSITION TO CHRONIC INFLAMMATION. REWIRING OF CELLULAR METABOLISM OF THE TRAINED CELLS TAKES PLACE DURING INDUCTION OF TI, INCLUDING INCREASED GLYCOLYSIS, GLUTAMINOLYSIS, INCREASED ACCUMULATION OF TRICARBOXYLIC ACID CYCLE METABOLITES AND ACETYL-COENZYME A PRODUCTION, AS WELL AS INCREASED MEVALONATE SYNTHESIS. SUBSEQUENTLY, THIS LEADS TO EPIGENETIC REMODELING, RESULTING IN IMPORTANT CHANGES IN CHROMATIN ARCHITECTURE THAT ENABLES INCREASED GENE TRANSCRIPTION AND ENHANCED PROINFLAMMATORY IMMUNE RESPONSE. HOWEVER, TI PATHWAYS AND INFLAMMATORY PATHWAYS ARE SEPARATED TO ENSURE MEMORY STAYS WHEN INFLAMMATION UNDERGOES RESOLUTION. ADDITIONALLY, REACTIVE OXYGEN SPECIES PLAY CONTEXT-DEPENDENT ROLES IN TI. THEREFORE, TI PLAYS SIGNIFICANT ROLES IN EC AND MACROPHAGE PATHOLOGY AND CHRONIC INFLAMMATION. HOWEVER, FURTHER CHARACTERIZATION OF TI IN ECS AND MACROPHAGES WOULD PROVIDE NOVEL INSIGHTS INTO CARDIOVASCULAR DISEASE PATHOGENESIS AND NEW THERAPEUTIC TARGETS. GRAPHIC ABSTRACT: A GRAPHIC ABSTRACT IS AVAILABLE FOR THIS ARTICLE. 2021 8 4489 22 MONOCYTE AND MACROPHAGE IMMUNOMETABOLISM IN ATHEROSCLEROSIS. ATHEROSCLEROSIS IS CHARACTERIZED BY CHRONIC LOW GRADE INFLAMMATION OF ARTERIES THAT RESULTS IN THE DEVELOPMENT OF LIPID DENSE PLAQUES. CHRONIC INFLAMMATION INDUCED BY WESTERN-TYPE DIET IS ASSOCIATED WITH THE RISK OF DEVELOPING ATHEROSCLEROSIS, AND NEW INSIGHTS SHED LIGHT ON THE IMPORTANCE OF METABOLIC AND FUNCTIONAL REPROGRAMMING IN MONOCYTES AND MACROPHAGES FOR PROGRESSION OF ATHEROSCLEROSIS. THIS REVIEW AIMS TO PROVIDE AN OVERVIEW OF OUR CURRENT UNDERSTANDING INTO HOW THE METABOLIC REPROGRAMMING OF GLUCOSE, CHOLESTEROL, FATTY ACID, AND AMINO ACID METABOLISM IN MACROPHAGES CONTRIBUTES TO INFLAMMATION DURING ATHEROSCLEROSIS. RECENT INSIGHTS SUGGEST THAT TRANSCRIPTIONAL AND EPIGENETIC ADAPTATION WITHIN INNATE IMMUNE CELLS (TERMED TRAINED IMMUNITY) PLAY AN IMPORTANT ROLE IN THE PATHOGENESIS OF ATHEROSCLEROSIS. WE PROPOSE THAT METABOLIC CHANGES INDUCED BY PRO-ATHEROGENIC LIPOPROTEINS PARTLY MEDIATE THESE CHANGES IN TRAINED MACROPHAGES. FINALLY, WE DISCUSS THE POSSIBILITY OF MANIPULATING CELLULAR METABOLISM OF IMMUNE CELLS FOR TARGETED THERAPEUTIC INTERVENTION AGAINST ATHEROSCLEROSIS. 2018 9 3608 36 IN SEARCH FOR GENES RELATED TO ATHEROSCLEROSIS AND DYSLIPIDEMIA USING ANIMAL MODELS. ATHEROSCLEROSIS IS A MULTIFACTORIAL CHRONIC DISEASE THAT AFFECTS LARGE ARTERIES AND MAY LEAD TO FATAL CONSEQUENCES. ACCORDING TO CURRENT UNDERSTANDING, INFLAMMATION AND LIPID ACCUMULATION ARE THE TWO KEY MECHANISMS OF ATHEROSCLEROSIS DEVELOPMENT. ANIMAL MODELS BASED ON GENETICALLY MODIFIED MICE HAVE BEEN DEVELOPED TO INVESTIGATE THESE ASPECTS. ONE SUCH MODEL IS LOW-DENSITY LIPOPROTEIN (LDL) RECEPTOR KNOCKOUT (KO) MICE (LDLR(-/-)), WHICH ARE CHARACTERIZED BY A MODERATE INCREASE OF PLASMA LDL CHOLESTEROL LEVELS. ANOTHER WIDELY USED GENETICALLY MODIFIED MOUSE STRAIN IS APOLIPOPROTEIN-E KO MICE (APOE(-/-)) THAT LACKS THE PRIMARY LIPOPROTEIN REQUIRED FOR THE UPTAKE OF LIPOPROTEINS THROUGH THE HEPATIC RECEPTORS, LEADING TO EVEN GREATER PLASMA CHOLESTEROL INCREASE THAN IN LDLR(-/-) MICE. THESE AND OTHER ANIMAL MODELS ALLOWED FOR CONDUCTING GENETIC STUDIES, SUCH AS GENOME-WIDE ASSOCIATION STUDIES, MICROARRAYS, AND GENOTYPING METHODS, WHICH HELPED IDENTIFYING MORE THAN 100 MUTATIONS THAT CONTRIBUTE TO ATHEROSCLEROSIS DEVELOPMENT. HOWEVER, TRANSLATION OF THE RESULTS OBTAINED IN ANIMAL MODELS FOR HUMAN SITUATIONS WAS SLOW AND CHALLENGING. AT THE SAME TIME, GENETIC STUDIES CONDUCTED IN HUMANS WERE LIMITED BY LOW SAMPLE SIZES AND HIGH HETEROGENEITY IN PREDICTIVE SUBCLINICAL PHENOTYPES. IN THIS REVIEW, WE SUMMARIZE THE CURRENT KNOWLEDGE ON THE USE OF KO MICE FOR IDENTIFICATION OF GENES IMPLICATED IN ATHEROSCLEROSIS AND PROVIDE A LIST OF GENES INVOLVED IN ATHEROSCLEROSIS-ASSOCIATED INFLAMMATORY PATHWAYS AND THEIR BRIEF CHARACTERISTICS. MOREOVER, WE DISCUSS THE APPROACHES FOR CANDIDATE GENE SEARCH IN ANIMALS AND HUMANS AND DISCUSS THE PROGRESS MADE IN THE FIELD OF EPIGENETIC STUDIES THAT APPEAR TO BE PROMISING FOR IDENTIFICATION OF NOVEL BIOMARKERS AND THERAPEUTIC TARGETS. 2020 10 4989 23 PCSK9 IS INCREASED IN CEREBROSPINAL FLUID OF INDIVIDUALS WITH ALCOHOL USE DISORDER. BACKGROUND: RECENT STUDIES HAVE SHOWN THAT ALCOHOL USE AFFECTS THE REGULATION AND EXPRESSION OF PROPROTEIN CONVERTASE SUBTILISIN/KEXIN 9 (PCSK9). WHILE A MAJOR ROLE OF PCSK9 IN HEPATIC FUNCTION AND LIPID REGULATION HAS BEEN CLEARLY ESTABLISHED, OTHER PLEIOTROPIC EFFECTS REMAIN POORLY UNDERSTOOD. EXISTING RESEARCH SUGGESTS A POSITIVE ASSOCIATION BETWEEN PCSK9 EXPRESSION IN THE BRAIN AND PSYCHOPATHOLOGY, WITH INCREASED LEVELS OF PCSK9 IN THE CEREBROSPINAL FLUID (CSF) OF INDIVIDUALS WITH DEMENTIA AND EPIGENETIC MODIFICATIONS OF PCSK9 ASSOCIATED WITH ALCOHOL USE DISORDER (AUD). IN THIS STUDY, WE HYPOTHESIZED THAT CHRONIC ALCOHOL USE WOULD INCREASE PCSK9 EXPRESSION IN CSF. METHODS: PCSK9 LEVELS IN CSF WERE MEASURED IN INDIVIDUALS WITH AUD (N = 42) ADMITTED TO AN INPATIENT REHABILITATION PROGRAM AND CONTROLS (N = 25). CSF SAMPLES IN AUD WERE ASSESSED AT 2 TIME POINTS, AT DAY 5 AND DAY 21 AFTER ADMISSION. FURTHERMORE, PLASMA SAMPLES WERE COLLECTED AND MEASURED FROM THE INDIVIDUALS WITH AUD. RESULTS: PCSK9 IN CSF WAS SIGNIFICANTLY INCREASED IN THE AUD GROUP AT DAY 5 AND DAY 21 COMPARED TO THE CONTROLS (P < 0.0001). PLASMA PCSK9 LEVELS WERE CORRELATED POSITIVELY WITH CSF PCSK9 LEVELS IN AUD (P = 0.0493). CONCLUSIONS: OUR DATA SUGGEST THAT PCSK9 IS ELEVATED IN THE CSF OF INDIVIDUALS WITH AUD, WHICH MAY INDICATE A POTENTIAL ROLE OF PCSK9 IN AUD. ADDITIONAL STUDIES ARE NECESSARY TO FURTHER ELUCIDATE THE FUNCTIONS OF PCSK9 IN THE BRAIN. 2019 11 6214 25 THE INTRACELLULAR SIGNALING PATHWAYS GOVERNING MACROPHAGE ACTIVATION AND FUNCTION IN HUMAN ATHEROSCLEROSIS. ATHEROSCLEROSIS IS A CHRONIC INFLAMMATORY DISEASE CHARACTERIZED BY LIPID ACCUMULATION AND PLAQUE FORMATION IN ARTERIAL VESSEL WALLS. ATHEROSCLEROTIC PLAQUES NARROW THE ARTERIAL LUMEN TO INCREASE THE RISK OF HEART ATTACKS, ISCHEMIC STROKE AND PERIPHERAL VASCULAR DISEASE, WHICH ARE MAJOR AND WORLDWIDE HEALTH AND ECONOMIC BURDENS. MACROPHAGE ACCUMULATION WITHIN PLAQUES IS CHARACTERISTIC OF ALL STAGES OF ATHEROSCLEROSIS AND THEIR PRESENCE IS A POTENTIAL MARKER OF DISEASE ACTIVITY AND PLAQUE STABILITY. MACROPHAGES ENGULF LIPIDS AND MODIFIED LIPOPROTEINS TO FORM FOAM CELLS THAT EXPRESS PRO-INFLAMMATORY AND CHEMOTACTIC EFFECTOR MOLECULES, STRESS INDUCING FACTORS AND REACTIVE OXYGEN SPECIES. THEY CONTROL PLAQUE STABILITY AND RUPTURE THROUGH SECRETION OF METALLOPROTEINASES AND EXTRACELLULAR MATRIX DEGRADATION. ALTHOUGH MACROPHAGES CAN WORSEN DISEASE BY PROPAGATING INFLAMMATION, THEY CAN STABILIZE ATHEROSCLEROTIC PLAQUES THROUGH TISSUE REMODELING, PROMOTING THE FORMATION OF A FIBROUS CAP, CLEARING APOPTOTIC CELLS TO PREVENT NECROTIC CORE FORMATION AND THROUGH VASCULAR REPAIR. IN ATHEROSCLEROSIS, MACROPHAGES RESPOND TO DYSLIPIDAEMIA, CYTOKINES, DYING CELLS, METABOLIC FACTORS, LIPIDS, PHYSICAL STIMULI AND EPIGENETIC FACTORS AND EXHIBIT HETEROGENEITY IN THEIR ACTIVATION DEPENDING ON THE STIMULI THEY RECEIVE. UNDERSTANDING THESE SIGNALS AND THE PATHWAYS DRIVING MACROPHAGE FUNCTION WITHIN DEVELOPING AND ESTABLISHED PLAQUES AND HOW THEY CAN BE PHARMACOLOGICALLY MODULATED, REPRESENTS A STRATEGY FOR THE PREVENTION AND TREATMENT OF ATHEROSCLEROSIS. THIS REVIEW FOCUSSES ON THE CURRENT UNDERSTANDING OF FACTORS CONTROLLING MACROPHAGE HETEROGENEITY AND FUNCTION IN ATHEROSCLEROSIS. PARTICULAR ATTENTION IS GIVEN TO THE MACROPHAGE INTRACELLULAR SIGNALING PATHWAYS AND TRANSCRIPTION FACTORS ACTIVATED BY BIOCHEMICAL AND BIOPHYSICAL STIMULI WITHIN PLAQUES, AND HOW THEY ARE INTEGRATED TO REGULATE PLAQUE FORMATION AND STABILITY. 2022 12 3342 28 HISTONE DEACETYLASE9 REPRESENTS THE EPIGENETIC PROMOTION OF M1 MACROPHAGE POLARIZATION AND INFLAMMATORY RESPONSE VIA TLR4 REGULATION. ATHEROSCLEROSIS IS A CHRONIC INFLAMMATORY RESPONSE MEDIATED BY VARIOUS FACTORS, WHERE EPIGENETIC REGULATION INVOLVING HISTONE DEACETYLATION IS ENVISAGED TO MODULATE THE EXPRESSION OF RELATED PROTEINS BY REGULATING THE BINDING OF TRANSCRIPTION FACTORS TO DNA, THEREBY INFLUENCING THE DEVELOPMENT OF ATHEROSCLEROSIS. THE MECHANISM OF ATHEROSCLEROSIS BY HISTONE DEACETYLATION IS PARTLY KNOWN; HENCE, THIS PROJECT AIMED AT INVESTIGATING THE ROLE OF HISTONE DEACETYLASE 9 (HDAC9) IN ATHEROSCLEROSIS. FOR THIS PURPOSE, SERUM WAS SEPARATED FROM BLOOD SAMPLES FOLLOWING CLOTTING AND CENTRIFUGATION FROM ATHEROSCLEROTIC AND HEALTHY PATIENTS (N = 40 EACH), AND THEN, VARIOUS TESTS WERE PERFORMED. THE RESULTS INDICATED THAT TOLL-LIKE RECEPTOR 4 (TLR4) WAS NOT ONLY POSITIVELY CORRELATED TO THE HDAC9 GENE, BUT WAS ALSO UPREGULATED IN ATHEROSCLEROSIS, WHERE IT WAS ALSO SIGNIFICANTLY UPREGULATED IN THE ATHEROSCLEROSIS CELL MODEL OF OXIDIZED LOW-DENSITY LIPOPROTEIN-INDUCED MACROPHAGES. CONVERSELY, THE TLR4 WAS SIGNIFICANTLY DOWNREGULATED IN INSTANCES OF LOSS OF HDAC9 FUNCTION, CEMENTING THE BRIDGING RELATIONSHIP BETWEEN HDAC9 AND MACROPHAGE POLARIZATION, WHERE THE HDAC9 WAS FOUND TO UPREGULATE M1 MACROPHAGE POLARIZATION WHICH TRANSLATED INTO THE RELEASE OF HIGHER CONTENT OF PROINFLAMMATORY CYTOKINES SUCH AS INTERLEUKIN-1BETA (IL-1BETA) AND TUMOR NECROSIS FACTOR-ALPHA (TNF-ALPHA), WHICH TEND TO SIGNIFICANTLY DECREASE FOLLOWING THE DELETION OF TLR4. HENCE, THIS STUDY REPORTS NOVEL RELATION BETWEEN EPIGENETIC CONTROL AND ATHEROSCLEROSIS, WHICH COULD PARTLY BE EXPLAINED BY HISTONE DEACETYLATION. 2022 13 522 27 ASSOCIATIONS BETWEEN NEIGHBORHOOD SOCIOECONOMIC DEPRIVATION, IFNGAMMA, AND HIGH-DENSITY LIPOPROTEIN PARTICLE SIZE: DATA FROM THE WASHINGTON, D.C. CARDIOVASCULAR HEALTH AND NEEDS ASSESSMENT. INTRODUCTION: NEIGHBORHOOD SOCIOECONOMIC DEPRIVATION IS ASSOCIATED WITH INCREASED CARDIOVASCULAR RISK FACTORS, INCLUDING INFLAMMATION. INFLAMMATION PLAYS AN IMPORTANT ROLE IN MODIFYING THE CARDIOPROTECTIVE FUNCTION OF HIGH-DENSITY LIPOPROTEIN (HDL). MOREOVER, RECENT STUDIES SUGGEST THAT VERY HIGH HDL IS ASSOCIATED WITH ADVERSE CARDIOVASCULAR DISEASE (CVD) OUTCOMES. THUS, WE SOUGHT TO EXPLORE THE RELATIONSHIPS BETWEEN NEIGHBORHOOD SOCIOECONOMIC DEPRIVATION AS A MARKER OF CHRONIC STRESS, INFLAMMATION, PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9 (PCSK9) (A CORE COMPONENT OF THE HDL PROTEOME), HDL CHARACTERISITCS, AND BIOLOGICAL AGING AS A PREDICTOR OF CVD AND ALL-CAUSE MORTALITY. METHODS: SIXTY AFRICAN AMERICAN SUBJECTS WERE RECRUITED TO THE NIH CLINICAL CENTER AS PART OF A COMMUNITY-BASED PARTICIPATORY RESEARCH-DESIGNED OBSERVATIONAL STUDY. NEIGHBORHOOD DEPRIVATION INDEX (NDI), A MARKER OF NEIGHBORHOOD SOCIOECONOMIC DEPRIVATION, WAS MEASURED USING US CENSUS DATA. HDL CHARACTERISTICS (CHOLESTEROL, PARTICLE NUMBER, SIZE, SUBSPECIES) WERE DETERMINED FROM NMR LIPOPROTEIN PROFILING, AND PLASMA CYTOKINES (IL-1BETA, IL-6, IL-8, TNFALPHA, IFNGAMMA) WERE MEASURED USING AN ELISA-BASED MULTIPLEX TECHNIQUE. EPIGENETIC CLOCK BIOMARKERS OF AGING WERE MEASURED USING DNA METHYLATION DATA OBTAINED FROM PARTICIPANTS' BUFFY COAT SAMPLES. WE USED LINEAR REGRESSION MODELING ADJUSTED FOR ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) RISK SCORE, BODY MASS INDEX (BMI), AND LIPID-LOWERING MEDICATION USE TO INVESTIGATE RELATIONSHIPS OF INTEREST. RESULTS: NDI DIRECTLY ASSOCIATED WITH LARGE HDL PARTICLE COUNT (H7P) AND IFNGAMMA AND TRENDED TOWARD SIGNIFICANCE WITH HDL-C AND PCSK9. IFNGAMMA AND PCSK9 THEN DIRECTLY ASSOCIATED WITH H7P. H7P ALSO DIRECTLY ASSOCIATED WITH HIGHER DNA METHYLATION PHENOTYPIC AGE (PHENOAGE). CONCLUSION: WE HIGHLIGHT ASSOCIATIONS BETWEEN NEIGHBORHOOD SOCIOECONOMIC DEPRIVATION, IFNGAMMA, PCSK9, HDL SUBSPECIES, AND EPIGENETIC BIOMARKERS OF AGING. TAKEN TOGETHER, OUR FINDINGS SUGGEST INDIRECT PATHWAYS LINKING NEIGHBORHOOD DEPRIVATION-RELATED STRESS AND INFLAMMATION TO HDL AND IMMUNE EPIGENETIC CHANGES. MOREOVER, THESE RESULTS ADD TO RECENT WORK SHOWING THE PATHOGENICITY OF HIGH HDL LEVELS AND UNDERSCORE THE NEED TO UNDERSTAND HOW CHRONIC STRESS-RELATED INFLAMMATION AND LIPOPROTEIN SUBSPECIES RELATE TO CVD RISK ACROSS DIVERSE POPULATIONS. 2023 14 6502 24 TRAINED IMMUNITY: LONG-TERM ADAPTATION IN INNATE IMMUNE RESPONSES. ADAPTIVE IMMUNE RESPONSES ARE CHARACTERIZED BY ANTIGEN SPECIFICITY AND INDUCTION OF LIFELONG IMMUNOLOGIC MEMORY. RECENTLY, IT HAS BEEN REPORTED THAT INNATE IMMUNE CELLS CAN ALSO BUILD IMMUNE MEMORY CHARACTERISTICS-A PROCESS TERMED TRAINED IMMUNITY. TRAINED IMMUNITY DESCRIBES THE PERSISTENT HYPERRESPONSIVE PHENOTYPE THAT INNATE IMMUNE CELLS CAN DEVELOP AFTER BRIEF STIMULATION. PATHOGENIC STIMULI SUCH AS MICROORGANISMS, AND ALSO ENDOGENOUS MOLECULES INCLUDING URIC ACID, OXIDIZED LDL (LOW-DENSITY LIPOPROTEIN), AND CATECHOLAMINES, ARE CAPABLE OF INDUCING MEMORY IN MONOCYTES AND MACROPHAGES. WHILE TRAINED IMMUNITY PROVIDES FAVORABLE CROSS-PROTECTION IN THE CONTEXT OF INFECTIOUS DISEASES, THE HEIGHTENED IMMUNE RESPONSE CAN BE MALADAPTIVE IN DISEASES DRIVEN BY CHRONIC SYSTEMIC INFLAMMATION, SUCH AS ATHEROSCLEROSIS. TRAINED IMMUNITY IS MAINTAINED BY DISTINCT EPIGENETIC AND METABOLIC MECHANISMS AND PERSISTS FOR AT LEAST SEVERAL MONTHS IN VIVO DUE TO REPROGRAMMING OF MYELOID PROGENITOR CELLS. ADDITIONALLY, CERTAIN NONIMMUNE CELLS ARE ALSO FOUND TO EXHIBIT TRAINED IMMUNITY CHARACTERISTICS. THUS, TRAINED IMMUNITY PRESENTS AN EXCITING FRAMEWORK TO DEVELOP NEW APPROACHES TO VACCINATION AND ALSO NOVEL PHARMACOLOGICAL TARGETS IN THE TREATMENT OF INFLAMMATORY DISEASES. 2021 15 4707 21 NMR PLASMA METABOLOMICS STUDY OF PATIENTS OVERCOMING ACUTE MYOCARDIAL INFARCTION: IN THE FIRST 12 H AFTER ONSET OF CHEST PAIN WITH STATISTICAL DISCRIMINATION TOWARDS METABOLOMIC BIOMARKERS. ACUTE MYOCARDIAL INFARCTION (AMI) IS ONE OF THE LEADING CAUSES OF DEATH AMONG ADULTS IN OLDER AGE. UNDERSTANDING MECHANISMS HOW ORGANISM RESPONDS TO ISCHEMIA IS ESSENTIAL FOR THE ISCHEMIC PATIENT'S PREVENTION AND TREATMENT. DESPITE THE GREAT PREVALENCE AND INCIDENCE ONLY A SMALL NUMBER OF STUDIES UTILIZE A METABOLOMIC APPROACH TO DESCRIBE AMI CONDITION. RECENT STUDIES HAVE SHOWN THE IMPACT OF METABOLITES ON EPIGENETIC CHANGES, IN THESE STUDIES PLASMA METABOLITES WERE RELATED TO NEUROLOGICAL OUTCOME OF THE PATIENTS MAKING METABOLOMIC STUDIES INCREASINGLY INTERESTING. THE AIM OF THIS STUDY WAS TO DESCRIBE METABOLOMIC RESPONSE OF AN ORGANISM TO ISCHEMIC STRESS THROUGH THE CHANGES IN ENERGETIC METABOLITES AND AMINOACIDS IN BLOOD PLASMA IN PATIENTS OVERCOMING ACUTE MYOCARDIAL INFARCTION. BLOOD PLASMA FROM PATIENTS IN THE FIRST 12 H AFTER ONSET OF CHEST PAIN WAS COLLECTED AND COMPARED WITH VOLUNTEERS WITHOUT ANY HISTORY OF ISCHEMIC DISEASES VIA NMR SPECTROSCOPY. LOWERED PLASMA LEVELS OF PYRUVATE, ALANINE, GLUTAMINE AND NEUROTRANSMITTER PRECURSORS TYROSINE AND TRYPTOPHAN WERE FOUND. FURTHER, WE OBSERVED INCREASED PLASMA LEVELS OF 3-HYDROXYBUTYRATE AND ACETOACETATE IN BALANCE WITH DECREASED LEVEL OF LIPOPROTEINS FRACTION, SUGGESTING THE ONGOING KETONIC STATE OF AN ORGANISM. DISCRIMINATORY ANALYSIS SHOWED VERY PROMISING PERFORMANCE WHERE COMPOUNDS: LIPOPROTEINS, ALANINE, PYRUVATE, GLUTAMINE, TRYPTOPHAN AND 3-HYDROXYBUTYRATE WERE OF THE HIGHEST DISCRIMINATORY POWER WITH FEASIBILITY OF SUCCESSFUL STATISTICAL DISCRIMINATION. 2020 16 3734 31 INNATE IMMUNE MEMORY IN MONOCYTES AND MACROPHAGES: THE POTENTIAL THERAPEUTIC STRATEGIES FOR ATHEROSCLEROSIS. ATHEROSCLEROSIS IS A COMPLEX METABOLIC DISEASE CHARACTERIZED BY THE DYSFUNCTION OF LIPID METABOLISM AND CHRONIC INFLAMMATION IN THE INTIMAL SPACE OF THE VESSEL. AS THE MOST ABUNDANT INNATE IMMUNE CELLS, MONOCYTE-DERIVED MACROPHAGES PLAY A PIVOTAL ROLE IN THE INFLAMMATORY RESPONSE, CHOLESTEROL METABOLISM, AND FOAM CELL FORMATION. IN RECENT DECADES, IT HAS BEEN DEMONSTRATED THAT MONOCYTES AND MACROPHAGES CAN ESTABLISH INNATE IMMUNE MEMORY (ALSO TERMED TRAINED IMMUNITY) VIA ENDOGENOUS AND EXOGENOUS ATHEROGENIC STIMULI AND EXHIBIT A LONG-LASTING PROINFLAMMATORY PHENOTYPE. THE IMPORTANT CELLULAR METABOLISM PROCESSES, INCLUDING GLYCOLYSIS, OXIDATIVE PHOSPHORYLATION (OXPHOS), THE TRICARBOXYLIC ACID (TCA) CYCLE, FATTY ACID SYNTHESIS, AND CHOLESTEROL SYNTHESIS, ARE REPROGRAMMED. TRAINED MONOCYTES/MACROPHAGES WITH INNATE IMMUNE MEMORY CAN BE PERSISTENTLY HYPERACTIVATED AND CAN UNDERGO EXTENSIVE EPIGENETIC REWIRING, WHICH CONTRIBUTES TO THE PATHOPHYSIOLOGICAL DEVELOPMENT OF ATHEROSCLEROSIS VIA INCREASED PROINFLAMMATORY CYTOKINE PRODUCTION AND LIPID ACCUMULATION. HERE, WE PROVIDE AN OVERVIEW OF THE REGULATION OF CELLULAR METABOLIC PROCESSES AND EPIGENETIC MODIFICATIONS OF INNATE IMMUNE MEMORY IN MONOCYTES/MACROPHAGES AS WELL AS THE POTENTIAL ENDOGENOUS AND EXOGENOUS STIMULATIONS INVOLVED IN THE PROGRESSION OF ATHEROSCLEROSIS THAT HAVE BEEN REPORTED RECENTLY. THESE ELUCIDATIONS MIGHT BE BENEFICIAL FOR FURTHER UNDERSTANDING INNATE IMMUNE MEMORY AND THE DEVELOPMENT OF THERAPEUTIC STRATEGIES FOR INFLAMMATORY DISEASES AND ATHEROSCLEROSIS. 2022 17 6505 24 TRAINED INNATE IMMUNITY AS A NOVEL MECHANISM LINKING INFECTION AND THE DEVELOPMENT OF ATHEROSCLEROSIS. RATIONALE: THERE IS STRONG EPIDEMIOLOGICAL EVIDENCE FOR AN ASSOCIATION BETWEEN ACUTE AND CHRONIC INFECTIONS AND THE OCCURRENCE OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE. THE UNDERLYING PATHOPHYSIOLOGICAL MECHANISMS REMAIN UNCLEAR. MONOCYTE-DERIVED MACROPHAGES ARE THE MOST ABUNDANT IMMUNE CELLS IN ATHEROSCLEROTIC PLAQUES. IT HAS RECENTLY BEEN ESTABLISHED THAT MONOCYTES/MACROPHAGES CAN DEVELOP A LONG-LASTING PROINFLAMMATORY PHENOTYPE AFTER BRIEF STIMULATION WITH MICRO-ORGANISMS OR MICROBIAL PRODUCTS, WHICH HAS BEEN TERMED TRAINED IMMUNITY. OBJECTIVE: THE AIM OF THIS STUDY IS TO ASSESS WHETHER TRAINED IMMUNITY MEDIATES THE LINK BETWEEN INFECTIONS AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASE. METHODS AND RESULTS: BRIEF EXPOSURE OF MONOCYTES TO VARIOUS MICRO-ORGANISMS RESULTS IN THE DEVELOPMENT OF MACROPHAGES WITH A PERSISTENT PROINFLAMMATORY PHENOTYPE: THIS REPRESENTS A DE FACTO NONSPECIFIC INNATE IMMUNE MEMORY, WHICH HAS BEEN TERMED TRAINED IMMUNITY. THIS IS MEDIATED BY EPIGENETIC REPROGRAMMING AT THE LEVEL OF HISTONE METHYLATION AND A PROFOUND REWIRING OF INTRACELLULAR METABOLISM. ALTHOUGH THIS MECHANISM OFFERS POWERFUL PROTECTION AGAINST REINFECTION, TRAINED MACROPHAGES DISPLAY AN ATHEROGENIC PHENOTYPE IN TERMS OF CYTOKINE PRODUCTION AND FOAM CELL FORMATION. TRAINED MONOCYTES ARE PRESENT UP TO 3 MONTHS AFTER EXPERIMENTAL INFECTION IN HUMANS. MOREOVER, A TRAINED IMMUNITY PHENOTYPE IS PRESENT IN PATIENTS WITH ESTABLISHED ATHEROSCLEROSIS. CONCLUSIONS: WE PROPOSE THAT TRAINED IMMUNITY PROVIDES THE MISSING MECHANISTIC LINK THAT EXPLAINS THE ASSOCIATION BETWEEN INFECTIONS AND ATHEROSCLEROSIS. THEREFORE, PHARMACOLOGICAL MODULATION OF TRAINED IMMUNITY HAS THE POTENTIAL TO PREVENT INFECTION-RELATED ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN THE FUTURE. 2018 18 6498 28 TRAINED IMMUNITY IN MONOCYTE/MACROPHAGE: NOVEL MECHANISM OF PHYTOCHEMICALS IN THE TREATMENT OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE. ATHEROSCLEROSIS (AS) IS THE PATHOLOGY OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASES (ASCVD), CHARACTERIZED BY PERSISTENT CHRONIC INFLAMMATION IN THE VESSEL WALL, IN WHICH MONOCYTES/MACROPHAGES PLAY A KEY ROLE. IT HAS BEEN REPORTED THAT INNATE IMMUNE SYSTEM CELLS CAN ASSUME A PERSISTENT PROINFLAMMATORY STATE AFTER SHORT STIMULATION WITH ENDOGENOUS ATHEROGENIC STIMULI. THE PATHOGENESIS OF AS CAN BE INFLUENCED BY THIS PERSISTENT HYPERACTIVATION OF THE INNATE IMMUNE SYSTEM, WHICH IS TERMED TRAINED IMMUNITY. TRAINED IMMUNITY HAS ALSO BEEN IMPLICATED AS A KEY PATHOLOGICAL MECHANISM, LEADING TO PERSISTENT CHRONIC INFLAMMATION IN AS. TRAINED IMMUNITY IS MEDIATED VIA EPIGENETIC AND METABOLIC REPROGRAMMING AND OCCURS IN MATURE INNATE IMMUNE CELLS AND THEIR BONE MARROW PROGENITORS. NATURAL PRODUCTS ARE PROMISING CANDIDATES FOR NOVEL PHARMACOLOGICAL AGENTS THAT CAN BE USED TO PREVENT OR TREAT CARDIOVASCULAR DISEASES (CVD). A VARIETY OF NATURAL PRODUCTS AND AGENTS EXHIBITING ANTIATHEROSCLEROTIC ABILITIES HAVE BEEN REPORTED TO POTENTIALLY INTERFERE WITH THE PHARMACOLOGICAL TARGETS OF TRAINED IMMUNITY. THIS REVIEW DESCRIBES IN AS MUCH DETAIL AS POSSIBLE THE MECHANISMS INVOLVED IN TRAINED IMMUNITY AND HOW PHYTOCHEMICALS OF THIS PROCESS INHIBIT AS BY AFFECTING TRAINED MONOCYTES/MACROPHAGES. 2023 19 6887 24 [ROLE OF METAFLAMMATION AS A SYSTEMIC MANIFESTATION OF METABOLIC DISEASES]. VISCERAL OBESITY AS A COMPONENT OF THE METABOLIC SYNDROME IS CHARACTERIZED BY SYSTEMIC AND LOCAL INFLAMMATION, WHICH CAN BE QUANTIFIED IN ORGANS (METAFLAMMATION). THIS PROCESS CAN BE REGARDED AS A CHRONIC, STERILE, AND LOW-GRADE STATE OF INFLAMMATION WITHOUT INFECTION, TRAUMA, TUMOR OR AUTOIMMUNITY. IT IS CAUSED BY AN INFLAMMATION OF THE VISCERAL ADIPOSE TISSUE (ADIPOSE INFLAMMATION OR ADIPOFLAMMATION) DUE TO ADIPOCYTE HYPERTROPHY AND HYPERPLASIA WITH INCREASED INFILTRATION BY MONOCYTES AND MACROPHAGES. IMPORTANT IS THE PRESENCE OF PROINFLAMMATORY, SO-CALLED POLARIZED M1 MACROPHAGES THAT ARE INDUCED BY INTERFERON GAMMA (IFN-GAMMA) AND LIPOPOLYSACCHARIDES (LPS) WITH SECRETION OF INTERLEUKIN (IL)-6, TUMOR NECROSIS FACTOR (TNF) AND IL?1. IN CONTRAST, THE ANTI-INFLAMMATORY, SO-CALLED POLARIZED M2 MACROPHAGES INDUCED BY IL?4 AND IL-13 WITH SECRETION OF IL?8 AND IL-10 DECREASE. IN ADDITION, THE SECRETED ADIPOKINE PATTERN CHANGES FROM ANTI-INFLAMMATORY TO PROINFLAMMATORY. ADIPOCYTE NECROSIS, LOCAL HYPOXIA, DYSREGULATED AUTOPHAGY, ACTIVATION OF INFLAMMASOMES, MODULATION OF TOLL-LIKE RECEPTORS, AND EPIGENETIC FACTORS PLAY A COMPLEX ROLE. THIS MECHANISM RESULTS IN LOCAL INSULIN RESISTANCE AND SUBSEQUENTLY A SYSTEMIC INSULIN RESISTANCE OF PERIPHERAL ORGANS AS WELL AS A SPILLOVER OF LOCAL MEDIATORS OF INFLAMMATION INTO THE SYSTEMIC CIRCULATION (MEASURED AS OBESITY C?REACTIVE PROTEIN, CRP). THE ACTIVATION OF INFLAMMATORY SIGNAL TRANSDUCTION CASCADES LEADS TO INHIBITORY PHOSPHORYLATION OF THE INSULIN SIGNALING PATHWAY AND A WEAKENING OF THE EFFECT OF INSULIN. IN PARALLEL, ECTOPIC LIPID ACCUMULATION OCCURS IN THE LIVER, MUSCULATURE, PANCREAS, PERICARDIUM AND LUNGS. DIACYLGLYCEROL (DAG) ACTIVATES SPECIFIC ISOFORMS OF PROTEIN KINASE C (EPSILON IN THE LIVER AND TAU IN THE MUSCULATURE), WHICH IN TURN LEAD TO INHIBITION OF THE INSULIN SIGNALING PATHWAY. INSULIN RESISTANCE IN OBESITY AND TYPE 2 DIABETES MELLITUS IS AN INFLAMMATORY DISEASE. THE AIM OF FUTURE TRANSLATIONAL APPROACHES IS AN ANTI-INFLAMMATORY, MOLECULARLY INDIVIDUALIZED (PRECISION MEDICINE) TREATMENT IN ADIPOSE TISSUE (TARGETED THERAPY) AND IN ORGANS OF INSULIN RESISTANCE. 2023 20 1382 31 DIABETES ALTERS ACTIVATION AND REPRESSION OF PRO- AND ANTI-INFLAMMATORY SIGNALING PATHWAYS IN THE VASCULATURE. A CENTRAL MECHANISM DRIVING VASCULAR DISEASE IN DIABETES IS IMMUNE CELL-MEDIATED INFLAMMATION. IN DIABETES, ENHANCED OXIDATION AND GLYCATION OF MACROMOLECULES, SUCH AS LIPOPROTEINS, INSULTS THE ENDOTHELIUM, AND ACTIVATES BOTH INNATE AND ADAPTIVE ARMS OF THE IMMUNE SYSTEM BY GENERATING NEW ANTIGENS FOR PRESENTATION TO ADAPTIVE IMMUNE CELLS. CHRONIC INFLAMMATION OF THE ENDOTHELIUM IN DIABETES LEADS TO CONTINUOUS INFILTRATION AND ACCUMULATION OF LEUKOCYTES AT SITES OF ENDOTHELIAL CELL INJURY. WE WILL DESCRIBE THE CENTRAL ROLE OF THE MACROPHAGE AS A SOURCE OF SIGNALING MOLECULES AND DAMAGING BY-PRODUCTS WHICH ACTIVATE INFILTRATING LYMPHOCYTES IN THE TISSUE AND CONTRIBUTE TO THE PRO-OXIDANT AND PRO-INFLAMMATORY MICROENVIRONMENT. AN IMPORTANT ASPECT TO BE CONSIDERED IS THE DIABETES-ASSOCIATED DEFECTS IN THE IMMUNE SYSTEM, SUCH AS FEWER OR DYSFUNCTIONAL ATHERO-PROTECTIVE LEUKOCYTE SUBSETS IN THE DIABETIC LESION COMPARED TO NON-DIABETIC LESIONS. THIS REVIEW WILL DISCUSS THE KEY PRO-INFLAMMATORY SIGNALING PATHWAYS RESPONSIBLE FOR LEUKOCYTE RECRUITMENT AND ACTIVATION IN THE INJURED VESSEL, WITH PARTICULAR FOCUS ON PRO- AND ANTI-INFLAMMATORY PATHWAYS ABERRANTLY ACTIVATED OR REPRESSED IN DIABETES. WE AIM TO DESCRIBE THE INTERACTION BETWEEN ADVANCED GLYCATION END PRODUCTS AND THEIR PRINCIPLE RECEPTOR RAGE, ANGIOTENSIN II, AND THE ANG II TYPE 1 RECEPTOR, IN ADDITION TO REACTIVE OXYGEN SPECIES (ROS) PRODUCTION BY NADPH-OXIDASE ENZYMES THAT ARE RELEVANT TO VASCULAR AND IMMUNE CELL FUNCTION IN THE CONTEXT OF DIABETIC VASCULOPATHY. FURTHERMORE, WE WILL TOUCH ON RECENT ADVANCES IN EPIGENETIC MEDICINE THAT HAVE REVEALED HIGH GLUCOSE-MEDIATED CHANGES IN THE TRANSCRIPTION OF GENES WITH KNOWN PRO-INFLAMMATORY DOWNSTREAM TARGETS. FINALLY, NOVEL ANTI-ATHEROSCLEROSIS STRATEGIES THAT TARGET THE VASCULAR IMMUNE INTERFACE WILL BE EXPLORED; SUCH AS VACCINATION AGAINST MODIFIED LOW-DENSITY LIPOPROTEIN AND PHARMACOLOGICAL INHIBITION OF ROS-PRODUCING ENZYMES. 2013