1 4346 144 MIR-10A, MIR-15A, LET-7A, AND LET-7G EXPRESSION AS STRESS-RELEVANT BIOMARKERS TO ASSESS ACUTE OR CHRONIC PSYCHOLOGICAL STRESS AND MENTAL HEALTH IN HUMAN CAPILLARY BLOOD. BACKGROUND: PSYCHOLOGICAL STRESS, AS AN IMPORTANT COFACTOR IN THE DEVELOPMENT OF MANY ACUTE AND CHRONIC DISEASES, IS CRUCIAL FOR GENERAL HEALTH OR WELL-BEING, AND IMPROVED MARKERS ARE NEEDED TO DISTINGUISH SITUATIONS OF PROGRESSIVE PATHOLOGICAL DEVELOPMENT, SUCH AS DEPRESSION, ANXIETY, OR BURNOUT, TO BE RECOGNIZED AT AN EARLY STAGE. EPIGENETIC BIOMARKERS PLAY AN IMPORTANT ROLE IN THE EARLY DETECTION AND TREATMENT OF COMPLEX DISEASES SUCH AS CANCER, AND METABOLIC OR MENTAL DISORDERS. THEREFORE, THIS STUDY AIMED TO IDENTIFY SO-CALLED MIRNAS, WHICH WOULD BE SUITABLE AS STRESS-RELATED BIOMARKERS. METHODS AND RESULTS: IN THIS STUDY, 173 PARTICIPANTS (36.4% MALES, AND 63.6% FEMALES) WERE INTERVIEWED ABOUT STRESS, STRESS-RELATED DISEASES, LIFESTYLE, AND DIET TO ASSESS THEIR ACUTE AND CHRONIC PSYCHOLOGICAL STRESS STATUS. USING QPCR ANALYSIS, 13 DIFFERENT MIRNAS (MIR-10A-5P, MIR-15A-5P, MIR-16-5P, MIR-19B-3P, MIR-26B-5P, MIR-29C-3P, MIR-106B-5P, MIR-126-3P, MIR-142-3P, LET-7A-5P, LET-7G-5P, MIR-21-5P, AND MIR-877-5P) WERE ANALYZED IN DRIED CAPILLARY BLOOD SAMPLES. FOUR MIRNAS WERE IDENTIFIED, MIR-10A-5P, MIR-15A-5P, LET-7A-5P, AND LET-7G-5P (P < 0.05), WHICH COULD BE USED AS POSSIBLE CANDIDATES FOR MEASURING PATHOLOGICAL FORMS OF ACUTE OR CHRONIC STRESS. LET-7A-5P, LET-7G-5P, AND MIR-15A-5P (P < 0.05) WERE ALSO SIGNIFICANTLY HIGHER IN SUBJECTS WITH AT LEAST ONE STRESS-RELATED DISEASE. FURTHER, CORRELATIONS WERE IDENTIFIED BETWEEN LET-7A-5P AND MEAT CONSUMPTION (P < 0.05) AND BETWEEN MIR-15A-5P AND COFFEE CONSUMPTION (P < 0.05). CONCLUSION: THE EXAMINATION OF THESE FOUR MIRNAS AS BIOMARKERS USING A MINIMALLY INVASIVE METHOD OFFERS THE POSSIBILITY OF DETECTING HEALTH PROBLEMS AT AN EARLY STAGE AND COUNTERACTING THEM TO MAINTAIN GENERAL AND MENTAL HEALTH. 2023 2 4367 60 MIRNA-BASED "FITNESS SCORE" TO ASSESS THE INDIVIDUAL RESPONSE TO DIET, METABOLISM, AND EXERCISE. BACKGROUND: REGULAR, ESPECIALLY SUSTAINED EXERCISE PLAYS AN IMPORTANT ROLE IN THE PREVENTION AND TREATMENT OF MULTIPLE CHRONIC DISEASES. SOME OF THE UNDERLYING MOLECULAR AND CELLULAR MECHANISMS BEHIND THE ADAPTIVE RESPONSE TO PHYSICAL ACTIVITY ARE STILL UNCLEAR, BUT RECENT FINDINGS SUGGEST A POSSIBLE ROLE OF EPIGENETIC MECHANISMS, ESPECIALLY MIRNAS, IN THE PROGRESSION AND MANAGEMENT OF EXERCISE-RELATED CHANGES. DUE TO THE COMBINATION OF THE ANALYSIS OF EPIGENETIC BIOMARKERS (MIRNAS), THE INTAKE OF FOOD AND SUPPLEMENTS, AND GENETIC DISPOSITIONS, A "FITNESS SCORE" WAS EVALUATED TO ASSESS THE INDIVIDUAL RESPONSE TO NUTRITION, EXERCISE, AND METABOLIC INFLUENCE. METHODS: IN RESPONSE TO A 12-WEEK SPORTS INTERVENTION, WE ANALYZED GENETIC AND EPIGENETIC BIOMARKERS IN CAPILLARY BLOOD FROM 61 SEDENTARY, HEALTHY PARTICIPANTS (66.1% FEMALES, 33.9% MALES, MEAN AGE 33 YEARS), INCLUDING LINE-1 METHYLATION, THREE SNPS, AND TEN MIRNAS USING HRM AND QPCR ANALYSIS. THESE BIOMARKERS WERE ALSO ANALYZED IN A HEALTHY, AGE- AND SEX-MATCHED CONTROL GROUP (N, 20) WITHOUT INTERVENTION. FOOD FREQUENCY INTAKE, INCLUDING DIETARY SUPPLEMENT INTAKE, AND GENERAL HEALTH QUESTIONNAIRES WERE SURVEYED UNDER THE SUPERVISION OF TRAINED STAFF. RESULTS: EXERCISE TRAINING DECREASED THE EXPRESSION OF MIR-20A-5P, -22-5P, AND -505-3P (P < 0.02) AND IMPROVED THE "FITNESS SCORE," WHICH ESTIMATES EIGHT DIFFERENT LIFESTYLE FACTORS TO ASSESS, NUTRITION, INFLAMMATION, CARDIOVASCULAR FITNESS, INJURY RISK, REGENERATION, MUSCLE AND HYDRATION STATUS, AS WELL AS STRESS LEVEL. IN ADDITION, WE WERE ABLE TO DETERMINE CORRELATIONS BETWEEN INDIVIDUAL MIRNAS, MIR-20A-5P, -22-5P, AND -101-3P (P < 0.04), AND THE GENETIC PREDISPOSITION FOR ENDURANCE AND/OR STRENGTH AND OBESITY RISK (ACE, ACTN3, AND FTO), AS WELL AS BETWEEN MIRNAS AND THE BODY COMPOSITION (P < 0.05). MIR-19B-3P AND -101-3P CORRELATED WITH THE INTAKE OF B VITAMINS. FURTHER, MIR-19B-3P CORRELATED WITH MAGNESIUM AND MIR-378A-3P WITH IRON INTAKE (P < 0.05). CONCLUSIONS: IN SUMMARY, OUR RESULTS INDICATE THAT A COMBINED ANALYSIS OF SEVERAL BIOMARKERS (MIRNAS) CAN PROVIDE INFORMATION ABOUT AN INDIVIDUAL'S TRAINING ADAPTIONS/FITNESS, BODY COMPOSITION, NUTRITIONAL NEEDS, AND POSSIBLE RECOVERY. IN CONTRAST TO MOST STUDIES USING MUSCLE BIOPSIES, WE WERE ABLE TO SHOW THAT THESE BIOMARKERS CAN ALSO BE MEASURED USING A MINIMALLY INVASIVE METHOD. 2022 3 1659 25 DOWN-REGULATION OF CANDIDATE TUMOR SUPPRESSOR GENES WITHIN CHROMOSOME BAND 13Q14.3 IS INDEPENDENT OF THE DNA METHYLATION PATTERN IN B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA. LOSS OF GENOMIC MATERIAL FROM CHROMOSOMAL BAND 13Q14.3 IS THE MOST COMMON GENETIC IMBALANCE IN B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA (B-CLL) AND MANTLE CELL LYMPHOMA, POINTING TO THE INVOLVEMENT OF THIS REGION IN A TUMOR SUPPRESSOR MECHANISM. FROM THE MINIMALLY DELETED REGION, 3 CANDIDATE GENES HAVE BEEN ISOLATED, RFP2, BCMS, AND BCMSUN. DNA SEQUENCE ANALYSES HAVE FAILED TO DETECT SMALL MUTATIONS IN ANY OF THESE GENES, SUGGESTING A DIFFERENT PATHOMECHANISM, MOST LIKELY HAPLOINSUFFICIENCY. WE, THEREFORE, TESTED B-CLL PATIENTS FOR EPIGENETIC ABERRATIONS BY MEASURING EXPRESSION OF GENES FROM 13Q14.3 AND METHYLATION OF THEIR PROMOTOR REGION. RB1, CLLD7, KPNA3, CLLD6, AND RFP2 WERE DOWN-REGULATED IN B-CLL PATIENTS AS COMPARED WITH B CELLS OF HEALTHY DONORS, WITH RFP2 SHOWING THE MOST PRONOUNCED LOSS OF EXPRESSION. TO TEST WHETHER THIS LOSS OF GENE EXPRESSION IS ASSOCIATED WITH METHYLATION OF CPG ISLANDS IN THE RESPECTIVE PROMOTOR REGIONS, WE PERFORMED METHYLATION-SENSITIVE QUANTITATIVE POLYMERASE CHAIN REACTION ANALYSES AND BISULFITE SEQUENCING ON DNA FROM B-CLL PATIENTS. NO DIFFERENCE IN THE METHYLATION PATTERNS COULD BE DETECTED IN ANY CPG ISLAND OF THE MINIMALLY DELETED REGION. DOWN-REGULATION OF GENES WITHIN CHROMOSOMAL BAND 13Q14.3 IN B-CLL IS IN LINE WITH THE CONCEPT OF HAPLOINSUFFICIENCY, BUT THIS TUMOR-SPECIFIC PHENOMENON IS NOT ASSOCIATED WITH DNA METHYLATION. 2002 4 458 25 APPLYING MINIMALLY INVASIVE BIOMARKERS OF CHRONIC STRESS ACROSS COMPLEX ECOLOGICAL CONTEXTS. CHRONIC STRESS IS BOTH THEORETICALLY AND METHODOLOGICALLY CHALLENGING TO OPERATIONALIZE THROUGH BIOMARKERS. YET MINIMALLY INVASIVE, FIELD-FRIENDLY BIOMARKERS OF CHRONIC STRESS ARE VALUABLE IN RESEARCH LINKING BIOLOGY AND CULTURE, SEEKING TO UNDERSTAND DIFFERENTIAL PATTERNS OF HUMAN DEVELOPMENT ACROSS ECOLOGICAL CONTEXTS, AND EXPLORING THE EVOLUTION OF HUMAN SOCIALITY. FOR HUMAN BIOLOGISTS, A CENTRAL QUESTION IN MEASUREMENT AND INTERPRETATION OF BIOMARKERS IS HOW STRESS-RESPONSIVE PHYSIOLOGICAL SYSTEMS ARE REGULATED ACROSS DIVERSE HUMAN ECOLOGIES. THIS ARTICLE AIMS TO DESCRIBE A CONDITIONAL TOOLKIT FOR HUMAN BIOLOGISTS INTERESTED IN THE STUDY OF CHRONIC STRESS, HIGHLIGHTING A MIX OF LONGSTANDING AND NOVEL BIOMARKERS, WITH SPECIAL FOCUS ON HAIR/FINGERNAIL CORTISOL, LATENT HERPESVIRUS ANTIBODIES, ALLOSTATIC LOAD INDICES, AND SERIAL/AMBULATORY DATA COLLECTION APPROACHES. FUTURE TRENDS IN CHRONIC STRESS BIOMARKER RESEARCH, INCLUDING EPIGENETIC APPROACHES, ARE BRIEFLY CONSIDERED. THIS OVERVIEW CONSIDERS: (1) CHALLENGES IN SEPARATING A DISTINCTLY PSYCHOSOCIAL DIMENSION OF CHRONIC STRESS FROM ADVERSITY MORE BROADLY; (2) ESSENTIAL CHARACTERISTICS OF HUMAN ECOLOGY THAT SHAPE INTERPRETATION; (3) RETROSPECTIVE VS. LONGITUDINAL SAMPLING; (4) THE ROLE OF AGE, DEVELOPMENTAL EFFECTS, AND LOCAL BIOLOGIES; (5) DIFFERENT TIMESCALES OF CHRONICITY; AND (6) THE ROLE OF CULTURE. 2022 5 6292 24 THE PRIMACY OF PSYCHOANALYTIC INTERVENTION IN RECOVERY FROM THE PSYCHOSES AND SCHIZOPHRENIAS. FUNCTIONAL CAPACITIES, SUCH AS ATTACHMENT AND AFFECT REGULATION, OBJECT RELATIONS CAPACITY, SYMBOLIC FUNCTION AND LANGUAGE DEVELOPMENT, NOW DOCUMENTED BY NEUROSCIENTIFIC RESEARCH AND EPIGENETICS, ARE REVIEWED. RESULTS FROM THIS RESEARCH, TOGETHER WITH OTHER FACTORS, ARE POSITED TO HAVE CONTRIBUTED TO EFFECTIVE CONTEMPORARY PSYCHOANALYTIC AND PSYCHOTHERAPEUTIC TREATMENTS FOR THE PSYCHOSES AND SCHIZOPHRENIAS. ETIOLOGICAL FACTORS INVOLVING THE SCHIZOPHRENIAS AND OTHER PSYCHOSES ARE CONSIDERED BOTH IN TERMS OF AN EPIGENETIC MODEL, AND IN TERMS OF HOW ETIOLOGY MAY, OR MAY NOT, AFFECT CLINICAL TREATMENT. THE LACANIAN 388 PROGRAM IS REVIEWED IN SOME DETAIL, AS ARE SEVERAL PSYCHOANALYTIC AND PSYCHOTHERAPEUTIC CLINICAL APPROACHES USED WITH THIS POPULATION OVER THE LAST SIX DECADES. ALL TREATMENTS FOCUS ON THE PRIMACY OF PSYCHOTHERAPEUTIC INTERVENTION, AND USE MEDICATIONS MINIMALLY, NOT AT ALL, OR ONLY AS INFORMED BY AN OVER-ARCHING PSYCHODYNAMIC MODEL OF TREATMENT. THE AUTHOR ARGUES THAT THERE IS NOW SUBSTANTIAL RESEARCH AND OUTCOME DATA SUGGESTING THAT THE PSYCHOSES AND SCHIZOPHRENIAS ARE NOT CHRONIC DETERIORATING CONDITIONS. RECOVERY IS OBSERVED IN MANY PSYCHOTIC AND SCHIZOPHRENIC PATIENTS TREATED WITH APPROACHES THAT FOCUS ON THE PRIMACY OF PSYCHOTHERAPEUTIC INTERVENTION. 2007 6 326 31 ALLELIC SILENCING AT THE TUMOR-SUPPRESSOR LOCUS 13Q14.3 SUGGESTS AN EPIGENETIC TUMOR-SUPPRESSOR MECHANISM. GENOMIC MATERIAL FROM CHROMOSOME BAND 13Q14.3 DISTAL TO THE RETINOBLASTOMA LOCUS IS RECURRENTLY LOST IN A VARIETY OF HUMAN NEOPLASMS, INDICATING AN AS-YET-UNIDENTIFIED TUMOR-SUPPRESSOR MECHANISM. NO PATHOGENIC MUTATIONS HAVE BEEN FOUND IN THE MINIMALLY DELETED REGION UNTIL NOW. HOWEVER, IN B CELL CHRONIC LYMPHOCYTIC LEUKEMIA TUMORS WITH LOSS OF ONE COPY OF THE CRITICAL REGION, RESPECTIVE CANDIDATE TUMOR-SUPPRESSOR GENES ARE DOWN-REGULATED BY A FACTOR >2, WHICH WOULD BE EXPECTED BY A NORMAL GENE-DOSAGE EFFECT. THIS FINDING POINTS TO AN EPIGENETIC PATHOMECHANISM. WE FIND THAT THE TWO COPIES OF THE CRITICAL REGION REPLICATE ASYNCHRONOUSLY, SUGGESTING DIFFERENTIAL CHROMATIN PACKAGING OF THE TWO COPIES OF 13Q14.3. ALTHOUGH WE ALSO DETECT MONOALLELIC SILENCING OF GENES LOCALIZED IN THE CRITICAL REGION, MONOALLELIC EXPRESSION ORIGINATES FROM EITHER THE MATERNAL OR PATERNAL COPY, EXCLUDING AN IMPRINTING MECHANISM. DNA METHYLATION ANALYSES REVEALED ONE CPG ISLAND OF THE REGION TO BE METHYLATED. DNA DEMETHYLATION OF THIS CPG ISLAND AND GLOBAL HISTONE HYPERACETYLATION INDUCED BIALLELIC EXPRESSION, WHEREAS REPLICATION TIMING WAS NOT AFFECTED. WE PROPOSE THAT DIFFERENTIAL REPLICATION TIMING REPRESENTS AN EARLY EPIGENETIC MARK THAT DISTINGUISHES THE TWO COPIES OF 13Q14.3, RESULTING IN DIFFERENTIAL CHROMATIN PACKAGING AND MONOALLELIC EXPRESSION. ACCORDINGLY, DELETION OF THE SINGLE ACTIVE COPY OF 13Q14.3 RESULTS IN SIGNIFICANT DOWN-REGULATION OF THE CANDIDATE GENES AND LOSS OF FUNCTION, PROVIDING A MODEL FOR THE INTERACTION OF GENETIC LESIONS AND EPIGENETIC SILENCING AT 13Q14.3 IN B CELL CHRONIC LYMPHOCYTIC LEUKEMIA. 2006 7 5233 33 PROFIBROTIC SIGNALING AND HCC RISK DURING CHRONIC VIRAL HEPATITIS: BIOMARKER DEVELOPMENT. DESPITE BREAKTHROUGHS IN ANTIVIRAL THERAPIES, CHRONIC VIRAL HEPATITIS B AND C ARE STILL THE MAJOR CAUSES OF LIVER FIBROSIS AND HEPATOCELLULAR CARCINOMA (HCC). IMPORTANTLY, EVEN IN PATIENTS WITH CONTROLLED INFECTION OR VIRAL CURE, THE CANCER RISK CANNOT BE FULLY ELIMINATED, HIGHLIGHTING A PERSISTING ONCOGENIC PRESSURE IMPOSED BY EPIGENETIC IMPRINTING AND ADVANCED LIVER DISEASE. RELIABLE AND MINIMALLY INVASIVE BIOMARKERS FOR EARLY FIBROSIS AND FOR RESIDUAL HCC RISK IN HCV-CURED PATIENTS ARE URGENTLY NEEDED. CHRONIC INFECTION WITH HBV AND/OR HCV DYSREGULATES ONCOGENIC AND PROFIBROGENIC SIGNALING WITHIN THE HOST, ALSO DISPLAYED IN THE SECRETION OF SOLUBLE FACTORS TO THE BLOOD. THE STUDY OF VIRUS-DYSREGULATED SIGNALING PATHWAYS MAY, THEREFORE, CONTRIBUTE TO THE IDENTIFICATION OF RELIABLE MINIMALLY INVASIVE BIOMARKERS FOR THE DETECTION OF PATIENTS AT EARLY-STAGE LIVER DISEASE POTENTIALLY COMPLEMENTING EXISTING NONINVASIVE METHODS IN CLINICS. WITH A FOCUS ON VIRUS-INDUCED SIGNALING EVENTS, THIS REVIEW PROVIDES AN OVERVIEW OF CANDIDATE BLOOD BIOMARKERS FOR LIVER DISEASE AND HCC RISK ASSOCIATED WITH CHRONIC VIRAL HEPATITIS AND EPIGENETIC VIRAL FOOTPRINTS. 2021 8 3925 32 LIQUID BIOPSIES BASED ON DNA METHYLATION AS BIOMARKERS FOR THE DETECTION AND PROGNOSIS OF LUNG CANCER. LUNG CANCER (LC) IS THE MAIN CAUSE OF CANCER-RELATED MORTALITY. MOST LC PATIENTS ARE DIAGNOSED IN AN ADVANCED STAGE WHEN THE SYMPTOMS ARE OBVIOUS, AND THE PROGNOSIS IS QUITE POOR. ALTHOUGH LOW-DOSE COMPUTED TOMOGRAPHY (LDCT) IS A ROUTINE CLINICAL EXAMINATION FOR EARLY DETECTION OF LC, THE FALSE-POSITIVE RATE IS OVER 90%. AS ONE OF THE INTENSELY STUDIED EPIGENETIC MODIFICATIONS, DNA METHYLATION PLAYS A KEY ROLE IN VARIOUS DISEASES, INCLUDING CANCER AND OTHER DISEASES. HYPERMETHYLATION IN TUMOR SUPPRESSOR GENES OR HYPOMETHYLATION IN ONCOGENES IS AN IMPORTANT EVENT IN TUMORIGENESIS. REMARKABLY, DNA METHYLATION USUALLY OCCURS IN THE VERY EARLY STAGE OF MALIGNANT TUMORS. THUS, DNA METHYLATION ANALYSIS MAY PROVIDE SOME USEFUL INFORMATION ABOUT THE EARLY DETECTION OF LC. IN RECENT YEARS, LIQUID BIOPSY HAS DEVELOPED RAPIDLY. LIQUID BIOPSY CAN DETECT AND MONITOR BOTH PRIMARY AND METASTATIC MALIGNANT TUMORS AND CAN REFLECT TUMOR HETEROGENEITY. MOREOVER, IT IS A MINIMALLY INVASIVE PROCEDURE, AND IT CAUSES LESS PAIN FOR PATIENTS. THIS REVIEW SUMMARIZED VARIOUS LIQUID BIOPSIES BASED ON DNA METHYLATION FOR LC. AT FIRST, WE BRIEFLY DISCUSSED SOME EMERGING TECHNOLOGIES FOR DNA METHYLATION ANALYSIS. SUBSEQUENTLY, WE OUTLINED CELL-FREE DNA (CFDNA), SPUTUM, BRONCHOALVEOLAR LAVAGE FLUID, BRONCHIAL ASPIRATES, AND BRONCHIAL WASHINGS DNA METHYLATION-BASED LIQUID BIOPSY FOR THE EARLY DETECTION OF LC. FINALLY, THE PROGNOSTIC VALUE OF DNA METHYLATION IN CFDNA AND SPUTUM AND THE DIAGNOSTIC VALUE OF OTHER DNA METHYLATION-BASED LIQUID BIOPSIES FOR LC WERE ALSO ANALYZED. 2022 9 6073 26 THE DRESDEN BURNOUT STUDY: PROTOCOL OF A PROSPECTIVE COHORT STUDY FOR THE BIO-PSYCHOLOGICAL INVESTIGATION OF BURNOUT. OBJECTIVES: THE DRESDEN BURNOUT STUDY (DBS) IS A 12-YEAR LONGITUDINAL COHORT STUDY THAT AIMS TO PROVIDE A DESCRIPTION OF THE BURNOUT SYNDROME ON THE BASIS OF TIME AND SYMPTOM CRITERIA WITH A SPECIAL FOCUS ON THE SEARCH FOR BIOMARKERS. BIOLOGICAL AND PSYCHOSOCIAL APPROACHES ARE APPLIED TO EXAMINE THE LONG-TERM COURSE AND CONSEQUENCES OF BURNOUT WITHIN A POPULATION-BASED GERMAN-SPEAKING SAMPLE AGED 18 TO 68 YEARS. METHODS: DEMOGRAPHICS AND PSYCHOSOCIAL DATA ARE GENERATED BY ONLINE ASSESSMENTS, INCLUDING DEMOGRAPHICS AND QUESTIONNAIRES ON BURNOUT, BURNOUT-RELATED CONSTRUCTS, WORK-ENVIRONMENT, AND HEALTH-RELATED FACTORS. THE LAB-BASED BIOMARKER ASSESSMENT INCLUDES ENDOCRINE, PHYSIOLOGICAL, IMMUNOLOGICAL, AND EPIGENETIC MARKERS OBTAINED FROM BLOOD AND HAIR SAMPLES. IN ADDITION, HEART RATE VARIABILITY IS ALSO MEASURED REPEATEDLY. WITHIN THE FIRST 2 YEARS, THE DBS COLLECTED PSYCHOSOCIAL DATA FROM OVER 7,600 PARTICIPANTS WITH BIOLOGICAL DATA OBTAINED FROM MORE THAN 800 INDIVIDUALS. DURING THE FOLLOWING 10 YEARS, DETAILED ASSESSMENTS OF BIOMARKERS AND PSYCHOSOCIAL FACTORS WILL BE COLLECTED IN ANNUAL STUDY WAVES. RESULTS: RESULTS WILL BE GENERATED DURING THE FOLLOWING DECADE. CONCLUSION: THE FINDINGS OF THE DBS ARE EXPECTED TO PAVE THE ROAD FOR AN IN-DEPTH BIOPSYCHOSOCIAL CHARACTERIZATION OF BURNOUT AND TO GIVE INSIGHT INTO THE LONG-TERM COURSE AND POTENTIAL MENTAL AND PHYSICAL HEALTH CONSEQUENCES OF THE BURNOUT SYNDROME. 2018 10 943 23 CHRONIC LYMPHOCYTIC LEUKEMIA. PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA CAN BE DIVIDED INTO THREE CATEGORIES: THOSE WHO ARE MINIMALLY AFFECTED BY THE PROBLEM, OFTEN NEVER REQUIRING THERAPY; THOSE THAT INITIALLY FOLLOW AN INDOLENT COURSE BUT SUBSEQUENTLY PROGRESS AND REQUIRE THERAPY; AND THOSE THAT FROM THE POINT OF DIAGNOSIS EXHIBIT AN AGGRESSIVE DISEASE NECESSITATING TREATMENT. LIKEWISE, SUCH PATIENTS PASS THROUGH THREE PHASES: DEVELOPMENT OF THE DISEASE, DIAGNOSIS, AND NEED FOR THERAPY. FINALLY, THE LEUKEMIC CLONES OF ALL PATIENTS APPEAR TO REQUIRE CONTINUOUS INPUT FROM THE EXTERIOR, MOST OFTEN THROUGH MEMBRANE RECEPTORS, TO ALLOW THEM TO SURVIVE AND GROW. THIS REVIEW IS PRESENTED ACCORDING TO THE TEMPORAL COURSE THAT THE DISEASE FOLLOWS, FOCUSING ON THOSE EXTERNAL INFLUENCES FROM THE TISSUE MICROENVIRONMENT (TME) THAT SUPPORT THE TIME LINES AS WELL AS THOSE INTERNAL INFLUENCES THAT ARE INHERITED OR DEVELOP AS GENETIC AND EPIGENETIC CHANGES OCCURRING OVER THE TIME LINE. REGARDING THE FORMER, SPECIAL EMPHASIS IS PLACED ON THE INPUT PROVIDED VIA THE B-CELL RECEPTOR FOR ANTIGEN AND THE C-X-C-MOTIF CHEMOKINE RECEPTOR-4 AND THE THERAPEUTIC AGENTS THAT BLOCK THESE INPUTS. REGARDING THE LATTER, PROMINENCE IS LAID UPON INHERITED SUSCEPTIBILITY GENES AND THE GENETIC AND EPIGENETIC ABNORMALITIES THAT LEAD TO THE DEVELOPMENTAL AND PROGRESSION OF THE DISEASE. 2021 11 939 23 CHRONIC LYMPHOCYTIC LEUKEMIA AND 13Q14: MIRS AND MORE. LOSS OF A CRITICAL REGION IN 13Q14.3 [DEL(13Q)] IS THE MOST COMMON GENOMIC ABERRATION IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), OCCURRING IN MORE THAN 50% OF PATIENTS (STILGENBAUER ET AL., ONCOGENE 1998;16:1891 - 1897, DOHNER ET AL., N ENGL J MED 2000;343:1910 - 1916). DESPITE EXTENSIVE INVESTIGATIONS, NO POINT MUTATIONS HAVE BEEN FOUND IN THE REMAINING ALLELE THAT WOULD INACTIVATE ONE OF THE CANDIDATE TUMOR SUPPRESSOR GENES AND EXPLAIN THE PATHOMECHANISM POSTULATED FOR THIS REGION. HOWEVER, THE GENES IN THE REGION ARE SIGNIFICANTLY DOWN-REGULATED IN CLL CELLS, MORE THAN WOULD BE EXPECTED BY GENE DOSAGE, AND RECENTLY A COMPLEX EPIGENETIC REGULATORY MECHANISM WAS IDENTIFIED FOR 13Q14.3 IN NON-MALIGNANT CELLS THAT INVOLVES ASYNCHRONOUS REPLICATION TIMING AND MONOALLELIC EXPRESSION OF CANDIDATE TUMOR SUPPRESSOR GENES. HERE, WE PROPOSE A MODEL OF A MULTIGENIC PATHOMECHANISM IN 13Q14.3, WHERE SEVERAL TUMOR SUPPRESSOR GENES, INCLUDING THE MIRNA GENES MIR-16-1 AND MIR-15A, ARE CO-REGULATED BY THE TWO LONG NON-CODING RNA GENES DLEU1 AND DLEU2 THAT SPAN THE CRITICAL REGION. FURTHERMORE, WE PROPOSE THESE CO-REGULATED GENES TO BE INVOLVED IN THE SAME MOLECULAR PATHWAYS, THEREBY ALSO FORMING A FUNCTIONAL GENE CLUSTER. ELUCIDATING THE MOLECULAR AND CELLULAR FUNCTION OF THE 13Q14.3 CANDIDATE GENES WILL SHED LIGHT ON THE UNDERLYING PATHOMECHANISM OF CLL. 2009 12 1 15 ON DECEMBER 5, 2017, THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE HOSTED A PUBLIC WORKSHOP TITLED NUTRIGENOMICS AND THE FUTURE OF NUTRITION IN WASHINGTON, DC, TO REVIEW CURRENT KNOWLEDGE IN THE FIELD OF NUTRIGENOMICS AS IT RELATES TO NUTRITION. WORKSHOP PARTICIPANTS EXPLORED THE INFLUENCE OF GENETIC AND EPIGENETIC EXPRESSION ON NUTRITIONAL STATUS AND THE POTENTIAL IMPACT OF PERSONALIZED NUTRITION ON HEALTH MAINTENANCE AND CHRONIC DISEASE PREVENTION. THIS PUBLICATION SUMMARIZES THE PRESENTATIONS AND DISCUSSIONS FROM THE WORKSHOP. 2018 13 2935 26 GENETIC ALTERATION ASSOCIATED WITH CHRONIC LYMPHOCYTIC LEUKEMIA. THE GENETICS OF B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA (B-CLL) DIFFER CONSIDERABLY FROM MOST OTHER FORMS OF HEMATOLOGIC MALIGNANCY WHICH ARE USUALLY CHARACTERIZED BY CHROMOSOME TRANSLOCATIONS. B-CLL TYPICALLY CONTAINS CHROMOSOMAL DELETIONS AND CHROMOSOMES 13Q14 AND 11Q22-->Q23 ARE THE MOST COMMON. THESE TWO REGIONS APPEAR TO SHARE A COMMON ANCESTRAL ORIGIN (AUER ET AL., 2007B). OVERALL, CHROMOSOMAL ABNORMALITIES CAN BE FOUND IN THE MAJORITY OF PATIENTS WITH B-CLL WHEN USING SENSITIVE TECHNIQUES (DOHNERET AL., 2000) AND POSSIBLY REFLECTS AN UNDERLYING PREDISPOSITION, WITH A SMALL BUT SIGNIFICANT NUMBER OF FAMILIAL CASES. ALTHOUGH SINGLE AND CONSISTENT ABNORMALITIES ARE MOST COMMON, MULTIPLE REARRANGEMENTS CAN OCCUR, OFTEN WITH DISEASE PROGRESSION (FEGANETAL., 1995; DOHNER ET AL., 2000). REGIONS OF RECURRENT DELETION SUGGEST THE PRESENCE OF TUMOR SUPPRESSOR GENES IF FOLLOWING KNUDSON'S THEORETICAL 2-HIT MODEL. HOWEVER, DESPITE EXTENSIVE SEQUENCING ANALYSIS OVER THE LAST DECADE AND LACK OF PATHOGENIC MUTATIONS IDENTIFIED, THERE HAS BEEN A MOVE AWAY FROM THIS SUGGESTED HYPOTHESIS AND ALTERNATIVE MECHANISMS OF GENE INACTIVATION INVOLVING EPIGENETIC SILENCING OR HAPLOINSUFFICIENCY MAY BE CONSIDERED AS MORE LIKELY IN THIS DISEASE. THIS REVIEW FOCUSES ON THE COMMON GENETIC ABNORMALITIES IN B-CLL AND RELATES THEM TO SOME OF THE MORE RECENT HYPOTHESES ON INACTIVATION OF GENES WITHIN THESE REGIONS OF DELETION. 2007 14 430 22 ANTICIPATION IN FAMILIES WITH CHRONIC LYMPHOCYTIC LEUKEMIA AND OTHER LYMPHOPROLIFERATIVE DISORDERS. FIFTY-ONE PARENT-OFFSPRING PAIRS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) OR OTHER LYMPHOPROLIFERATIVE DISORDERS (NONCLL) SUCH AS MALIGNANT LYMPHOMA, MULTIPLE MYELOMA, OR OTHER TYPES OF LYMPHOCYTIC LEUKEMIA THAN CLL WERE ASCERTAINED INDEPENDENTLY IN 38 FAMILIES. THERE WERE 30 CLL-CLL PARENT-OFFSPRING PAIRS AND 21 PAIRS WITH NONCLL IN PARENTS AND/OR IN OFFSPRING. THE MEDIAN AGE OF ONSET OF DISEASE WAS 13 YEARS LOWER IN THE OFFSPRING THAN IN THE PARENTS WHEN COMPARING ALL 51 PAIRS (P < 0.001). THIS DIFFERENCE WAS MAINLY CAUSED BY A SIGNIFICANTLY LOWER AGE AT ONSET IN OFFSPRING WITH PARENTAL NONCLL (P < 0.001) WHERE PATERNAL DISEASE WAS TRANSFERRED ESPECIALLY TO SONS, WHILE AFFECTED OFFSPRING TO PARENTS WITH CLL HAVE THE SAME AGE AT DEBUT OF DISEASE THAN THEIR PARENTS (P = 0.130) AND A NEARLY EQUAL TRANSFER TO SONS AND DAUGHTERS. THE LOW-MALIGNANT FOLLICULAR SMALL B-CELL LYMPHOMA WAS THE PREDOMINANT DIAGNOSIS WITHIN NONCLL. ANTICIPATION IS POINTED OUT AS ONE LIKELY MECHANISM BEHIND THE LOWER AGE AT ONSET OF DISEASE IN OFFSPRING THAN IN PARENTS, EVEN IF A PART OF THIS DIFFERENCE IS ASCRIBED TO A GENERALLY EARLIER DIAGNOSIS WITH MODERN TECHNOLOGY IN OFFSPRING THAN IN PARENTS. 2010 15 2469 13 EPIGENETIC TRAJECTORIES OF THE PREMALIGNANT-TO-MALIGNANT TRANSITION OF CHRONIC LYMPHOCYTIC LEUKEMIA. KRETZMER AND COLLEAGUES SHOW THAT THE TRANSITION TO ALTERED METHYLOME OCCURS VERY EARLY IN CHRONIC LYMPHOCYTIC LEUKEMIA, AND ONCE ACQUIRED, IT IS A CLONAL AND EXTREMELY STABLE CHANGE. HOWEVER, THE PRECISE TIME POINT WHEN THE LEUKEMIC CLONE STARTS DEVIATING SIGNIFICANTLY FROM THE NORMAL B-CELL DIFFERENTIATION TRAJECTORY IS STILL ELUSIVE. SEE RELATED ARTICLE BY KRETZMER ET AL., P. 54. 2021 16 4833 30 ON THE CUTTING EDGE OF ORAL CANCER PREVENTION: FINDING RISK-PREDICTIVE MARKERS IN PRECANCEROUS LESIONS BY LONGITUDINAL STUDIES. EARLY IDENTIFICATION AND MANAGEMENT OF PRECANCEROUS LESIONS AT HIGH RISK OF DEVELOPING CANCERS IS THE MOST EFFECTIVE AND ECONOMICAL WAY TO REDUCE THE INCIDENCE, MORTALITY, AND MORBIDITY OF CANCERS AS WELL AS MINIMIZING TREATMENT-RELATED COMPLICATIONS, INCLUDING PAIN, IMPAIRED FUNCTIONS, AND DISFIGURATION. RELIABLE CANCER-RISK-PREDICTIVE MARKERS PLAY AN IMPORTANT ROLE IN ENABLING EVIDENCE-BASED DECISION MAKING AS WELL AS PROVIDING MECHANISTIC INSIGHT INTO THE MALIGNANT CONVERSION OF PRECANCEROUS LESIONS. THE FOCUS OF THIS ARTICLE IS TO REVIEW UPDATES ON MARKERS THAT MAY PREDICT THE RISK OF ORAL PREMALIGNANT LESIONS (OPLS) IN DEVELOPING INTO ORAL SQUAMOUS CELL CARCINOMAS (OSCCS), WHICH CAN LOGICALLY BE DISCOVERED ONLY BY PROSPECTIVE OR RETROSPECTIVE LONGITUDINAL STUDIES THAT ANALYZE PRE-PROGRESSION OPL SAMPLES WITH LONG-TERM FOLLOW-UP OUTCOMES. THESE RISK-PREDICTIVE MARKERS ARE DIFFERENT FROM THOSE THAT PROGNOSTICATE THE SURVIVAL OUTCOME OF CANCERS AFTER THEY HAVE BEEN DIAGNOSED AND TREATED, OR THOSE THAT DIFFERENTIATE BETWEEN DIFFERENT LESION TYPES AND STAGES. UP-TO-DATE KNOWLEDGE ON CANCER-RISK-PREDICTIVE MARKERS DISCOVERED BY LONGITUDINALLY FOLLOWED STUDIES WILL BE REVIEWED. THE GOAL OF THIS ENDEAVOR IS TO USE THIS INFORMATION AS A STARTING POINT TO ADDRESS SOME KEY CHALLENGES LIMITING OUR PROGRESS IN THIS AREA IN THE HOPE OF ACHIEVING EFFECTIVE TRANSLATION OF RESEARCH DISCOVERIES INTO NEW CLINICAL INTERVENTIONS. 2022 17 1095 32 COHORT PROFILE: THE EWHA BIRTH AND GROWTH STUDY. WITH THE INTRODUCTION OF LIFE-COURSE EPIDEMIOLOGY, RESEARCHERS REALIZED THE IMPORTANCE OF IDENTIFYING RISK FACTORS IN EARLY LIFE TO PREVENT CHRONIC DISEASES. THIS LED TO THE ESTABLISHMENT OF THE EWHA BIRTH AND GROWTH STUDY IN 2001; THE STUDY IS A PROSPECTIVE BIRTH COHORT DESIGNED TO PROVIDE EVIDENCE OF EARLY LIFE RISK FACTORS FOR A CHILD'S GROWTH AND HEALTH. PARTICIPANTS WERE RECRUITED FROM THOSE WHO VISITED EWHA WOMANS UNIVERSITY MOKDONG HOSPITAL (A TERTIARY HOSPITAL IN SOUTHWEST SEOUL, KOREA) FOR PRENATAL CARE AT 24-28 WEEKS OF GESTATION. IN TOTAL, 891 MOTHERS ENROLLED IN THIS STUDY BETWEEN 2001 AND 2006 AND THEIR OFFSPRING (N=940) WERE FOLLOWED-UP. REGULAR CHECK-UP EXAMINATIONS OF OFFSPRING WERE CONDUCTED AT 3 YEARS, 5 YEARS, AND 7 YEARS OF AGE AND EVERY YEAR THEREAFTER. TO CONSIDER AGE-RELATED HEALTH ISSUES, EXTENSIVE DATA WERE COLLECTED USING QUESTIONNAIRES AND MEASUREMENTS. IN 2021, THE STUDY SUBJECTS WILL REACH 19 YEARS OF AGE, AND WE ARE PLANNING A CHECK-UP EXAMINATION FOR EARLY ADULTHOOD. ABOUT 20 YEARS HAVE PASSED SINCE THE COHORT DATA WERE COLLECTED, AND WE HAVE PUBLISHED RESULTS ON CHILDHOOD HEALTH OUTCOMES ASSOCIATED WITH PRENATAL AND BIRTH CHARACTERISTICS, GENETIC AND EPIGENETIC CHARACTERISTICS RELATED TO CHILDHOOD METABOLISM, THE EFFECTS OF EXPOSURE TO ENDOCRINE DISRUPTORS, AND DIETARY PATTERNS IN CHILDHOOD. RECENTLY, WE STARTED REPORTING ON TOPICS RELATED TO ADOLESCENT HEALTH. THE FINDINGS WILL FACILITATE IDENTIFICATION OF EARLY LIFE RISK FACTORS FOR CHRONIC DISEASES AND THE DEVELOPMENT OF INTERVENTIONS FOR DISEASES LATER IN LIFE. 2021 18 844 37 CHILDHOOD ALLERGY DISEASE, EARLY DIAGNOSIS, AND THE POTENTIAL OF SALIVARY PROTEIN BIOMARKERS. ALLERGIC DISEASE HAS RISEN TO EPIDEMIC PROPORTIONS SINCE THE LAST DECADE AND IS AMONG THE MOST COMMON NONCOMMUNICABLE, CHRONIC DISEASES IN CHILDREN AND ADOLESCENTS WORLDWIDE. ALLERGIC DISEASE USUALLY OCCURS IN EARLY LIFE; THUS, EARLY BIOMARKERS OF ALLERGIC SUSCEPTIBILITY ARE REQUIRED FOR PREVENTIVE MEASURES TO HIGH-RISK INFANTS WHICH ENABLE EARLY INTERVENTIONS TO DECREASE ALLERGIC SEVERITY. HOWEVER, TO DATE, THERE IS NO RELIABLE GENERAL OR SPECIFIC ALLERGY PHENOTYPE DETECTION METHOD THAT IS EASY AND NONINVASIVE FOR CHILDREN. MOST REPORTED ALLERGIC PHENOTYPE DETECTION METHODS ARE INVASIVE, SUCH AS THE SKIN PRICK TEST (SPT), ORAL FOOD CHALLENGE (OFC), AND BLOOD TEST, AND MANY INVOLVE NOT READILY ACCESSIBLE BIOLOGICAL SAMPLES, SUCH AS CORD BLOOD (CB), MATERNAL BLOOD, OR NEWBORN VERNIX. SALIVA IS A BIOLOGICAL SAMPLE THAT HAS GREAT POTENTIAL AS A BIOMARKER MEASUREMENT AS IT CONSISTS OF AN ABUNDANCE OF BIOMARKERS, SUCH AS GENETIC MATERIAL AND PROTEINS. IT IS EASILY ACCESSIBLE, NONINVASIVE, COLLECTED VIA A PAINLESS PROCEDURE, AND AN EASY BEDSIDE SCREENING FOR REAL-TIME MEASUREMENT OF THE ONGOING HUMAN PHYSIOLOGICAL SYSTEM. ALL THESE ADVANTAGES EMPHASISE SALIVA AS A VERY PROMISING DIAGNOSTIC CANDIDATE FOR THE DETECTION AND MONITORING OF DISEASE BIOMARKERS, ESPECIALLY IN CHILDREN. FURTHERMORE, PROTEIN BIOMARKERS HAVE THE ADVANTAGES AS MODIFIABLE INFLUENCING FACTORS RATHER THAN GENETIC AND EPIGENETIC FACTORS THAT ARE MOSTLY NONMODIFIABLE FACTORS FOR ALLERGIC DISEASE SUSCEPTIBILITY IN CHILDHOOD. SALIVA HAS GREAT POTENTIAL TO REPLACE SERUM AS A BIOLOGICAL FLUID BIOMARKER IN DIAGNOSING CLINICAL ALLERGY. HOWEVER, TO DATE, SALIVA IS NOT CONSIDERED AS AN ESTABLISHED MEDICALLY ACCEPTABLE BIOMARKER. THIS REVIEW CONSIDERS WHETHER THE SALIVA COULD BE SUITABLE BIOLOGICAL SAMPLES FOR EARLY DETECTION OF ALLERGIC RISK. SUCH TOOLS MAY BE USED AS JUSTIFICATION FOR TARGETED INTERVENTIONS IN EARLY CHILDHOOD FOR DISEASE PREVENTION AND ASSISTING IN REDUCING MORBIDITY AND MORTALITY CAUSED BY CHILDHOOD ALLERGY. 2021 19 623 24 BIOINFORMATICS FOR CANCER MANAGEMENT IN THE POST-GENOME ERA. HUMAN CANCER IS CAUSED BY MULTIPLE FACTORS, SUCH AS GENETIC PREDISPOSITION, CHRONIC PERSISTENT INFLAMMATION, ENVIRONMENTAL FACTORS, LIFE STYLE, AND AGING. DYSREGULATED PROLIFERATION, DYSREGULATED ADHESION, RESISTANCE TO APOPTOSIS, RESISTANCE TO SENESCENCE, AND RESISTANCE TO ANTI-CANCER DRUGS ARE FEATURES OF CANCER CELLS. ACCUMULATION OF MULTIPLE EPIGENETIC CHANGES AND GENETIC ALTERATIONS OF CANCER-ASSOCIATED GENES DURING MULTI-STAGE CARCINOGENESIS RESULTS IN MORE MALIGNANT PHENOTYPES. POST-GENOME SCIENCE IS CHARACTERIZED BY OMICS DATA RELATED TO GENOME, TRANSCRIPTOME, PROTEOME, METABOLOME, INTERACTOME, AND EPIGENOME AS WELL AS BY HIGH-THROUGHPUT TECHNOLOGY, SUCH AS WHOLE-GENOME TILING OLIGONUCLEOTIDE ARRAY, ARRAY CGH WITH 32,433 OVERLAPPING BAC CLONES, TRANSCRIPTOME MICROARRAY, MASS SPECTROMETRY, TISSUE-BASED EXPRESSION ARRAY, AND CELL-BASED TRANSFECTION ARRAY. BENCHTOP ONCOLOGY SUPPLIES DESKTOP ONCOLOGY WITH LARGE AMOUNTS OF OMICS DATA PRODUCED BY HIGH-THROUGHPUT TECHNOLOGY. DESKTOP ONCOLOGY ESTABLISHES KNOWLEDGE ON CANCER-RELATED BIOMARKERS, SUCH AS PREDISPOSITION MARKERS, DIAGNOSTIC MARKERS, PROGNOSTIC MARKERS, AND THERAPEUTIC MARKERS, BY USING BIOINFORMATICS AND HUMAN INTELLIGENCE OF EXPERTS FOR DATA MINING AND TEXT MINING. BEDSIDE ONCOLOGY APPLIES THE KNOWLEDGE ESTABLISHED BY DESKTOP ONCOLOGY TO DETERMINE THERAPEUTICS FOR CANCER PATIENTS. ANTIBODY DRUGS (TRASTUZUMAB/HERCEPTIN, CETUXIMAB/ERBITUX, BEVACIZUMAB/AVASTIN, ET CETERA), SMALL MOLECULE INHIBITORS FOR TYROSINE KINASES (GEFITINIB/IRESSA, ERLOTINIB/TARCEVA, IMATINIB/GLEEVEC, ET CETERA), CONVENTIONAL CYTOTOXIC DRUGS, AND ANTI-HORMONAL DRUGS ARE USED FOR CANCER CHEMOTHERAPY. BIOMARKER MONITORING CONTRIBUTES TO THERAPEUTIC OPTIONAL CHOICE AND DRUG DOSAGE DETERMINATION FOR CANCER PATIENTS. KNOWLEDGE ON BIOMARKERS IS FEEDFORWARDED FROM DESKTOP TO BEDSIDE IN THE TRANSLATIONAL RESEARCH, AND THEN BIOMARKER MONITORING IS FEEDBACKED FROM BEDSIDE TO DESKTOP IN THE REVERSE TRANSLATIONAL RESEARCH. DESKTOP ONCOLOGY IS INDISPENSABLE FOR CANCER RESEARCH IN THE POST-GENOME ERA. COMBINATION OF GENETIC SCREENING FOR CANCER PREDISPOSITION IN THE GENERAL POPULATION AND PRECISE SELECTION OF THERAPEUTIC OPTIONS DURING CANCER MANAGEMENT COULD CONTRIBUTE TO THE REALIZATION OF PERSONALIZED PREVENTION AND TO DRAMATICALLY IMPROVE THE PROGNOSIS OF CANCER PATIENTS IN THE FUTURE. 2006 20 1138 33 COMPUTATIONAL METHODS FOR DETECTION OF DIFFERENTIALLY METHYLATED REGIONS USING KERNEL DISTANCE AND SCAN STATISTICS. MOTIVATION: RESEARCHERS IN GENOMICS ARE INCREASINGLY INTERESTED IN EPIGENETIC FACTORS SUCH AS DNA METHYLATION BECAUSE THEY PLAY AN IMPORTANT ROLE IN REGULATING GENE EXPRESSION WITHOUT CHANGES IN THE SEQUENCE OF DNA. ABNORMAL DNA METHYLATION IS ASSOCIATED WITH MANY HUMAN DISEASES. RESULTS: WE PROPOSE TWO DIFFERENT APPROACHES TO TEST FOR DIFFERENTIALLY METHYLATED REGIONS (DMRS) ASSOCIATED WITH COMPLEX TRAITS, WHILE ACCOUNTING FOR CORRELATIONS AMONG CPG SITES IN THE DMRS. THE FIRST APPROACH IS A NONPARAMETRIC METHOD USING A KERNEL DISTANCE STATISTIC AND THE SECOND ONE IS A LIKELIHOOD-BASED METHOD USING A BINOMIAL SPATIAL SCAN STATISTIC. THE KERNEL DISTANCE METHOD USES THE KERNEL FUNCTION, WHILE THE BINOMIAL SCAN STATISTIC APPROACH USES A MIXED-EFFECTS MODEL TO INCORPORATE CORRELATIONS AMONG CPG SITES. EXTENSIVE SIMULATIONS SHOW THAT BOTH APPROACHES HAVE EXCELLENT CONTROL OF TYPE I ERROR, AND BOTH HAVE REASONABLE STATISTICAL POWER. THE BINOMIAL SCAN STATISTIC APPROACH APPEARS TO HAVE HIGHER POWER, WHILE THE KERNEL DISTANCE METHOD IS COMPUTATIONALLY FASTER. THE PROPOSED METHODS ARE DEMONSTRATED USING DATA FROM A CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) STUDY. 2019