1 5735 126 SMALL VESSEL DISEASE-RELATED DEMENTIA: AN INVALID NEUROVASCULAR COUPLING? THE ARTERIOSCLEROSIS-DEPENDENT ALTERATION OF BRAIN PERFUSION IS ONE OF THE MAJOR DETERMINANTS IN SMALL VESSEL DISEASE, SINCE SMALL VESSELS HAVE A PIVOTAL ROLE IN THE BRAIN'S AUTOREGULATION. NEVERTHELESS, AS FAR AS WE KNOW, ENDOTHELIUM DISTRESS CAN POTENTIATE THE FLOW DYSREGULATION AND LEAD TO SUBCORTICAL VASCULAR DEMENTIA THAT IS RELATED TO SMALL VESSEL DISEASE (SVD), ALSO BEING DEFINED AS SUBCORTICAL VASCULAR DEMENTIA (SVAD), AS WELL AS MICROGLIA ACTIVATION, CHRONIC HYPOXIA AND HYPOPERFUSION, VESSEL-TONE DYSREGULATION, ALTERED ASTROCYTES, AND PERICYTES FUNCTIONING BLOOD-BRAIN BARRIER DISRUPTION. THE MOLECULAR BASIS OF THIS PATHOLOGY REMAINS CONTROVERSIAL. THE APPARENT CONSEQUENCE (OR A FIRST EVENT, TOO) IS THE MACROSCOPIC ALTERATION OF THE NEUROVASCULAR COUPLING. HERE, WE EXAMINED THE POSSIBLE MECHANISMS THAT LEAD A HEALTHY AGING PROCESS TOWARDS SUBCORTICAL DEMENTIA. WE REMARKED THAT SVD AND WHITE MATTER ABNORMALITIES RELATED TO AGE COULD BE ACCELERATED AND POTENTIATED BY DIFFERENT VASCULAR RISK FACTORS. VASCULAR FUNCTION CHANGES CAN BE HEAVILY INFLUENCED BY GENETIC AND EPIGENETIC FACTORS, WHICH ARE, TO THE BEST OF OUR KNOWLEDGE, MOSTLY UNKNOWN. METABOLIC DEMANDS, ACTIVE NEUROVASCULAR COUPLING, CORRECT GLYMPHATIC PROCESS, AND ADEQUATE OXIDATIVE AND INFLAMMATORY RESPONSES COULD BE BULWARKS IN DEFENSE OF THE CORRECT AGING PROCESS; THEIR IMPAIRMENTS LEAD TO A POTENTIALLY CATASTROPHIC AND NON-REVERSIBLE CONDITION. 2020 2 3120 36 GESTATIONAL HYPOXIA AND BLOOD-BRAIN BARRIER PERMEABILITY: EARLY ORIGINS OF CEREBROVASCULAR DYSFUNCTION INDUCED BY EPIGENETIC MECHANISMS. FETAL CHRONIC HYPOXIA LEADS TO INTRAUTERINE GROWTH RESTRICTION (IUGR), WHICH IS LIKELY TO REDUCE OXYGEN DELIVERY TO THE BRAIN AND INDUCE LONG-TERM NEUROLOGICAL IMPAIRMENTS. THESE INDICATE A MODULATORY ROLE FOR OXYGEN IN CEREBROVASCULAR DEVELOPMENT. DURING INTRAUTERINE HYPOXIA, THE FETAL CIRCULATION SUFFERS MARKED ADAPTATIONS IN THE FETAL CARDIAC OUTPUT TO MAINTAIN OXYGEN AND NUTRIENT DELIVERY TO VITAL ORGANS, KNOWN AS THE "BRAIN-SPARING PHENOTYPE." THIS IS A WELL-CHARACTERIZED RESPONSE; HOWEVER, LITTLE IS KNOWN ABOUT THE POSTNATAL COURSE AND OUTCOMES OF THIS FETAL CEREBROVASCULAR ADAPTATION. IN ADDITION, SEVERAL NEURODEVELOPMENTAL DISORDERS HAVE THEIR ORIGINS DURING GESTATION. STILL, FEW STUDIES HAVE FOCUSED ON HOW INTRAUTERINE FETAL HYPOXIA MODULATES THE NORMAL BRAIN DEVELOPMENT OF THE BLOOD-BRAIN BARRIER (BBB) IN THE IUGR NEONATE. THE BBB IS A CELLULAR STRUCTURE FORMED BY THE NEUROVASCULAR UNIT (NVU) AND IS ORGANIZED BY A MONOLAYER OF ENDOTHELIAL AND MURAL CELLS. THE BBB REGULATES THE ENTRY OF PLASMA CELLS AND MOLECULES FROM THE SYSTEMIC CIRCULATION TO THE BRAIN. A HIGHLY SELECTIVE PERMEABILITY SYSTEM ACHIEVES THIS THROUGH INTEGRAL MEMBRANE PROTEINS IN BRAIN ENDOTHELIAL CELLS. BBB BREAKDOWN AND DYSFUNCTION IN CEREBROVASCULAR DISEASES LEAD TO LEAKAGE OF BLOOD COMPONENTS INTO THE BRAIN PARENCHYMA, CONTRIBUTING TO NEUROLOGICAL DEFICITS. THE FETAL BRAIN CIRCULATION IS PARTICULARLY SUSCEPTIBLE IN IUGR AND IS PROPOSED TO BE ONE OF THE MAIN PATHOLOGICAL PROCESSES DERIVING BBB DISRUPTION. IN THE LAST DECADE, SEVERAL EPIGENETIC MECHANISMS ACTIVATED BY IU HYPOXIA HAVE BEEN PROPOSED TO REGULATE THE POSTNATAL BBB PERMEABILITY. HOWEVER, FEW MECHANISTIC STUDIES ABOUT THIS TOPIC ARE AVAILABLE, AND LITTLE EVIDENCE SHOWS CONTROVERSY. THEREFORE, IN THIS MINI-REVIEW, WE ANALYZE THE BBB PERMEABILITY-ASSOCIATED EPIGENETIC MECHANISMS IN THE BRAIN EXPOSED TO CHRONIC INTRAUTERINE HYPOXIA. 2021 3 4982 30 PATHOPHYSIOLOGY OF THE BLOOD-BRAIN BARRIER: ANIMAL MODELS AND METHODS. THE SPECIALIZED CEREBRAL MICROVASCULAR ENDOTHELIUM INTERACTS WITH THE CELLULAR MILIEU OF THE BRAIN AND EXTRACELLULAR MATRIX TO FORM A NEUROVASCULAR UNIT, ONE ASPECT OF WHICH IS A REGULATED INTERFACE BETWEEN THE BLOOD AND CENTRAL NERVOUS SYSTEM (CNS). THE CONCEPT OF THIS BLOOD-BRAIN BARRIER (BBB) AS A DYNAMICALLY REGULATED SYSTEM RATHER THAN A STATIC BARRIER HAS WIDE-RANGING IMPLICATIONS FOR PATHOPHYSIOLOGY OF THE CNS. WHILE IN VITRO MODELS OF THE BBB ARE USEFUL FOR SCREENING DRUGS TARGETED TO THE CNS AND INDISPENSABLE FOR STUDIES OF CEREBRAL ENDOTHELIAL CELL BIOLOGY, THE COMPLEX INTERACTIONS OF THE NEUROVASCULAR UNIT MAKE ANIMAL-BASED MODELS AND METHODS ESSENTIAL TOOLS FOR UNDERSTANDING THE PATHOPHYSIOLOGY OF THE BBB. BBB DYSFUNCTION IS A COMPLICATION OF NEURODEGENERATIVE DISEASE AND BRAIN INJURY. STUDIES ON ANIMAL MODELS HAVE SHOWN THAT DISEASES OF THE PERIPHERY, SUCH AS DIABETES AND INFLAMMATORY PAIN, HAVE DELETERIOUS EFFECTS ON THE BBB WHICH MAY CONTRIBUTE TO NEUROLOGICAL COMPLICATIONS ASSOCIATED WITH THESE CONDITIONS. FURTHERMORE, GENETIC AND/OR EPIGENETIC ABNORMALITIES IN CONSTITUENTS OF THE BBB MAY BE SIGNIFICANT CONTRIBUTING FACTORS IN DISEASE ETIOLOGY. RESEARCH THAT APPROACHES THE BBB AS A DYNAMIC SYSTEM INTEGRATED WITH BOTH THE CNS AND THE PERIPHERY IS THEREFORE CRITICAL TO UNDERSTANDING AND TREATING DISEASES OF THE CNS. HEREIN, WE REVIEW VARIOUS METHODOLOGICAL APPROACHES USED TO STUDY BBB FUNCTION IN THE CONTEXT OF DISEASE. THESE INCLUDE MEASUREMENT OF TRANSPORT BETWEEN BLOOD AND BRAIN, IMAGING-BASED TECHNOLOGIES, AND GENOMIC/PROTEOMIC APPROACHES. 2008 4 1459 42 DISORDERED APP METABOLISM AND NEUROVASCULATURE IN TRAUMA AND AGING: COMBINED RISKS FOR CHRONIC NEURODEGENERATIVE DISORDERS. TRAUMATIC BRAIN INJURY (TBI), ADVANCED AGE, AND CEREBRAL VASCULAR DISEASE ARE FACTORS CONFERRING INCREASED RISK FOR LATE ONSET ALZHEIMER'S DISEASE (AD). THESE CONDITIONS ARE ALSO RELATED PATHOLOGICALLY THROUGH MULTIPLE INTERACTING MECHANISMS. THE HALLMARK PATHOLOGY OF AD CONSISTS OF PATHOLOGICAL AGGREGATES OF AMYLOID-BETA (ABETA) PEPTIDES AND TAU PROTEINS. THESE MOLECULES ARE ALSO INVOLVED IN NEUROPATHOLOGY OF SEVERAL OTHER CHRONIC NEURODEGENERATIVE DISEASES, AND ARE UNDER INTENSE INVESTIGATION IN THE AFTERMATH OF TBI AS POTENTIAL CONTRIBUTORS TO THE RISK FOR DEVELOPING AD AND CHRONIC TRAUMATIC ENCEPHALOPATHY (CTE). THE PATHOLOGY OF TBI IS COMPLEX AND DEPENDENT ON INJURY SEVERITY, AGE-AT-INJURY, AND LENGTH OF TIME BETWEEN INJURY AND NEUROPATHOLOGICAL EVALUATION. IN ADDITION, THE MECHANISMS INFLUENCING PATHOLOGY AND RECOVERY AFTER TBI LIKELY INVOLVE GENETIC/EPIGENETIC FACTORS AS WELL AS ADDITIONAL DISORDERS OR COMORBID STATES RELATED TO AGE AND CENTRAL AND PERIPHERAL VASCULAR HEALTH. IN THIS REGARD, DYSFUNCTION OF THE AGING NEUROVASCULAR SYSTEM COULD BE AN IMPORTANT LINK BETWEEN TBI AND CHRONIC NEURODEGENERATIVE DISEASES, EITHER AS A PRECIPITATING EVENT OR RELATED TO ACCUMULATION OF AD-LIKE PATHOLOGY WHICH IS AMPLIFIED IN THE CONTEXT OF AGING. THUS WITH ADVANCED AGE AND VASCULAR DYSFUNCTION, TBI CAN TRIGGER SELF-PROPAGATING CYCLES OF NEURONAL INJURY, PATHOLOGICAL PROTEIN AGGREGATION, AND SYNAPTIC LOSS RESULTING IN CHRONIC NEURODEGENERATIVE DISEASE. IN THIS REVIEW WE DISCUSS EVIDENCE SUPPORTING TBI AND AGING AS DUAL, INTERACTING RISK FACTORS FOR AD, AND THE ROLE OF ABETA AND CEREBRAL VASCULAR DYSFUNCTION IN THIS RELATIONSHIP. EVIDENCE IS DISCUSSED THAT ABETA IS INVOLVED IN CYTO- AND SYNAPTO-TOXICITY AFTER SEVERE TBI, AND THAT ITS CHRONIC EFFECTS ARE POTENTIATED BY AGING AND IMPAIRED CEREBRAL VASCULAR FUNCTION. FROM A THERAPEUTIC PERSPECTIVE, WE EMPHASIZE THAT IN THE FIELDS OF TBI- AND AGING-RELATED NEURODEGENERATION PROTECTIVE STRATEGIES SHOULD INCLUDE PRESERVATION OF NEUROVASCULAR FUNCTION. 2017 5 1250 33 CURRENT PERSPECTIVES ON MITOCHONDRIAL DYSFUNCTION IN MIGRAINE. MITOCHONDRIA ARE AN AUTONOMOUS ORGANELLE THAT PLAYS A CRUCIAL ROLE IN THE METABOLIC ASPECTS OF A CELL. CORTICAL SPREADING DEPRESSION (CSD) AND FLUCTUATIONS IN THE CEREBRAL BLOOD FLOW HAVE FOR LONG BEEN MECHANISMS UNDERLYING MIGRAINE. IT IS A NEUROVASCULAR DISORDER WITH A UNILATERAL MANIFESTATION OF DISTURBING, THROBBING AND PULSATING HEAD PAIN. MIGRAINE AFFECTS 2.6% AND 21.7% OF THE GENERAL POPULATION AND IS THE MAJOR CAUSE OF PARTIAL DISABILITY IN THE AGE GROUP 15-49. HIGHER MUTATION RATES, IMBALANCE IN CONCENTRATION OF PHYSIOLOGICALLY RELEVANT MOLECULES AND OXIDATIVE STRESS BIOMARKERS HAVE BEEN THE MAIN THEMES OF DISCUSSION IN DETERMINING THE ROLE OF MITOCHONDRIAL DISABILITY IN MIGRAINE. THE CORRELATION OF MIGRAINE WITH OTHER DISORDERS LIKE HEMIPLEGIC MIGRAINE; MITOCHONDRIAL MYOPATHY, ENCEPHALOPATHY, LACTIC ACIDOSIS AND STROKE-LIKE EPISODES [MELAS]; TENSION-TYPE HEADACHE (TTH); CYCLIC VOMITING SYNDROME (CVS), ISCHAEMIC STROKE; AND HYPERTENSION HAS HELPED IN THE ASSESSMENT OF THE PHYSIOLOGICAL AND MORPHOGENETIC BASIS OF MIGRAINE. HERE, WE HAVE REVIEWED THE DIFFERENT NUANCES OF MITOCHONDRIAL DYSFUNCTION AND MIGRAINE. THE DIFFERENT MTDNA POLYMORPHISMS THAT CAN AFFECT THE GENERATION AND TRANSMISSION OF NERVE IMPULSE HAS BEEN HIGHLIGHTED AND SUPPORTED WITH RESEARCH FINDINGS. IN ADDITION TO THIS, THE GENETIC BASIS OF MIGRAINE PATHOGENESIS AS A CONSEQUENCE OF MUTATIONS IN NUCLEAR DNA THAT CAN, IN TURN, AFFECT THE SYNTHESIS OF DEFECTIVE MITOCHONDRIAL PROTEINS IS DISCUSSED ALONG WITH A BRIEF OVERVIEW OF EPIGENETIC PROFILE. THIS REVIEW GIVES AN OVERVIEW OF THE PATHOPHYSIOLOGY OF MIGRAINE AND EXPLORES MITOCHONDRIAL DYSFUNCTION AS A POTENTIAL UNDERLYING MECHANISM. ALSO, THERAPEUTIC SUPPLEMENTS FOR MANAGING MIGRAINE HAVE BEEN DISCUSSED AT DIFFERENT JUNCTURES IN THIS PAPER. 2022 6 6012 27 THE APKC-CBP PATHWAY REGULATES POST-STROKE NEUROVASCULAR REMODELING AND FUNCTIONAL RECOVERY. EPIGENETIC MODIFICATIONS HAVE EMERGED AS ATTRACTIVE MOLECULAR SUBSTRATES THAT INTEGRATE EXTRINSIC CHANGES INTO THE DETERMINATION OF CELL IDENTITY. SINCE STROKE-RELATED BRAIN DAMAGE RELEASES MICRO-ENVIRONMENTAL CUES, WE EXAMINED THE ROLE OF A SIGNALING-INDUCED EPIGENETIC PATHWAY, AN ATYPICAL PROTEIN KINASE C (APKC)-MEDIATED PHOSPHORYLATION OF CREB-BINDING PROTEIN (CBP), IN POST-STROKE NEUROVASCULAR REMODELING. USING A KNOCKIN MOUSE STRAIN (CBPS436A) WHERE THE APKC-CBP PATHWAY WAS DEFECTIVE, WE SHOW THAT DISRUPTION OF THE APKC-CBP PATHWAY IN A MURINE FOCAL ISCHEMIC STROKE MODEL INCREASES THE REPROGRAMMING EFFICIENCY OF ISCHEMIA-ACTIVATED PERICYTES (I-PERICYTES) TO NEURAL PRECURSORS. AS A CONSEQUENCE OF ENHANCED CELLULAR REPROGRAMMING, CBPS436A MICE SHOW AN INCREASED TRANSIENT POPULATION OF LOCALLY DERIVED NEURAL PRECURSORS AFTER STROKE, WHILE DISPLAYING A REDUCED NUMBER OF I-PERICYTES, IMPAIRED VASCULAR REMODELING, AND PERTURBED MOTOR RECOVERY DURING THE CHRONIC PHASE OF STROKE. TOGETHER, THIS STUDY ELUCIDATES THE ROLE OF THE APKC-CBP PATHWAY IN MODULATING NEUROVASCULAR REMODELING AND FUNCTIONAL RECOVERY FOLLOWING FOCAL ISCHEMIC STROKE. 2017 7 4405 32 MOLECULAR ADAPTATIONS OF THE BLOOD-BRAIN BARRIER PROMOTE STRESS RESILIENCE VS. DEPRESSION. PRECLINICAL AND CLINICAL STUDIES SUGGEST THAT INFLAMMATION AND VASCULAR DYSFUNCTION CONTRIBUTE TO THE PATHOGENESIS OF MAJOR DEPRESSIVE DISORDER (MDD). CHRONIC SOCIAL STRESS ALTERS BLOOD-BRAIN BARRIER (BBB) INTEGRITY THROUGH LOSS OF TIGHT JUNCTION PROTEIN CLAUDIN-5 (CLDN5) IN MALE MICE, PROMOTING PASSAGE OF CIRCULATING PROINFLAMMATORY CYTOKINES AND DEPRESSION-LIKE BEHAVIORS. THIS EFFECT IS PROMINENT WITHIN THE NUCLEUS ACCUMBENS, A BRAIN REGION ASSOCIATED WITH MOOD REGULATION; HOWEVER, THE MECHANISMS INVOLVED ARE UNCLEAR. MOREOVER, COMPENSATORY RESPONSES LEADING TO PROPER BEHAVIORAL STRATEGIES AND ACTIVE RESILIENCE ARE UNKNOWN. HERE WE IDENTIFY ACTIVE MOLECULAR CHANGES WITHIN THE BBB ASSOCIATED WITH STRESS RESILIENCE THAT MIGHT SERVE A PROTECTIVE ROLE FOR THE NEUROVASCULATURE. WE ALSO CONFIRM THE RELEVANCE OF SUCH CHANGES TO HUMAN DEPRESSION AND ANTIDEPRESSANT TREATMENT. WE SHOW THAT PERMISSIVE EPIGENETIC REGULATION OF CLDN5 EXPRESSION AND LOW ENDOTHELIUM EXPRESSION OF REPRESSIVE CLDN5-RELATED TRANSCRIPTION FACTOR FOXO1 ARE ASSOCIATED WITH STRESS RESILIENCE. REGION- AND ENDOTHELIAL CELL-SPECIFIC WHOLE TRANSCRIPTOMIC ANALYSES REVEALED MOLECULAR SIGNATURES ASSOCIATED WITH STRESS VULNERABILITY VS. RESILIENCE. WE IDENTIFIED PROINFLAMMATORY TNFALPHA/NFKAPPAB SIGNALING AND HDAC1 AS MEDIATORS OF STRESS SUSCEPTIBILITY. PHARMACOLOGICAL INHIBITION OF STRESS-INDUCED INCREASE IN HDAC1 ACTIVITY RESCUED CLDN5 EXPRESSION IN THE NAC AND PROMOTED RESILIENCE. IMPORTANTLY, WE CONFIRMED CHANGES IN HDAC1 EXPRESSION IN THE NAC OF DEPRESSED PATIENTS WITHOUT ANTIDEPRESSANT TREATMENT IN LINE WITH CLDN5 LOSS. CONVERSELY, MANY OF THESE DELETERIOUS CLDN5-RELATED MOLECULAR CHANGES WERE REDUCED IN POSTMORTEM NAC FROM ANTIDEPRESSANT-TREATED SUBJECTS. THESE FINDINGS REINFORCE THE IMPORTANCE OF CONSIDERING STRESS-INDUCED NEUROVASCULAR PATHOLOGY IN DEPRESSION AND PROVIDE THERAPEUTIC TARGETS TO TREAT THIS MOOD DISORDER AND PROMOTE RESILIENCE. 2020 8 5494 22 REVIEW OF THE MOLECULAR MECHANISMS IN WOUND HEALING: NEW THERAPEUTIC TARGETS? THE RESTORATION OF THE SKIN BARRIER IN ACUTE AND CHRONIC WOUNDS IS CONTROLLED BY SEVERAL MOLECULAR MECHANISMS THAT SYNERGISTICALLY REGULATE CELL KINETICS, ENZYMATIC FUNCTIONS, AND NEUROVASCULAR ACTIVATION. THESE PATHWAYS INCLUDE GENETIC AND EPIGENETIC ACTIVATION, WHICH MODULATE PHYSIOLOGICAL WOUND HEALING. OUR REVIEW DESCRIBES THE GENETIC BACKGROUND OF SKIN REPAIR, NAMELY TRANSCRIPTION-INDEPENDENT DIFFUSIBLE DAMAGE SIGNALS, INDIVIDUAL VARIABILITY, EPIGENETIC MECHANISM, CONTROLLED QUALITATIVE TRAITS, POST-TRANSLATIONAL MECHANISMS, ANTIOXIDANTS, NUTRIENTS, DNA MODIFICATIONS, BACTERIA ACTIVATION, MITOCHONDRIAL ACTIVITY, AND OXIDATIVE STRESS. THE DNA BACKGROUND MODULATING SKIN RESTORATION COULD BE USED TO PLAN NEW DIAGNOSTICS AND THERAPEUTICS. 2017 9 6367 26 THE ROLE OF MICROGLIA IN THE ETIOLOGY AND EVOLUTION OF CHRONIC TRAUMATIC ENCEPHALOPATHY. CHRONIC TRAUMATIC ENCEPHALOPATHY (CTE) IS A PROGRESSIVE NEURODEGENERATIVE DISEASE THAT PRESENTS AS A LATE SEQUELA FROM TRAUMATIC BRAIN INJURY (TBI). TBI IS A GROWING AND UNDER-RECOGNIZED PUBLIC HEALTH CONCERN WITH A HIGH DEGREE OF MORBIDITY AND LARGE ASSOCIATED GLOBAL COSTS. WHILE THE IMMUNE RESPONSE TO TBI IS COMPLEX, ITS CONTRIBUTION TO THE DEVELOPMENT OF CTE REMAINS LARGELY UNKNOWN. IN THIS REVIEW, WE SUMMARIZE THE CURRENT UNDERSTANDING OF THE LINK BETWEEN CTE AND THE RESIDENT INNATE IMMUNE SYSTEM OF THE BRAIN-MICROGLIA. WE DISCUSS THE NEUROPATHOLOGY UNDERLYING CTE INCLUDING THE CREATION AND AGGREGATION OF PHOSPHORYLATED TAU PROTEIN INTO NEUROFIBRILLARY TANGLES AND THE FORMATION OF AMYLOID BETA DEPOSITS. WE ALSO PRESENT HOW MICROGLIA, THE RESIDENT INNATE IMMUNE CELLS OF THE BRAIN, DRIVE THE CONTINUOUS LOW-LEVEL INFLAMMATION ASSOCIATED WITH THE INSIDIOUS ONSET OF CTE. IN THIS REVIEW, WE CONCLUDE THAT THE LATENCY PERIOD BETWEEN THE INDEX BRAIN INJURY AND THE LONG-TERM DEVELOPMENT OF CTE PRESENTS AN OPPORTUNITY FOR THERAPEUTIC INTERVENTION. ENCOURAGING ADVANCES WITH MICROTUBULE STABILIZERS, CIS P-TAU ANTIBODIES, AND THE ABILITY TO THERAPEUTICALLY ALTER THE INFLAMMATORY STATE OF MICROGLIA HAVE SHOWN POSITIVE RESULTS IN BOTH ANIMAL AND HUMAN TRIALS. LOOKING FORWARD, RECENT ADVANCEMENTS IN NEXT-GENERATION SEQUENCING TECHNOLOGY FOR THE STUDY OF GENOMIC, TRANSCRIPTOMIC, AND EPIGENETIC INFORMATION WILL PROVIDE AN OPPORTUNITY FOR SIGNIFICANT ADVANCEMENT IN OUR UNDERSTANDING OF PROREPAIR AND PRO-INJURY GENE SIGNATURES ALLOWING FOR TARGETED INTERVENTION IN THIS HIGHLY MORBID INJURY PROCESS. 2017 10 4338 26 MICROVASCULAR BARRIER PROTECTION BY MICRORNA-183 VIA FOXO1 REPRESSION: A PATHWAY DISTURBED IN NEUROPATHY AND COMPLEX REGIONAL PAIN SYNDROME. BLOOD NERVE BARRIER DISRUPTION AND EDEMA ARE COMMON IN NEUROPATHIC PAIN AS WELL AS IN COMPLEX REGIONAL PAIN SYNDROME (CRPS). MICRORNAS (MIRNA) ARE EPIGENETIC MULTITARGET SWITCHES CONTROLLING NEURONAL AND NON-NEURONAL CELLS IN PAIN. THE MIR-183 COMPLEX ATTENUATES HYPEREXCITABILITY IN NOCICEPTORS, BUT ADDITIONAL NON-NEURONAL EFFECTS VIA TRANSCRIPTION FACTORS COULD CONTRIBUTE AS WELL. THIS STUDY EXPLORED EXOSOMAL MIR-183 IN CRPS AND MURINE NEUROPATHY, ITS EFFECT ON THE MICROVASCULAR BARRIER VIA TRANSCRIPTION FACTOR FOXO1 AND TIGHT JUNCTION PROTEIN CLAUDIN-5, AND ITS ANTIHYPERALGESIC POTENTIAL. SCIATIC MIR-183 DECREASED AFTER CCI. SUBSTITUTION WITH PERINEURAL MIR-183 MIMIC ATTENUATED MECHANICAL HYPERSENSITIVITY AND RESTORED BLOOD NERVE BARRIER FUNCTION. IN VITRO, SERUM FROM CCI MICE UND CRPS PATIENTS WEAKENED THE MICROVASCULAR BARRIER OF MURINE CEREBELLAR ENDOTHELIAL CELLS, INCREASED ACTIVE FOXO1 AND REDUCED CLAUDIN-5, CONCOMITANT WITH A LACK OF EXOSOMAL MIR-183 IN CRPS PATIENTS. CELLULAR STRESS ALSO COMPROMISED THE MICROVASCULAR BARRIER WHICH WAS RESCUED EITHER BY MIR-183 MIMIC VIA FOXO1 REPRESSION OR BY PRIOR SILENCING OF FOXO1. PERSPECTIVE: LOW MIR-183 LEADING TO BARRIER IMPAIRMENT VIA FOXO1 AND SUBSEQUENT CLAUDIN-5 SUPPRESSION IS A NEW ASPECT IN THE PATHOPHYSIOLOGY OF CRPS AND NEUROPATHIC PAIN. THIS PATHWAY MIGHT HELP UNTANGLE THE WIDE SYMPTOMATIC RANGE OF CRPS AND NURTURE FURTHER RESEARCH INTO MIRNA MIMICS OR FOXO1 INHIBITORS. 2022 11 6893 29 [SLEEP AND DEMENTIA]. AGING IS ASSOCIATED WITH CHANGES IN SLEEP STRUCTURE AND CEREBRAL DEPOSITION OF AMYLOID BETA AND TAU PROTEINS. SLEEP DISTURBANCES PRECEDE THE ONSET OF DEMENTIA BY YEARS. COMORBID SLEEP DISORDERS, SUCH AS INSOMNIA AND SLEEP-DISORDERED BREATHING, A FAMILY HISTORY OF DEMENTIA AND EPIGENETIC FACTORS CAN CONTRIBUTE TO THE DEVELOPMENT OF DEMENTIA. THIS ARTICLE EXPLORES THE QUESTION OF THE INTERACTION BETWEEN SLEEP AND DEMENTIA BASED ON THE EXISTING LITERATURE. ALTERATIONS CAUSED BY SLOW WAVE SLEEP LEAD TO CHANGES IN THE GLYMPHATIC CLEARANCE OF AMYLOID BETA, TAU PROTEINS AND OTHER PROTEINS. TRANSIENT AND CHRONIC SLEEP DISORDERS CAUSE DISTURBANCES IN THE BRAIN AREAS RESPONSIBLE FOR COGNITION AND BEHAVIOR. SLEEP-REGULATING BRAIN AREAS ARE THE FIRST TO BE AFFECTED IN THE NEURODEGENERATIVE PROCESS AND ACCELERATE THE RISK OF DEMENTIA. CIRCADIAN AGE-RELATED CHANGES IN AMYLOID BETA AND TAU PROTEINS AFFECT THE AMOUNT AND DEPTH OF SLEEP AND VICE VERSA. AMYLOID BETA IN CEREBROSPINAL FLUID SHOWS AN INVERSE CORRELATION WITH SLEEP. OREXINS MODULATE AMYLOID BETA AND SLEEP. 2023 12 5837 31 STRESSED MITOCHONDRIA: A TARGET TO INTRUDE ALZHEIMER'S DISEASE. ALZHEIMER'S DISEASE (AD) IS THE INOPERABLE, INCAPACITATING, NEUROPSYCHIATRIC, AND DEGENERATIVE MANIFESTATION THAT DRASTICALLY AFFECTS HUMAN LIFE QUALITY. THE CURRENT MEDICATIONS TARGET EXTRA-NEURONAL SENILE PLAQUES, OXIDATIVE STRESS, NEUROINFLAMMATION, INTRANEURONAL NEUROFIBRILLARY TANGLES, CHOLINERGIC DEFICITS, AND EXCITOTOXICITY. AMONG NOVEL PATHWAYS AND TARGETS, BIOENERGETIC AND RESULTANT MITOCHONDRIAL DYSFUNCTION HAS BEEN RECOGNIZED AS ESSENTIAL FACTORS THAT DECIDE THE NEURONAL FATE AND CONSEQUENT NEURODEGENERATION IN AD. THE CRUCIAL ATTRIBUTES OF MITOCHONDRIA, INCLUDING BIOENERGESIS, SIGNALING, SENSING, INTEGRATING, AND TRANSMITTING BIOLOGICAL SIGNALS CONTRIBUTE TO OPTIMUM NETWORKING OF NEURONAL DYNAMICS AND MAKE THEM INDISPENSABLE FOR CELL SURVIVAL. IN AD, MITOCHONDRIAL DYSFUNCTION AND MITOPHAGY ARE A PRELIMINARY AND CRITICAL EVENT THAT AGGRAVATES THE PATHOLOGICAL CASCADE. STRESS IS KNOWN TO PROMOTE AND EXAGGERATE THE NEUROPATHOLOGICAL ALTERATION DURING NEURODEGENERATION AND METABOLIC IMPAIRMENTS, ESPECIALLY IN THE CORTICO-LIMBIC SYSTEM, BESIDES ADVERSELY AFFECTING THE NORMAL PHYSIOLOGY AND MITOCHONDRIAL DYNAMICS. STRESS INVOLVES THE ALLOCATION OF ENERGY RESOURCES FOR NEURONAL SURVIVAL. CHRONIC AND AGGRAVATED STRESS RESPONSE LEADS TO EXCESSIVE RELEASE OF GLUCOCORTICOIDS BY ACTIVATION OF THE HYPOTHALAMIC-PITUITARYADRENAL (HPA) AXIS. BY ACTING THROUGH THEIR RECEPTORS, GLUCOCORTICOIDS INFLUENCE ADVERSE MITOCHONDRIAL CHANGES AND ALTER MTDNA TRANSCRIPTION, MTRNA EXPRESSION, HIPPOCAMPAL MITOCHONDRIAL NETWORK, AND ULTIMATELY MITOCHONDRIAL PHYSIOLOGY. CHRONIC STRESS ALSO AFFECTS MITOCHONDRIAL DYNAMICS BY CHANGING METABOLIC AND NEURO-ENDOCRINAL SIGNALLING, AGGRAVATING OXIDATIVE STRESS, PROVOKING INFLAMMATORY MEDIATORS, ALTERING TROPIC FACTORS, INFLUENCING GENE EXPRESSION, AND MODIFYING EPIGENETIC PATHWAYS. THUS, EXPLORING CHRONIC STRESS-INDUCED GLUCOCORTICOID DYSREGULATION AND RESULTANT BIO-BEHAVIORAL AND PSYCHOSOMATIC MITOCHONDRIAL ALTERATIONS MAY BE A FEASIBLE NARRATIVE TO INVESTIGATE AND UNRAVEL THE MYSTERIOUS PATHOBIOLOGY OF AD. 2021 13 375 20 AN ENERGETIC VIEW OF STRESS: FOCUS ON MITOCHONDRIA. ENERGY IS REQUIRED TO SUSTAIN LIFE AND ENABLE STRESS ADAPTATION. AT THE CELLULAR LEVEL, ENERGY IS LARGELY DERIVED FROM MITOCHONDRIA - UNIQUE MULTIFUNCTIONAL ORGANELLES WITH THEIR OWN GENOME. FOUR MAIN ELEMENTS CONNECT MITOCHONDRIA TO STRESS: (1) ENERGY IS REQUIRED AT THE MOLECULAR, (EPI)GENETIC, CELLULAR, ORGANELLAR, AND SYSTEMIC LEVELS TO SUSTAIN COMPONENTS OF STRESS RESPONSES; (2) GLUCOCORTICOIDS AND OTHER STEROID HORMONES ARE PRODUCED AND METABOLIZED BY MITOCHONDRIA; (3) RECIPROCALLY, MITOCHONDRIA RESPOND TO NEUROENDOCRINE AND METABOLIC STRESS MEDIATORS; AND (4) EXPERIMENTALLY MANIPULATING MITOCHONDRIAL FUNCTIONS ALTERS PHYSIOLOGICAL AND BEHAVIORAL RESPONSES TO PSYCHOLOGICAL STRESS. THUS, MITOCHONDRIA ARE ENDOCRINE ORGANELLES THAT PROVIDE BOTH THE ENERGY AND SIGNALS THAT ENABLE AND DIRECT STRESS ADAPTATION. NEURAL CIRCUITS REGULATING SOCIAL BEHAVIOR - AS WELL AS PSYCHOPATHOLOGICAL PROCESSES - ARE ALSO INFLUENCED BY MITOCHONDRIAL ENERGETICS. AN INTEGRATIVE VIEW OF STRESS AS AN ENERGY-DRIVEN PROCESS OPENS NEW OPPORTUNITIES TO STUDY MECHANISMS OF ADAPTATION AND REGULATION ACROSS THE LIFESPAN. 2018 14 1884 22 ENDOCANNABINOID-EPIGENETIC CROSS-TALK: A BRIDGE TOWARD STRESS COPING. THERE IS NO ARGUMENT WITH REGARD TO THE PHYSICAL AND PSYCHOLOGICAL STRESS-RELATED NATURE OF NEUROPSYCHIATRIC DISORDERS. YET, THE MECHANISMS THAT FACILITATE DISEASE ONSET STARTING FROM MOLECULAR STRESS RESPONSES ARE ELUSIVE. ENVIRONMENTAL STRESS CHALLENGES INDIVIDUALS' EQUILIBRIUM, ENHANCING HOMEOSTATIC REQUEST IN THE ATTEMPT TO STEER DOWN AROUSAL-INSTRUMENTAL MOLECULAR PATHWAYS THAT UNDERLIE HYPERVIGILANCE AND ANXIETY. A RELEVANT HOMEOSTATIC PATHWAY IS THE ENDOCANNABINOID SYSTEM (ECS). IN THIS REVIEW, WE SUMMARIZE RECENT DISCOVERIES UNAMBIGUOUSLY LISTING ECS AS A STRESS COPING MECHANISM. AS STRESS EVOKES HUGE EXCITATORY RESPONSES IN EMOTIONAL-RELEVANT LIMBIC AREAS, THE ECS LIMITS GLUTAMATE RELEASE VIA 2-ARACHYDONILGLYCEROL (2-AG) STRESS-INDUCED SYNTHESIS AND RETROGRADE CANNABINOID 1 (CB1)-RECEPTOR ACTIVATION AT THE SYNAPSE. HOWEVER, ECS SHOWS INTRINSIC VULNERABILITY AS 2-AG OVERSTIMULATION BY CHRONIC STRESS RAPIDLY LEADS TO CB1-RECEPTOR DESENSITIZATION. IN THIS REVIEW, WE EMPHASIZE THE PROTECTIVE ROLE OF 2-AG IN STRESS-RESPONSE TERMINATION AND STRESS RESILIENCY. INTERESTINGLY, WE DISCUSS ECS REGULATION WITH A FURTHER NUCLEAR HOMEOSTATIC SYSTEM WHOSE NATURE IS EXQUISITELY EPIGENETIC, ORCHESTRATED BY LYSINE SPECIFIC DEMETHYLASE 1. WE HERE EMPHASIZE A REMARKABLE EXAMPLE OF STRESS-COPING NETWORK WHERE TRANSCRIPTIONAL HOMEOSTASIS SUBSERVES SYNAPTIC AND BEHAVIORAL ADAPTATION, AIMING AT REDUCING PSYCHIATRIC EFFECTS OF TRAUMATIC EXPERIENCES. 2020 15 5537 25 ROLE OF CALCITONIN GENE-RELATED PEPTIDE IN LIGHT-AVERSIVE BEHAVIOR: IMPLICATIONS FOR MIGRAINE. MIGRAINE IS A CHRONIC NEUROLOGICAL DISORDER CHARACTERIZED BY RECURRENT EPISODES OF SEVERE UNILATERAL THROBBING HEAD PAIN AND ASSOCIATED SYMPTOMS, SUCH AS PHOTOPHOBIA. OUR CURRENT UNDERSTANDING OF THE MECHANISMS UNDERLYING MIGRAINE HAS BEEN HAMPERED BY LIMITATIONS IN ASCERTAINING MIGRAINE SYMPTOMS IN ANIMAL MODELS. CLINICAL STUDIES HAVE ESTABLISHED THE NEUROPEPTIDE CALCITONIN GENE-RELATED PEPTIDE (CGRP) AS A KEY PLAYER IN MIGRAINE. HERE, WE ESTABLISH A GENETIC MODEL OF PHOTOPHOBIA BY ENGINEERING INCREASED SENSITIVITY TO CGRP IN MICE. THESE TRANSGENIC MICE (NESTIN/HRAMP1) DISPLAY LIGHT-AVERSIVE BEHAVIOR THAT IS GREATLY ENHANCED BY INTRACEREBROVENTRICULAR INJECTION OF CGRP AND BLOCKED BY COADMINISTRATION OF THE CGRP RECEPTOR ANTAGONIST OLCEGEPANT. THIS BEHAVIOR APPEARS TO BE AN INDICATOR OF PHOTOPHOBIA AND CANNOT BE FULLY EXPLAINED BY GROSS ABNORMALITY OF OCULAR ANATOMY OR DIFFERENCES IN GENERAL ANXIETY OR MOTOR ACTIVITY. OUR FINDINGS DEMONSTRATE THAT A SINGLE GENE, RECEPTOR ACTIVITY-MODIFYING PROTEIN 1 (RAMP1), CAN BE A MODIFIER OF PHOTOPHOBIA AND, BY EXTENSION, SUGGEST THAT GENETIC OR EPIGENETIC MODULATION OF RAMP1 LEVELS MAY CONTRIBUTE TO MIGRAINE SUSCEPTIBILITY. MOREOVER, THEY VALIDATE CGRP HYPERSENSITIVE MICE AS A TOOL FOR EXPLORING THE NEUROBIOLOGY AND NOVEL THERAPIES FOR MIGRAINE AND OTHER DISORDERS INVOLVING PHOTOPHOBIA. 2009 16 2868 21 FUNCTIONAL CONSEQUENCES OF CALCIUM-DEPENDENT SYNAPSE-TO-NUCLEUS COMMUNICATION: FOCUS ON TRANSCRIPTION-DEPENDENT METABOLIC PLASTICITY. IN THE NERVOUS SYSTEM, CALCIUM SIGNALS PLAY A MAJOR ROLE IN THE CONVERSION OF SYNAPTIC STIMULI INTO TRANSCRIPTIONAL RESPONSES. SIGNAL-REGULATED GENE TRANSCRIPTION IS FUNDAMENTAL FOR A RANGE OF LONG-LASTING ADAPTIVE BRAIN FUNCTIONS THAT INCLUDE LEARNING AND MEMORY, STRUCTURAL PLASTICITY OF NEURITES AND SYNAPSES, ACQUIRED NEUROPROTECTION, CHRONIC PAIN, AND ADDICTION. IN THIS REVIEW, WE SUMMARIZE THE DIVERSE MECHANISMS GOVERNING CALCIUM-DEPENDENT TRANSCRIPTIONAL REGULATION ASSOCIATED WITH CENTRAL NERVOUS SYSTEM PLASTICITY. WE FOCUS ON RECENT ADVANCES IN THE FIELD OF SYNAPSE-TO-NUCLEUS COMMUNICATION THAT INCLUDE STUDIES OF THE SIGNAL-REGULATED TRANSCRIPTOME IN HUMAN NEURONS, IDENTIFICATION OF NOVEL REGULATORY MECHANISMS SUCH AS ACTIVITY-INDUCED DNA DOUBLE-STRAND BREAKS, AND THE IDENTIFICATION OF NOVEL FORMS OF ACTIVITY- AND TRANSCRIPTION-DEPENDENT ADAPTATIONS, IN PARTICULAR, METABOLIC PLASTICITY. WE SUMMARIZE THE RECIPROCAL INTERACTIONS BETWEEN DIFFERENT KINDS OF NEUROADAPTATIONS AND HIGHLIGHT THE EMERGING ROLE OF ACTIVITY-REGULATED EPIGENETIC MODIFIERS IN GATING THE INDUCIBILITY OF SIGNAL-REGULATED GENES. 2020 17 3708 21 INFLUENCE OF PHARMACOLOGICAL AND EPIGENETIC FACTORS TO SUPPRESS NEUROTROPHIC FACTORS AND ENHANCE NEURAL PLASTICITY IN STRESS AND MOOD DISORDERS. STRESS-INDUCED MAJOR DEPRESSION AND MOOD DISORDERS ARE CHARACTERIZED BY BEHAVIOURAL ABNORMALITIES AND PSYCHIATRIC ILLNESS, LEADING TO DISABILITY AND IMMATURE MORTALITY WORLDWIDE. NEUROBIOLOGICAL MECHANISMS OF STRESS AND MOOD DISORDERS ARE DISCUSSED CONSIDERING RECENT FINDINGS, AND CHALLENGES TO ENHANCE PHARMACOLOGICAL EFFECTS OF ANTIDEPRESSANT, AND MOOD STABILIZERS. PHARMACOLOGICAL ENHANCEMENT OF KETAMINE AND SCOPOLAMINE REGULATES DEPRESSION AT THE MOLECULAR LEVEL, INCREASING SYNAPTIC PLASTICITY IN PREFRONTAL REGIONS. BLOOD-DERIVED NEUROTROPHIC FACTORS FACILITATE MOOD-DEFICIT SYMPTOMS. EPIGENETIC FACTORS MAINTAIN STRESS-RESILIENCE IN HIPPOCAMPAL REGION. REGULATION OF NEUROTROPHIC FACTORS BLOCKADES STRESS, AND ENHANCES NEURONAL SURVIVAL THOUGH IT PARALYZES LIMBIC REGIONS. MOLECULAR AGENTS AND NEUROTROPHIC FACTORS ALSO CONTROL BEHAVIORAL AND SYNAPTIC PLASTICITY IN ADDICTION AND STRESS DISORDERS. FUTURE RESEARCH ON NEURONAL DYNAMICS AND CELLULAR ACTIONS CAN BE DIRECTED TO OBTAIN THE ETIOLOGY OF SYNAPTIC DYSREGULATION IN MOOD DISORDER AND STRESS. FOR THE FIRST TIME, THE CURRENT REVIEW CONTRIBUTES TO THE LITERATURE OF SYNAPTIC PLASTICITY REPRESENTING THE ROLE OF EPIGENETIC MECHANISMS AND GLUCOCORTICOID RECEPTORS TO PREDICT DEPRESSION AND ANXIETY IN CLINICAL CONDITIONS. 2019 18 5541 29 ROLE OF DIETARY PHENOLS IN MITIGATING MICROGLIA-MEDIATED NEUROINFLAMMATION. CHRONIC NEUROINFLAMMATION IS A PATHOLOGICAL FEATURE OF A NUMBER OF CENTRAL NERVOUS SYSTEM (CNS) DISEASES AND IS MEDIATED BY SUSTAINED ACTIVATION OF MICROGLIAL CELLS, THE INNATE IMMUNE CELLS OF THE CNS. STUDIES HAVE MAINLY FOCUSED ON IDENTIFYING THE MOLECULAR AND EPIGENETIC MECHANISMS OF MICROGLIAL ACTIVATION. THIS IS CRUCIAL IN DESIGNING THERAPEUTIC STRATEGIES FOR NEUROPATHOLOGIES IN WHICH PROLONGED MICROGLIAL ACTIVATION IS KNOWN TO EXACERBATE DISEASE CONDITION. IN RECENT YEARS, INCREASING EVIDENCE SHOW THAT NATURALLY OCCURRING COMPOUNDS PRESENT IN REGULAR DIET COULD FUNCTION AS "NUTRACEUTICALS," ARRESTING MICROGLIAL ACTIVATION, AND THUS CONFERRING NEUROPROTECTION. THIS REVIEW SUMMARIZES OUR UNDERSTANDING OF THE ROLE OF DIETARY PHENOLIC NUTRACEUTICALS IN MITIGATING MICROGLIA-MEDIATED NEUROINFLAMMATION. STUDIES SHOW THAT THESE NATURAL PHENOLS INHIBIT KEY SIGNALING PATHWAYS IN ACTIVATED MICROGLIA SUCH AS THE NFKAPPAB, MAPK AND JAK-STAT THAT TRIGGER MICROGLIA-MEDIATED INFLAMMATION IN VARIOUS NEUROPATHOLOGICAL CONDITIONS SUCH AS INJURY, INFECTION, STROKE, AUTISM AND NEURODEGENERATIVE DISEASES, I.E., ALZHEIMER'S DISEASE AND PARKINSON'S DISEASE. THE ANTI-INFLAMMATORY AND ANTIOXIDANT EFFECT EXERTED BY THESE NATURAL PHENOLS HAVE SHOWN CONSIDERABLE SUCCESS IN IMPROVING DISEASE CONDITION IN ANIMAL MODELS OF NEUROPATHOLOGIES, AND THUS SEEM TO BE SUITABLE CANDIDATES FOR DEVELOPING THERAPEUTIC STRATEGIES. 2016 19 4585 31 NAD(+) AND VASCULAR DYSFUNCTION: FROM MECHANISMS TO THERAPEUTIC OPPORTUNITIES. NICOTINAMIDE ADENINE DINUCLEOTIDE (NAD(+)) IS AN ESSENTIAL AND PLEIOTROPIC COENZYME INVOLVED NOT ONLY IN CELLULAR ENERGY METABOLISM, BUT ALSO IN CELL SIGNALING, EPIGENETIC REGULATION, AND POST-TRANSLATIONAL PROTEIN MODIFICATIONS. VASCULAR DISEASE RISK FACTORS ARE ASSOCIATED WITH ABERRANT NAD(+) METABOLISM. CONVERSELY, THE THERAPEUTIC INCREASE OF NAD(+) LEVELS THROUGH THE ADMINISTRATION OF NAD(+) PRECURSORS OR INHIBITORS OF NAD(+)-CONSUMING ENZYMES REDUCES CHRONIC LOW-GRADE INFLAMMATION, REACTIVATES AUTOPHAGY AND MITOCHONDRIAL BIOGENESIS, AND ENHANCES OXIDATIVE METABOLISM IN VASCULAR CELLS OF HUMANS AND RODENTS WITH VASCULAR PATHOLOGIES. AS SUCH, NAD(+) HAS EMERGED AS A POTENTIAL TARGET FOR COMBATTING AGE-RELATED CARDIOVASCULAR AND CEREBROVASCULAR DISORDERS. THIS REVIEW DISCUSSES NAD(+)-REGULATED MECHANISMS CRITICAL FOR VASCULAR HEALTH AND SUMMARIZES NEW ADVANCES IN NAD(+) RESEARCH DIRECTLY RELATED TO VASCULAR AGING AND DISEASE, INCLUDING HYPERTENSION, ATHEROSCLEROSIS, CORONARY ARTERY DISEASE, AND AORTIC ANEURYSMS. FINALLY, WE ENUMERATE CHALLENGES AND OPPORTUNITIES FOR NAD(+) REPLETION THERAPY WHILE ANTICIPATING THE FUTURE OF THIS EXCITING RESEARCH FIELD, WHICH WILL HAVE A MAJOR IMPACT ON VASCULAR MEDICINE. 2022 20 1869 27 EMERGING ROLE OF DREAM IN HEALTHY BRAIN AND NEUROLOGICAL DISEASES. THE DOWNSTREAM REGULATORY ELEMENT ANTAGONIST MODULATOR (DREAM) IS A MULTIFUNCTIONAL CA(2+)-SENSITIVE PROTEIN EXERTING A DUAL MECHANISM OF ACTION TO REGULATE SEVERAL CA(2+)-DEPENDENT PROCESSES. UPON SUMOYLATION, DREAM ENTERS IN NUCLEUS WHERE IT DOWNREGULATES THE EXPRESSION OF SEVERAL GENES PROVIDED WITH A CONSENSUS SEQUENCE NAMED DREAM REGULATORY ELEMENT (DRE). ON THE OTHER HAND, DREAM COULD ALSO DIRECTLY MODULATE THE ACTIVITY OR THE LOCALIZATION OF SEVERAL CYTOSOLIC AND PLASMA MEMBRANE PROTEINS. IN THIS REVIEW, WE SUMMARIZE RECENT ADVANCES IN THE KNOWLEDGE OF DREAM DYSREGULATION AND DREAM-DEPENDENT EPIGENETIC REMODELING AS A CENTRAL MECHANISM IN THE PROGRESSION OF SEVERAL DISEASES AFFECTING CENTRAL NERVOUS SYSTEM, INCLUDING STROKE, ALZHEIMER'S AND HUNTINGTON'S DISEASES, AMYOTROPHIC LATERAL SCLEROSIS, AND NEUROPATHIC PAIN. INTERESTINGLY, DREAM SEEMS TO EXERT A COMMON DETRIMENTAL ROLE IN THESE DISEASES BY INHIBITING THE TRANSCRIPTION OF SEVERAL NEUROPROTECTIVE GENES, INCLUDING THE SODIUM/CALCIUM EXCHANGER ISOFORM 3 (NCX3), BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF), PRO-DYNORPHIN, AND C-FOS. THESE FINDINGS LEAD TO THE CONCEPT THAT DREAM MIGHT REPRESENT A PHARMACOLOGICAL TARGET TO AMELIORATE SYMPTOMS AND REDUCE NEURODEGENERATIVE PROCESSES IN SEVERAL PATHOLOGICAL CONDITIONS AFFECTING CENTRAL NERVOUS SYSTEM. 2023