1 6314 133 THE RELATIONSHIP BETWEEN THE EPIGENETIC AGING BIOMARKER "GRIMAGE" AND LUNG FUNCTION IN BOTH THE AIRWAY AND BLOOD OF PEOPLE LIVING WITH HIV: AN OBSERVATIONAL COHORT STUDY. BACKGROUND: AGE-RELATED COMORBIDITIES SUCH AS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE COMMON IN PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (PLWH). WE INVESTIGATED THE RELATIONSHIP BETWEEN COPD AND THE EPIGENETIC AGE OF THE AIRWAY EPITHELIUM AND PERIPHERAL BLOOD OF PLWH. METHODS: AIRWAY EPITHELIAL BRUSHINGS FROM 34 PLWH ENROLLED IN THE ST. PAUL'S HOSPITAL HIV BRONCHOSCOPY COHORT AND PERIPHERAL BLOOD FROM 378 PLWH ENROLLED IN THE STRATEGIC TIMING OF ANTIRETROVIRAL TREATMENT (START) STUDY WERE PROFILED FOR DNA METHYLATION. THE DNA METHYLATION BIOMARKER OF AGE AND HEALTHSPAN, GRIMAGE, WAS CALCULATED IN BOTH TISSUE COMPARTMENTS. WE TESTED THE ASSOCIATION OF GRIMAGE WITH COPD IN THE AIRWAY EPITHELIUM AND AIRFLOW OBSTRUCTION AS DEFINED BY AN FEV(1)/FVC<0.70, AND FEV(1) DECLINE OVER 6 YEARS IN BLOOD. FINDINGS: THE AIRWAY EPITHELIUM OF PLWH WITH COPD WAS ASSOCIATED WITH GREATER GRIMAGE RESIDUALS COMPARED TO PLWH WITHOUT COPD (BETA=3.18, 95%CI=1.06-5.31, P=0.005). IN BLOOD, FEV(1)/FVC500/MICROL AND WERE ENROLLED IN THE STRATEGIC TIMING OF ANTIRETROVIRAL THERAPY TRIAL (PULMONARY SUBSTUDY) WERE COMPARED WITH 34 HIV-NEGATIVE CONTROLS. DNA METHYLATION WAS PERFORMED USING THE ILLUMINA METHYLATIONEPIC BEADCHIP. DIFFERENTIALLY METHYLATED POSITIONS (DMPS) AND DIFFERENTIALLY METHYLATED REGIONS (DMRS) IN PLWH COMPARED WITH CONTROLS WERE IDENTIFIED USING A ROBUST LINEAR MODEL. METHYLATION AGE WAS CALCULATED USING A PREVIOUSLY DESCRIBED EPIGENETIC CLOCK. RESULTS: THERE WERE A TOTAL OF 56 639 DMPS AND 6103 DMRS AT A FALSE DISCOVERY RATE OF <0.1. THE TOP 5 DMPS CORRESPONDED TO GENES NLRC5, VRK2, B2M, AND GPR6 AND WERE HIGHLY ENRICHED FOR CANCER-RELATED PATHWAYS. PLWH HAD SIGNIFICANTLY HIGHER METHYLATION AGE THAN HIV-NEGATIVE CONTROLS (P = .001), WITH BLACK RACE, LOW CD4 AND HIGH CD8 T-CELL COUNTS, AND DURATION OF HIV BEING RISK FACTORS FOR AGE ACCELERATION. CONCLUSIONS: PLWH BEFORE THE INITIATION OF ART AND WITH PRESERVED IMMUNE STATUS SHOW EVIDENCE OF ADVANCED METHYLATION AGING. 2021 4 304 51 AIRWAY AGING AND METHYLATION DISRUPTIONS IN HIV-ASSOCIATED CHRONIC OBSTRUCTIVE PULMONARY DISEASE. RATIONALE: AGE-RELATED DISEASES LIKE CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) OCCUR AT HIGHER RATES IN PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (PLWH) THAN IN UNINFECTED POPULATIONS. OBJECTIVES: TO IDENTIFY WHETHER ACCELERATED AGING CAN BE OBSERVED IN THE AIRWAYS OF PLWH WITH COPD, MANIFEST BY A UNIQUE DNA METHYLATION SIGNATURE. METHODS: BRONCHIAL EPITHELIAL BRUSHINGS FROM PLWH WITH AND WITHOUT COPD AND HIV-UNINFECTED ADULTS WITH AND WITHOUT COPD (N = 76) WERE PROFILED FOR DNA METHYLATION AND GENE EXPRESSION. WE EVALUATED GLOBAL ALU AND LINE-1 METHYLATION AND CALCULATED THE EPIGENETIC AGE USING THE HORVATH CLOCK AND THE METHYLATION TELOMERE LENGTH ESTIMATOR. TO IDENTIFY GENOME-WIDE DIFFERENTIAL DNA METHYLATION AND GENE EXPRESSION ASSOCIATED WITH HIV AND COPD, ROBUST LINEAR MODELS WERE USED FOLLOWED BY AN EXPRESSION QUANTITATIVE TRAIT METHYLATION (EQTM) ANALYSIS. MEASUREMENTS AND MAIN RESULTS: EPIGENETIC AGE ACCELERATION AND SHORTER METHYLATION ESTIMATES OF TELOMERE LENGTH WERE FOUND IN PLWH WITH COPD COMPARED WITH PLWH WITHOUT COPD AND UNINFECTED PATIENTS WITH AND WITHOUT COPD. GLOBAL HYPOMETHYLATION WAS IDENTIFIED IN PLWH. WE IDENTIFIED 7,970 CYTOSINE BASES LOCATED NEXT TO A GUANINE BASE (CPG SITES), 293 GENES, AND 9 EXPRESSION QUANTITATIVE TRAIT METHYLATION-GENE PAIRS ASSOCIATED WITH THE INTERACTION BETWEEN HIV AND COPD. ACTIN BINDING LIM PROTEIN FAMILY MEMBER 3 (ABLIM3) WAS ONE OF THE NOVEL CANDIDATE GENES FOR HIV-ASSOCIATED COPD HIGHLIGHTED BY OUR ANALYSIS. CONCLUSIONS: METHYLATION AGE ACCELERATION IS OBSERVED IN THE AIRWAY EPITHELIUM OF PLWH WITH COPD, A PROCESS THAT MAY BE RESPONSIBLE FOR THE HEIGHTENED RISK OF COPD IN THIS POPULATION. THEIR DISTINCT METHYLATION PROFILE, DIFFERING FROM THAT OBSERVED IN PATIENTS WITH COPD ALONE, SUGGESTS A UNIQUE PATHOGENESIS TO HIV-ASSOCIATED COPD. THE ASSOCIATIONS WARRANT FURTHER INVESTIGATION TO ESTABLISH CAUSALITY. 2022 5 4270 41 MICROBIAL DYSBIOSIS AND THE HOST AIRWAY EPITHELIAL RESPONSE: INSIGHTS INTO HIV-ASSOCIATED COPD USING MULTI'OMICS PROFILING. BACKGROUND: PEOPLE LIVING WITH HIV (PLWH) ARE AT INCREASED RISK OF DEVELOPING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) INDEPENDENT OF CIGARETTE SMOKING. WE HYPOTHESIZED THAT DYSBIOSIS IN PLWH IS ASSOCIATED WITH EPIGENETIC AND TRANSCRIPTOMIC DISRUPTIONS IN THE AIRWAY EPITHELIUM. METHODS: AIRWAY EPITHELIAL BRUSHINGS WERE COLLECTED FROM 18 COPD + HIV + , 16 COPD - HIV + , 22 COPD + HIV - AND 20 COPD - HIV - SUBJECTS. THE MICROBIOME, METHYLOME, AND TRANSCRIPTOME WERE PROFILED USING 16S SEQUENCING, ILLUMINA INFINIUM METHYLATION EPIC CHIP, AND RNA SEQUENCING, RESPECTIVELY. MULTI 'OMIC INTEGRATION WAS PERFORMED USING DATA INTEGRATION ANALYSIS FOR BIOMARKER DISCOVERY USING LATENT COMPONENTS. A CORRELATION > 0.7 WAS USED TO IDENTIFY KEY INTERACTIONS BETWEEN THE 'OMES. RESULTS: THE COPD + HIV -, COPD -HIV + , AND COPD + HIV + GROUPS HAD REDUCED SHANNON DIVERSITY (P = 0.004, P = 0.023, AND P = 5.5E-06, RESPECTIVELY) COMPARED TO INDIVIDUALS WITH NEITHER COPD NOR HIV, WITH THE COPD + HIV + GROUP DEMONSTRATING THE MOST REDUCED DIVERSITY. MICROBIAL COMMUNITIES WERE SIGNIFICANTLY DIFFERENT BETWEEN THE FOUR GROUPS (P = 0.001). MULTI 'OMIC INTEGRATION IDENTIFIED CORRELATIONS BETWEEN BACTEROIDETES PREVOTELLA, GENES FUZ, FASTKD3, AND ACVR1B, AND EPIGENETIC FEATURES CPG-FUZ AND CPG-PHLDB3. CONCLUSION: PLWH WITH COPD MANIFEST DECREASED DIVERSITY AND ALTERED MICROBIAL COMMUNITIES IN THEIR AIRWAY EPITHELIAL MICROBIOME. THE REDUCTION IN PREVOTELLA IN THIS GROUP WAS LINKED WITH EPIGENETIC AND TRANSCRIPTOMIC DISRUPTIONS IN HOST GENES INCLUDING FUZ, FASTKD3, AND ACVR1B. 2023 6 5094 39 PLASMA EXTRACELLULAR VESICLE SUBTYPES MAY BE USEFUL AS POTENTIAL BIOMARKERS OF IMMUNE ACTIVATION IN PEOPLE WITH HIV. BACKGROUND: EXTRACELLULAR VESICLES (EVS) ARE INTERCELLULAR MESSENGERS WITH EPIGENETIC POTENTIAL SINCE THEY CAN SHUTTLE MICRORNA (MIRNA). EVS AND MIRNA PLAY A ROLE IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION IMMUNOPATHOGENESIS. CHRONIC IMMUNE ACTIVATION AND SYSTEMIC INFLAMMATION DURING HIV INFECTION DESPITE EFFECTIVE ANTIRETROVIRAL THERAPY (ART) ARE ASSOCIATED WITH NON-ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) COMORBIDITIES IN PEOPLE LIVING WITH HIV (PLWH). ANALYSIS OF PLASMA EVS AND THEIR MIRNA CONTENT MAY BE USEFUL AS IMMUNE ACTIVATION OR INFLAMMATORY BIOMARKERS IN PLWH RECEIVING ART. IN THIS STUDY, WE HYPOTHESIZED THAT THE NUMBER, SIZE, AND MIRNA OF LARGE AND SMALL EVS COULD REFLECT IMMUNE ACTIVATION ASSOCIATED WITH AN ELEVATED CD8 T-CELL COUNT OR A LOW CD4/CD8 RATIO IN PLWH. METHODS: PLASMA EVS SUBTYPE PURIFIED FROM PLWH AND UNINFECTED CONTROLS WERE SIZED USING DYNAMIC LIGHT SCATTERING AND QUANTIFIED USING FLOW CYTOMETRY AND ACETYLCHOLINE ESTERASE (ACHE) ACTIVITY. EXPRESSION OF MATURE MIRNAS MIR-92, MIR-155, MIR-223 WAS MEASURED BY QUANTITATIVE REVERSE-TRANSCRIPTASE POLYMERASE CHAIN REACTION IN EVS AND LEUCOCYTES. RESULTS: HIV INFECTION INDUCES INCREASED PRODUCTION OF SMALL EVS IN PLASMA. EV SUBTYPES WERE DIFFERENTIALLY ENRICHED IN MIR-92, MIR-155, AND MIR-223. POSITIVE CORRELATIONS BETWEEN CD8 T-CELL COUNT AND LARGE EVS ABUNDANCE AND SMALL EVS ACHE ACTIVITY WERE OBSERVED. CD4/CD8 RATIO WAS NEGATIVELY CORRELATED WITH SMALL EV ACHE ACTIVITY, AND MIRNA-155 LEVEL PER SMALL EV WAS NEGATIVELY CORRELATED WITH CD8 T-CELL COUNT. CONCLUSIONS: THESE FINDINGS SUGGEST THAT QUANTIFYING LARGE OR SMALL EVS AND PROFILING MIRNA CONTENT PER EV MIGHT PROVIDE NEW FUNCTIONAL BIOMARKERS OF IMMUNE ACTIVATION AND INFLAMMATION. 2021 7 3687 44 INFLAMMATION-RELATED GENES ARE ASSOCIATED WITH EPIGENETIC AGING IN HIV. CHRONIC INFLAMMATION IS CHARACTERISTIC OF BOTH HIV AND AGING ("INFLAMMAGING") AND MAY CONTRIBUTE TO THE ACCELERATED AGING OBSERVED IN PEOPLE LIVING WITH HIV (PLWH). WE EXAMINED WHETHER THREE INFLAMMATION-RELATED SINGLE-NUCLEOTIDE POLYMORPHISMS (SNPS) WERE RISK FACTORS FOR ACCELERATED AGING AND HIV-ASSOCIATED, NON-AIDS (HANA) CONDITIONS AMONG PLWH. WE EXAMINED 155 POSTMORTEM CASES WITH HIV (MEAN AGE = 47.3, 81% MALE, 68% SELF-REPORTED WHITE) FROM THE NATIONAL NEUROAIDS TISSUE CONSORTIUM WHO HAD PRE-MORTEM NEUROBEHAVIORAL/MEDICAL/VIROLOGIC DATA AND EPIGENOMIC DATA FROM OCCIPITAL CORTEX TISSUE. ACCELERATED AGING WAS MEASURED ACCORDING TO THE EPIGENETIC CLOCK; AN AGING BIOMARKER BASED ON DNA METHYLATION LEVELS. PAST OR CURRENT AGE-ASSOCIATED HANA CONDITIONS INCLUDING CEREBROVASCULAR, LIVER AND KIDNEY DISEASE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CANCER, AND DIABETES WERE DETERMINED VIA SELF-REPORT. EPIGENETIC AGING Z-SCORES AND LIKELIHOOD OF PAST/CURRENT HANA CONDITIONS WERE COMPARED BETWEEN MAJOR ALLELE HOMOZYGOTES AND MINOR ALLELE CARRIERS FOR EACH SNP (IL-6 - 174G>C, IL-10 - 592C>A, TNF-ALPHA - 308 G>A) SEPARATELY. ANALYSES WERE ADJUSTED FOR RELEVANT DEMOGRAPHIC/CLINICAL FACTORS. EPIGENETIC AGING (E.G., HIGHER Z-SCORES) WAS SIGNIFICANTLY GREATER IN IL-6 C ALLELE CARRIERS (P = .002) AND IL-10 CC HOMOZYGOTES (P = .02) COMPARED TO OTHER GENOTYPE GROUPS. THE LIKELIHOOD OF ANY PAST/CURRENT HANA CONDITION DID NOT DIFFER BY IL-10 GENOTYPE BUT WAS 3.36 TIMES GREATER IN IL-6 C ALLELE CARRIERS VERSUS OTHERS (OR = 3.36, 95%CI = 1.09-10.34, P = .03). TNF-ALPHA GENOTYPE WAS NOT ASSOCIATED WITH EPIGENETIC AGING OR HANA CONDITIONS. IL-6 AND IL-10 SNPS MAY HELP TO IDENTIFY PLWH WHO ARE AT HIGH RISK FOR ACCELERATED AGING. THESE INSIGHTS INTO PATHOPHYSIOLOGICAL PATHWAYS MAY INFORM INTERVENTIONAL APPROACHES TO TREAT RAPID AGING AMONG PLWH. 2019 8 3555 37 IMPACT OF AGE, ANTIRETROVIRAL THERAPY, AND CANCER ON EPIGENETIC AGING IN PEOPLE LIVING WITH HIV. BACKGROUND: PREMATURE AGING HAS BEEN IDENTIFIED AS A GLOBAL RISK FACTOR FOR CANCER. CAUSES OF PREMATURE AGING ARE MULTIFACTORIAL, INCLUDING INFLAMMATION, INFECTION, CHRONIC STRESS, AND LIFESTYLE FACTORS. METHOD: WE EVALUATED WHETHER PREMATURE AGING IN PEOPLE LIVING WITH HIV (PLWH) WAS ASSOCIATED WITH ANTIRETROVIRAL THERAPY (ART) OR THE DIAGNOSIS OF CANCER. WE USED WELL-ESTABLISHED DNA METHYLATION PATTERNS TO ASSESS PREMATURE AGING, USING HORVATH ET AL., IN INDIVIDUALS WITH HIV LOCATED IN CLEVELAND, OHIO AND COMPARED THESE TO STANDARDIZED DATASETS OF US HISTORICAL BLOOD SAMPLES. SOME OF THE PLWH DEVELOPED CANCER OVER TIME. RESULTS: WE FOUND THAT DNA METHYLATION ANALYSIS IDENTIFIED ACCELERATED AGING IN PLWH WHEREAS ART THERAPY MITIGATED THE ADVANCEMENT OF DNA METHYLATION AGE. A VARIETY OF CANCERS WERE OBSERVED IN THIS POPULATION, BUT A CANCER DIAGNOSIS WAS NOT SIGNIFICANTLY ASSOCIATED WITH MORE ADVANCED DNA METHYLATION AGE. CONCLUSION: WE FIND THAT THE AGE ACCELERATION DETECTED IN PLWH IS MITIGATED BY ART THERAPY AND IS NOT FURTHER ACCELERATED BY A DIAGNOSIS OF CANCER. 2023 9 4249 39 METHYLATION-BASED BIOLOGICAL AGE AND BREAST CANCER RISK. BACKGROUND: AGE IS ONE OF THE STRONGEST PREDICTORS OF CANCER, CHRONIC DISEASE, AND MORTALITY, BUT BIOLOGICAL RESPONSES TO AGING DIFFER AMONG PEOPLE. EPIGENETIC DNA MODIFICATIONS HAVE BEEN USED TO ESTIMATE "BIOLOGICAL AGE," WHICH MAY BE A USEFUL PREDICTOR OF DISEASE RISK. WE TESTED THIS HYPOTHESIS FOR BREAST CANCER. METHODS: USING A CASE-COHORT APPROACH, WE MEASURED BASELINE BLOOD DNA METHYLATION OF 2764 WOMEN ENROLLED IN THE SISTER STUDY, 1566 OF WHOM SUBSEQUENTLY DEVELOPED BREAST CANCER AFTER AN AVERAGE OF 6 YEARS. USING THREE PREVIOUSLY ESTABLISHED METHYLATION-BASED "CLOCKS" (HANNUM, HORVATH, AND LEVINE), WE DEFINED BIOLOGICAL AGE ACCELERATION FOR EACH WOMAN BY COMPARING HER ESTIMATED BIOLOGICAL AGE WITH HER CHRONOLOGICAL AGE. HAZARD RATIOS AND 95% CONFIDENCE INTERVALS FOR BREAST CANCER RISK WERE ESTIMATED USING COX REGRESSION MODELS. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: EACH OF THE THREE CLOCKS SHOWED THAT BIOLOGICAL AGE ACCELERATION WAS STATISTICALLY SIGNIFICANTLY ASSOCIATED WITH INCREASED RISK OF DEVELOPING BREAST CANCER (5-YEAR AGE ACCELERATION, HANNUM'S CLOCK: HAZARD RATIO [HR] = 1.10, 95% CONFIDENCE INTERVAL [CI] = 1.00 TO 1.21, P = .04; HORVATH'S CLOCK: HR = 1.08, 95% CI = 1.00 TO 1.17, P = .04; LEVINE'S CLOCK: HR = 1.15, 95% CI = 1.07 TO 1.23, P < .001). FOR LEVINE'S CLOCK, EACH 5-YEAR ACCELERATION IN BIOLOGICAL AGE CORRESPONDED WITH A 15% INCREASE IN BREAST CANCER RISK. ALTHOUGH BIOLOGICAL AGE MAY ACCELERATE WITH MENOPAUSAL TRANSITION, AGE ACCELERATION IN PREMENOPAUSAL WOMEN INDEPENDENTLY PREDICTED BREAST CANCER. CASE-ONLY ANALYSIS SUGGESTED THAT, AMONG WOMEN WHO DEVELOP BREAST CANCER, INCREASED AGE ACCELERATION IS ASSOCIATED WITH INVASIVE CANCER (ODDS RATIO FOR INVASIVE = 1.09, 95% CI = 0.98 TO 1.22, P = .10). CONCLUSIONS: DNA METHYLATION-BASED MEASURES OF BIOLOGICAL AGE MAY BE IMPORTANT PREDICTORS OF BREAST CANCER RISK. 2019 10 2185 25 EPIGENETIC MECHANISMS UNDERLYING HIV-INFECTION INDUCED SUSCEPTIBILITY OF CD4+ T CELLS TO ENHANCED ACTIVATION-INDUCED FASL EXPRESSION AND CELL DEATH. BACKGROUND: CHRONIC IMMUNE ACTIVATION AND CD4 T CELL DEPLETION ARE SIGNIFICANT PATHOGENIC FEATURES OF HIV INFECTION. EXPRESSION OF FAS LIGAND (FASL), A KEY MEDIATOR OF ACTIVATION-INDUCED CELL DEATH IN T CELLS, IS ELEVATED IN PEOPLE LIVING WITH HIV-1 INFECTION (PLWH). HOWEVER, THE EPIGENETIC MECHANISMS UNDERLYING THE ENHANCED INDUCTION OF FASL EXPRESSION IN CD4 T LYMPHOCYTES IN PLWH ARE NOT COMPLETELY ELUCIDATED. HENCE, THE CURRENT WORK EXAMINED THE EFFECT OF HIV INFECTION ON FASL PROMOTER-ASSOCIATED HISTONE MODIFICATIONS AND TRANSCRIPTIONAL REGULATION IN CD4 T LYMPHOCYTES IN PLWH. METHOD: FLOW CYTOMETRIC ANALYSIS WAS PERFORMED TO EXAMINE THE FAS-FASL EXPRESSION ON TOTAL CD4 T CELLS AND NAIVE/MEMORY CD4 T CELL SUBSETS. EPIGENETIC FASL PROMOTER HISTONE MODIFICATIONS WERE INVESTIGATED BY CHROMATIN IMMUNOPRECIPITATION-QUANTITATIVE REAL-TIME POLYMERASE CHAIN REACTION ANALYSIS USING FRESHLY ISOLATED TOTAL CD4 T LYMPHOCYTES FROM HIV-1 INFECTED AND NONINFECTED INDIVIDUALS. RESULTS: ALL NAIVE/MEMORY CD4 T CELL SUBSETS FROM PLWH SHOWED MARKEDLY GREATER FREQUENCY OF FASL EXPRESSION. NOTABLY, EXAMINATION OF FUNCTIONAL OUTCOME OF FASL/FAS CO-EXPRESSION DEMONSTRATED THE PREFERENTIAL SUSCEPTIBILITY OF TCM AND TEM SUBSETS TO ACTIVATION-INDUCED APOPTOSIS. IMPORTANTLY, THESE CD4 T CELLS COLLECTIVELY DEMONSTRATED A DISTINCT FASL PROMOTER HISTONE PROFILE INVOLVING A COORDINATED CROSS-TALK BETWEEN HISTONE H3 MODIFICATIONS LEADING TO ENHANCED FASL GENE EXPRESSION. SPECIFICALLY, LEVELS OF TRANSCRIPTIONALLY PERMISSIVE HISTONE H3K4-TRIMETHYLATION (H3K4ME3) AND HISTONE H3K9-ACETYLATION (H3K9AC) WERE INCREASED, WITH A CONCOMITANT DECREASE IN THE REPRESSIVE H3K9-TRIMETHYLATION (H3K9ME3). CONCLUSION: THE PRESENT WORK DEMONSTRATES THAT EPIGENETIC MECHANISMS INVOLVING PROMOTER-HISTONE MODIFICATIONS REGULATE TRANSCRIPTIONAL COMPETENCE AND FASL EXPRESSION IN CD4 T CELLS FROM PLWH AND RENDER THEM SUSCEPTIBLE TO ACTIVATION-INDUCED CELL DEATH. 2021 11 284 30 AGEING WITH HIV: CHALLENGES AND BIOMARKERS. THE ANTIRETROVIRAL TREATMENT (ART) DEVELOPED TO CONTROL HIV INFECTION LED TO A REVOLUTION IN THE PROGNOSIS OF PEOPLE LIVING WITH HIV (PLWH). PLWH UNDERWENT FROM SUFFERING SEVERE DISEASE AND OFTEN FATAL COMPLICATIONS AT YOUNG AGES TO HAVING A CHRONIC CONDITION AND A LIFE EXPECTANCY CLOSE TO THE GENERAL POPULATION. NEVERTHELESS, CHRONIC AGE-RELATED DISEASES INCREASE AS PLWH AGE. THE HARMFUL EFFECT OF HIV INFECTION ON THE INDIVIDUAL'S IMMUNE SYSTEM ADDS TO ITS DETERIORATION DURING AGEING, EXACERBATING COMORBIDITIES. IN ADDITION, PLWH ARE MORE EXPOSED TO RISK FACTORS AFFECTING AGEING, SUCH AS COINFECTIONS OR HARMFUL LIFESTYLES. THE ART INITIATION REVERSES THE BIOLOGICAL AGEING PROCESS BUT ONLY PARTIALLY, AND ADDITIONALLY CAN HAVE SOME TOXICITIES THAT INFLUENCE AGEING. OBSERVATIONAL STUDIES SUGGEST PREMATURE AGEING IN PLWH. THEREFORE, THERE IS CONSIDERABLE INTEREST IN THE EARLY PREDICTION OF UNHEALTHY AGEING THROUGH VALIDATED BIOMARKERS, EASY TO IMPLEMENT IN HIV-CLINICAL SETTINGS. THE MOST PROMISING BIOMARKERS ARE SECOND-GENERATION EPIGENETIC CLOCKS AND INTEGRATIVE ALGORITHMS. 2022 12 525 31 ASSOCIATIONS OF BODY COMPOSITION AND PHYSICAL ACTIVITY LEVEL WITH MULTIPLE MEASURES OF EPIGENETIC AGE ACCELERATION. EPIGENETIC CLOCKS USE DNA METHYLATION TO ESTIMATE BIOLOGICAL AGE. WHETHER BODY COMPOSITION AND PHYSICAL ACTIVITY ARE ASSOCIATED WITH THESE CLOCKS IS NOT WELL UNDERSTOOD. USING BLOOD SAMPLES COLLECTED AT ENROLLMENT (2003-2009) FROM 2,758 WOMEN IN THE US NATIONWIDE SISTER STUDY, WE CALCULATED 6 EPIGENETIC AGE ACCELERATION METRICS USING 4 EPIGENETIC CLOCKS (HANNUM, HORVATH, PHENOAGE, GRIMAGE). RECREATIONAL PHYSICAL ACTIVITY WAS SELF-REPORTED, AND ADIPOSITY MEASURES WERE ASSESSED BY TRAINED MEDICAL EXAMINERS (BODY MASS INDEX (BMI), WAIST-TO-HIP RATIO (WTH), WAIST CIRCUMFERENCE). IN CROSS-SECTIONAL ANALYSES, ALL ADIPOSITY MEASURES WERE ASSOCIATED WITH EPIGENETIC AGE ACCELERATION. THE STRONGEST ASSOCIATION WAS FOR BMI AND PHENOAGE, A MEASURE OF BIOLOGICAL AGE THAT CORRELATES WITH CHRONIC DISEASE (BMI OF >/=35.0 VS. 18.5-24.9, BETA = 3.15 YEARS, 95% CONFIDENCE INTERVAL (CI): 2.41, 3.90; P FOR TREND < 0.001). IN A MUTUAL-ADJUSTMENT MODEL, BOTH WERE ASSOCIATED WITH PHENOAGE AGE ACCELERATION (BMI OF >/=35.0 VS. 18.5-24.9, BETA = 2.69 YEARS, 95% CI: 1.90, 3.48; P FOR TREND < 0.001; QUARTILE 4 VS.1 WTH, BETA = 1.00 YEARS, 95% CI: 0.34, 1.65; P FOR TREND < 0.008). AFTER ADJUSTMENT, PHYSICAL ACTIVITY WAS ASSOCIATED ONLY WITH GRIMAGE (QUARTILE 4 VS. 1, BETA = -0.42 YEARS, 95% CI: -0.70, -0.14; P FOR TREND = 0.001). PHYSICAL ACTIVITY ATTENUATED THE WAIST CIRCUMFERENCE ASSOCIATIONS WITH PHENOAGE AND GRIMAGE. EXCESS ADIPOSITY WAS ASSOCIATED WITH EPIGENETIC AGE ACCELERATION; PHYSICAL ACTIVITY MIGHT ATTENUATE ASSOCIATIONS WITH WAIST CIRCUMFERENCE. 2021 13 6751 26 WHY ARE PEOPLE WITH HIV CONSIDERED "OLDER ADULTS" IN THEIR FIFTIES? ONE IN SIX NEW HIV DIAGNOSES IN EUROPE OCCUR AMONG PEOPLE OVER 50 YEARS OF AGE. AS IN THE GENERAL POPULATION, THE AGING PROCESS IS NOT HOMOGENEOUS AMONG OLDER ADULTS WITH HIV, AND SOME OF THEM EXHIBIT IMPAIRED PHYSICAL FUNCTION, HIGHER FRAILTY AND MORE FREQUENT GERIATRIC SYNDROMES. THESE ILLNESS REFLECT A HIGHER BIOLOGICAL AGE INDEPENDENTLY OF THEIR CHRONOLOGICAL AGE. AFTER STARTING ANTIRRETROVIRAL TREATMENT, PEOPLE LIVING WITH HIV (PLWH) OLDER THAN 50 EXHIBIT A POORER IMMUNOLOGICAL RECOVERY THAN YOUNGER PLWH. MOREOVER, OLDER ADULTS WITH HIV PRESENT EARLY ONSET OF COMORBIDITIES AND FUNCTIONAL IMPAIRMENT CAUSED BY PERSISTENT AND CHRONIC ACTIVATION OF THE IMMUNE SYSTEM, WHICH LEADS TO IMMUNE EXHAUSTION AND ACCELERATED IMMUNOSENESCENCE DESPITE OPTIMAL SUPPRESSION OF HIV REPLICATION. THE EVIDENCE OF POORER IMMUNOLOGICAL RESPONSE TO ARV, LINKED WITH EARLY IMMUNOSENESCENCE IN PLWH AND ITS PREMATURELY DELETERIOUS EFFECT IN PHYSIOLOGICAL FUNCTIONS AND ITS CLINICAL CONSEQUENCES, ARE THE BASIS TO ACCEPT THE CUT-OFF OF 50 YEARS OF AGE TO DEFINE AN "OLDER ADULT WITH HIV". 2019 14 2005 40 EPIGENETIC ASSOCIATIONS WITH ESTIMATED GLOMERULAR FILTRATION RATE AMONG MEN WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION. BACKGROUND: PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION HAVE HIGHER RISK FOR CHRONIC KIDNEY DISEASE (CKD), DEFINED BY A REDUCED ESTIMATED GLOMERULAR FILTRATION RATE (EGFR). PREVIOUS STUDIES HAVE IMPLICATED EPIGENETIC CHANGES RELATED TO CKD; HOWEVER, THE MECHANISM OF HIV-RELATED CKD HAS NOT BEEN THOROUGHLY INVESTIGATED. METHODS: WE CONDUCTED AN EPIGENOME-WIDE ASSOCIATION STUDY OF EGFR AMONG 567 HIV-POSITIVE AND 117 HIV-NEGATIVE MALE PARTICIPANTS IN THE VETERANS AGING COHORT STUDY TO IDENTIFY EPIGENETIC SIGNATURES OF KIDNEY FUNCTION. RESULTS: BY SURVEYING MORE THAN 400 000 CYTOSINE GUANINE DINUCLEOTIDE (CPG) SITES MEASURED FROM PERIPHERAL BLOOD MONONUCLEAR CELLS, WE IDENTIFIED 15 SITES THAT WERE SIGNIFICANTLY ASSOCIATED WITH EGFR (FALSE DISCOVERY RATE Q VALUE < 0.05) AMONG HIV-POSITIVE PARTICIPANTS. THE MOST SIGNIFICANT CPG SITES, LOCATED AT MAD1L1, TSNARE1/BAI1, AND LTV1, WERE ALL NEGATIVELY ASSOCIATED WITH EGFR (CG06329547, P = 5.25 X 10-9; CG23281907, P = 1.37 X 10-8; CG18368637, P = 5.17 X 10-8). WE ALSO REPLICATED PREVIOUSLY REPORTED EGFR-ASSOCIATED CPG SITES INCLUDING CG17944885 (P = 2.5 X 10-5) LOCATED BETWEEN ZNF788 AND ZNF20 ON CHROMOSOME 19 IN THE POOLED POPULATION. CONCLUSIONS: IN THIS STUDY WE UNCOVERED NOVEL EPIGENETIC ASSOCIATIONS WITH KIDNEY FUNCTION AMONG PEOPLE LIVING WITH HIV AND SUGGEST POTENTIAL EPIGENETIC MECHANISMS LINKED WITH HIV-RELATED CKD RISK. 2020 15 175 26 ACCELERATED AGING WITH HIV BEGINS AT THE TIME OF INITIAL HIV INFECTION. LIVING WITH HIV INFECTION IS ASSOCIATED WITH EARLY ONSET OF AGING-RELATED CHRONIC CONDITIONS, SOMETIMES DESCRIBED AS ACCELERATED AGING. EPIGENETIC DNA METHYLATION PATTERNS CAN EVALUATE ACCELERATION OF BIOLOGICAL AGE RELATIVE TO CHRONOLOGICAL AGE. THE IMPACT OF INITIAL HIV INFECTION ON FIVE EPIGENETIC MEASURES OF AGING WAS EXAMINED BEFORE AND APPROXIMATELY 3 YEARS AFTER HIV INFECTION IN THE SAME INDIVIDUALS (N=102). SIGNIFICANT EPIGENETIC AGE ACCELERATION (MEDIAN 1.9-4.8 YEARS) AND ESTIMATED TELOMERE LENGTH SHORTENING (ALL P5 YEARS FROM CANCER DIAGNOSIS). DESIGN, SETTING, AND PARTICIPANTS: STUDY PARTICIPANTS WERE FROM THE ST JUDE LIFETIME COHORT, INITIATED IN 2007 WITH ONGOING FOLLOW-UP. THE PRESENT STUDY WAS CONDUCTED FROM APRIL 17, 2022, TO MARCH 23, 2023. SURVIVORS IN THIS COHORT OF EUROPEAN ANCESTRY WITH DNA METHYLATION DATA WERE INCLUDED. CROSS-SECTIONAL ANNUAL CHANGES IN EA AND EAA WERE COMPARED ACROSS 5 DIFFERENT CHRONOLOGIC AGE GROUPS: AGE 0 TO 9 (CHILDREN), 10 TO 19 (ADOLESCENTS), 20 TO 34 (YOUNGER ADULTS), 35 TO 49 (MIDDLE-AGED ADULTS), AND GREATER THAN OR EQUAL TO 50 (OLDER ADULTS) YEARS. LOGISTIC REGRESSION EVALUATED THE ASSOCIATION BETWEEN EAA AND EARLY-ONSET OBESITY OR SEVERITY/BURDEN OF CHCS. COX PROPORTIONAL HAZARDS REGRESSION ASSESSED THE ASSOCIATION BETWEEN EAA AND LATE MORTALITY. MAIN OUTCOMES AND MEASURES: EARLY-ONSET OBESITY, SEVERITY/BURDEN OF CHCS (GRADED USING THE COMMON TERMINOLOGY CRITERIA FOR ADVERSE EVENTS (GRADE 1, MILD; 2, MODERATE; 3, SEVERE/DISABLING; 4, LIFE-THREATENING) AND WERE COMBINED INTO HIGH VS LOW SEVERITY/BURDEN BASED ON FREQUENCY AND GRADE), AND LATE MORTALITY WERE THE OUTCOMES BASED ON FOLLOW-UP UNTIL APRIL 2020. EXPANDED DNA METHYLATION PROFILING INCREASED THE NUMBER OF SURVIVORS YOUNGER THAN 20 YEARS (N = 690). EPIGENETIC AGE WAS CALCULATED PRIMARILY USING THE LEVINE CLOCK, AND EAA WAS DERIVED FROM LEAST SQUARES REGRESSION OF EA AGAINST CHRONOLOGIC AGE AND WAS STANDARDIZED TO A Z SCORE (LEVINE EEA). RESULTS: AMONG 2846 PARTICIPANTS (MEDIAN AGE, 30.3 [IQR, 9.3-41.5] YEARS; 53% MALES), THE CROSS-SECTIONAL ANNUAL CHANGE IN EA_LEVINE WAS HIGHER IN CHILDREN (1.63 YEARS) AND ADOLESCENTS (1.14 YEARS), AND THE ADJUSTED LEAST-SQUARES MEAN OF LEVINE EEA WAS LOWER IN CHILDREN (-0.22 YEARS) AND OLDER ADULTS (-1.70 YEARS). EACH 1-SD INCREASE IN LEVINE EEA WAS ASSOCIATED WITH INCREASED RISK OF DEVELOPING EARLY-ONSET OBESITY (ODDS RATIO [OR], 1.46; 95% CI, 1.19-1.78), HIGH SEVERITY/BURDEN OF CHCS (OR, 1.13; 95% CI, 1.03-1.24), AND LATE MORTALITY (HAZARD RATIO, 1.75; 95% CI, 1.35-2.26). CONCLUSIONS AND RELEVANCE: THE FINDINGS OF THIS STUDY SUGGEST THAT EAA MEASURED IN CHILDREN AND ADOLESCENT SURVIVORS OF CHILDHOOD CANCER IS ASSOCIATED WITH EARLY-ONSET OBESITY, SEVERITY/BURDEN OF ALL CHCS, AND LATE MORTALITY. EVALUATING EAA MAY HELP IDENTIFY SURVIVORS OF CHILDHOOD CANCER AT INCREASED RISK FOR EARLY-ONSET OBESITY, MORBIDITY IN GENERAL, AND MORTALITY. 2023