1 5054 171 PHARMACOPROTEOMICS REVEAL NOVEL PROTECTIVE ACTIVITY OF BROMODOMAIN CONTAINING 4 INHIBITORS ON VASCULAR HOMEOSTASIS IN TLR3-MEDIATED AIRWAY REMODELING. SMALL MOLECULE INHIBITORS OF THE EPIGENETIC REGULATOR BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) ARE POTENTIAL THERAPEUTICS FOR VIRAL AND ALLERGEN-INDUCED AIRWAY REMODELING. A LIMITATION OF THEIR PRECLINICAL ADVANCEMENT IS THE LACK OF DETAILED UNDERSTANDING OF MECHANISMS OF ACTION AND BIOMARKERS OF EFFECT. WE REPORT A SYSTEMS-LEVEL PHARMACOPROTEOMICS IN A STANDARDIZED MURINE MODEL OF TOLL-LIKE RECEPTOR TLR3-NFKAPPAB/RELA INNATE INFLAMMATION IN THE ABSENCE OR PRESENCE OF A HIGHLY SELECTIVE BRD4 INHIBITOR (ZL0454) OR NONSELECTIVE BROMODOMAIN AND EXTRATERMINAL DOMAIN INHIBITOR (JQ1). PROTEOMICS OF BRONCHOALVEOLAR LAVAGE FLUID (BALF) SECRETOME AND EXOSOMAL PROTEINS FROM THIS MURINE MODEL REVEALED INCREASED, SELECTIVE, CAPILLARY LEAK ASSOCIATED WITH PERICYTE-MYOFIBROBLAST TRANSITION, A PHENOMENON BLOCKED BY BRD4 INHIBITORS. BALF PROTEOMICS ALSO SUGGESTED THAT ZL0454 BETTER REDUCED THE VASCULAR LEAKAGE AND EXTRACELLULAR MATRIX DEPOSITION THAN JQ1. A SIGNIFICANT SUBSET OF INFLAMMATION-MEDIATED REMODELING FACTORS WAS ALSO IDENTIFIED IN A MOUSE MODEL OF IDIOPATHIC PULMONARY FIBROSIS PRODUCED BY BLEOMYCIN. BALF EXOSOME ANALYSIS INDICATED THAT BRD4 INHIBITORS REDUCED THE INDUCTION OF EXOSOMES ENRICHED IN COAGULATION FACTORS WHOSE PRESENCE CORRELATED WITH INTERSTITIAL FIBRIN DEPOSITION. FINALLY, BALF SAMPLES FROM HUMANS WITH SEVERE ASTHMA DEMONSTRATED SIMILAR UPREGULATIONS OF ORM2, APCS, SPARCL1, FGA, AND FN1, SUGGESTING THEIR POTENTIAL AS BIOMARKERS FOR EARLY DETECTION OF AIRWAY REMODELING AND/OR MONITORING OF THERAPY RESPONSE. SIGNIFICANCE: REPETITIVE AND CHRONIC VIRAL UPPER RESPIRATORY TRACT INFECTIONS TRIGGER TOLL-LIKE RECEPTOR (TLR)3-NFKAPPAB/RELA MEDIATED AIRWAY REMODELING WHICH IS LINKED TO A PROGRESSIVE DECLINE IN PULMONARY FUNCTION IN PATIENTS WITH ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE. SMALL MOLECULE INHIBITORS OF THE EPIGENETIC REGULATOR BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) ARE POTENTIAL THERAPEUTICS FOR VIRAL AND ALLERGEN-INDUCED AIRWAY REMODELING. A LIMITATION OF THEIR PRECLINICAL ADVANCEMENT IS THE LACK OF DETAILED UNDERSTANDING OF MECHANISMS OF ACTION AND BIOMARKERS OF EFFECT. OUR STUDY REVEALED THAT THE ACTIVATION OF (TLR)3-NFKAPPAB/RELA PATHWAY IN THE LUNG INDUCED AN ELEVATION IN COAGULATION, COMPLEMENT, AND PLATELET FACTORS, INDICATING THE INCREASED VASCULAR LEAK DURING AIRWAY REMODELING. THE MECHANISM OF VASCULAR LEAKAGE WAS CHRONIC INFLAMMATION-INDUCED PERICYTE-MYOFIBROBLAST TRANSITION, WHICH WAS BLOCKED BY BRD4 INHIBITORS. FINALLY, PROTEOMICS ANALYSIS OF THE BRONCHOALVEOLAR LAVAGE FLUID SAMPLES FROM HUMANS WITH SEVERE ASTHMA DEMONSTRATED SIMILAR FINDINGS THAT WE OBSERVED IN THE ANIMAL MODEL. 2019 2 5907 51 TARGET-BASED SMALL MOLECULE DRUG DISCOVERY TOWARDS NOVEL THERAPEUTICS FOR INFLAMMATORY BOWEL DISEASES. INFLAMMATORY BOWEL DISEASE (IBD), INCLUDING ULCERATIVE COLITIS (UC) AND CROHN'S DISEASE (CD), IS A CLASS OF SEVERE AND CHRONIC DISEASES OF THE GASTROINTESTINAL (GI) TRACT WITH RECURRENT SYMPTOMS AND SIGNIFICANT MORBIDITY. LONG-TERM PERSISTENCE OF CHRONIC INFLAMMATION IN IBD IS A MAJOR CONTRIBUTING FACTOR TO NEOPLASTIC TRANSFORMATION AND THE DEVELOPMENT OF COLITIS-ASSOCIATED COLORECTAL CANCER. CONVERSELY, PERSISTENCE OF TRANSMURAL INFLAMMATION IN CD IS ASSOCIATED WITH FORMATION OF FIBROSING STRICTURES, RESULTING IN SUBSTANTIAL MORBIDITY. THE RECENT INTRODUCTION OF BIOLOGICAL RESPONSE MODIFIERS AS IBD THERAPIES, SUCH AS ANTIBODIES NEUTRALIZING TUMOR NECROSIS FACTOR (TNF)-ALPHA, HAVE REPLACED NONSELECTIVE ANTI-INFLAMMATORY CORTICOSTEROIDS IN DISEASE MANAGEMENT. HOWEVER, A LARGE PROPORTION (~40%) OF PATIENTS WITH THE TREATMENT OF ANTI-TNF-ALPHA ANTIBODIES ARE DISCONTINUED OR WITHDRAWN FROM THERAPY BECAUSE OF (1) PRIMARY NONRESPONSE, (2) SECONDARY LOSS OF RESPONSE, (3) OPPORTUNISTIC INFECTION, OR (4) ONSET OF CANCER. THEREFORE, THE DEVELOPMENT OF NOVEL AND EFFECTIVE THERAPEUTICS TARGETING SPECIFIC SIGNALING PATHWAYS IN THE PATHOGENESIS OF IBD IS URGENTLY NEEDED. IN THIS COMPREHENSIVE REVIEW, WE SUMMARIZE THE RECENT ADVANCES IN DRUG DISCOVERY OF NEW SMALL MOLECULES IN PRECLINICAL OR CLINICAL DEVELOPMENT FOR TREATING IBD THAT TARGET BIOLOGICALLY RELEVANT PATHWAYS IN MUCOSAL INFLAMMATION. THESE INCLUDE INTRACELLULAR ENZYMES (JANUS KINASES, RECEPTOR INTERACTING PROTEIN, PHOSPHODIESTERASE 4, IKAPPAB KINASE), INTEGRINS, G PROTEIN-COUPLED RECEPTORS (S1P, CCR9, CXCR4, CB2) AND INFLAMMASOME MEDIATORS (NLRP3), ETC. WE WILL ALSO DISCUSS EMERGING EVIDENCE OF A DISTINCT MECHANISM OF ACTION, BROMODOMAIN-CONTAINING PROTEIN 4, AN EPIGENETIC REGULATOR OF PATHWAYS INVOLVED IN THE ACTIVATION, COMMUNICATION, AND TRAFFICKING OF IMMUNE CELLS. WE HIGHLIGHT THEIR CHEMOTYPES, MODE OF ACTIONS, STRUCTURE-ACTIVITY RELATIONSHIPS, CHARACTERIZATIONS, AND THEIR IN VITRO/IN VIVO ACTIVITIES AND THERAPEUTIC POTENTIAL. THE PERSPECTIVES ON THE RELEVANT CHALLENGES, NEW OPPORTUNITIES, AND FUTURE DIRECTIONS IN THIS FIELD ARE ALSO DISCUSSED. 2021 3 2578 35 EPIGENETICS OF INFLAMMATORY BOWEL DISEASES. INFLAMMATORY BOWEL DISEASES ARE MULTIFACTORIAL, CHRONIC, CONTINUOUS, RELAPSING, AND IMMUNE-MEDIATED DISEASES OF THE GASTROINTESTINAL TRACT. IT HAS BEEN BELIEVED THAT MECHANISMS UNDERLYING INFLAMMATORY BOWEL DISEASES INCLUDE GENETIC PREDISPOSITION, ENVIRONMENTAL FACTORS, AND ALTERED IMMUNE RESPONSE TO THE GUT MICROBIOME. THE EPIGENETIC MODULATION TAKES PLACE VIA CHROMATIN MODIFICATIONS, INCLUDING PHOSPHORYLATION, ACETYLATION, METHYLATION, SUMOYLATION, AND UBIQUITINATION. THE METHYLATION LEVELS OF COLONIC TISSUE WERE FOUND WELL CORRELATED TO BLOOD SAMPLES IN INFLAMMATORY BOWEL DISEASES. MOREOVER, THE METHYLATION LEVEL OF SPECIFIC GENES WAS DIFFERENT BETWEEN CROHN'S DISEASE AND ULCERATIVE COLITIS. IT HAS BEEN SHOWN THAT THE ENZYMES AFFECTING HISTONE MODIFICATIONS LIKE HISTONE DEACETYLASES AND HISTONE ACETYLTRANSFERASES DO NOT ACT SOLELY ON HISTONES BUT ALSO AFFECT THE ACETYLATION OF MANY PROTEINS SUCH AS P53 AND STAT3. IT HAS BEEN ALREADY SHOWN THAT A NONSELECTIVE HISTONE DEACETYLASE INHIBITOR, VORINOSTAT (SAHA), WHICH IS CURRENTLY BEING USED IN SEVERAL CANCER TREATMENTS, SHOWED ANTI-INFLAMMATORY ACTIVITIES IN MOUSE MODELS. AMONG EPIGENETIC ALTERATIONS, LONG NON-CODING RNAS AND MICRORNAS PLAY SIGNIFICANT ROLES IN T-CELL MATURATION, DIFFERENTIATION, ACTIVATION, AND SENILITY. THE LONG NON-CODING RNA AND MICRORNA EXPRESSION PROFILES CAN PERFECTLY SEPARATE INFLAMMATORY BOWEL DISEASE PATIENTS FROM HEALTHY CONTROLS AND ARE REMARKED AS BIOMARKERS OF INFLAMMATORY BOWEL DISEASES. OVERALL, MANY STUDIES HAVE SHOWN THAT EPIGENETIC INHIBITORS CAN TARGET SIGNIFICANT SIGNAL PATHWAYS IN THE PATHOGENESIS OF INFLAMMATORY BOWEL DISEASES, AND THE IMPACT OF EPIGENETIC INHIBITORS IS BEING STUDIED IN CLINICAL TRIALS. IN CONCLUSION, EXPLORING MORE EPIGENETIC PATHWAYS REGARDING INFLAMMATORY BOWEL DISEASE PATHOGENESIS WILL HELP US TO DISCOVER THERAPEUTIC TARGETS AND NEW DRUGS AND AGENTS TARGETING MIRNAS IN INFLAMMATORY BOWEL DISEASES. IN GENERAL, DISCOVERING EPIGENETIC TARGETS COULD IMPROVE THE DIAGNOSIS AND TREATMENT OF INFLAMMATORY BOWEL DISEASES. 2023 4 4724 30 NONINVASIVE MULTIMODAL METHODS TO DIFFERENTIATE INFLAMED VS FIBROTIC STRICTURES IN PATIENTS WITH CROHN'S DISEASE. FIBROTIC STRICTURES OCCUR IN 30% OF PATIENTS WITH CROHN'S DISEASE (CD). HOWEVER, THERE ARE NO THERAPEUTIC AGENTS THAT PREVENT OR REVERSE FIBROTIC STRICTURES. STRICTURES ARE TREATED BY ENDOSCOPIC DILATATION PROCEDURES AND SURGICAL PROCEDURES, BUT THERE ARE HIGH RATES OF RECURRENCE. TWO ANTIFIBROTIC AGENTS (NINTEDANIB AND PIRFENIDONE) RECENTLY WERE APPROVED FOR THE TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS AND INHIBITORS OF RHO-ASSOCIATED PROTEIN KINASES 1 AND 2 REVERSED FIBROSIS IN MICE WITH CHRONIC INTESTINAL INFLAMMATION. CROSS-SECTIONAL IMAGING TECHNIQUES, SUCH AS MAGNETIC RESONANCE (MR) ENTEROGRAPHY, COMPUTED TOMOGRAPHY ENTEROGRAPHY, AND BOWEL ULTRASOUND, ARE USED TO ASSESS SMALL-BOWEL AND CD-RELATED COMPLICATIONS, INCLUDING STRICTURES. IT IS IMPORTANT TO BE ABLE TO DETERMINE THE DEGREE OF INFLAMMATION AND FIBROSIS IN STRICTURES TO SELECT THE BEST THERAPY; THIS CAN BE A CHALLENGE BECAUSE INFLAMMATION AND FIBROSIS CO-EXIST TO VARYING DEGREES IN A DAMAGED BOWEL SEGMENT. DELAYED GADOLINIUM ENHANCEMENT, MAGNETIZATION TRANSFER MR IMAGING, AND ULTRASOUND ELASTOGRAPHY SEEM TO BE PROMISING TOOLS FOR ASSESSING FIBROSIS IN PATIENTS WITH CD. WE REVIEW NONINVASIVE TECHNIQUES FOR FIBROSIS ASSESSMENT, INCLUDING ANALYSES OF GENETIC, EPIGENETIC, AND PROTEIN MARKERS. WE DISCUSS THE POTENTIAL OF IMAGING TECHNIQUES SUCH AS DIFFUSION-WEIGHTED AND MAGNETIZATION TRANSFER MR IMAGING, STRAIN ELASTOGRAPHY, SHEAR-WAVE IMAGING, AND POSITRON EMISSION TOMOGRAPHY TO GUIDE THERAPEUTIC DECISIONS FOR PATIENTS WITH STRICTURING CD. 2019 5 6687 33 VALIDATION OF THE EPIGENETIC READER BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) AS A THERAPEUTIC TARGET FOR TREATMENT OF AIRWAY REMODELING. STRUCTURAL REMODELING IS CENTRAL TO THE INITIATION AND PROGRESSION OF MANY CHRONIC LUNG DISEASES, REPRESENTING AN IMPORTANT UNMET NEED. WE EXAMINE THE EVIDENCE SUPPORTING BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) AS A VALIDATED BIOLOGICAL TARGET FOR TREATMENT OF AIRWAY REMODELING. IN EPITHELIAL CELLS AND FIBROBLASTS, BRD4 SERVES AS A SCAFFOLD FOR CHROMATIN REMODELING COMPLEXES IN ACTIVE SUPER-ENHANCERS. IN RESPONSE TO INFLAMMATORY STIMULI, BRD4 IS REPOSITIONED TO INNATE AND MESENCHYMAL GENES ACTIVATING THEIR PRODUCTION. PROOF-OF-CONCEPT STUDIES SHOW PROMISING BENEFIT OF SELECTIVE BRD4 INHIBITORS IN DISRUPTING EPITHELIAL MESENCHYMAL TRANSITION AND MYOFIBROBLAST TRANSITION IN DIVERSE MODELS OF LUNG INJURY. RECENT IDENTIFICATION OF BIOMARKERS OF BRD4 PROVIDES A BASIS FOR FURTHER DRUG DEVELOPMENT FOR APPLICATION IN VIRAL-INDUCED AIRWAY INFLAMMATION, COPD AND INTERSTITIAL LUNG DISEASES. 2020 6 700 36 BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4): A KEY PLAYER IN INFLAMMATORY BOWEL DISEASE AND POTENTIAL TO INSPIRE EPIGENETIC THERAPEUTICS. INTRODUCTION: INFLAMMATORY BOWEL DISEASES (IBDS) ARE DEBILITATING CHRONIC INFLAMMATORY DISORDERS WITH INCREASING PREVALENCE WORLDWIDE. EPIGENETIC REGULATOR BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) IS CRITICAL IN CONTROLLING GENE EXPRESSION OF IBD-ASSOCIATED INFLAMMATORY CYTOKINE NETWORKS. BRD4 AS A PROMISING THERAPEUTIC TARGET IS ALSO TIGHTLY ASSOCIATED WITH MANY OTHER DISEASES, SUCH AS AIRWAY INFLAMMATION AND FIBROSIS, CANCERS, INFECTIOUS DISEASES AND CENTRAL NERVOUS SYSTEM DISORDERS. AREAS COVERED: THIS REVIEW BRIEFLY SUMMARIZED THE CRITICAL ROLE OF BRD4 IN THE PATHOGENESIS OF IBDS AND THE CURRENT CLINICAL LANDSCAPE OF DEVELOPING BROMODOMAIN AND EXTRA TERMINAL DOMAIN (BET) INHIBITORS. THE CHALLENGES AND OPPORTUNITIES AS WELL AS FUTURE DIRECTIONS OF TARGETING BRD4 INHIBITION FOR POTENTIAL IBD MEDICATIONS WERE ALSO DISCUSSED. EXPERT OPINION: TARGETING BRD4 WITH POTENT AND SPECIFIC INHIBITORS MAY OFFER NOVEL EFFECTIVE THERAPEUTICS FOR IBD PATIENTS, PARTICULARLY THOSE WHO ARE REFRACTORY TO ANTI-TNFALPHA THERAPY AND IBD-RELATED PROFIBROTIC. DEVELOPING HIGHLY SPECIFIC BRD4 INHIBITORS FOR IBD MEDICATIONS MAY HELP ERASE THE DRAWBACKS OF MOST CURRENT PAN-BET/BRD4 INHIBITORS, SUCH AS OFF-TARGET EFFECTS, POOR ORAL BIOAVAILABILITY, AND LOW GUT MUCOSAL ABSORBANCE. NOVEL STRATEGIES SUCH AS COMBINATORIAL THERAPY, BRD4-BASED DUAL INHIBITORS AND PROTEOLYSIS TARGETING CHIMERAS (PROTACS) MAY ALSO HAVE GREAT POTENTIAL TO MITIGATE SIDE EFFECTS AND OVERCOME DRUG RESISTANCE DURING IBD TREATMENT. 2023 7 4756 44 NOVEL THERAPEUTIC TARGET(S) FOR PSORIATIC DISEASE. PSORIASIS AND PSORIATIC ARTHRITIS, TOGETHER KNOWN AS PSORIATIC DISEASE, IS HIGHLY PREVALENT CHRONIC RELAPSING INFLAMMATORY DISEASE AFFECTING SKIN, JOINTS OR BOTH AND IS ASSOCIATED WITH SEVERAL COMORBIDITIES SUCH AS CARDIOVASCULAR, METABOLIC, PSYCHIATRIC, RENAL DISEASE ETC. THE ETIOPATHOGENESIS OF PSORIASIS IS COMPLEX AND MAINLY DRIVEN BY ABERRANT IMMUNE RESPONSE OWING TO THE GENETIC SUSCEPTIBILITY AND VARIOUS ENVIRONMENTAL FACTORS SUCH AS TRAUMA, INFECTIONS AND DRUGS. RECENT ADVANCES IN UNDERSTANDING MOLECULAR AND CELLULAR PATHWAYS HAVE IDENTIFIED TUMOR NECROSIS FACTOR-ALPHA (TNF-ALPHA), INTERLEUKIN-17 (IL-17), IL-23, IL-22 AS MAJOR CONTRIBUTORS IN PSORIASIS PATHOGENESIS. ADVANCES IN THE KNOWLEDGE OF PATHOPHYSIOLOGY, THE INTERACTION OF AUTOINFLAMMATION AND CLINICAL PHENOTYPES HAVE LED TO THE DEVELOPMENT OF HIGHLY EFFECTIVE TARGETED THERAPEUTIC AGENTS WHICH INCLUDE TNF-ALPHA, IL-17, IL-23, IL-1 ALPHA/BETA OR IL-36 INHIBITORS OR RECEPTOR BLOCKERS, SMALL MOLECULE DRUGS LIKE PHOSPHODIESTERASE-4 INHIBITORS (APREMILAST), JANUS KINASE (JAK) INHIBITORS, RETINOIC ACID RECEPTOR-RELATED ORPHAN RECEPTOR GAMMAT (RORGAMMAT) INHIBITORS. THESE NOVEL DRUGS HAVE PROMISED THE POTENTIAL OF IMPROVED DISEASE CONTROL. IN RECENT YEARS, THE TRANSITION FROM BIOLOGICS TO BIOSIMILARS ESPECIALLY WITH TNF-ALPHA INHIBITORS HAD SIGNIFICANT IMPACT ON DECREASING HEALTH CARE COST AND INCREASING THERAPEUTIC OPTIONS TO THE PATIENTS. HOWEVER, SELECTION OF RIGHT TREATMENT FOR AN INDIVIDUAL PATIENT STILL REMAINS CHALLENGING. MOREOVER, INTERPLAY BETWEEN DIFFERENT EPIGENETIC MECHANISMS SUCH AS THE DNA METHYLATION, CHROMATIN MODIFICATIONS AND NONCODING RNA REGULATION HAS RECENTLY BEEN STARTED TO BE DECIPHERED. ENZYMES INHIBITORS INVOLVED IN EPIGENETIC PATHWAYS SUCH AS DNA METHYLTRANSFERASES AND HISTONE DEACETYLASES DEMONSTRATED TO RESTORE NORMAL EPIGENETIC PATTERNS IN CLINICAL SETTINGS AND HAVE PROVIDED THE POTENTIAL AS NOVEL THERAPEUTIC TARGETS FOR PSORIASIS. IN THIS REVIEW, WE WILL DISCUSS NOVEL BIOLOGIC AGENTS AND NEWER THERAPEUTIC APPROACHES IN TREATMENT OF PSORIATIC DISEASE. 2022 8 698 68 BROMODOMAIN CONTAINING PROTEIN 4 (BRD4) REGULATES EXPRESSION OF ITS INTERACTING COACTIVATORS IN THE INNATE RESPONSE TO RESPIRATORY SYNCYTIAL VIRUS. BROMODOMAIN-CONTAINING PROTEIN 4 PLAYS A CENTRAL ROLE IN COORDINATING THE COMPLEX EPIGENETIC COMPONENT OF THE INNATE IMMUNE RESPONSE. PREVIOUS STUDIES IMPLICATED BRD4 AS A COMPONENT OF A CHROMATIN-MODIFYING COMPLEX THAT IS DYNAMICALLY RECRUITED TO A NETWORK OF PROTECTIVE CYTOKINES BY BINDING ACTIVATED TRANSCRIPTION FACTORS, POLYMERASES, AND HISTONES TO TRIGGER THEIR RAPID EXPRESSION VIA TRANSCRIPTIONAL ELONGATION. OUR PREVIOUS STUDY EXTENDED OUR UNDERSTANDING OF THE AIRWAY EPITHELIAL BRD4 INTERACTOME BY IDENTIFYING OVER 100 FUNCTIONALLY IMPORTANT COACTIVATORS AND TRANSCRIPTION FACTORS, WHOSE ASSOCIATION IS INDUCED BY RESPIRATORY SYNCYTIAL VIRUS (RSV) INFECTION. RSV IS AN ETIOLOGICAL AGENT OF RECURRENT RESPIRATORY TRACT INFECTIONS ASSOCIATED WITH EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. USING A HIGHLY SELECTIVE SMALL-MOLECULE BRD4 INHIBITOR (ZL0454) DEVELOPED BY US, WE EXTEND THESE FINDINGS TO IDENTIFY THE GENE REGULATORY NETWORK DEPENDENT ON BRD4 BROMODOMAIN (BD) INTERACTIONS. HUMAN SMALL AIRWAY EPITHELIAL CELLS WERE INFECTED IN THE ABSENCE OR PRESENCE OF ZL0454, AND GENE EXPRESSION PROFILING WAS PERFORMED. A HIGHLY REPRODUCIBLE DATASET WAS OBTAINED WHICH INDICATED THAT BRD4 MEDIATES BOTH ACTIVATION AND REPRESSION OF RSV-INDUCIBLE GENE REGULATORY NETWORKS CONTROLLING CYTOKINE EXPRESSION, INTERFERON (IFN) PRODUCTION, AND EXTRACELLULAR MATRIX REMODELING. INDEX GENES OF FUNCTIONALLY SIGNIFICANT CLUSTERS WERE VALIDATED INDEPENDENTLY. WE DISCOVER THAT BRD4 REGULATES THE EXPRESSION OF ITS OWN GENE DURING THE INNATE IMMUNE RESPONSE. INTERESTINGLY, BRD4 ACTIVATES THE EXPRESSION OF NFKAPPAB/RELA, A COACTIVATOR THAT BINDS TO BRD4 IN A BD-DEPENDENT MANNER. WE EXTEND THIS FINDING TO SHOW THAT BRD4 ALSO REGULATES OTHER COMPONENTS OF ITS FUNCTIONAL INTERACTOME, INCLUDING THE MEDIATOR (MED) COACTIVATOR COMPLEX AND THE SWI/SNF-RELATED, MATRIX-ASSOCIATED, ACTIN-DEPENDENT REGULATOR OF CHROMATIN (SMARC) SUBUNITS. TO PROVIDE FURTHER INSIGHT INTO MECHANISMS FOR BRD4 IN RSV EXPRESSION, WE MAPPED 7,845 RSV-INDUCIBLE TN5 TRANSPOSASE PEAKS ONTO THE BRD4-DEPENDENT GENE BODIES. THESE WERE LOCATED IN PROMOTERS AND INTRONS OF CYTOSTRUCTURAL AND EXTRACELLULAR MATRIX (ECM) FORMATION GENES. THESE DATA INDICATE THAT BRD4 MEDIATES THE DYNAMIC RESPONSE OF AIRWAY EPITHELIAL CELLS TO RNA INFECTION BY MODULATING THE EXPRESSION OF ITS COACTIVATORS, CONTROLLING THE EXPRESSION OF HOST DEFENSE MECHANISMS AND REMODELING GENES THROUGH CHANGES IN PROMOTER ACCESSIBILITY. 2021 9 689 48 BRD4 AS A THERAPEUTIC TARGET IN PULMONARY DISEASES. BROMODOMAIN AND EXTRA-TERMINAL DOMAIN (BET) PROTEINS ARE EPIGENETIC MODULATORS THAT REGULATE GENE TRANSCRIPTION THROUGH INTERACTING WITH ACETYLATED LYSINE RESIDUES OF HISTONE PROTEINS. BET PROTEINS HAVE MULTIPLE ROLES IN REGULATING KEY CELLULAR FUNCTIONS SUCH AS CELL PROLIFERATION, DIFFERENTIATION, INFLAMMATION, OXIDATIVE AND REDOX BALANCE, AND IMMUNE RESPONSES. AS A RESULT, BET PROTEINS HAVE BEEN FOUND TO BE ACTIVELY INVOLVED IN A BROAD RANGE OF HUMAN LUNG DISEASES INCLUDING ACUTE LUNG INFLAMMATION, ASTHMA, PULMONARY ARTERIAL HYPERTENSION, PULMONARY FIBROSIS, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). DUE TO THE IDENTIFICATION OF SPECIFIC SMALL MOLECULAR INHIBITORS OF BET PROTEINS, TARGETING BET IN THESE LUNG DISEASES HAS BECOME AN AREA OF INCREASING INTEREST. EMERGING EVIDENCE HAS DEMONSTRATED THE BENEFICIAL EFFECTS OF BET INHIBITORS IN PRECLINICAL MODELS OF VARIOUS HUMAN LUNG DISEASES. THIS IS, IN GENERAL, LARGELY RELATED TO THE ABILITY OF BET PROTEINS TO BIND TO PROMOTERS OF GENES THAT ARE CRITICAL FOR INFLAMMATION, DIFFERENTIATION, AND BEYOND. BY MODULATING THESE CRITICAL GENES, BET PROTEINS ARE INTEGRATED INTO THE PATHOGENESIS OF DISEASE PROGRESSION. THE INTRINSIC HISTONE ACETYLTRANSFERASE ACTIVITY OF BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4) IS OF PARTICULAR INTEREST, SEEMS TO ACT INDEPENDENTLY OF ITS BROMODOMAIN BINDING ACTIVITY, AND HAS IMPLICATION IN SOME CONTEXTS. IN THIS REVIEW, WE PROVIDE A BRIEF OVERVIEW OF THE RESEARCH ON BET PROTEINS WITH A FOCUS ON BRD4 IN SEVERAL MAJOR HUMAN LUNG DISEASES, THE UNDERLYING MOLECULAR MECHANISMS, AS WELL AS FINDINGS OF TARGETING BET PROTEINS USING PHARMACEUTICAL INHIBITORS IN DIFFERENT LUNG DISEASES PRECLINICALLY. 2023 10 5783 33 SPONTANEOUS AND TRANSGENIC RODENT MODELS OF INFLAMMATORY BOWEL DISEASE. INFLAMMATORY BOWEL DISEASE (IBD) IS A MULTIFACTORIAL DISORDER WITH MANY DIFFERENT PUTATIVE INFLUENCES MEDIATING DISEASE ONSET, SEVERITY, PROGRESSION AND DIMINUTION. SPONTANEOUS NATURAL IBD IS CLASSICALLY EXPRESSED AS CROHN'S DISEASE (CD) AND ULCERATIVE COLITIS (UC) COMMONLY FOUND IN PRIMATES; LYMPHOPLASMOCYTIC ENTERITIS, EOSINOPHILIC GASTRITIS AND COLITIS, AND ULCERATIVE COLITIS WITH NEURONAL HYPERPLASIA IN DOGS; AND COLITIS IN HORSES. SPONTANEOUS INFLAMMATORY BOWEL DISEASE HAS BEEN NOTED IN A NUMBER OF RODENT MODELS WHICH DIFFER IN GENETIC STRAIN BACKGROUND, INDUCED MUTATION, MICROBIOTA INFLUENCES AND IMMUNOPATHOGENIC PATHWAYS. HISTOLOGICAL LESIONS IN CROHN'S DISEASE FEATURE NONCASEATING GRANULOMATOUS INFLAMMATION WHILE UC LESIONS TYPICALLY EXHIBIT ULCERATION, LAMINA PROPRIA INFLAMMATORY INFILTRATES AND LACK OF GRANULOMA DEVELOPMENT. INTESTINAL INFLAMMATION CAUSED BY CD AND UC IS ALSO ASSOCIATED WITH INCREASED INCIDENCE OF INTESTINAL NEOPLASIA. TRANSGENIC MURINE MODELS HAVE DETERMINED UNDERLYING ETIOLOGICAL INFLUENCES AND APPROPRIATE THERAPEUTIC TARGETS IN IBD. THIS LITERATURE REVIEW WILL DISCUSS CURRENT OPINION AND FINDINGS IN SPONTANEOUS IBD, HIGHLIGHT SELECTED TRANSGENIC RODENT MODELS OF IBD AND DISCUSS THEIR RESPECTIVE PATHOGENIC MECHANISMS. IT IS VERY IMPORTANT TO PROVIDE ACCOMMODATION OF INDUCED PUTATIVE DEFICITS IN ACTIVITIES OF DAILY LIVING AND TO ASSESS DISCOMFORT AND PAIN LEVELS IN THE FACE OF SIGNIFICANT MORBIDITY AND/OR MORTALITY IN THESE MODELS. EPIGENETIC, ENVIRONMENTAL (MICROBIOME, METABOLOME) AND NUTRITIONAL FACTORS ARE IMPORTANT IN IBD PATHOGENESIS, AND EVALUATING WAYS IN WHICH THEY INFLUENCE DISEASE EXPRESSION REPRESENT POTENTIAL INVESTIGATIVE APPROACHES WITH THE GREATEST POTENTIAL FOR NEW DISCOVERIES. 2015 11 1257 33 CURRENT TRENDS IN EPIGENETIC, CELLULAR AND MOLECULAR PATHWAYS IN MANAGEMENT OF RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS IS A SYSTEMIC CHRONIC POLYARTICULAR AUTOIMMUNE DISORDER OF JOINTS AND JOINT MEMBRANE MAINLY AFFECTING FEET AND HANDS. THE PATHOLOGICAL MANIFESTATION OF THE DISEASE INCLUDES INFILTRATION OF IMMUNE CELLS, HYPERPLASIA OF THE LINING OF SYNOVIUM, FORMATION OF PANNUS AND BONE AND CARTILAGE DESTRUCTION. IF LEFT UNTREATED, THE APPEARANCE OF SMALL FOCAL NECROSIS, ADHESION OF GRANULATION, AND FORMATION OF FIBROUS TISSUE ON THE SURFACE OF ARTICULAR CARTILAGE IS NOTED. THE DISEASE PRIMARILY AFFECTS NEARLY 1% OF THE POPULATION GLOBALLY, WOMEN BEING MORE AFFECTED THAN MEN WITH A RATIO 2:1 AND CAN INITIATE REGARDLESS OF ANY AGE. THE SYNOVIAL FIBROBLAST IN RHEUMATOID ARTHRITIS INDIVIDUALS EXHIBITS AN AGGRESSIVE PHENOTYPE WHICH UPREGULATES THE MANIFESTATION OF PROTOONCOGENES, ADHESIVE COMPOUNDS, INFLAMMATORY CYTOKINES AND MATRIX-DETERIORATING ENZYMES. APART FROM THE INFLAMMATORY EFFECTS OF CYTOKINES, CHEMOKINES ARE ALSO NOTED TO INDUCE SWELLING AND PAIN IN ARTHRITIC INDIVIDUALS BY RESIDING IN SYNOVIAL MEMBRANE AND FORMING PANNUS. THE CURRENT TREATMENT OF RHEUMATOID ARTHRITIS INCLUDES TREATMENT WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS, DISEASE-MODIFYING ANTIRHEUMATIC DRUGS, TREATMENT WITH BIOLOGICS SUCH AS INHIBITORS OF TNF-ALPHA, INTERLEUKINS, PLATELET ACTIVATING FACTOR, ETC. WHICH PROVIDES SIGNIFICANT RELIEF FROM SYMPTOMS AND AIDS IN MANAGEMENT OF THE DISEASE. THE CURRENT REVIEW HIGHLIGHTS THE PATHOGENESIS INVOLVED IN THE ONSET OF RHEUMATOID ARTHRITIS AND ALSO COVERS EPIGENETIC, CELLULAR AND MOLECULAR PARAMETERS ASSOCIATED WITH IT TO AID BETTER AND ADVANCED THERAPEUTIC APPROACHES FOR MANAGEMENT OF THE DEBILITATING DISEASE. 2023 12 3691 40 INFLAMMATORY BOWEL DISEASES: AN UPDATED OVERVIEW ON THE HEAT SHOCK PROTEIN INVOLVEMENT. INFLAMMATORY BOWEL DISEASES (IBDS) REPRESENT CHRONIC IDIOPATHIC DISORDERS, INCLUDING CROHN'S DISEASE (CD) AND ULCERATIVE COLITIS (UC), IN WHICH ONE OF THE TRIGGER FACTORS IS REPRESENTED BY ABERRANT IMMUNE INTERACTIONS BETWEEN THE INTESTINAL EPITHELIUM AND THE INTESTINAL MICROBIOTA. THE INVOLVEMENT OF HEAT SHOCK PROTEINS (HSPS) AS ETIOLOGICAL AND PATHOGENETIC FACTORS IS BECOMING OF INCREASING INTEREST. HSPS WERE FOUND TO BE DIFFERENTIALLY EXPRESSED IN THE INTESTINAL TISSUES AND SERA OF PATIENTS WITH CD AND UC. IT HAS BEEN SHOWN THAT HSPS CAN PLAY A DUAL ROLE IN THE DISEASE, DEPENDING ON THE STAGE OF PROGRESSION. THEY CAN SUPPORT THE INFLAMMATORY AND FIBROSIS PROCESS, BUT THEY CAN ALSO ACT AS PROTECTIVE FACTORS DURING DISEASE PROGRESSION OR BEFORE THE ONSET OF ONE OF THE WORST COMPLICATIONS OF IBD, COLORECTAL CANCER. FURTHERMORE, HSPS ARE ABLE TO MEDIATE THE INTERACTION BETWEEN THE INTESTINAL MICROBIOTA AND INTESTINAL EPITHELIAL CELLS. IN THIS WORK, WE DISCUSS THE INVOLVEMENT OF HSPS IN IBD CONSIDERING THEIR GENETIC, EPIGENETIC, IMMUNE AND MOLECULAR ROLES, REFERRING TO THE MOST RECENT WORKS PRESENT IN THE LITERATURE. WITH OUR REVIEW, WE WANT TO SHED LIGHT ON THE IMPORTANCE OF FURTHER EXPLORING THE ROLE OF HSPS, OR EVEN BETTER, THE ROLE OF THE MOLECULAR CHAPERONE SYSTEM (CS), IN IBD: VARIOUS MOLECULES OF THE CS INCLUDING HSPS MAY HAVE DIAGNOSTIC, PROGNOSTIC AND THERAPEUTIC POTENTIAL, PROMOTING THE CREATION OF NEW DRUGS THAT COULD OVERCOME THE SIDE-EFFECTS OF THE THERAPIES CURRENTLY USED. 2023 13 3853 27 IS MIR-223 UPREGULATION IN INFLAMMATORY BOWEL DISEASES A PROTECTIVE RESPONSE? INFLAMMATORY BOWEL DISEASES (IBD) ARE CHARACTERIZED BY CHRONIC INFLAMMATION AND DAMAGE OF COLONOCYTES WITH ETIOLOGY OF GENETIC, EPIGENETIC AND ENVIRONMENTAL FACTORS. MICRORNA-223 (MIR-223) HAS BEEN FOUND TO BE INCREASED IN BOTH IBD PATIENTS AND ANIMAL COLITIS MODELS. HOWEVER, CONTENTIOUS OPINIONS RELEVANT TO THE ROLES OF MIR-223 IN IBD HAVE BEEN REPORTED. NOTWITHSTADING THAT MOST STUDIES HAVE DESCRIBED THAT MIR-223 HAS ANTI-INFLAMMATORY EFFECTS, SEVERAL REPORTS HAVE PROGRESSED A PRO-INFLAMMATORY VIEW. IN THIS REVIEW, WE SUMMARISE BOTH THE ANTI-INFLAMMATORY AND PRO-INFLAMMATORY EFFECTS OF MIR-223 ON KEY MOLECULES IN INFLAMMATORY RESPONSES IN BOTH ANIMAL MODELS AND IN PATIENTS DIAGNOSED WITH IBD AND OBJECTIVELY DISCUSS THE POSSIBLE BASIS FOR THE DISCREPANCIES. 2023 14 2726 31 EXPERIMENTAL PHARMACOLOGICAL MANAGEMENT OF PSORIASIS. PSORIASIS IS A CHRONIC, RELAPSING, IMMUNE-MEDIATED SYSTEMIC DISEASE. ITS PATHOGENESIS IS COMPLEX AND NOT FULLY UNDERSTOOD YET. GENETIC AND EPIGENETIC FACTORS INTERACT WITH MOLECULAR PATHWAYS INVOLVING TNF-ALPHA, IL-23/IL-17 AXIS, AND PECULIAR CYTOKINES, AS IL-36 OR PHOSPHODIESTERASE 4. THIS REVIEW DISCUSSES THE MECHANISMS INVOLVED IN THE DEVELOPMENT OF THE DISEASE, AS WELL AS THE THERAPEUTIC OPTIONS PROPOSED FOLLOWING THE INVESTIGATION OF THE INFLAMMATORY PSORIATIC PATHWAYS. WE PERFORMED A COMPREHENSIVE SEARCH USING THE WORDS "PSORIASIS" AND THE NEWEST MOLECULES CURRENTLY UNDER INVESTIGATION AND APPROVAL. FROM THESE DATA, A NEW SCENARIO IN PSORIASIS IS OCCURRING TO PERSONALIZE THE THERAPIES - ESPECIALLY SYSTEMIC ONES AND THOSE USING SMALL MOLECULES - AND AVOID TOPICAL AND INJECTABLE DRUGS. WE REPORTED THE NEWEST THERAPEUTIC OPPORTUNITIES, INCLUDING THE INHIBITORS OF JANUS KINASE/TYROSINE KINASE 2, PHOSPHODIESTERASE-4 AND IL-36 RECEPTOR. TODAY, MORE THAN 20 MOLECULES ARE UNDER INVESTIGATION FOR THE TREATMENT OF CUTANEOUS PSORIASIS. MOST OF THEM ARE CONSTITUTED BY SMALL MOLECULES OR BIOLOGIC THERAPIES. THIS UNDERLINES HOW PSORIASIS NEEDS SYSTEMIC THERAPIES, DUE TO ITS COMPLEX PATHOGENESIS AND MULTISYSTEMIC INVOLVEMENT. 2021 15 3701 34 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 16 4582 40 N-TERMINAL BET BROMODOMAIN INHIBITORS DISRUPT A BRD4-P65 INTERACTION AND REDUCE INDUCIBLE NITRIC OXIDE SYNTHASE TRANSCRIPTION IN PANCREATIC BETA-CELLS. CHRONIC INFLAMMATION OF PANCREATIC ISLETS IS A KEY DRIVER OF BETA-CELL DAMAGE THAT CAN LEAD TO AUTOREACTIVITY AND THE EVENTUAL ONSET OF AUTOIMMUNE DIABETES (T1D). IN THE ISLET, ELEVATED LEVELS OF PROINFLAMMATORY CYTOKINES INDUCE THE TRANSCRIPTION OF THE INDUCIBLE NITRIC OXIDE SYNTHASE (INOS) GENE, NOS2, ULTIMATELY RESULTING IN INCREASED NITRIC OXIDE (NO). EXCESSIVE OR PROLONGED EXPOSURE TO NO CAUSES BETA-CELL DYSFUNCTION AND FAILURE ASSOCIATED WITH DEFECTS IN MITOCHONDRIAL RESPIRATION. RECENT STUDIES SHOWED THAT INHIBITION OF THE BROMODOMAIN AND EXTRATERMINAL DOMAIN (BET) FAMILY OF PROTEINS, A DRUGGABLE CLASS OF EPIGENETIC READER PROTEINS, PREVENTS THE ONSET AND PROGRESSION OF T1D IN THE NON-OBESE DIABETIC MOUSE MODEL. WE HYPOTHESIZED THAT BET PROTEINS CO-ACTIVATE TRANSCRIPTION OF CYTOKINE-INDUCED INFLAMMATORY GENE TARGETS IN BETA-CELLS AND THAT SELECTIVE, CHEMOTHERAPEUTIC INHIBITION OF BET BROMODOMAINS COULD REDUCE SUCH TRANSCRIPTION. HERE, WE INVESTIGATED THE ABILITY OF BET BROMODOMAIN SMALL MOLECULE INHIBITORS TO REDUCE THE BETA-CELL RESPONSE TO THE PROINFLAMMATORY CYTOKINE INTERLEUKIN 1 BETA (IL-1BETA). BET BROMODOMAIN INHIBITION ATTENUATED IL-1BETA-INDUCED TRANSCRIPTION OF THE INFLAMMATORY MEDIATOR NOS2 AND CONSEQUENT INOS PROTEIN AND NO PRODUCTION. REDUCED NOS2 TRANSCRIPTION IS CONSISTENT WITH INHIBITION OF NF-KAPPAB FACILITATED BY DISRUPTING THE INTERACTION OF A SINGLE BET FAMILY MEMBER, BRD4, WITH THE NF-KAPPAB SUBUNIT, P65. USING RECENTLY REPORTED SELECTIVE INHIBITORS OF THE FIRST AND SECOND BET BROMODOMAINS, INHIBITION OF ONLY THE FIRST BROMODOMAIN WAS NECESSARY TO REDUCE THE INTERACTION OF BRD4 WITH P65 IN BETA-CELLS. MOREOVER, INHIBITION OF THE FIRST BROMODOMAIN WAS SUFFICIENT TO MITIGATE IL-1BETA-DRIVEN DECREASES IN MITOCHONDRIAL OXYGEN CONSUMPTION RATES AND BETA-CELL VIABILITY. BY IDENTIFYING A ROLE FOR THE INTERACTION BETWEEN BRD4 AND P65 IN CONTROLLING THE RESPONSE OF BETA-CELLS TO PROINFLAMMATORY CYTOKINES, WE PROVIDE MECHANISTIC INFORMATION ON HOW BET BROMODOMAIN INHIBITION CAN DECREASE INFLAMMATION. THESE STUDIES ALSO SUPPORT THE POTENTIAL THERAPEUTIC APPLICATION OF MORE SELECTIVE BET BROMODOMAIN INHIBITORS IN ATTENUATING BETA-CELL INFLAMMATION. 2022 17 5939 51 TARGETING MECHANOTRANSDUCTION AT THE TRANSCRIPTIONAL LEVEL: YAP AND BRD4 ARE NOVEL THERAPEUTIC TARGETS FOR THE REVERSAL OF LIVER FIBROSIS. LIVER FIBROSIS IS THE RESULT OF A DEREGULATED WOUND HEALING PROCESS CHARACTERIZED BY THE EXCESSIVE DEPOSITION OF EXTRACELLULAR MATRIX. HEPATIC STELLATE CELLS (HSCS), WHICH ARE ACTIVATED IN RESPONSE TO LIVER INJURY, ARE THE MAJOR SOURCE OF EXTRACELLULAR MATRIX AND DRIVE THE WOUND HEALING PROCESS. HOWEVER, CHRONIC LIVER DAMAGE LEADS TO PERPETUAL HSC ACTIVATION, PROGRESSIVE FORMATION OF PATHOLOGICAL SCAR TISSUE AND ULTIMATELY, CIRRHOSIS AND ORGAN FAILURE. HSC ACTIVATION IS TRIGGERED LARGELY IN RESPONSE TO MECHANOSIGNALING FROM THE MICROENVIRONMENT, WHICH INDUCES A PROFIBROTIC NUCLEAR TRANSCRIPTION PROGRAM THAT PROMOTES HSC PROLIFERATION AND EXTRACELLULAR MATRIX SECRETION THEREBY SETTING UP A POSITIVE FEEDBACK LOOP LEADING TO MATRIX STIFFENING AND SELF-SUSTAINED, PATHOLOGICAL, HSC ACTIVATION. DESPITE THE SIGNIFICANT PROGRESS IN OUR UNDERSTANDING OF LIVER FIBROSIS, THE MOLECULAR MECHANISMS THROUGH WHICH THE EXTRACELLULAR MATRIX PROMOTES HSC ACTIVATION ARE NOT WELL UNDERSTOOD AND NO EFFECTIVE THERAPIES HAVE BEEN APPROVED TO DATE THAT CAN TARGET THIS EARLY, REVERSIBLE, STAGE IN LIVER FIBROSIS. SEVERAL NEW LINES OF INVESTIGATION NOW PROVIDE IMPORTANT INSIGHT INTO THIS AREA OF STUDY AND IDENTIFY TWO NUCLEAR TARGETS WHOSE INHIBITION HAS THE POTENTIAL OF REVERSING LIVER FIBROSIS BY INTERFERING WITH HSC ACTIVATION: YES-ASSOCIATED PROTEIN (YAP), A TRANSCRIPTIONAL CO-ACTIVATOR AND EFFECTOR OF THE MECHANOSENSITIVE HIPPO PATHWAY, AND BROMODOMAIN-CONTAINING PROTEIN 4 (BRD4), AN EPIGENETIC REGULATOR OF GENE EXPRESSION. YAP AND BRD4 ACTIVITY IS INDUCED IN RESPONSE TO MECHANICAL STIMULATION OF HSCS AND EACH PROTEIN INDEPENDENTLY CONTROLS WAVES OF EARLY GENE EXPRESSION NECESSARY FOR HSC ACTIVATION. SIGNIFICANTLY, INHIBITION OF EITHER PROTEIN CAN REVERT THE CHRONIC ACTIVATION OF HSCS AND IMPEDE PATHOLOGICAL PROGRESSION OF LIVER FIBROSIS IN CLINICALLY RELEVANT MODEL SYSTEMS. IN THIS REVIEW WE WILL DISCUSS THE ROLES OF THESE NUCLEAR CO-ACTIVATORS IN HSC ACTIVATION, THEIR MECHANISM OF ACTION IN THE FIBROTIC PROCESS IN THE LIVER AND OTHER ORGANS, AND THE POTENTIAL OF TARGETING THEIR ACTIVITY WITH SMALL MOLECULE DRUGS FOR FIBROSIS REVERSAL. 2016 18 2233 33 EPIGENETIC MODIFICATIONS OF THE NUCLEAR FACTOR KAPPA B SIGNALLING PATHWAY AND ITS IMPACT ON INFLAMMATORY BOWEL DISEASE. BACKGROUND: INFLAMMATORY BOWEL DISEASE (IBD) IS A MULTIFACTORIAL CONDITION INFLUENCED BY THE IMMUNE SYSTEM, THE INTESTINAL MICROBIOTA, ENVIRONMENTAL FACTORS, GENETIC AND EPIGENETIC FACTORS. GENETIC- AND ENVIRONMENT- INDUCED DYSREGULATION OF THE NUCLEAR FACTOR-KAPPA B (NF-KAPPAB) TRANSCRIPTION FACTOR PATHWAY HAS BEEN LINKED TO IBD PATHOGENESIS. OBJECTIVE: TO ASSESS THE CURRENT EVIDENCE IN RELATION TO THE CONTRIBUTION OF THE CLASSICAL AND ALTERNATIVE NF-KAPPAB PATHWAYS IN IBD AND TO DISCUSS THE EPIGENETIC MECHANISMS THAT IMPACT ON NF-KAPPAB FUNCTION. METHODS: A MEDLINE SEARCH FOR 'NF-KAPPAB/NF-KAPPAB', IN COMBINATION WITH TERMS INCLUDING 'INFLAMMATORY BOWEL DISEASE/IBD', 'INTESTINAL INFLAMMATION', 'CROHN'S DISEASE', 'ULCERATIVE COLITIS', 'COLITIS'; 'EPIGENETICS', 'DNA METHYLATION', 'HISTONES', 'MICRORNAS/MIRNAS' AND 'SHORT NON-CODING/LONG NON-CODING RNAS' WAS PERFORMED. RESULTS: BOTH NF-KAPPAB PATHWAYS CONTRIBUTE TO THE CHRONIC INFLAMMATION UNDERLYING IBD BY REGULATING THE INFLAMMATORY IMMUNE RESPONSES AND HOMEOSTASIS OF THE INTESTINAL EPITHELIUM (CLASSICAL PATHWAY) OR REGULATING BOWEL INFLAMMATION AND EPITHELIAL MICROFOLD (M) CELL FUNCTION (ALTERNATIVE PATHWAY). DNA METHYLATION IS A COMMON EPIGENETIC MODIFICATION IN INTESTINAL INFLAMMATION, INCLUDING NFKB1 AND RELA LOCI. CONVERSELY, LITTLE IS UNDERSTOOD REGARDING EPIGENETIC EFFECTS ON GENES ENCODING OTHER NF-KAPPAB SUBUNITS, PARTICULARLY THOSE OF THE ALTERNATIVE PATHWAY, AND IN THE CONTEXT OF IBD. HOWEVER, NF-KAPPAB INTERACTION WITH CHROMATIN MODIFIERS IS ALSO SEEN TO BE AN ESSENTIAL MECHANISM OF REGULATION OF DOWNSTREAM TARGET GENES RELEVANT TO NF-KAPPAB-MEDIATED INFLAMMATORY RESPONSES. CONCLUSION: FURTHER RESEARCH IS CLEARLY WARRANTED IN THIS AREA, AS UNDERSTANDING THE CELL-SPECIFIC REGULATION OF THE NF-KAPPAB PATHWAYS WILL BRING RESEARCHERS INTO A POSITION TO ACHIEVE MORE EFFICIENT STRATIFICATION OF IBD PATIENTS, AND MORE TARGETED AND EFFECTIVE CHOICE OF TREATMENT. 2021 19 4732 45 NOVEL BIOMARKERS FOR INFLAMMATORY BOWEL DISEASE AND COLORECTAL CANCER: AN INTERPLAY BETWEEN METABOLIC DYSREGULATION AND EXCESSIVE INFLAMMATION. PERSISTENT INFLAMMATION CAN TRIGGER ALTERED EPIGENETIC, INFLAMMATORY, AND BIOENERGETIC STATES. INFLAMMATORY BOWEL DISEASE (IBD) IS AN IDIOPATHIC DISEASE CHARACTERIZED BY CHRONIC INFLAMMATION OF THE GASTROINTESTINAL TRACT, WITH EVIDENCE OF SUBSEQUENT METABOLIC SYNDROME DISORDER. STUDIES HAVE DEMONSTRATED THAT AS MANY AS 42% OF PATIENTS WITH ULCERATIVE COLITIS (UC) WHO ARE FOUND TO HAVE HIGH-GRADE DYSPLASIA, EITHER ALREADY HAD COLORECTAL CANCER (CRC) OR DEVELOP IT WITHIN A SHORT TIME. THE PRESENCE OF LOW-GRADE DYSPLASIA IS ALSO PREDICTIVE OF CRC. MANY SIGNALING PATHWAYS ARE SHARED AMONG IBD AND CRC, INCLUDING CELL SURVIVAL, CELL PROLIFERATION, ANGIOGENESIS, AND INFLAMMATORY SIGNALING PATHWAYS. CURRENT IBD THERAPEUTICS TARGET A SMALL SUBSET OF MOLECULAR DRIVERS OF IBD, WITH MANY FOCUSED ON THE INFLAMMATORY ASPECT OF THE PATHWAYS. THUS, THERE IS A GREAT NEED TO IDENTIFY BIOMARKERS OF BOTH IBD AND CRC, THAT CAN BE PREDICTIVE OF THERAPEUTIC EFFICACY, DISEASE SEVERITY, AND PREDISPOSITION TO CRC. IN THIS STUDY, WE EXPLORED THE CHANGES IN BIOMARKERS SPECIFIC FOR INFLAMMATORY, METABOLIC, AND PROLIFERATIVE PATHWAYS, TO HELP DETERMINE THE RELEVANCE TO BOTH IBD AND CRC. OUR ANALYSIS DEMONSTRATED, FOR THE FIRST TIME IN IBD, THE LOSS OF THE TUMOR SUPPRESSOR PROTEIN RAS ASSOCIATED FAMILY PROTEIN 1A (RASSF1A), VIA EPIGENETIC CHANGES, THE HYPERACTIVATION OF THE OBLIGATE KINASE OF THE NOD2 PATHOGEN RECOGNITION RECEPTOR (RECEPTOR INTERACTING PROTEIN KINASE 2 [RIPK2]), THE LOSS OF ACTIVATION OF THE METABOLIC KINASE, AMP ACTIVATED PROTEIN KINASE (AMPKALPHA1), AND, LASTLY, THE ACTIVATION OF THE TRANSCRIPTION FACTOR AND KINASE YES ASSOCIATED PROTEIN (YAP) KINASE, THAT IS INVOLVED IN PROLIFERATION OF CELLS. THE EXPRESSION AND ACTIVATION STATUS OF THESE FOUR ELEMENTS ARE MIRRORED IN IBD, CRC, AND IBD-CRC PATIENTS AND, IMPORTANTLY, IN MATCHED BLOOD AND BIOPSY SAMPLES. THE LATTER WOULD SUGGEST THAT BIOMARKER ANALYSIS CAN BE PERFORMED NON-INVASIVELY, TO UNDERSTAND IBD AND CRC, WITHOUT THE NEED FOR INVASIVE AND COSTLY ENDOSCOPIC ANALYSIS. THIS STUDY, FOR THE FIRST TIME, ILLUSTRATES THE NEED TO UNDERSTAND IBD OR CRC BEYOND AN INFLAMMATORY PERSPECTIVE AND THE VALUE OF THERAPEUTICS DIRECTED TO RESET ALTERED PROLIFERATIVE AND METABOLIC STATES WITHIN THE COLON. THE USE OF SUCH THERAPEUTICS MAY TRULY DRIVE PATIENTS INTO REMISSION. 2023 20 4365 29 MIRNA MOLECULES-LATE BREAKING TREATMENT FOR INFLAMMATORY BOWEL DISEASES? MICRORNAS (MIRNAS) ARE A GROUP OF NON-CODING RNAS THAT PLAY A CRITICAL ROLE IN REGULATING EPIGENETIC MECHANISMS IN INFLAMMATION-RELATED DISEASES. INFLAMMATORY BOWEL DISEASES (IBDS), WHICH PRIMARILY INCLUDE ULCERATIVE COLITIS (UC) AND CROHN'S DISEASE (CD), ARE CHARACTERIZED BY CHRONIC RECURRENT INFLAMMATION OF INTESTINAL TISSUES. DUE TO THE MULTIFACTORIAL ETIOLOGY OF THESE DISEASES, THE DEVELOPMENT OF INNOVATIVE TREATMENT STRATEGIES THAT CAN EFFECTIVELY MAINTAIN REMISSION AND ALLEVIATE DISEASE SYMPTOMS IS A MAJOR CHALLENGE. IN RECENT YEARS, EVIDENCE FOR THE REGULATORY ROLE OF MIRNAS IN THE PATHOGENETIC MECHANISMS OF VARIOUS DISEASES, INCLUDING IBD, HAS BEEN ACCUMULATING. IN LIGHT OF THESE FINDINGS, MIRNAS REPRESENT POTENTIAL INNOVATIVE CANDIDATES FOR THERAPEUTIC APPLICATION IN IBD. IN THIS REVIEW, WE DISCUSS RECENT FINDINGS ON THE ROLE OF MIRNAS IN REGULATING INFLAMMATORY RESPONSES, MAINTAINING INTESTINAL BARRIER INTEGRITY, AND DEVELOPING FIBROSIS IN CLINICAL AND EXPERIMENTAL IBD. THE FOCUS IS ON THE EXISTING LITERATURE, INDICATING POTENTIAL THERAPEUTIC APPLICATION OF MIRNAS IN BOTH PRECLINICAL EXPERIMENTAL IBD MODELS AND TRANSLATIONAL DATA IN THE CONTEXT OF CLINICAL IBD. TO DATE, A LARGE AND DIVERSE DATA SET, WHICH IS GROWING RAPIDLY, SUPPORTS THE POTENTIAL USE OF MIRNA-BASED THERAPIES IN CLINICAL PRACTICE, ALTHOUGH MANY QUESTIONS REMAIN UNANSWERED. 2023