1 3635 122 INCREASED DNA METHYLATION, CELLULAR SENESCENCE AND PREMATURE EPIGENETIC AGING IN GUINEA PIGS AND HUMANS WITH TUBERCULOSIS. BACKGROUND: TUBERCULOSIS (TB) IS THE ARCHETYPICAL CHRONIC INFECTION, WITH PATIENTS HAVING MONTHS OF SYMPTOMS BEFORE DIAGNOSIS. IN THE TWO YEARS AFTER SUCCESSFUL THERAPY, SURVIVORS OF TB HAVE A THREE-FOLD INCREASED RISK OF DEATH. METHODS: GUINEA PIGS WERE INFECTED WITH MYCOBACTERIUM TUBERCULOSIS (MTB) FOR 45 DAYS, FOLLOWED BY RRBS DNA METHYLATION ANALYSIS. IN HUMANS, NETWORK ANALYSIS OF DIFFERENTIALLY EXPRESSED GENES ACROSS THREE TB COHORTS WERE VISUALIZED AT THE PATHWAY-LEVEL. SERUM LEVELS OF INFLAMMATION WERE MEASURED BY ELISA. HORVATH (DNA METHYLATION) AND RNA-SEQ BIOLOGICAL CLOCKS WERE USED TO INVESTIGATE SHIFTS IN CHRONOLOGICAL AGE AMONG HUMANS WITH TB. RESULTS: GUINEA PIGS WITH TB DEMONSTRATED DNA HYPERMETHYLATION AND SHOWED SYSTEM-LEVEL SIMILARITY TO HUMANS WITH TB (P-VALUE = 0.002). THE TRANSCRIPTOME IN TB IN MULTIPLE COHORTS WAS ENRICHED FOR DNA METHYLATION AND CELLULAR SENESCENCE. SENESCENCE ASSOCIATED PROTEINS CXCL9, CXCL10, AND TNF WERE ELEVATED IN TB PATIENTS COMPARED TO HEALTHY CONTROLS. HUMANS WITH TB DEMONSTRATE 12.7 YEARS (95% CI: 7.5, 21.9) AND 14.38 YEARS (95% CI: 10.23-18.53) OF CELLULAR AGING AS MEASURED BY EPIGENETIC AND GENE EXPRESSION BASED CELLULAR CLOCKS, RESPECTIVELY. CONCLUSIONS: IN BOTH GUINEA PIGS AND HUMANS, TB PERTURBS EPIGENETIC PROCESSES, PROMOTING PREMATURE CELLULAR AGING AND INFLAMMATION, A PLAUSIBLE MEANS TO EXPLAIN THE LONG-TERM DETRIMENTAL HEALTH OUTCOMES AFTER TB. 2022 2 5800 19 STEPWISE PATHOGENIC EVOLUTION OF MYCOBACTERIUM ABSCESSUS. ALTHOUGH ALMOST ALL MYCOBACTERIAL SPECIES ARE SAPROPHYTIC ENVIRONMENTAL ORGANISMS, A FEW, SUCH AS MYCOBACTERIUM TUBERCULOSIS, HAVE EVOLVED TO CAUSE TRANSMISSIBLE HUMAN INFECTION. BY ANALYZING THE RECENT EMERGENCE AND SPREAD OF THE ENVIRONMENTAL ORGANISM M. ABSCESSUS THROUGH THE GLOBAL CYSTIC FIBROSIS POPULATION, WE HAVE DEFINED KEY, GENERALIZABLE STEPS INVOLVED IN THE PATHOGENIC EVOLUTION OF MYCOBACTERIA. WE SHOW THAT EPIGENETIC MODIFIERS, ACQUIRED THROUGH HORIZONTAL GENE TRANSFER, CAUSE SALTATIONAL INCREASES IN THE PATHOGENIC POTENTIAL OF SPECIFIC ENVIRONMENTAL CLONES. ALLOPATRIC PARALLEL EVOLUTION DURING CHRONIC LUNG INFECTION THEN PROMOTES RAPID INCREASES IN VIRULENCE THROUGH MUTATIONS IN A DISCRETE GENE NETWORK; THESE MUTATIONS ENHANCE GROWTH WITHIN MACROPHAGES BUT IMPAIR FOMITE SURVIVAL. AS A CONSEQUENCE, WE OBSERVE CONSTRAINED PATHOGENIC EVOLUTION WHILE PERSON-TO-PERSON TRANSMISSION REMAINS INDIRECT, BUT POSTULATE ACCELERATED PATHOGENIC ADAPTATION ONCE DIRECT TRANSMISSION IS POSSIBLE, AS OBSERVED FOR M. TUBERCULOSIS OUR FINDINGS INDICATE HOW KEY INTERVENTIONS, SUCH AS EARLY TREATMENT AND CROSS-INFECTION CONTROL, MIGHT RESTRICT THE SPREAD OF EXISTING MYCOBACTERIAL PATHOGENS AND PREVENT NEW, EMERGENT ONES. 2021 3 4404 24 MODULATION OF THE RESPONSE TO MYCOBACTERIUM LEPRAE AND PATHOGENESIS OF LEPROSY. THE INITIAL INFECTION BY THE OBLIGATE INTRACELLULAR BACILLUS MYCOBACTERIUM LEPRAE EVOLVES TO LEPROSY IN A SMALL SUBSET OF THE INFECTED INDIVIDUALS. TRANSMISSION IS BELIEVED TO OCCUR MAINLY BY EXPOSURE TO BACILLI PRESENT IN AEROSOLS EXPELLED BY INFECTED INDIVIDUALS WITH HIGH BACILLARY LOAD. MYCOBACTERIUM LEPRAE-SPECIFIC DNA HAS BEEN DETECTED IN THE BLOOD OF ASYMPTOMATIC HOUSEHOLD CONTACTS OF LEPROSY PATIENTS YEARS BEFORE ACTIVE DISEASE ONSET, SUGGESTING THAT, FOLLOWING INFECTION, THE BACTERIUM REACHES THE LYMPHATIC DRAINAGE AND THE BLOOD OF AT LEAST SOME INDIVIDUALS. THE LOWER TEMPERATURE AND AVAILABILITY OF PROTECTED MICROENVIRONMENTS MAY PROVIDE THE INITIAL CONDITIONS FOR THE SURVIVAL OF THE BACILLUS IN THE AIRWAYS AND SKIN. A SUBSET OF SKIN-RESIDENT MACROPHAGES AND THE SCHWANN CELLS OF PERIPHERAL NERVES, TWO M. LEPRAE PERMISSIVE CELLS, MAY PROTECT M. LEPRAE FROM EFFECTOR CELLS IN THE INITIAL PHASE OF THE INFECTION. THE INTERACTION OF M. LEPRAE WITH THESE CELLS INDUCES METABOLIC CHANGES, INCLUDING THE FORMATION OF LIPID DROPLETS, THAT ARE ASSOCIATED WITH MACROPHAGE M2 PHENOTYPE AND THE PRODUCTION OF MEDIATORS THAT FACILITATE THE DIFFERENTIATION OF SPECIFIC T CELLS FOR M. LEPRAE-EXPRESSED ANTIGENS TO A MEMORY REGULATORY PHENOTYPE. HERE, WE DISCUSS THE POSSIBLE INITIALS STEPS OF M. LEPRAE INFECTION THAT MAY LEAD TO ACTIVE DISEASE ONSET, MAINLY FOCUSING ON EVENTS PRIOR TO THE MANIFESTATION OF THE ESTABLISHED CLINICAL FORMS OF LEPROSY. WE HYPOTHESIZE THAT THE PROGRESSIVE DIFFERENTIATION OF T CELLS TO THE TREGS PHENOTYPE INHIBITS EFFECTOR FUNCTION AGAINST THE BACILLUS, ALLOWING AN INCREASE IN THE BACILLARY LOAD AND EVOLUTION OF THE INFECTION TO ACTIVE DISEASE. EPIGENETIC AND METABOLIC MECHANISMS DESCRIBED IN OTHER CHRONIC INFLAMMATORY DISEASES ARE EVALUATED FOR POTENTIAL APPLICATION TO THE UNDERSTANDING OF LEPROSY PATHOGENESIS. A POTENTIAL ROLE FOR POST-EXPOSURE PROPHYLAXIS OF LEPROSY IN REDUCING M. LEPRAE-INDUCED ANTI-INFLAMMATORY MEDIATORS AND, IN CONSEQUENCE, TREG/T EFFECTOR RATIOS IS PROPOSED. 2022 4 5350 23 RATIONAL DEVELOPMENT OF ADJUNCT IMMUNE-BASED THERAPIES FOR DRUG-RESISTANT TUBERCULOSIS: HYPOTHESES AND EXPERIMENTAL DESIGNS. THE POOR TREATMENT OUTCOMES FOR EXTENSIVELY DRUG-RESISTANT AND MULTIDRUG-RESISTANT TUBERCULOSIS AND THE SLOW PROGRESS IN DEVELOPMENT AND EVALUATION OF NEW TUBERCULOSIS DRUGS GAVE RISE TO DEVELOPMENT OF SEVERAL POTENTIAL IMMUNE-BASED THERAPIES FOR ADJUNCT USE WITH DRUG TREATMENT. HOWEVER, NONE OF THESE THERAPIES HAVE BEEN SHOWN TO BE OF BENEFIT IN CONTROLLED CLINICAL TRIALS IN HUMANS. THERE IS AN URGENT NEED TO RETHINK THE IMMUNOLOGY OF MYCOBACTERIUM TUBERCULOSIS INFECTION AND TO ASCERTAIN PROTECTIVE IMMUNE MECHANISMS THAT COULD BE EXPLOITED TO DEVELOP MORE EFFECTIVE ADJUNCT IMMUNE THERAPIES. T CELLS OBTAINED FROM THE PERIPHERAL BLOOD CIRCULATION MAY NOT REFLECT THE BIOLOGICALLY RELEVANT RECOGNITION OF ANTI-M. TUBERCULOSIS T-CELL RESPONSES IN SITU. THUS, T CELLS THAT MEDIATE PROTECTIVE ANTI-M. TUBERCULOSIS IMMUNE RESPONSES RECOGNIZE AN AS-YET UNDISCOVERED SET OF M. TUBERCULOSIS ANTIGENS THAT REQUIRE DEFINITION. THE BIOLOGICALLY AND CLINICALLY RELEVANT M. TUBERCULOSIS TARGETS THAT ELICIT PROTECTIVE IMMUNE RESPONSES MAY HAVE YET TO BE DISCOVERED. THE ENTIRE M. TUBERCULOSIS PROTEOME IS NOW ACCESSIBLE FOR SCREENING BY ANTIBODY RECOGNITION AND CAN THEREFORE BE USED TO IDENTIFY SPECIFIC T-CELL M. TUBERCULOSIS TARGET ANTIGENS. INHIBITORY CYTOKINES AND LYMPHOCYTOSIS PRESENT IN CHRONIC TUBERCULOSIS INFLAMMATION MAY BE DELETERIOUS IN MOUNTING AN EFFECTIVE M. TUBERCULOSIS T-CELL RESPONSE. CONSEQUENTLY, ABERRANT AND NONEFFECTIVE IMMUNE RESPONSES COULD BE REFOCUSED WITH ANTICYTOKINE OR CELLULAR THERAPY. EPIGENETIC CHANGES DUE TO CHRONIC INFLAMMATION MAY BE RESPONSIBLE, IN PART, FOR IMPAIRED IMMUNE RESPONSES IN TUBERCULOSIS AND THESE CHANGES COULD BE REVERSED. WE PRESENT FEASIBLE EXPERIMENTAL DESIGNS TO TEST THESE HYPOTHESES; THE RESULTS OF WHICH MAY GUIDE AND REFOCUS DEVELOPMENT OF NOVEL IMMUNE-BASED THERAPIES FOR ADJUNCT TREATMENT OF DRUG-RESISTANT TUBERCULOSIS. INSIGHTS FROM CANCER IMMUNOLOGY WILL CROSS-FERTILIZE TUBERCULOSIS IMMUNOLOGY AND HELP TO DEVISE MORE EFFECTIVE ADJUNCT TREATMENT AND VACCINATION STRATEGIES. 2012 5 3904 23 LEPROSY PIRNOME: EXPLORING NEW POSSIBILITIES FOR AN OLD DISEASE. LEPROSY, WHICH IS CAUSED BY THE HUMAN PATHOGEN MYCOBACTERIUM LEPRAE, CAUSES NERVE DAMAGE, DEFORMITY AND DISABILITY IN OVER 200,000 PEOPLE EVERY YEAR. BECAUSE OF THE LONG DOUBLING TIME OF M. LEPRAE (13 DAYS) AND THE DELAYED ONSET OF DETECTABLE SYMPTOMS, WHICH IS ESTIMATED TO BE APPROXIMATELY 3-7 YEARS AFTER INFECTION, THERE IS ALWAYS A LARGE PERCENTAGE OF SUBCLINICALLY INFECTED INDIVIDUALS IN THE POPULATION WHO WILL EVENTUALLY DEVELOP THE DISEASE, MAINLY IN ENDEMIC COUNTRIES. PIRNAS COMPRISE THE LARGEST GROUP OF SMALL NONCODING RNAS FOUND IN HUMANS, AND THEY ARE DISTINCT FROM MICRORNAS (MIRNAS) AND SMALL INTERFERING RNAS (SIRNAS). PIRNAS FUNCTION IN TRANSPOSON SILENCING, EPIGENETIC REGULATION, AND GERMLINE DEVELOPMENT. THE FUNCTIONAL ROLE OF PIRNAS AND THEIR ASSOCIATED PIWI PROTEINS HAVE STARTED TO EMERGE IN THE DEVELOPMENT OF HUMAN CANCERS AND VIRAL INFECTIONS, BUT THEIR RELEVANCE TO BACTERIAL DISEASES HAS NOT BEEN INVESTIGATED. THE PRESENT STUDY REPORTS THE PIRNOME OF HUMAN SKIN, REVEALING THAT ALL BUT ONE OF THE PIRNAS EXAMINED ARE DOWNREGULATED IN LEPROSY SKIN LESIONS. CONSIDERING THAT ONE OF THE BEST CHARACTERIZED FUNCTIONS OF PIRNAS IN HUMANS IS POSTTRANSCRIPTIONAL MRNA SILENCING, THEIR FUNCTIONS ARE SIMILAR TO WHAT WE HAVE DESCRIBED FOR MIRNAS, INCLUDING ACTING ON APOPTOSIS, M. LEPRAE RECOGNITION AND ENGULFMENT, SCHWANN CELL (SC) DEMYELINATION, EPITHELIAL-MESENCHYMAL TRANSITION (EMT), LOSS OF SENSATION AND NEUROPATHIC PAIN. IN ADDITION TO NEW FINDINGS ON LEPROSY PHYSIOPATHOLOGY, THE DISCOVERY OF RELEVANT PIRNAS INVOLVED IN DISEASE PROCESSES IN HUMAN SKIN MAY PROVIDE NEW CLUES FOR THERAPEUTIC TARGETS, SPECIFICALLY TO CONTROL NERVE DAMAGE, A PROMINENT FEATURE OF LEPROSY THAT HAS NO CURRENTLY AVAILABLE PHARMACEUTICAL TREATMENT. 2020 6 1308 23 DEFINING A RESEARCH AGENDA TO ADDRESS THE CONVERGING EPIDEMICS OF TUBERCULOSIS AND DIABETES: PART 2: UNDERLYING BIOLOGIC MECHANISMS. THERE IS GROWING INTEREST IN THE RE-EMERGING INTERACTION BETWEEN TYPE 2 DIABETES (DM) AND TB, BUT THE UNDERLYING BIOLOGIC MECHANISMS ARE POORLY UNDERSTOOD DESPITE THEIR POSSIBLE IMPLICATIONS IN CLINICAL MANAGEMENT. EXPERTS IN EPIDEMIOLOGIC, PUBLIC HEALTH, BASIC SCIENCE, AND CLINICAL STUDIES RECENTLY CONVENED AND IDENTIFIED RESEARCH PRIORITIES FOR ELUCIDATING THE UNDERLYING MECHANISMS FOR THE CO-OCCURRENCE OF TB AND DM. WE IDENTIFIED GAPS IN CURRENT KNOWLEDGE OF ALTERED IMMUNITY IN PATIENTS WITH DM DURING TB, WHERE MOST STUDIES SUGGEST AN UNDERPERFORMING INNATE IMMUNITY, BUT EXAGGERATED ADAPTIVE IMMUNITY TO MYCOBACTERIUM TUBERCULOSIS. VARIOUS MOLECULAR MECHANISMS AND PATHWAYS MAY UNDERLIE THESE OBSERVATIONS IN THE DM HOST. THESE INCLUDE SIGNALING INDUCED BY EXCESS ADVANCED GLYCATION END PRODUCTS AND THEIR RECEPTOR, HIGHER LEVELS OF REACTIVE OXIDATIVE SPECIES AND OXIDATIVE STRESS, EPIGENETIC CHANGES DUE TO CHRONIC HYPERGLYCEMIA, ALTERED NUCLEAR RECEPTORS, AND/OR DIFFERENCES IN CELL METABOLISM (IMMUNOMETABOLISM). STUDIES IN HUMANS AT DIFFERENT STAGES OF DM (NO DM, PRE-DM, AND DM) OR TB (LATENT OR ACTIVE TB) SHOULD BE COMPLEMENTED WITH FINDINGS IN ANIMAL MODELS, WHICH PROVIDE THE UNIQUE OPPORTUNITY TO STUDY EARLY EVENTS IN THE HOST-PATHOGEN INTERACTION. SUCH STUDIES COULD ALSO HELP IDENTIFY BIOMARKERS THAT WILL COMPLEMENT CLINICAL STUDIES IN ORDER TO TAILOR THE PREVENTION OF TB-DM, OR TO AVOID THE ADVERSE TB TREATMENT OUTCOMES THAT ARE MORE LIKELY IN THESE PATIENTS. SUCH STUDIES WILL ALSO INFORM NEW APPROACHES TO HOST-DIRECTED THERAPIES. 2017 7 1053 25 CLINICAL IMPLICATIONS OF INTERFERON-GAMMA GENETIC AND EPIGENETIC VARIANTS. INTERFERON-GAMMA (IFN-GAMMA) IS AN INTEGRAL AND CRITICAL MOLECULE OF THE IMMUNE SYSTEM, WITH MULTIPLE FUNCTIONS, MOSTLY RELATED TO THE T HELPER TYPE 1 (TH1) RESPONSE TO INFECTION. IT IS CRITICAL FOR DEFENCE AGAINST MYCOBACTERIAL INFECTION AND IS OF INCREASING INTEREST IN DEFENCE AGAINST FUNGI. IN THIS ARTICLE, WE REVIEW THE GENETIC AND EPIGENETIC VARIANTS AFFECTING IFN-GAMMA EXPRESSION AND INVESTIGATE ITS ROLE IN DISEASE, WITH AN EMPHASIS ON FUNGAL DISEASES SUCH AS INVASIVE AND CHRONIC PULMONARY ASPERGILLOSIS. OVER 347 IFN-GAMMA GENE VARIANTS HAVE BEEN DESCRIBED, IN MULTIPLE ETHNIC POPULATIONS. MANY APPEAR TO CONFER A SUSCEPTIBILITY TO DISEASE, ESPECIALLY TUBERCULOSIS (TB) AND HEPATITIS, BUT ALSO SOME NON-INFECTIOUS CONDITIONS SUCH AS APLASTIC ANAEMIA, CERVICAL CANCER AND PSORIASIS. SEVERAL EPIGENETIC MODIFICATIONS ARE ALSO DESCRIBED, INCREASING IFN-GAMMA EXPRESSION IN TH1 LYMPHOCYTES AND REDUCING IFN-GAMMA EXPRESSION IN TH2 LYMPHOCYTES. RECOMBINANT IFN-GAMMA ADMINISTRATION IS LICENSED FOR THE PROPHYLAXIS OF INFECTION (BACTERIAL AND FUNGAL) IN PATIENTS WITH THE PHAGOCYTE FUNCTIONAL DEFICIENCY SYNDROME CHRONIC GRANULOMATOUS DISEASE, ALTHOUGH THE BENEFITS APPEAR LIMITED. INTERFERON-GAMMA THERAPY IS GIVEN TO PATIENTS WITH PROFOUND DEFECTS IN IFN-GAMMA AND INTERLEUKIN-12 PRODUCTION AND APPEARS TO BE BENEFICIAL FOR PATIENTS WITH INVASIVE ASPERGILLOSIS AND CRYPTOCOCCAL MENINGITIS, BUT THE STUDIES ARE NOT DEFINITIVE. A HIGH PROPORTION OF PATIENTS WITH CHRONIC PULMONARY ASPERGILLOSIS ARE POOR PRODUCERS OF IFN-GAMMA IN RESPONSE TO MULTIPLE STIMULI AND COULD ALSO BENEFIT FROM IFN-GAMMA ADMINISTRATION. THE INVESTIGATION AND MANAGEMENT OF PATIENTS WITH POSSIBLE OR DEMONSTRATED IFN-GAMMA DEFICIENCY IN ADULTHOOD IS POORLY STUDIED AND COULD BE GREATLY ENHANCED WITH THE INTEGRATION OF GENETIC DATA. 2014 8 923 22 CHRONIC INFECTION DRIVES DNMT3A-LOSS-OF-FUNCTION CLONAL HEMATOPOIESIS VIA IFNGAMMA SIGNALING. AGE-RELATED CLONAL HEMATOPOIESIS (CH) IS A RISK FACTOR FOR MALIGNANCY, CARDIOVASCULAR DISEASE, AND ALL-CAUSE MORTALITY. SOMATIC MUTATIONS IN DNMT3A ARE DRIVERS OF CH, BUT DECADES MAY ELAPSE BETWEEN THE ACQUISITION OF A MUTATION AND CH, SUGGESTING THAT ENVIRONMENTAL FACTORS CONTRIBUTE TO CLONAL EXPANSION. WE TESTED WHETHER INFECTION PROVIDES SELECTIVE PRESSURE FAVORING THE EXPANSION OF DNMT3A MUTANT HEMATOPOIETIC STEM CELLS (HSCS) IN MOUSE CHIMERAS. WE CREATED DNMT3A-MOSAIC MICE BY TRANSPLANTING DNMT3A(-/-) AND WT HSCS INTO WT MICE AND OBSERVED THE SUBSTANTIAL EXPANSION OF DNMT3A(-/-) HSCS DURING CHRONIC MYCOBACTERIAL INFECTION. INJECTION OF RECOMBINANT IFNGAMMA ALONE WAS SUFFICIENT TO PHENOCOPY CH BY DNMT3A(-/-) HSCS UPON INFECTION. TRANSCRIPTIONAL AND EPIGENETIC PROFILING AND FUNCTIONAL STUDIES INDICATE REDUCED DIFFERENTIATION ASSOCIATED WITH WIDESPREAD METHYLATION ALTERATIONS, AND REDUCED SECONDARY STRESS-INDUCED APOPTOSIS ACCOUNTS FOR DNMT3A(-/-) CLONAL EXPANSION DURING INFECTION. DNMT3A MUTANT HUMAN HSCS SIMILARLY EXHIBIT DEFECTIVE IFNGAMMA-INDUCED DIFFERENTIATION. WE THUS DEMONSTRATE THAT IFNGAMMA SIGNALING INDUCED DURING CHRONIC INFECTION CAN DRIVE DNMT3A-LOSS-OF-FUNCTION CH. 2021 9 1114 21 COMMONALITIES AND DISPARITIES BETWEEN ENDOMETRIOSIS AND CHRONIC ENDOMETRITIS: THERAPEUTIC POTENTIAL OF NOVEL ANTIBIOTIC TREATMENT STRATEGY AGAINST ECTOPIC ENDOMETRIUM. CHRONIC ENDOMETRITIS (CE) IS A LOCAL MUCOSAL INFLAMMATORY DISORDER OF THE UTERINE LINING, WHICH IS HISTOPATHOLOGICALLY RECOGNIZED AS THE UNUSUAL INFILTRATION OF CD138(+) PLASMACYTES INTO THE ENDOMETRIAL STROMAL COMPARTMENT. ACCUMULATING BODY OF RESEARCH DOCUMENTED THAT CE IS ASSOCIATED WITH FEMALE INFERTILITY AND SEVERAL OBSTETRIC/NEONATAL COMPLICATIONS. THE MAJOR CAUSE OF CE IS THOUGHT TO BE INTRAUTERINE INFECTION REPRESENTED BY COMMON BACTERIA (ESCHERICHIA COLI, ENTEROCOCCUS FAECALIS, STREPTOCOCCUS, AND STAPHYLOCOCCUS), MYCOPLASMA/UREAPLASMA, AND MYCOBACTERIUM. ADDITIONALLY, LOCAL DYSBIOSIS IN THE FEMALE REPRODUCTIVE TRACT MAY BE INVOLVED IN THE ONSET AND DEVELOPMENT OF CE. ANTIBIOTIC TREATMENTS AGAINST THESE MICROORGANISMS ARE EFFECTIVE IN THE ELIMINATION OF ENDOMETRIAL STROMAL PLASMACYTES IN THE AFFECTED PATIENTS. MEANWHILE, ENDOMETRIOSIS IS A COMMON FEMALE REPRODUCTIVE TRACT DISEASE CHARACTERIZED BY ENDOMETRIOTIC TISSUES (ECTOPIC ENDOMETRIUM) GROWING OUTSIDE THE UTERUS AND POTENTIALLY CAUSES CHRONIC PELVIC SYMPTOMS (DYSMENORRHEA, DYSPAREUNIA, DYSCHEZIA, AND DYSURIA), INFERTILITY, AND OVARIAN CANCERS. ENDOMETRIOSIS INVOLVES ENDOCRINOLOGICAL, GENETIC, AND EPIGENETIC FACTORS IN ITS ETIOLOGY AND PATHOGENESIS. RECENT STUDIES FOCUS ON IMMUNOLOGICAL, INFLAMMATORY, AND INFECTIOUS ASPECTS OF ENDOMETRIOSIS AND DEMONSTRATE SEVERAL COMMON CHARACTERISTICS BETWEEN ENDOMETRIOSIS AND CE. THIS REVIEW AIMED TO BETTER UNDERSTAND THE IMMUNOLOGICAL AND MICROBIAL BACKGROUNDS UNDERLYING ENDOMETRIOSIS AND CE AND LOOK INTO THE THERAPEUTIC POTENTIAL OF THE NOVEL ANTIBIOTIC TREATMENT STRATEGY AGAINST ENDOMETRIOSIS IN LIGHT OF ENDOMETRIAL INFECTIOUS DISEASE. 2023 10 858 27 CHROMATIN DECONDENSATION AND T CELL HYPERRESPONSIVENESS IN DIABETES-ASSOCIATED HYPERGLYCEMIA. DIABETES IS LINKED TO INCREASED INFLAMMATION AND SUSCEPTIBILITY TO CERTAIN INFECTIOUS DISEASES INCLUDING TUBERCULOSIS (TB). WE PREVIOUSLY REPORTED THAT AEROSOL TB IN MICE WITH CHRONIC (>/= 12 WK) HYPERGLYCEMIA FEATURES INCREASED BACTERIAL LOAD, OVERPRODUCTION OF SEVERAL CYTOKINES, AND INCREASED IMMUNE PATHOLOGY COMPARED WITH NORMOGLYCEMIC CONTROLS. A SIMILAR PHENOTYPE EXISTS IN HUMAN PATIENTS WITH DIABETES WITH TB. THE MECHANISMS OF INCREASED T CELL ACTIVATION IN DIABETES ARE UNKNOWN. IN THE CURRENT STUDY, WE TESTED THE HYPOTHESIS THAT HYPERGLYCEMIA MODIFIES THE INTRINSIC RESPONSIVENESS OF NAIVE T CELLS TO TCR STIMULATION. PURIFIED T CELLS FROM CHRONICALLY HYPERGLYCEMIC (HG) MICE PRODUCED HIGHER LEVELS OF TH1, TH2, AND TH17 CYTOKINES AND PROLIFERATED MORE THAN T CELLS FROM NORMOGLYCEMIC CONTROLS AFTER ANTI-CD3E OR AG STIMULATION. IN THIS WAY, NAIVE T CELLS FROM HG MICE RESEMBLED AG-EXPERIENCED CELLS, ALTHOUGH CD44 EXPRESSION WAS NOT INCREASED. CHROMATIN DECONDENSATION, ANOTHER CHARACTERISTIC OF AG-EXPERIENCED T CELLS, WAS INCREASED IN NAIVE T CELLS FROM HG MICE. THAT PHENOTYPE DEPENDED ON EXPRESSION OF THE RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS AND COULD BE REVERSED BY INHIBITING P38 MAPK. CHROMATIN DECONDENSATION AND HYPERRESPONSIVENESS TO TCR STIMULATION PERSISTED FOLLOWING TRANSFER OF T CELLS FROM HG MICE INTO NORMOGLYCEMIC MICE. WE PROPOSE THAT CHRONIC HYPERGLYCEMIA CAUSES RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS-MEDIATED EPIGENETIC MODIFICATION OF NAIVE T CELLS LEADING TO P38 MAPK-DEPENDENT CHROMATIN DECONDENSATION. THIS PREACTIVATION STATE FACILITATES TRANSCRIPTION FACTOR ACCESS TO DNA, INCREASING CYTOKINE PRODUCTION AND PROLIFERATION FOLLOWING TCR STIMULATION. THIS MECHANISM MAY CONTRIBUTE TO PATHOLOGICAL INFLAMMATION ASSOCIATED WITH DIABETES AND MIGHT OFFER A NOVEL THERAPEUTIC TARGET. 2014 11 2563 19 EPIGENETICS IN TUBERCULOSIS: IMMUNOMODULATION OF HOST IMMUNE RESPONSE. TUBERCULOSIS IS A STERN, DIFFICULT TO TREAT CHRONIC INFECTION CAUSED BY ACID-FAST BACILLI THAT TEND TO TAKE A LONG TIME TO BE ERADICATED FROM THE HOST'S ENVIRONMENT. IT REQUIRES THE ACTION OF BOTH INNATE AND ADAPTIVE IMMUNE SYSTEMS BY THE HOST. THERE ARE VARIOUS PATTERN RECOGNITION RECEPTORS PRESENT ON IMMUNE CELLS, WHICH RECOGNIZE FOREIGN PATHOGENS OR ITS PRODUCT AND TRIGGER THE IMMUNE RESPONSE. THE EPIGENETIC MODIFICATION PLAYS A CRUCIAL ROLE IN TRIGGERING THE SUSCEPTIBILITY OF THE HOST TOWARDS THE PATHOGEN AND ACTIVATING THE HOST'S IMMUNE SYSTEM AGAINST THE INVADING PATHOGEN. IT ALTERS THE GENE EXPRESSION MODIFYING THE GENETIC MATERIAL OF THE HOST'S CELL. EPIGENETIC MODIFICATION SUCH AS HISTONE ACETYLATION, ALTERATION IN NON-CODING RNA, DNA METHYLATION AND ALTERATION IN MIRNA HAS BEEN STUDIED FOR THEIR INFLUENCE ON THE PATHOPHYSIOLOGY OF TUBERCULOSIS TO CONTROL THE SPREAD OF INFECTION. DESPITE SEVERAL STUDIES BEING CONDUCTED, MANY GAPS STILL EXIST. HEREIN, WE DISCUSS THE IMMUNOPATHOPHYSIOLOGICAL MECHANISM OF TUBERCULOSIS, THE ESSENTIALS OF EPIGENETICS AND THE RECENT ENCROACHMENT OF EPIGENETICS IN THE FIELD OF TUBERCULOSIS AND ITS INFLUENCE ON THE OUTCOME AND PATHOPHYSIOLOGY OF THE INFECTION. 2022 12 5489 25 REVERSING POST-INFECTIOUS EPIGENETIC-MEDIATED IMMUNE SUPPRESSION. THE IMMUNE RESPONSE MUST BALANCE THE PRO-INFLAMMATORY, CELL-MEDIATED CYTOTOXICITY WITH THE ANTI-INFLAMMATORY AND WOUND REPAIR RESPONSE. EPIGENETIC MECHANISMS MEDIATE THIS BALANCE AND LIMIT HOST IMMUNITY FROM INDUCING EXUBERANT COLLATERAL DAMAGE TO HOST TISSUE AFTER SEVERE AND CHRONIC INFECTIONS. HOWEVER, FOLLOWING TREATMENT FOR THESE INFECTIONS, INCLUDING SEPSIS, PNEUMONIA, HEPATITIS B, HEPATITIS C, HIV, TUBERCULOSIS (TB) OR SCHISTOSOMIASIS, DETRIMENTAL EPIGENETIC SCARS PERSIST, AND RESULT IN LONG-LASTING IMMUNE SUPPRESSION. THIS IS HYPOTHESIZED TO BE ONE OF THE CONTRIBUTING MECHANISMS EXPLAINING WHY SURVIVORS OF INFECTION HAVE INCREASED ALL-CAUSE MORTALITY AND INCREASED RATES OF UNRELATED SECONDARY INFECTIONS. THE MECHANISMS THAT INDUCE EPIGENETIC-MEDIATED IMMUNE SUPPRESSION HAVE BEEN DEMONSTRATED IN-VITRO AND IN ANIMAL MODELS. MODULATION OF THE AMP-ACTIVATED PROTEIN KINASE (AMPK)-MAMMALIAN TARGET OF RAPAMYCIN (MTOR), NUCLEAR FACTOR OF ACTIVATED T CELLS (NFAT) OR NUCLEAR RECEPTOR (NR4A) PATHWAYS IS ABLE TO BLOCK OR REVERSE THE DEVELOPMENT OF DETRIMENTAL EPIGENETIC SCARS. SIMILARLY, DRUGS THAT DIRECTLY MODIFY EPIGENETIC ENZYMES, SUCH AS THOSE THAT INHIBIT HISTONE DEACETYLASES (HDAC) INHIBITORS, DNA HYPOMETHYLATING AGENTS OR MODIFIERS OF THE NUCLEOSOME REMODELING AND DNA METHYLATION (NURD) COMPLEX OR POLYCOMB REPRESSIVE COMPLEX (PRC) HAVE DEMONSTRATED CAPACITY TO RESTORE HOST IMMUNITY IN THE SETTING OF CANCER-, LCMV- OR MURINE SEPSIS-INDUCED EPIGENETIC-MEDIATED IMMUNE SUPPRESSION. A THIRD CLINICALLY FEASIBLE STRATEGY FOR REVERSING DETRIMENTAL EPIGENETIC SCARS INCLUDES BIOENGINEERING APPROACHES TO EITHER DIRECTLY REVERSE THE DETRIMENTAL EPIGENETIC MARKS OR TO MODIFY THE EPIGENETIC ENZYMES OR TRANSCRIPTION FACTORS THAT INDUCE DETRIMENTAL EPIGENETIC SCARS. EACH OF THESE APPROACHES, ALONE OR IN COMBINATION, HAVE ABLATED OR REVERSED DETRIMENTAL EPIGENETIC MARKS IN IN-VITRO OR IN ANIMAL MODELS; TRANSLATIONAL STUDIES ARE NOW REQUIRED TO EVALUATE CLINICAL APPLICABILITY. 2021 13 5539 18 ROLE OF CYSTIC FIBROSIS BRONCHIAL EPITHELIUM IN NEUTROPHIL CHEMOTAXIS. A HALLMARK OF CYSTIC FIBROSIS (CF) CHRONIC RESPIRATORY DISEASE IS AN EXTENSIVE NEUTROPHIL INFILTRATE IN THE MUCOSA FILLING THE BRONCHIAL LUMEN, STARTING EARLY IN LIFE FOR CF INFANTS. THE GENETIC DEFECT OF THE CF TRANSMEMBRANE CONDUCTANCE REGULATOR (CFTR) ION CHANNEL PROMOTES DEHYDRATION OF THE AIRWAY SURFACE LIQUID, ALTERS MUCUS PROPERTIES, AND DECREASES MUCOCILIARY CLEARANCE, FAVORING THE ONSET OF RECURRENT AND, ULTIMATELY, CHRONIC BACTERIAL INFECTION. NEUTROPHIL INFILTRATES ARE UNABLE TO CLEAR BACTERIAL INFECTION AND, AS AN ADVERSE EFFECT, CONTRIBUTE TO MUCOSAL TISSUE DAMAGE BY RELEASING PROTEASES AND REACTIVE OXYGEN SPECIES. MOREOVER, THE RAPID CELLULAR TURNOVER OF LUMENAL NEUTROPHILS RELEASES NUCLEIC ACIDS THAT FURTHER ALTER THE MUCUS VISCOSITY. A PROMINENT ROLE IN THE RECRUITMENT OF NEUTROPHIL IN BRONCHIAL MUCOSA IS PLAYED BY CF BRONCHIAL EPITHELIAL CELLS CARRYING THE DEFECTIVE CFTR PROTEIN AND ARE EXPOSED TO WHOLE BACTERIA AND BACTERIAL PRODUCTS, MAKING PHARMACOLOGICAL APPROACHES TO REGULATE THE EXAGGERATED NEUTROPHIL CHEMOTAXIS IN CF A RELEVANT THERAPEUTIC TARGET. HERE WE REVISE: (A) THE MAJOR RECEPTORS, KINASES, AND TRANSCRIPTION FACTORS LEADING TO THE EXPRESSION, AND RELEASE OF NEUTROPHIL CHEMOKINES IN BRONCHIAL EPITHELIAL CELLS; (B) THE ROLE OF INTRACELLULAR CALCIUM HOMEOSTASIS AND, IN PARTICULAR, THE CALCIUM CROSSTALK BETWEEN ENDOPLASMIC RETICULUM AND MITOCHONDRIA; (C) THE EPIGENETIC REGULATION OF THE KEY CHEMOKINES; (D) THE ROLE OF MUTANT CFTR PROTEIN AS A CO-REGULATOR OF CHEMOKINES TOGETHER WITH THE HOST-PATHOGEN INTERACTIONS; AND (E) DIFFERENT PHARMACOLOGICAL STRATEGIES TO REGULATE THE EXPRESSION OF CHEMOKINES IN CF BRONCHIAL EPITHELIAL CELLS THROUGH NOVEL DRUG DISCOVERY AND DRUG REPURPOSING. 2020 14 6502 17 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 9 22 'TRAINED IMMUNITY': CONSEQUENCES FOR LYMPHOID MALIGNANCIES. IN HEMATOLOGICAL MALIGNANCIES COMPLEX INTERACTIONS EXIST BETWEEN THE IMMUNE SYSTEM, MICROORGANISMS AND MALIGNANT CELLS. ON ONE HAND, MICROORGANISMS CAN INDUCE CANCER, AS ILLUSTRATED BY SPECIFIC INFECTION-INDUCED LYMPHOPROLIFERATIVE DISEASES SUCH AS HELICOBACTER PYLORI-ASSOCIATED GASTRIC MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMA. ON THE OTHER HAND, MALIGNANT CELLS CREATE AN IMMUNOSUPPRESSIVE ENVIRONMENT FOR THEIR OWN BENEFIT, BUT THIS ALSO RESULTS IN AN INCREASED RISK OF INFECTIONS. DISRUPTED INNATE IMMUNITY CONTRIBUTES TO THE NEOPLASTIC TRANSFORMATION OF BLOOD CELLS BY SEVERAL MECHANISMS, INCLUDING THE UNCONTROLLED CLEARANCE OF MICROBIAL AND AUTOANTIGENS RESULTING IN CHRONIC IMMUNE STIMULATION AND PROLIFERATION, CHRONIC INFLAMMATION, AND DEFECTIVE IMMUNE SURVEILLANCE AND ANTI-CANCER IMMUNITY. RESTORING DYSFUNCTION OR ENHANCING RESPONSIVENESS OF THE INNATE IMMUNE SYSTEM MIGHT THEREFORE REPRESENT A NEW ANGLE FOR THE PREVENTION AND TREATMENT OF HEMATOLOGICAL MALIGNANCIES, IN PARTICULAR LYMPHOID MALIGNANCIES AND ASSOCIATED INFECTIONS. RECENTLY, IT HAS BEEN SHOWN THAT CELLS OF THE INNATE IMMUNE SYSTEM, SUCH AS MONOCYTES/MACROPHAGES AND NATURAL KILLER CELLS, HARBOR FEATURES OF IMMUNOLOGICAL MEMORY AND DISPLAY ENHANCED FUNCTIONALITY LONG-TERM AFTER STIMULATION WITH CERTAIN MICROORGANISMS AND VACCINES. THESE FUNCTIONAL CHANGES RELY ON EPIGENETIC REPROGRAMMING AND HAVE BEEN TERMED 'TRAINED IMMUNITY'. IN THIS REVIEW THE CONCEPT OF 'TRAINED IMMUNITY' IS DISCUSSED IN THE SETTING OF LYMPHOID MALIGNANCIES. AMELIORATION OF INFECTIOUS COMPLICATIONS AND HEMATOLOGICAL DISEASE PROGRESSION CAN BE ENVISIONED TO RESULT FROM THE INDUCTION OF TRAINED IMMUNITY, BUT FUTURE STUDIES ARE REQUIRED TO PROVE THIS EXCITING NEW HYPOTHESIS. 2016 16 6214 16 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 17 1031 23 CIRCULATING TUMOR DNA DETECTION AND ITS APPLICATION STATUS IN GASTRIC CANCER: A NARRATIVE REVIEW. CIRCULATING TUMOR DNA (CTDNA) IS THE SMALL GENOMIC FRAGMENT RELEASED BY TUMOR CELLS INTO THE CIRCULATING SYSTEM, WHICH CARRIES THE GENE VARIATION FEATURES, SUCH AS MUTATION, INSERTION, DELETION, REARRANGEMENT, COPY NUMBER VARIATION (CNV) AND METHYLATION, RENDERING IT AN IMPORTANT BIOMARKER. IT CAN BE USED NOT ONLY TO DIAGNOSE CERTAIN TYPES OF SOLID TUMORS, BUT ALSO TO MONITOR THE THERAPEUTIC RESPONSE AND EXPLORE THE MINIMAL RESIDUAL DISEASE (MRD) AND RESISTANT MUTATION OF TARGETED THERAPY. THEREFORE, CTDNA DETECTION MAY BECOME THE PREFERRED NON-INVASIVE TUMOR SCREENING METHOD. FOR PATIENTS WHO CANNOT RECEIVE FURTHER GENE DETECTION DUE TO INSUFFICIENT OR RESTRICTED SAMPLE COLLECTION WITH THE DEFINED PATHOLOGICAL DIAGNOSIS, CTDNA DETECTION CAN BE CARRIED OUT TO DETERMINE THE GENE MUTATION TYPE, WITH NO NEED FOR REPEATED SAMPLING. GASTRIC CANCER (GC) IS A MALIGNANCY WITH EXTREMELY HIGH MORBIDITY AND MORTALITY, AND ITS GENESIS AND DEVELOPMENT ARE THE CONSEQUENCE OF INTERACTIONS OF MULTIPLE FACTORS, INCLUDING ENVIRONMENT, DIET, HEREDITY, HELICOBACTER PYLORI INFECTION, CHRONIC INFLAMMATORY INFILTRATION, AND PRECANCEROUS LESION. AS THE RESEARCH ON GC MOVES FORWARD, THE EXISTING RESEARCH MAINLY FOCUSES ON GENETIC AND EPIGENETIC CHANGES, INCLUDING DNA METHYLATION, HISTONE MODIFICATION, NON-CODING RNA CHANGES, GENE MUTATION, GENE HETEROZYGOSITY LOSS AND MICROSATELLITE INSTABILITY. THIS PAPER AIMED TO SUMMARIZE THE CONTENTS OF CTDNA DETECTION, ITS APPLICATION STATUS IN GC AND CLINICAL SIGNIFICANCE. 2021 18 6494 15 TRAINED IMMUNITY AS A NOVEL THERAPEUTIC STRATEGY. RECENT STUDIES HAVE SHOWN THAT UPON CERTAIN VACCINATIONS OR INFECTIONS HUMAN INNATE IMMUNE CELLS CAN UNDERGO EXTENSIVE METABOLIC AND EPIGENETIC REPROGRAMMING, WHICH RESULTS IN ENHANCED IMMUNE RESPONSES UPON HETEROLOGOUS RE-INFECTION, A PROCESS TERMED TRAINED IMMUNITY. TRAINED IMMUNITY HAS ALSO BEEN SHOWN TO BE INAPPROPRIATELY ACTIVATED IN INFLAMMATORY DISEASES. THIS PROVIDES THE POTENTIAL FOR IDENTIFYING NOVEL THERAPEUTIC TARGETS: POTENTIATION OF TRAINED IMMUNITY COULD PROTECT FROM SECONDARY INFECTIONS AND REVERSE IMMUNOTOLERANT STATES, WHILE INHIBITION OF TRAINED IMMUNITY MIGHT REDUCE EXCESSIVE IMMUNE ACTIVATION IN CHRONIC INFLAMMATORY CONDITIONS. BY TARGETING SPECIFIC MECHANISMS OF TRAINED IMMUNITY ON EITHER IMMUNOLOGIC, METABOLIC OR EPIGENETIC LEVEL, NOVEL THERAPEUTIC APPROACHES COULD BE DEVELOPED. 2018 19 5738 24 SMOKING AND LUNG CANCER: THE ROLE OF INFLAMMATION. WORLDWIDE OVER 1 MILLION PEOPLE DIE DUE TO LUNG CANCER EACH YEAR. IT IS ESTIMATED THAT CIGARETTE SMOKING EXPLAINS ALMOST 90% OF LUNG CANCER RISK IN MEN AND 70 TO 80% IN WOMEN. CLINICALLY EVIDENT LUNG CANCERS HAVE MULTIPLE GENETIC AND EPIGENETIC ABNORMALITIES. THESE ABNORMALITIES MAY RESULT IN ACTIVATION OF ONCOGENES AND INACTIVATION OF TUMOR-SUPPRESSOR GENES. CHRONIC INFLAMMATION, WHICH IS KNOWN TO PROMOTE CANCER, MAY RESULT BOTH FROM SMOKING AND FROM GENETIC ABNORMALITIES. THESE MEDIATORS IN TURN MAY BE RESPONSIBLE FOR INCREASED MACROPHAGE RECRUITMENT, DELAYED NEUTROPHIL CLEARANCE, AND INCREASE IN REACTIVE OXYGEN SPECIES (ROS). THUS, THE PULMONARY ENVIRONMENT PRESENTS A UNIQUE MILIEU IN WHICH LUNG CARCINOGENESIS PROCEEDS IN COMPLICITY WITH THE HOST CELLULAR NETWORK. THE PULMONARY DISEASES THAT ARE ASSOCIATED WITH THE GREATEST RISK FOR LUNG CANCER ARE CHARACTERIZED BY ABUNDANT AND DEREGULATED INFLAMMATION. PULMONARY DISORDERS SUCH AS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)/EMPHYSEMA ARE CHARACTERIZED BY PROFOUND ABNORMALITIES IN INFLAMMATORY AND FIBROTIC PATHWAYS. THE CYTOKINES AND GROWTH FACTORS ABERRANTLY PRODUCED IN COPD AND THE DEVELOPING TUMOR MICROENVIRONMENT HAVE BEEN FOUND TO HAVE DELETERIOUS PROPERTIES THAT SIMULTANEOUSLY PAVE THE WAY FOR BOTH EPITHELIAL-MESENCHYMAL TRANSITION (EMT) AND DESTRUCTION OF SPECIFIC HOST CELL-MEDIATED IMMUNE RESPONSES. FULL DEFINITION OF THESE PATHWAYS WILL AFFORD THE OPPORTUNITY TO INTERVENE IN SPECIFIC INFLAMMATORY EVENTS MEDIATING LUNG TUMORIGENESIS AND RESISTANCE TO THERAPY. 2008 20 6571 15 TRANSPOSABLE ELEMENTS CROSS KINGDOM BOUNDARIES AND CONTRIBUTE TO INFLAMMATION AND AGEING: SOMATIC ACQUISITION OF FOREIGN TRANSPOSABLE ELEMENTS AS A CATALYST OF GENOME INSTABILITY, EPIGENETIC DYSREGULATION, INFLAMMATION, SENESCENCE, AND AGEING. THE DE-REPRESSION OF TRANSPOSABLE ELEMENTS (TES) IN MAMMALIAN GENOMES IS THOUGHT TO CONTRIBUTE TO GENOME INSTABILITY, INFLAMMATION, AND AGEING, YET IS VIEWED AS A CELL-AUTONOMOUS EVENT. IN CONTRAST TO MAMMALIAN CELLS, PROKARYOTES CONSTANTLY EXCHANGE GENETIC MATERIAL THROUGH TES, CROSSING BOTH CELL AND SPECIES BARRIERS, CONTRIBUTING TO RAPID MICROBIAL EVOLUTION AND DIVERSITY IN COMPLEX COMMUNITIES SUCH AS THE MAMMALIAN GUT. HERE, IT IS PROPOSED THAT TES RELEASED FROM PROKARYOTES IN THE MICROBIOME OR FROM PATHOGENIC INFECTIONS REGULARLY CROSS THE KINGDOM BARRIER TO THE SOMATIC CELLS OF THEIR EUKARYOTIC HOSTS. IT IS PROPOSED THIS HORIZONTAL TRANSFER OF TES FROM MICROBE TO HOST IS A STOCHASTIC, ONGOING CATALYST OF GENOME DESTABILIZATION, RESULTING IN STRUCTURAL AND EPIGENETIC VARIATIONS, AND ACTIVATION OF WELL-EVOLVED HOST DEFENSE MECHANISMS CONTRIBUTING TO INFLAMMATION, SENESCENCE, AND BIOLOGICAL AGEING. IT IS PROPOSED THAT INNATE IMMUNITY PATHWAYS DEFEND AGAINST THE HORIZONTAL ACQUISITION OF MICROBIAL TES, AND THAT ACTIVATION OF THIS PATHWAY DURING HORIZONTAL TRANSPOSON TRANSFER PROMOTES CHRONIC INFLAMMATION DURING AGEING. FINALLY, IT IS SUGGESTED THAT HORIZONTAL ACQUISITION OF PROKARYOTIC TES INTO MAMMALIAN GENOMES HAS BEEN MASKED AND SUBSEQUENTLY UNDER-REPORTED DUE TO FLAWS IN CURRENT SEQUENCING PIPELINES, AND NEW STRATEGIES TO UNCOVER THESE EVENTS ARE PROPOSED. 2020