1 373 115 AN EMERGING ROLE OF NEUTROPHILS AND NETOSIS IN CHRONIC INFLAMMATION AND FIBROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND ANCA-ASSOCIATED VASCULITIDES (AAV): IMPLICATIONS FOR THE PATHOGENESIS AND TREATMENT. NEUTROPHILS DERIVE FROM HEMATOPOIETIC STEM CELLS (HSCS) WITH SYSTEMIC INFLAMMATION DRIVING THEIR ACTIVATION AND DIFFERENTIATION TO MYELOID PROGENITORS TO ENSURE ENHANCED MYELOPOIESIS. EPIGENETIC REPROGRAMING AND RE-EDUCATION OF THESE HSCS PRODUCES NEUTROPHILS PRIMED TOWARDS ELIMINATION OF PATHOGENS AND INCREASED INFLAMMATORY RESPONSE. NEUTROPHILS -AN IMPORTANT COMPONENT OF ACUTE INFLAMMATION- ARE NOT PRESENT IN CHRONIC INFLAMMATORY TISSUES LEADING TO THE FALSE ASSUMPTION THAT THEY MAY NOT BE AS IMPORTANT FOR THE LATTER. ACTIVATED NEUTROPHILS MAY RELEASE NEUTROPHIL EXTRACELLULAR TRAPS (NETS) DURING A DISTINCT FORM OF CELL DEATH, NAMED NETOSIS; NETS ARE RICH IN BIOACTIVE MOLECULES THAT PROMOTE THROMBOSIS (INCLUDING ATHEROTHROMBOSIS), INFLAMMATION AND FIBROSIS. THUS, ALTHOUGH NEUTROPHILS MAY NOT BE PRESENT IN CHRONIC INFLAMMATORY LESIONS, THEIR REMNANTS MAY AMPLIFY THE INFLAMMATORY RESPONSE BEYOND THEIR SHORT LIFE-SPAN IN THE TISSUES. HEREIN, WE REVIEW CURRENT EVIDENCE SUPPORTING A ROLE OF NEUTROPHILS AND NETOSIS IN TISSUE INJURY AND DYSFUNCTION IN SYSTEMIC AUTOIMMUNITY USING AS DISEASE PARADIGMS SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND THE ANCA-ASSOCIATED VASCULITIDES (AAV). WE ALSO DISCUSS THE MECHANISMS INVOLVED AND THEIR POTENTIAL AS TARGETS FOR NOVEL THERAPY AND DRUG REPOSITIONING. 2019 2 4964 30 PATHOGENETIC AND CLINICAL ASPECTS OF ANTI-NEUTROPHIL CYTOPLASMIC AUTOANTIBODY-ASSOCIATED VASCULITIDES. ANTI-NEUTROPHIL CYTOPLASMIC AUTOANTIBODIES (ANCA) TARGETING PROTEINASE 3 (PR3) AND MYELOPEROXIDASE EXPRESSED BY INNATE IMMUNE CELLS (NEUTROPHILS AND MONOCYTES) ARE SALIENT DIAGNOSTIC AND PATHOGENIC FEATURES OF SMALL VESSEL VASCULITIS, COMPRISING GRANULOMATOSIS WITH POLYANGIITIS (GPA), MICROSCOPIC POLYANGIITIS, AND EOSINOPHILIC GPA. GENETIC STUDIES SUGGEST THAT ANCA-ASSOCIATED VASCULITIDES (AAV) CONSTITUTE SEPARATE DISEASES, WHICH SHARE COMMON IMMUNOLOGICAL AND PATHOLOGICAL FEATURES, BUT ARE OTHERWISE HETEROGENEOUS. THE SUCCESSFUL THERAPEUTIC USE OF ANTI-CD20 ANTIBODIES EMPHASIZES THE PROMINENT ROLE OF ANCA AND POSSIBLY OTHER AUTOANTIBODIES IN THE PATHOGENESIS OF AAV. HOWEVER, TO ELUCIDATE CAUSAL EFFECTS IN AAV, A BETTER UNDERSTANDING OF THE COMPLEX INTERPLAY LEADING TO THE EMERGENCE OF B LYMPHOCYTES THAT PRODUCE PATHOGENIC ANCA REMAINS A CHALLENGE. DIFFERENT SCENARIOS SEEM POSSIBLE; E.G., THE BREAK OF TOLERANCE INDUCED BY A SHIFT FROM NON-PATHOGENIC TOWARD PATHOGENIC AUTOANTIGEN EPITOPES IN INFLAMED TISSUE. THIS REVIEW GIVES A BRIEF OVERVIEW ON CURRENT KNOWLEDGE ABOUT GENETIC AND EPIGENETIC FACTORS, BARRIER DYSFUNCTION AND CHRONIC NON-RESOLVING INFLAMMATION, NECRO-INFLAMMATORY AUTO-AMPLIFICATION OF CELLULAR DEATH AND INFLAMMATION, ALTERED AUTOANTIGEN PRESENTATION, ALTERNATIVE COMPLEMENT PATHWAY ACTIVATION, ALTERATIONS WITHIN PERIPHERAL AND INFLAMED TISSUE-RESIDING T- AND B-CELL POPULATIONS, ECTOPIC LYMPHOID TISSUE NEOFORMATION, THE CHARACTERIZATION OF PR3-SPECIFIC T-CELLS, PROPERTIES OF ANCA, LINKS BETWEEN AUTOIMMUNE DISEASE AND INFECTION-TRIGGERED PATHOLOGY, AND ANIMAL MODELS IN AAV. 2018 3 6394 37 THE ROLE OF THE HOST-NEUTROPHIL BIOLOGY. NEUTROPHILIC POLYMORPHONUCLEAR LEUKOCYTES (NEUTROPHILS) ARE MYELOID CELLS PACKED WITH LYSOSOMAL GRANULES (HENCE ALSO CALLED GRANULOCYTES) THAT CONTAIN A FORMIDABLE ANTIMICROBIAL ARSENAL. THEY ARE TERMINALLY DIFFERENTIATED CELLS THAT PLAY A CRITICAL ROLE IN ACUTE AND CHRONIC INFLAMMATION, AS WELL AS IN THE RESOLUTION OF INFLAMMATION AND WOUND HEALING. NEUTROPHILS EXPRESS A DENSE ARRAY OF SURFACE RECEPTORS FOR MULTIPLE LIGANDS, RANGING FROM INTEGRINS TO SUPPORT THEIR EGRESS FROM BONE MARROW INTO THE CIRCULATION AND FROM THE CIRCULATION INTO TISSUES, TO CYTOKINE/CHEMOKINE RECEPTORS THAT DRIVE THEIR NAVIGATION TO THE SITE OF INFECTION OR TISSUE DAMAGE AND ALSO PRIME THEM FOR A SECOND STIMULUS, TO PATTERN RECOGNITION RECEPTORS AND IMMUNOGLOBULIN RECEPTORS TO FACILITATE THE DESTRUCTION AND REMOVAL OF INFECTIVE AGENTS OR DEBRIDEMENT OF DAMAGED TISSUES. WHEN AFFERENT NEUTROPHIL SIGNALS ARE PROPORTIONATE AND COORDINATED THEY WILL PHAGOCYTOSE OPSONIZED AND UNOPSONIZED BACTERIA, ACTIVATING THE NICOTINAMIDE ADENINE DINUCLEOTIDE PHOSPHATE OXIDASE (RESPIRATORY BURST) TO GENERATE REACTIVE OXYGEN SPECIES, WHICH AUGMENT THE PROTEOLYTIC DESTRUCTION OF MICROBES SECURED WITHIN THE PHAGOSOME. A HIGHLY ORCHESTRATED PROCESS OF APOPTOSIS FOLLOWS, FORMING MEMBRANE-BOUND SUBSTRUCTURES THAT ARE REMOVED BY MACROPHAGES. NEUTROPHILS ARE CAPABLE OF VARIOUS OTHER FORMS OF PROGRAMMED CELL DEATH, SUCH AS NETOSIS AND PYROPTOTIC CELL DEATH, AS WELL AS NONPROGRAMMED CELL DEATH BY NECROSIS. IN RECENT YEARS, RESEARCH HAS REVEALED THAT NEUTROPHILS ARE CAPABLE OF FAR MORE SUBTLE CELL-CELL INTERACTIONS THAN PREVIOUSLY THOUGHT POSSIBLE. THIS INCLUDES SYNTHESIS OF VARIOUS INFLAMMATORY MEDIATORS AND ALSO MYELOID CELL TRAINING WITHIN BONE MARROW, WHERE EPIGENETIC AND METABOLIC SIGNALS ASSOCIATED WITH RETURNING NEUTROPHILS THAT UNDERGO REVERSE EGRESS FROM TISSUES INTO THE VASCULATURE AND BACK TO BONE MARROW PROGRAM A HYPERREACTIVE SUBSET OF NEUTROPHILS DURING MYELOPOIESIS THAT ARE CAPABLE OF HYPERSENSITIVE REACTIONS TO MICROBIAL AGGRESSORS. THESE CHARACTERISTICS ARE EVIDENT IN VARIOUS NEUTROPHIL SUBSETS/SUBPOPULATIONS, CREATING BROAD HETEROGENEITY IN THE BEHAVIOR AND BIOLOGICAL REPERTOIRE OF THESE SEEMINGLY SCHIZOPHRENIC IMMUNE CELLS. MOREOVER, NEUTROPHILS ARE CRITICAL EFFECTOR CELLS OF ADAPTIVE AND INNATE IMMUNITY, BINDING TO OPSONIZED BACTERIA AND DESTROYING THEM BY EXTRACELLULAR AND INTRACELLULAR METHODS. THE FORMER CREATES SUBSTANTIAL COLLATERAL HOST TISSUE DAMAGE, AS THEY ARE LESS SPECIFIC THAN T-CYTOTOXIC CELL-KILLING MECHANISMS, AND IN CONDITIONS SUCH AS PERI-IMPLANTITIS, WHERE PLASMA CELLS AND NEUTROPHILS DOMINATE THE IMMUNE INFILTRATE, BONE AND TISSUE DESTRUCTION ARE RAPID AND APPEAR RELENTLESS. FINALLY, THE ROLE OF NEUTROPHILS AS CONDUITS FOR PERIODONTAL-SYSTEMIC DISEASE CONNECTIONS AND FOR OXIDATIVE DAMAGE TO ACT AS A CAUSAL LINK BETWEEN THE TWO HAS ONLY RECENTLY BEEN REALIZED. IN THIS CHAPTER, WE ATTEMPT TO EXPAND ON THESE ISSUES, EMPHASIZING THE CONTRIBUTIONS OF EUROPEAN SCIENTISTS THROUGHOUT A DETAILED APPRAISAL OF THE BENEFITS AND SIDE EFFECTS OF NEUTROPHILIC INFLAMMATION AND IMMUNE FUNCTION. 2023 4 1033 39 CITRULLINATION OF AUTOANTIGENS IMPLICATES NETOSIS IN THE INDUCTION OF AUTOIMMUNITY. TOLERANCE BLOCKS THE EXPRESSION OF AUTOANTIBODIES, WHEREAS AUTOIMMUNITY PROMOTES IT. HOW TOLERANCE BREAKS AND AUTOANTIBODY PRODUCTION BEGINS THUS ARE CRUCIAL QUESTIONS FOR UNDERSTANDING AND TREATMENT OF AUTOIMMUNE DISEASES. EVIDENCE IMPLICATES CELL DEATH AND AUTOANTIGEN MODIFICATIONS IN THE INITIATION OF AUTOIMMUNE REACTIONS. ONE FORM OF NEUTROPHIL CELL DEATH CALLED NETOSIS DESERVES ATTENTION BECAUSE IT REQUIRES THE POST-TRANSLATIONAL MODIFICATION OF HISTONES AND RESULTS IN THE EXTRACELLULAR RELEASE OF CHROMATIN. NETOSIS RECEIVED ITS NAME FROM NET, THE ACRONYM GIVEN TO NEUTROPHIL EXTRACELLULAR TRAP. THE EXTRACELLULAR CHROMATIN INCORPORATES HISTONES IN WHICH ARGININES HAVE BEEN CONVERTED TO CITRULLINES BY PEPTIDYLARGININE DEIMINASE IV (PAD4). THE DEIMINATED CHROMATIN MAY FUNCTION TO CAPTURE OR 'TRAP' BACTERIAL PATHOGENS, THUS GENERATING AN EXTRACELLULAR COMPLEX OF DEIMINATED HISTONES AND BACTERIAL CELL ADJUVANTS. THE COMPLEX OF BACTERIAL ANTIGENS AND DEIMINATED CHROMATIN MAY BE INTERNALISED BY HOST PHAGOCYTES DURING ACUTE INFLAMMATORY CONDITIONS, AS ARISE DURING BACTERIAL INFECTIONS OR CHRONIC AUTOINFLAMMATORY DISORDERS. THE UPTAKE AND PROCESSING OF DEIMINATED CHROMATIN TOGETHER WITH BACTERIAL ADJUVANTS BY PHAGOCYTES MAY INDUCE THE PRESENTATION OF MODIFIED HISTONE EPITOPES AND CO-STIMULATION, THUS YIELDING A POWERFUL STIMULUS TO BREAK TOLERANCE. AUTOANTIBODIES TO DEIMINATED HISTONES ARE PREVALENT IN FELTY'S SYNDROME PATIENTS AND ARE PRESENT IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND PATIENTS WITH RHEUMATOID ARTHRITIS (RA). THESE OBSERVATIONS CLEARLY IMPLICATE HISTONE DEIMINATION AS AN EPIGENETIC MARK THAT CAN ACT AS AN AUTOANTIBODY STIMULANT. 2014 5 3701 32 INFLAMMATORY RESPONSE TO REGULATED CELL DEATH IN GOUT AND ITS FUNCTIONAL IMPLICATIONS. GOUT, A CHRONIC INFLAMMATORY ARTHRITIS DISEASE, IS CHARACTERIZED BY HYPERURICEMIA AND CAUSED BY INTERACTIONS BETWEEN GENETIC, EPIGENETIC, AND METABOLIC FACTORS. ACUTE GOUT SYMPTOMS ARE TRIGGERED BY THE INFLAMMATORY RESPONSE TO MONOSODIUM URATE CRYSTALS, WHICH IS MEDIATED BY THE INNATE IMMUNE SYSTEM AND IMMUNE CELLS (E.G., MACROPHAGES AND NEUTROPHILS), THE NACHT, LRR, AND PYD DOMAINS-CONTAINING PROTEIN 3 (NLRP3) INFLAMMASOME ACTIVATION, AND PRO-INFLAMMATORY CYTOKINE (E.G., IL-1BETA) RELEASE. RECENT STUDIES HAVE INDICATED THAT THE MULTIPLE PROGRAMMED CELL DEATH PATHWAYS INVOLVED IN THE INFLAMMATORY RESPONSE INCLUDE PYROPTOSIS, NETOSIS, NECROPTOSIS, AND APOPTOSIS, WHICH INITIATE INFLAMMATORY REACTIONS. IN THIS REVIEW, WE EXPLORE THE CORRELATION AND INTERACTIONS AMONG THESE FACTORS AND THEIR ROLES IN THE PATHOGENESIS OF GOUT TO PROVIDE FUTURE RESEARCH DIRECTIONS AND POSSIBILITIES FOR IDENTIFYING POTENTIAL NOVEL THERAPEUTIC TARGETS AND ENHANCING OUR UNDERSTANDING OF GOUT PATHOGENESIS. 2022 6 3025 27 GENETICS AND PATHOPHYSIOLOGY OF GRANULOMATOSIS WITH POLYANGIITIS (GPA) AND ITS MAIN AUTOANTIGEN PROTEINASE 3. GRANULOMATOSIS WITH POLYANGIITIS (GPA) IS A SEVERE AUTOIMMUNE DISEASE AND ONE OF THE SMALL VESSEL ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA)-ASSOCIATED VASCULITIDES. ALTHOUGH ITS ETIOLOGY AND PATHOPHYSIOLOGY ARE STILL WIDELY UNKNOWN, IT IS ACCEPTED THAT INFECTIONS, ENVIRONMENTAL FACTORS, EPIGENETIC MODIFICATIONS, AND A GENETIC PREDISPOSITION PROVIDE THE BASIS FOR THIS SYSTEMIC DISORDER. GPA TYPICALLY EVOLVES INTO TWO PHASES: AN INITIAL PHASE CHARACTERIZED BY EAR, NOSE AND THROAT (ENT) MANIFESTATIONS, SUCH AS CHRONIC SINUSITIS AND OTITIS, ULCERATION OF THE ORAL CAVITY AND PHARYNX, AS WELL AS PULMONARY NODULES AND A SEVERE GENERALIZED PHASE, DEFINED BY THE OCCURRENCE OF RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS, PULMONARY HEMORRHAGE, AND ARTHRITIS. ANCAS, DIRECTED AGAINST THE NEUTROPHILIC ENZYMES PROTEINASE 3 AND MYELOPEROXIDASE, ARE PRESENT IN UP TO 90% OF THE AFFECTED PATIENTS IN THE SYSTEMIC PHASE. AS THE HUMORAL IMMUNITY IS PREDOMINANTLY DIRECTED AGAINST NEUTROPHILIC ANTIGENS, IT IS APPARENT THAT NEUTROPHILS PLAY A CRITICAL ROLE IN GPA BOTH AS TARGET AND EFFECTOR CELLS. ALTHOUGH GPA PATHOGENESIS IS NOT WELL KNOWN, SOME SUSCEPTIBILITY GENES AND LOCI HAVE BEEN IDENTIFIED BY CANDIDATE GENE APPROACHES, GENOME-WIDE ASSOCIATION STUDIES, AND META-ANALYSES, AS WELL AS FAMILIAL ASSOCIATION STUDIES. SUCH GENES ARE CTLA4, PTPN22, COL11A2, SERPINA1, AND THE MHC CLASS II GENE CLUSTER. THIS REVIEW HIGHLIGHTS THE CLINICAL, PATHOPHYSIOLOGICAL, AND GENETIC BACKGROUND OF GPA AND AIMS TO GIVE AN OVERVIEW OF RECENT EFFORTS TO IDENTIFY GPA SUSCEPTIBILITY GENES. WE POINT OUT THE GENETIC BASIS OF THE MAIN AUTOANTIGEN PR3 AND WHY IT IS SO DIFFICULT TO ESTABLISH A MURINE GPA MODEL. 2016 7 6376 30 THE ROLE OF NEUTROPHILS IN TRAINED IMMUNITY. THE PRINCIPLE OF TRAINED IMMUNITY REPRESENTS INNATE IMMUNE MEMORY DUE TO SUSTAINED, MAINLY EPIGENETIC, CHANGES TRIGGERED BY ENDOGENOUS OR EXOGENOUS STIMULI IN BONE MARROW (BM) PROGENITORS (CENTRAL TRAINED IMMUNITY) AND THEIR INNATE IMMUNE CELL PROGENY, THEREBY TRIGGERING ELEVATED RESPONSIVENESS AGAINST SECONDARY STIMULI. BM PROGENITORS CAN RESPOND TO MICROBIAL AND STERILE SIGNALS, THEREBY POSSIBLY ACQUIRING TRAINED IMMUNITY-MEDIATED LONG-LASTING ALTERATIONS THAT MAY SHAPE THE FATE AND FUNCTION OF THEIR PROGENY, FOR EXAMPLE, NEUTROPHILS. NEUTROPHILS, THE MOST ABUNDANT INNATE IMMUNE CELL POPULATION, ARE PRODUCED IN THE BM FROM COMMITTED PROGENITOR CELLS IN A PROCESS DESIGNATED GRANULOPOIESIS. NEUTROPHILS ARE THE FIRST RESPONDERS AGAINST INFECTIOUS OR INFLAMMATORY CHALLENGES AND HAVE VERSATILE FUNCTIONS IN IMMUNITY. TOGETHER WITH OTHER INNATE IMMUNE CELLS, NEUTROPHILS ARE EFFECTORS OF PERIPHERAL TRAINED IMMUNITY. HOWEVER, GIVEN THE SHORT LIFETIME OF NEUTROPHILS, THEIR ABILITY TO ACQUIRE IMMUNOLOGICAL MEMORY MAY LIE IN THE CENTRAL TRAINING OF THEIR BM PROGENITORS RESULTING IN GENERATION OF REPROGRAMMED, THAT IS, "TRAINED", NEUTROPHILS. ALTHOUGH TRAINED IMMUNITY MAY HAVE BENEFICIAL EFFECTS IN INFECTION OR CANCER, IT MAY ALSO MEDIATE DETRIMENTAL OUTCOMES IN CHRONIC INFLAMMATION. HERE, WE REVIEW THE EMERGING RESEARCH AREA OF TRAINED IMMUNITY WITH A PARTICULAR EMPHASIS ON THE ROLE OF NEUTROPHILS AND GRANULOPOIESIS. 2023 8 3107 26 GENOMICS OF CHRONIC NEUTROPHILIC LEUKEMIA. CHRONIC NEUTROPHILIC LEUKEMIA (CNL) IS A DISTINCT MYELOPROLIFERATIVE NEOPLASM WITH A HIGH PREVALENCE (>80%) OF MUTATIONS IN THE COLONY-STIMULATING FACTOR 3 RECEPTOR (CSF3R). THESE MUTATIONS ACTIVATE THE RECEPTOR, LEADING TO THE PROLIFERATION OF NEUTROPHILS THAT ARE A HALLMARK OF CNL. RECENTLY, THE WORLD HEALTH ORGANIZATION GUIDELINES HAVE BEEN UPDATED TO INCLUDE CSF3R MUTATIONS AS PART OF THE DIAGNOSTIC CRITERIA FOR CNL. BECAUSE OF THE HIGH PREVALENCE OF CSF3R MUTATIONS IN CNL, IT IS TEMPTING TO THINK OF THIS DISEASE AS BEING SOLELY DRIVEN BY THIS GENETIC LESION. HOWEVER, RECENT ADDITIONAL GENOMIC CHARACTERIZATION DEMONSTRATES THAT CNL HAS MUCH IN COMMON WITH OTHER CHRONIC MYELOID MALIGNANCIES AT THE GENETIC LEVEL, SUCH AS THE CLINICALLY RELATED DIAGNOSIS ATYPICAL CHRONIC MYELOID LEUKEMIA. THESE COMMONALITIES INCLUDE MUTATIONS IN SETBP1, SPLICEOSOME PROTEINS (SRSF2, U2AF1), AND EPIGENETIC MODIFIERS (TET2, ASXL1). SOME OF THESE SAME MUTATIONS ALSO HAVE BEEN CHARACTERIZED AS FREQUENT EVENTS IN CLONAL HEMATOPOIESIS OF INDETERMINATE POTENTIAL, SUGGESTING A MORE COMPLEX DISEASE EVOLUTION THAN WAS PREVIOUSLY UNDERSTOOD AND RAISING THE POSSIBILITY THAT AN AGE-RELATED CLONAL PROCESS OF PRELEUKEMIC CELLS COULD PRECEDE THE DEVELOPMENT OF CNL. THE ORDER OF ACQUISITION OF CSF3R MUTATIONS RELATIVE TO MUTATIONS IN SETBP1, EPIGENETIC MODIFIERS, OR THE SPLICEOSOME HAS BEEN DETERMINED ONLY IN ISOLATED CASE REPORTS; THUS, FURTHER WORK IS NEEDED TO UNDERSTAND THE IMPACT OF MUTATION CHRONOLOGY ON THE CLONAL EVOLUTION AND PROGRESSION OF CNL. UNDERSTANDING THE COMPLETE LANDSCAPE AND CHRONOLOGY OF GENOMIC EVENTS IN CNL WILL HELP IN THE DEVELOPMENT OF IMPROVED THERAPEUTIC STRATEGIES FOR THIS PATIENT POPULATION. 2017 9 2697 26 EX VIVO MODELS OF CHRONIC GRANULOMATOUS DISEASE. INDUCED PLURIPOTENT STEM CELLS (IPSCS) ARE PLURIPOTENT STEM CELLS THAT CAN BE ESTABLISHED FROM DEDIFFERENTIATION OF ALL SOMATIC CELL TYPES BY EPIGENETIC PHENOMENA. IPSCS CAN BE DIFFERENTIATED INTO ANY MATURE CELLS LIKE NEURONS, HEPATOCYTES, OR PANCREATIC CELLS THAT HAVE NOT BEEN EASILY AVAILABLE TO DATE. THUS, IPSCS ARE WIDELY USED FOR DISEASE MODELING, DRUG DISCOVERY, AND CELL THERAPY DEVELOPMENT. HERE, WE DESCRIBE A PROTOCOL TO OBTAIN HUMAN MATURE AND FUNCTIONAL NEUTROPHILS AND MACROPHAGES AS EX VIVO MODELS OF X-LINKED CHRONIC GRANULOMATOUS DISEASE (X-CGD). THIS METHOD CAN BE APPLIED TO MODEL THE OTHER GENETIC FORMS OF CGD. WE ALSO DESCRIBE METHODS FOR TESTING THE CHARACTERISTICS AND FUNCTIONS OF NEUTROPHILS AND MACROPHAGES BY MORPHOLOGY, PHAGOCYTOSIS ASSAY, RELEASE OF GRANULE MARKERS OR CYTOKINES, CELL SURFACE MARKERS, AND NADPH OXIDASE ACTIVITY. 2019 10 5539 26 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 11 5425 27 REGULATION OF MYELOPOIESIS BY THE TRANSCRIPTION FACTOR IRF8. INTERFERON REGULATORY FACTOR-8 (IRF8) IS A TRANSCRIPTION FACTOR EXPRESSED IN HEMATOPOIETIC CELLS, PARTICULARLY IN MONONUCLEAR PHAGOCYTES [MONOCYTES/MACROPHAGES AND DENDRITIC CELLS (DCS)] AND THEIR PROGENITORS. VARIOUS STUDIES HAVE DEMONSTRATED THAT IRF8 IS ESSENTIAL FOR THE DEVELOPMENT OF MONOCYTES, DCS, EOSINOPHILS, AND BASOPHILS. CONVERSELY, IRF8 SUPPRESSES THE GENERATION OF NEUTROPHILS. ACCORDINGLY, IRF8 (-/-) MICE DEVELOP IMMUNODEFICIENCY AND A CHRONIC MYELOID LEUKEMIA (CML)-LIKE DISEASE. MUTATIONS AND LOSS OF EXPRESSION OF THE HUMAN IRF8 GENE ARE ALSO ASSOCIATED WITH IMMUNODEFICIENCY AND CML, RESPECTIVELY. RECENT FINDINGS HAVE BEGUN TO REVEAL THE TRANSCRIPTION FACTOR NETWORK AND EPIGENETIC CHANGES GOVERNED BY IRF8. FOR EXAMPLE, IN MONONUCLEAR PHAGOCYTE PROGENITORS, IRF8 COOPERATES WITH PU.1 TO PROMOTE THE FORMATION OF PROMOTER-DISTAL ENHANCERS TO INDUCE MONOCYTE-RELATED GENES INCLUDING THE CRITICAL DOWNSTREAM TRANSCRIPTION FACTOR GENE KLF4. ON THE OTHER HAND, IRF8 BLOCKS C/EBPALPHA ACTIVITY TO SUPPRESS THE NEUTROPHIL DIFFERENTIATION PROGRAM. INDEED, IRF8 (-/-) MONONUCLEAR PHAGOCYTE PROGENITORS FAIL TO EFFICIENTLY GENERATE MONOCYTES AND DCS AND, INSTEAD, ABERRANTLY GIVE RISE TO NEUTROPHILS. THIS ARTICLE PROVIDES AN OVERVIEW OF RECENT ADVANCES IN OUR UNDERSTANDING OF THE ROLE OF IRF8 IN MYELOPOIESIS AND RELATED DISEASES. 2015 12 620 34 BIOCHEMISTRY AND MOLECULAR BIOLOGY OF GELATINASE B OR MATRIX METALLOPROTEINASE-9 (MMP-9): THE NEXT DECADE. RESEARCH ON MATRIX METALLOPROTEINASES (MMPS) AND IN PARTICULAR ON GELATINASE B, ALIAS MMP-9, HAS GROWN EXPONENTIALLY IN THE DECADE 2003-2012. STRUCTURAL DETAILS ABOUT FLEXIBILITY OF MMP-9 MONOMERS, TOGETHER WITH GLYCOSYLATION, OLIGOMERIZATION, HETEROGENEITY AND INSTABILITY OF THE WILDTYPE ENZYME EXPLAIN WHY CRYSTALLOGRAPHY EXPERIMENTS HAVE NOT YET BEEN SUCCESSFUL FOR THE INTACT ENZYME. MMP-9 MAY BE VIEWED AS A MULTIDOMAIN ENZYME IN WHICH THE HEMOPEXIN, THE O-GLYCOSYLATED AND THE CATALYTIC DOMAINS YIELD SUPPORT FOR ATTACHMENT, ARTICULATION AND CATALYSIS, RESPECTIVELY. THE STEPWISE PROTEOLYTIC ACTIVATION OF THE INACTIVE ZYMOGEN INTO A CATALYTICALLY ACTIVE FORM BECOMES GRADUALLY BETTER UNDERSTOOD. PRIMING OF ACTIVATION BY MMP-3 MAY BE EXECUTED BY MEPRINS THAT DESTABILIZE THE INTERACTION OF THE AMINOTERMINUS WITH THE THIRD FIBRONECTIN REPEAT. ALTERNATIVELY, AUTOCATALYTIC ACTIVATION MAY OCCUR IN THE PRESENCE OF MOLECULES THAT TIGHTLY BIND TO THE CATALYTIC SITE AND THAT PUSH THE CYSTEIN RESIDUE IN THE PRODOMAIN AWAY FROM THE CATALYTIC ZINC ION. THANKS TO THE DEVELOPMENT OF DEGRADOMICS TECHNOLOGIES, SUBSTRATE REPERTOIRES OF MMP-9 HAVE BEEN DEFINED, BUT IT REMAINS A CHALLENGE TO DETERMINE AND PROVE WHICH SUBSTRATES ARE BIOLOGICALLY RELEVANT. THE SUBSTRATE REPERTOIRE HAS BEEN ENLARGED FROM EXTRACELLULAR TO MEMBRANE-BOUND AND EFFICIENT INTRACELLULAR SUBSTRATES, SUCH AS CRYSTALLINS, TUBULINS AND ACTINS. BIOLOGICAL STUDIES OF MMP-9 HAVE TUNED THE FIELD FROM BEING PRIMARILY CANCER-ORIENTED TOWARDS VASCULAR AND INFLAMMATORY RESEARCH. IN TUMOR BIOLOGY, IT HAS BEEN INCREASINGLY APPRECIATED THAT MMP-9 FROM INFLAMMATORY CELLS, PARTICULARLY NEUTROPHILS, CO-DETERMINES PROGNOSIS AND OUTCOME. ASIDE FROM THE CATALYTIC FUNCTIONS EXECUTED BY AMINOTERMINAL DOMAINS OF MMP-9, THE CARBOXYTERMINAL HEMOPEXIN (PEX) DOMAIN OF GELATINASE B EXERTS NON-CATALYTIC ANTI-APOPTOTIC SIGNALING EFFECTS. THE RECOGNITION THAT GELATINASE B IS INDUCED BY MANY PRO-INFLAMMATORY CYTOKINES, WHEREAS ITS INHIBITORS ARE INCREASED BY ANTI-INFLAMMATORY CYTOKINES, HAS GENERATED INTEREST TO TARGET MMP-9 IN ACUTE LETHAL CONDITIONS, SUCH AS BACTERIAL MENINGITIS, SEPSIS AND ENDOTOXIN SHOCK, AND IN ACUTE EXACERBATIONS OF CHRONIC DISEASES. PREVIOUSLY DESCRIBED TRANSCRIPTIONAL REGULATION OF MMP-9 IS COMPLEMENTED BY EPIGENETIC CHECKPOINTS, INCLUDING HISTONE MODIFICATIONS AND MICRORNAS. BECAUSE ACTIVATION OF PROMMP-9 MAY BE EXECUTED BY OTHER MMPS, THE THERAPEUTIC DOGMA THAT MMP INHIBITORS NEED TO BE HIGHLY SELECTIVE MAY BE KEYED DOWN FOR THE TREATMENT OF LIFE-THREATENING CONDITIONS. WHEN INFLAMMATION AND MMP-9 FULFILL BENEFICIAL FUNCTIONS TO CLEAR DAMAGING PROTEIN COMPLEXES, SUCH AS IN SYSTEMIC AUTOIMMUNE DISEASES, THERAPEUTIC MMP INHIBITION HAS TO BE AVOIDED. IN MMP9 GENE KNOCKOUT MICE, SPECIFIC SPONTANEOUS PHENOTYPES EMERGED WITH EFFECTS ON THE SKELETAL, REPRODUCTIVE AND NERVOUS SYSTEMS. THESE FINDINGS NOT ONLY HAVE CLINICAL CORRELATES IN BONE GROWTH AND FERTILITY, BUT ALSO STIMULATE RESEARCH ON THE ROLES OF MMPS AND MMP-9 IN ENDOCRINOLOGY, IMMUNOLOGY AND THE NEUROSCIENCES. MMP9-DEFICIENT MICE ARE VALUABLE TOOLS TO DEFINE MMP-9 SUBSTRATES IN VIVO AND TO STUDY THE ROLE OF THIS ENZYME IN ANIMAL MODELS OF INFLAMMATORY, VASCULAR, NEOPLASTIC AND DEGENERATIVE DISEASES. FUTURE CHALLENGES INCLUDE SOLVING THE CRYSTAL STRUCTURE, DEFINITION OF THE FUNCTIONS OF COVALENT OLIGOMERS AND HETEROMERS IN BIOLOGY AND PATHOLOGY, LIFE-IMAGING OF MMP-9 ACTIVITY, SUBSTRATE DETERMINATION IN SITU AND THE STUDY OF INHIBITOR EFFECTS ON FERTILITY, CANCER AND INFLAMMATION AND IN NEUROBIOLOGY AND REGENERATIVE MEDICINE. SUCH STUDIES WILL BETTER DEFINE CONDITIONS IN WHICH INHIBITION OF MMP-9 IS BENEFICIAL OR HAS TO BE AVOIDED. 2013 13 3760 27 INTEGRATED SINGLE CELL ANALYSIS SHOWS CHRONIC ALCOHOL DRINKING DISRUPTS MONOCYTE DIFFERENTIATION IN THE BONE MARROW. CHRONIC HEAVY ALCOHOL DRINKING (CHD) REWIRES MONOCYTES AND MACROPHAGES TOWARD HEIGHTENED INFLAMMATORY STATES WITH COMPROMISED ANTIMICROBIAL DEFENSES THAT PERSIST AFTER 1-MONTH ABSTINENCE. TO DETERMINE WHETHER THESE CHANGES ARE MEDIATED THROUGH ALTERATIONS IN THE BONE MARROW NICHE, WE PROFILED MONOCYTES AND HEMATOPOIETIC STEM CELL PROGENITORS (HSCPS) FROM CHD RHESUS MACAQUES USING A COMBINATION OF FUNCTIONAL ASSAYS AND SINGLE CELL GENOMICS. CHD RESULTED IN TRANSCRIPTIONAL PROFILES CONSISTENT WITH INCREASED ACTIVATION AND INFLAMMATION WITHIN BONE MARROW RESIDENT MONOCYTES AND MACROPHAGES. FURTHERMORE, CHD RESULTED IN TRANSCRIPTIONAL SIGNATURES ASSOCIATED WITH INCREASED OXIDATIVE AND CELLULAR STRESS IN HSCP. DIFFERENTIATION OF HSCP IN VITRO REVEALED SKEWING TOWARD MONOCYTES EXPRESSING "NEUTROPHIL-LIKE" MARKERS WITH GREATER INFLAMMATORY RESPONSES TO BACTERIAL AGONISTS. FURTHER ANALYSES OF HSCPS SHOWED BROAD EPIGENETIC CHANGES THAT WERE IN LINE WITH EXACERBATED INFLAMMATORY RESPONSES WITHIN MONOCYTES AND THEIR PROGENITORS. IN SUMMARY, CHD ALTERS HSCPS IN THE BONE MARROW LEADING TO THE PRODUCTION OF MONOCYTES POISED TO GENERATE DYSREGULATED HYPER-INFLAMMATORY RESPONSES. 2023 14 3759 28 INTEGRATED SINGLE CELL ANALYSIS SHOWS CHRONIC ALCOHOL DRINKING DISRUPTS MONOCYTE DIFFERENTIATION IN THE BONE MARROW NICHE. CHRONIC ALCOHOL DRINKING REWIRES CIRCULATING MONOCYTES AND TISSUE-RESIDENT MACROPHAGES TOWARDS HEIGHTENED INFLAMMATORY STATES WITH COMPROMISED ANTI-MICROBIAL DEFENSES. AS THESE EFFECTS REMAIN CONSISTENT IN SHORT-LIVED MONOCYTES AFTER A 1-MONTH ABSTINENCE PERIOD IT IS UNCLEAR WHETHER THESE CHANGES ARE RESTRICTED TO THE PERIPHERY OR MEDIATED THROUGH ALTERATIONS IN THE PROGENITOR NICHE. TO TEST THIS HYPOTHESIS, WE PROFILED MONOCYTES/MACROPHAGES AND HEMATOPOIETIC STEM CELL PROGENITORS (HSCP) OF THE BONE MARROW COMPARTMENT FROM RHESUS MACAQUES AFTER 12 MONTHS OF ETHANOL CONSUMPTION USING A COMBINATION OF FUNCTIONAL ASSAYS AND SINGLE CELL GENOMICS. BONE MARROW-RESIDENT MONOCYTES/MACROPHAGES FROM ETHANOL-CONSUMING ANIMALS EXHIBITED HEIGHTENED INFLAMMATION. DIFFERENTIATION OF HSCP IN VITRO REVEALED SKEWING TOWARDS MONOCYTES EXPRESSING NEUTROPHIL-LIKE MARKERS WITH HEIGHTENED INFLAMMATORY RESPONSES TO BACTERIAL AGONISTS. SINGLE CELL TRANSCRIPTIONAL ANALYSIS OF HSCPS SHOWED REDUCED PROLIFERATION BUT INCREASED INFLAMMATORY MARKERS IN MATURE MYELOID PROGENITORS. WE OBSERVED TRANSCRIPTIONAL SIGNATURES ASSOCIATED WITH INCREASED OXIDATIVE AND CELLULAR STRESS AS WELL AS OXIDATIVE PHOSPHORYLATION IN IMMATURE AND MATURE MYELOID PROGENITORS. SINGLE CELL ANALYSIS OF THE CHROMATIN LANDSCAPE SHOWED ALTERED DRIVERS OF DIFFERENTIATION IN MONOCYTES AND PROGENITORS. COLLECTIVELY, THESE DATA INDICATE THAT CHRONIC ETHANOL DRINKING RESULTS IN REMODELING OF THE TRANSCRIPTIONAL AND EPIGENETIC LANDSCAPES OF THE BONE MARROW COMPARTMENT LEADING TO ALTERED FUNCTIONS IN THE PERIPHERY. 2023 15 3507 21 IDENTIFICATION OF TARGET GENES AT JUVENILE IDIOPATHIC ARTHRITIS GWAS LOCI IN HUMAN NEUTROPHILS. JUVENILE IDIOPATHIC ARTHRITIS (JIA) IS THE MOST COMMON CHRONIC RHEUMATIC DISEASE AMONG CHILDREN WHICH COULD CAUSE SEVERE DISABILITY. GENOMIC STUDIES HAVE DISCOVERED SUBSTANTIAL NUMBER OF RISK LOCI FOR JIA, HOWEVER, THE MECHANISM OF HOW THESE LOCI AFFECT JIA DEVELOPMENT IS NOT FULLY UNDERSTOOD. NEUTROPHIL IS AN IMPORTANT CELL TYPE INVOLVED IN AUTOIMMUNE DISEASES. TO BETTER UNDERSTAND THE BIOLOGICAL FUNCTION OF GENETIC LOCI IN NEUTROPHILS DURING JIA DEVELOPMENT, WE TOOK AN INTEGRATED MULTI-OMICS APPROACH TO IDENTIFY TARGET GENES AT JIA RISK LOCI IN NEUTROPHILS AND CONSTRUCTED A PROTEIN-PROTEIN INTERACTION NETWORK VIA A MACHINE LEARNING APPROACH. WE IDENTIFIED GENES LIKELY TO BE JIA RISK LOCI TARGETED GENES IN NEUTROPHILS WHICH COULD CONTRIBUTE TO JIA DEVELOPMENT. 2019 16 3023 30 GENETICS AND IMMUNODYSFUNCTION UNDERLYING BEHCET'S DISEASE AND IMMUNOMODULANT TREATMENT APPROACHES. BEHCET'S DISEASE (BD) IS A CHRONIC AUTOIMMUNE CONDITION PRIMARILY PREVALENT IN POPULATIONS ALONG THE MEDITERRANEAN SEA. THE EXACT ETIOLOGY OF BD HAS NOT BEEN FULLY EXPLAINED YET, BUT THE DISEASE OCCURRENCE IS ASSOCIATED WITH A GENETIC FACTOR, HUMAN LEUKOCYTE ANTIGEN (HLA)-B51 ANTIGEN. AMONG THE VARIOUS IMMUNODYSFUNCTIONS THAT ARE FOUND IN BD, PATIENTS ARE INCREASED NEUTROPHIL MOTILITY AND SUPEROXIDE PRODUCTION, AS WELL AS ELEVATED PRODUCTION OF TUMOR NECROSIS FACTOR (TNF)-ALPHA AND DECREASED PRODUCTION OF INTERLEUKIN (IL)-10. ELEVATED LEVELS OF INFLAMMATORY CYTOKINES LIKE IL-1 AND IL-17 IN BD HAVE BEEN FOUND ASSOCIATED WITH ABERRANT EXPRESSION OF MICRORNA. GENE POLYMORPHISMS IN BD PATIENTS HAVE BEEN OBSERVED IN MOLECULES INVOLVED IN RESPONSES TO PATHOGENS THAT CAN ULTIMATELY MODULATE THE HOST ANTIMICROBIAL RESPONSE. MOREOVER, SEVERAL SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS) HAVE BEEN REPORTED IN GENES ENCODING CHEMOKINES AND ADHESION MOLECULES; MANY OF THESE CHANGES MANIFEST AS INCREASES IN VASCULAR INFLAMMATION AND VASCULAR DAMAGE. LASTLY, GENETIC AND EPIGENETIC CHANGES HAVE BEEN SUGGESTED AS INVOLVED IN THE PATHOGENESIS OF BD. MODIFICATIONS IN DNA METHYLATION HAVE BEEN FOUND IN BD PATIENT MONOCYTES AND LYMPHOCYTES, LEADING TO ADVERSE FUNCTION OF THESE CELLS. THIS REVIEW PRESENTS A COMPREHENSIVE COMPILATION OF THE LITERATURE WITH REGARD TO THE IMMUNODYSFUNCTION UNDERLYING BD, AS WELL AS OF THE GENETICS, NEWLY DESCRIBED CLINICAL SPECIFICATIONS AND NOVEL TREATMENT STRATEGIES USING IMMUNOMODULANTS BASED ON THE CURRENT UNDERSTANDING OF BD. 2017 17 6079 25 THE EFFECT OF CXCL12 PROCESSING ON CD34+ CELL MIGRATION IN MYELOPROLIFERATIVE NEOPLASMS. PRIMARY MYELOFIBROSIS (PMF) AND POLYCYTHEMIA VERA (PV) ARE CHRONIC MYELOPROLIFERATIVE NEOPLASMS. PMF AND, TO A LESSER DEGREE, PV ARE CHARACTERIZED BY CONSTITUTIVE MOBILIZATION OF HEMATOPOIETIC STEM CELLS (HSC) AND PROGENITOR CELLS (HPC) INTO THE PERIPHERAL BLOOD (PB). THE INTERACTION BETWEEN THE CHEMOKINE CXCL12 AND ITS RECEPTOR CXCR4 PLAYS A PIVOTAL ROLE IN DETERMINING THE TRAFFICKING OF CD34(+) CELLS BETWEEN THE BONE MARROW (BM) AND THE PB. PMF, BUT NOT PV, IS ASSOCIATED WITH DOWNREGULATION OF CXCR4 BY CD34(+) CELLS DUE TO EPIGENETIC EVENTS. BOTH PV AND PMF PATIENTS HAVE ELEVATED LEVELS OF IMMUNOREACTIVE FORMS OF CXCL12 IN THE BM AND PB. USING ELECTROSPRAY MASS SPECTROMETRY, THE PB AND BM PLASMA OF PV AND PMF PATIENTS WAS SHOWN TO CONTAIN REDUCED AMOUNTS OF INTACT CXCL12 BUT SIGNIFICANT AMOUNTS OF SEVERAL TRUNCATED FORMS OF CXCL12, WHICH ARE LACKING IN NORMAL PB AND BM PLASMA. THESE TRUNCATED FORMS OF CXCL12 ARE THE PRODUCT OF THE ACTION OF SEVERAL SERINE PROTEASES, INCLUDING DIPEPTIDYL PEPTIDASE-IV, NEUTROPHIL ELASTASE, MATRIX METALLOPROTEINASE-2 (MMP-2), MMP-9, AND CATHEPSIN G. UNLIKE CXCL12, THESE TRUNCATES EITHER LACK THE ABILITY TO ACT AS A CHEMOATTRACTANT FOR CD34(+) CELLS AND/OR ACT AS AN ANTAGONIST TO THE ACTION OF CXCL12. THESE DATA SUGGEST THAT PROTEOLYTIC DEGRADATION OF CXCL12 IS CHARACTERISTIC OF BOTH PV AND PMF AND THAT THE RESULTING TRUNCATED FORMS OF CXCL12, IN ADDITION TO THE REDUCED EXPRESSION OF CXCR4 BY CD34(+) CELLS, LEAD TO A PROFOUND MOBILIZATION OF HSC/HPC IN PMF. 2010 18 1072 25 CLONAL EVOLUTION IN A CHRONIC NEUTROPHILIC LEUKEMIA PATIENT. OBJECTIVES AND IMPORTANCE: CHRONIC NEUTROPHILIC LEUKEMIA (CNL) IS A DISTINCT MYELOPROLIFERATIVE NEOPLASM WITH A HIGH PREVALENCE (>80%) OF MUTATIONS IN THE COLONY-STIMULATING FACTOR 3 RECEPTOR (CSF3R); THESE MUTATIONS ACTIVATE THE RECEPTOR, LEADING TO THE PROLIFERATION OF NEUTROPHILS THAT ARE A HALLMARK OF CNL. CLINICAL PRESENTATION: WE PRESENT A MALE PATIENT WHO PRESENTED PERIPHERAL BLOOD LEUKOCYTOSIS. ON THE BASIS OF HIS MORPHOLOGICAL APPEARANCES AND MOLECULAR FINDINGS HE WAS DETERMINED TO HAVE A DIAGNOSIS OF CHRONIC NEUTROPHILIC LEUKEMIA. AT A FOLLOW-UP AT 7 MONTHS, IN ADDITION TO THE CSF3R C.2373G > A (P.W791*) TRUNCATED MUTATION, ANOTHER CSF3R MUTATION APPEARED AS C.1853C > T(P.T618I). DISCUSSION AND CONCLUSION: WE PRESENT THE FIRST PATIENT WITH A DIAGNOSIS OF CHRONIC NEUTROPHILIC LEUKEMIA WITH A C.2373G > A (P.W791*) TRUNCATED MUTATION OF CSF3R. THESE FINDINGS ELUCIDATE A NOVEL PARADIGM OF CNL PATHOGENESIS AND EXPLAIN HOW MUTATIONS DRIVE THE DEVELOPMENT OF THE DISEASE. THE ORDER OF ACQUISITION OF CSF3R MUTATIONS RELATIVE TO MUTATIONS IN EPIGENETIC MODIFIERS AND THE SPLICEOSOME HAVE BEEN DETERMINED ONLY IN ISOLATED CASE REPORTS; THUS, FURTHER WORK IS NEEDED TO UNDERSTAND THE IMPACT OF MUTATION CHRONOLOGY ON THE CLONAL EVOLUTION AND PROGRESSION OF CNL. 2019 19 4272 27 MICROBIOME AND BEHCET'S DISEASE: A SYSTEMATIC REVIEW. THE AIM OF THIS REVIEW WAS TO DESCRIBE THE CHANGES IN THE MICROBIOTA OF PATIENTS WITH BEHCET'S DISEASE (BD) AND THE MECHANISMS INVOLVED IN THE RELATIONSHIP BETWEEN THE MICROBIOME AND IMMUNITY IN BD. A SYSTEMATIC SEARCH FOR RELEVANT ARTICLES WAS MADE ON PUBMED AND THE COCHRANE LIBRARY DATABASE USING THE FOLLOWING TERMS: "MICROBIOTA AND BEHCET'S DISEASE" OR "MICROBIOME AND BEHCET'S DISEASE". SIXTEEN ARTICLES WERE INCLUDED IN A QUALITATIVE SYNTHESIS. THIS SYSTEMATIC REVIEW ON THE MICROBIOME AND BEHCET'S DISEASE UNDERLINES THE PRESENCE OF GUT DYSBIOSIS IN BD PATIENTS. THIS DYSBIOSIS IS MARKED BY (I) A DECREASE IN BUTYRATE-PRODUCING BACTERIA, WHICH COULD AFFECT T CELL DIFFERENTIATION AND EPIGENETIC REGULATION OF IMMUNE-RELATED GENES, (II) A MODIFICATION OF TRYPTOPHAN-METABOLISING BACTERIA, WHICH COULD BE LINKED TO DYSREGULATED IL-22 SECRETION, AND (III) A DECREASE IN BACTERIA KNOWN TO HAVE ANTI-INFLAMMATORY PROPERTIES. REGARDING ORAL MICROBIOTA, THIS REVIEW UNDERLINES THE POSSIBLE ROLE OF STREPTOCOCCUS SANGUINIS THROUGH MOLECULAR MIMICRY AND NETOSIS. CLINICAL STUDIES OF BD HAVE SHOWN THAT (I) NEED FOR DENTISTRY IS ASSOCIATED WITH A MORE SEVERE COURSE IN BD, AND (II) ANTIBIOTIC-SUPPLEMENTED MOUTHWASH REDUCES PAIN AND ULCERS. FECAL TRANSPLANTATION OF BD PATIENTS' MICROBIOTA INTO MOUSE MODELS LED TO DECREASED SCFA PRODUCTION, NEUTROPHIL ACTIVATION, AND TH1/TH17 RESPONSES.RECIPIENT MICE SHOWED EXACERBATED EXPERIMENTAL AUTOIMMUNE UVEITIS (EAU) AND EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS (EAE). IN HERPES VIRUS SIMPLEX-1 (HSV-1) INFECTED MICE MIMICKING BD, ADMINISTRATION OF BUTYRATEPRODUCING BACTERIA IMPROVED SYMPTOMS AND IMMUNE VARIABLES. THE MICROBIOME MAY THUS BE INVOLVED IN BD THROUGH IMMUNITY REGULATION AND EPIGENETIC MODIFICATIONS. 2023 20 959 25 CHRONIC MYELOMONOCYTIC LEUKEMIA AND ATYPICAL CHRONIC MYELOID LEUKEMIA: NOVEL PATHOGENETIC LESIONS. CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) AND ATYPICAL CHRONIC MYELOID LEUKEMIA (ACML) ARE DISTINCT, YET RELATED, ENTITIES OF MYELODYSPLASTIC/MYELOPROLIFERATIVE NEOPLASMS (MDS/MPN) CHARACTERIZED BY MORPHOLOGIC DYSPLASIA WITH ACCUMULATION OF MONOCYTES OR NEUTROPHILS, RESPECTIVELY. OUR UNDERSTANDING OF THE MOLECULAR PATHOGENESIS OF CMML AND ACML HAS ADVANCED, MAINLY DUE TO THE APPLICATION OF NOVEL TECHNOLOGIES SUCH AS ARRAY-BASED KARYOTYPING AND NEXT-GENERATION SEQUENCING. IN ADDITION TO PREVIOUSLY KNOWN RECURRENT ABERRATIONS, SOMATIC UNIPARENTAL DISOMY AFFECTING CHROMOSOMES 3, 4, 7, AND 11 FREQUENTLY OCCURS IN CMML. NOVEL SOMATIC MUTATIONS OF GENES, INCLUDING THOSE ASSOCIATED WITH PROLIFERATION SIGNALING (CBL, RAS, RUNX1, JAK2 (V617F)) AND WITH MODIFICATION OF EPIGENETIC STATUS (TET2, ASXL1, UTX, EZH2) HAVE BEEN FOUND. VARIOUS COMBINATIONS OF MUTATIONS SUGGEST A MULTISTEP PATHOGENESIS AND MAY ACCOUNT FOR CLINICAL HETEROGENEITY. MOST RECENTLY, SEVERAL SPLICEOSOME-ASSOCIATED-GENE MUTATIONS WERE REPORTED AND SRSF2 MUTATIONS ARE FREQUENTLY DETECTED IN CMML. THE PROGNOSTIC AND DIAGNOSTIC SIGNIFICANCE OF THESE MOLECULAR LESIONS, IN PARTICULAR THEIR VALUE AS BIOMARKERS OF RESPONSE OR RESISTANCE TO SPECIFIC THERAPIES, WHILE UNCERTAIN NOW IS LIKELY TO BE CLARIFIED AS LARGE SYSTEMATIC STUDIES COME TO COMPLETION. 2012