1 2241 124 EPIGENETIC MODULATION IN PERIODONTITIS: INTERACTION OF ADIPONECTIN AND JMJD3-IRF4 AXIS IN MACROPHAGES. EMERGING EVIDENCE SUGGESTS AN IMPORTANT ROLE FOR EPIGENETIC MECHANISMS IN MODULATING SIGNALS DURING MACROPHAGE POLARIZATION AND INFLAMMATION. JMJD3, A JMJC FAMILY HISTONE DEMETHYLASE NECESSARY FOR M2 POLARIZATION IS ALSO REQUIRED FOR EFFECTIVE INDUCTION OF MULTIPLE M1 GENES BY LIPOPOLYSACCHARIDE (LPS). HOWEVER, THE EFFECTS OF JMJD3 TO INFLAMMATION IN THE CONTEXT OF OBESITY REMAINS UNKNOWN. TO ADDRESS THIS DEFICIENCY, WE FIRSTLY EXAMINED THE EXPRESSION OF JMJD3 IN MACROPHAGE ISOLATED FROM BONE MARROW AND ADIPOSE TISSUE OF DIET INDUCED OBESITY (DIO) MICE. THE RESULTS INDICATED THAT JMJD3 WAS DOWN-REGULATED IN OBESITY. ADIPONECTIN (APN), A FACTOR SECRETED BY ADIPOSE TISSUE WHICH IS DOWN-REGULATED IN OBESITY, FUNCTIONS TO SWITCH MACROPHAGE POLARIZATION FROM M1 TO M2, THEREBY ATTENUATING CHRONIC INFLAMMATION. INTRIGUINGLY, OUR RESULTS INDICATED THAT APN CONTRIBUTED TO JMJD3 UP-REGULATION, REDUCED MACROPHAGE INFILTRATION IN OBESE ADIPOSE TISSUE, AND ABOLISHED THE UP-REGULATION OF JMJD3 IN PERITONEAL MACROPHAGES ISOLATED FROM DIO MICE WHEN CHALLENGED WITH PORPHYROMONAS GINGIVALIS LPS (PG.LPS). TO ELUCIDATE THE INTERACTION OF APN AND JMJD3 INVOLVED IN MACROPHAGE TRANSFORMATION IN THE CONTEXT OF INFLAMMATION, WE DESIGNED THE LOSS AND GAIN-FUNCTION EXPERIMENTS OF APN IN VIVO WITH APN(-/-) MICE WITH EXPERIMENTAL PERIODONTITIS AND IN VITRO WITH MACROPHAGE ISOLATED FROM APN(-/-) MICE. FOR THE FIRST TIME, WE FOUND THAT APN CAN HELP TO REDUCE PERIODONTITIS-RELATED BONE LOSS, MODULATE JMJD3 AND IRF4 EXPRESSION, AND MACROPHAGE INFILTRATION. THEREFORE, IT CAN BE INFERRED THAT APN MAY CONTRIBUTE TO ANTI-INFLAMMATION MACROPHAGE POLARIZATION BY REGULATING JMJD3 EXPRESSION, WHICH PROVIDES A BASIS FOR MACROPHAGE-CENTERED EPIGENETIC THERAPEUTIC STRATEGIES. 2016 2 4097 28 MATRIX STIFFNESS REGULATES MACROPHAGE POLARIZATION IN ATHEROSCLEROSIS. ATHEROSCLEROSIS IS A CHRONIC INFLAMMATORY DISEASE AND THE PATHOLOGICAL BASIS OF MANY FATAL CARDIOVASCULAR DISEASES. MACROPHAGES, THE MAIN INFLAMMATORY CELLS IN ATHEROSCLEROTIC PLAQUE, HAVE A PARADOX ROLE IN DISEASE PROGRESSION. IN RESPONSE TO DIFFERENT MICROENVIRONMENTS, MACROPHAGES MAINLY HAVE TWO POLARIZED DIRECTIONS: PRO-INFLAMMATORY MACROPHAGES AND ANTI-INFLAMMATORY MACROPHAGES. MORE AND MORE EVIDENCE SHOWS THAT MACROPHAGE IS MECHANOSENSITIVE AND MATRIX STIFFNESS REGULATE MACROPHAGE PHENOTYPES IN ATHEROSCLEROSIS. HOWEVER, THE MOLECULAR MECHANISM OF MATRIX STIFFNESS REGULATING MACROPHAGE POLARIZATION STILL LACKS IN-DEPTH RESEARCH, WHICH HINDERS THE DEVELOPMENT OF NEW ANTI-ATHEROSCLEROTIC THERAPIES. IN THIS REVIEW, WE DISCUSS THE IMPORTANT ROLE OF MATRIX STIFFNESS IN REGULATING MACROPHAGE POLARIZATION THROUGH MECHANICAL SIGNAL TRANSDUCTION (HIPPO, PIEZO, CYTOSKELETON, AND INTEGRIN) AND EPIGENETIC MECHANISMS (MIRNA, DNA METHYLATION, AND HISTONE). WE HOPE TO PROVIDE A NEW PERSPECTIVE FOR ATHEROSCLEROSIS THERAPY BY TARGETING MATRIX STIFFNESS AND MACROPHAGE POLARIZATION. 2022 3 1476 29 DIVERSE EPIGENETIC REGULATIONS OF MACROPHAGES IN ATHEROSCLEROSIS. EMERGING RESEARCH ON EPIGENETICS HAS RESULTED IN MANY NOVEL DISCOVERIES IN ATHEROSCLEROSIS (AS), AN INFLAMMAGING-ASSOCIATED DISEASE CHARACTERIZED BY CHRONIC INFLAMMATION PRIMARILY DRIVEN BY MACROPHAGES. THE BULK OF EVIDENCE HAS DEMONSTRATED THE CENTRAL ROLE OF EPIGENETIC MACHINERY IN MACROPHAGE POLARIZATION TO PRO- (M1-LIKE) OR ANTI-INFLAMMATORY (M2-LIKE) PHENOTYPE. AN INCREASING NUMBER OF EPIGENETIC ALTERATIONS AND THEIR MODIFIERS INVOLVED IN REPROGRAMMING MACROPHAGES BY REGULATING DNA METHYLATION OR HISTONE MODIFICATIONS (E.G., METHYLATION, ACETYLATION, AND RECENTLY LACTYLATION) HAVE BEEN IDENTIFIED. THEY MAY ACT TO DETERMINE OR SKEW THE DIRECTION OF MACROPHAGE POLARIZATION IN AS LESIONS, THEREBY REPRESENTING A PROMISING TARGET. HERE WE DESCRIBE THE CURRENT UNDERSTANDING OF THE EPIGENETIC MACHINERY INVOLVING MACROPHAGE POLARIZATION, TO SHED LIGHT ON CHRONIC INFLAMMATION-DRIVING ONSET AND PROGRESSION OF INFLAMMAGING-ASSOCIATED DISEASES, USING AS AS A PROTOTYPIC EXAMPLE, AND DISCUSS THE CHALLENGE FOR DEVELOPING EFFECTIVE THERAPIES TARGETING THE EPIGENETIC MODIFIERS AGAINST THESE DISEASES, PARTICULARLY HIGHLIGHTING A POTENTIAL STRATEGY BASED ON EPIGENETICALLY-GOVERNED REPOLARIZATION FROM M1-LIKE TO M2-LIKE PHENOTYPE. 2022 4 2247 28 EPIGENETIC MODULATION OF MACROPHAGE POLARIZATION PREVENTS LUMBAR DISC DEGENERATION. INFLAMMATION PLAYS AN ESSENTIAL ROLE IN THE DEVELOPMENT OF LUMBAR DISC DEGENERATION (LDD), ALTHOUGH THE EXACT EFFECTS OF MACROPHAGE SUBTYPES ON LDD REMAIN UNCLEAR. BASED ON PREVIOUS STUDIES, WE HYPOTHESIZED THAT M2-POLARIZATION OF LOCAL MACROPHAGES AND SIMULTANEOUS SUPPRESSION OF THEIR PRODUCTION OF FIBROTIC TRANSFORMING GROWTH FACTOR BETA 1 (TGFBETA1) COULD INHIBIT PROGRESSION OF LDD. THUS, WE APPLIED AN ORTHOTOPIC INJECTION OF ADENO-ASSOCIATED VIRUS (AAV) CARRYING SHRNA FOR DNA METHYLTRANSFERASE 1 (DNMT1) AND/OR SHRNA FOR TGFBETA1 UNDER A MACROPHAGE-SPECIFIC CD68 PROMOTER TO SPECIFICALLY TARGET LOCAL MACROPHAGES IN A MOUSE MODEL FOR LDD. WE FOUND THAT SHDNMT1 SIGNIFICANTLY REDUCED LEVELS OF THE PRO-INFLAMMATORY CYTOKINES TNFALPHA, IL-1BETA AND IL-6, SIGNIFICANTLY INCREASED LEVELS OF THE ANTI-INFLAMMATORY CYTOKINES IL-4 AND IL-10, SIGNIFICANTLY INCREASED M2 MACROPHAGE POLARIZATION, SIGNIFICANTLY REDUCED CELL APOPTOSIS IN THE DISC DEGENERATION ZONE AND SIGNIFICANTLY REDUCED LDD-ASSOCIATED PAIN. THE ANTI-APOPTOTIC AND ANTI-PAIN EFFECTS WERE FURTHER STRENGTHENED BY CO-APPLICATION OF SHTGFBETA1. TOGETHER, THESE DATA SUGGEST THAT M2 POLARIZATION OF MACROPHAGES INDUCED BY BOTH EPIGENETIC MODULATION AND SUPPRESSED PRODUCTION AND RELEASE OF TGFBETA1 FROM POLARIZED M2 MACROPHAGES, MAY HAVE A DEMONSTRABLE THERAPEUTIC EFFECT ON LDD. 2020 5 4040 26 MACROPHAGE PLASTICITY AND POLARIZATION: IN VIVO VERITAS. DIVERSITY AND PLASTICITY ARE HALLMARKS OF CELLS OF THE MONOCYTE-MACROPHAGE LINEAGE. IN RESPONSE TO IFNS, TOLL-LIKE RECEPTOR ENGAGEMENT, OR IL-4/IL-13 SIGNALING, MACROPHAGES UNDERGO M1 (CLASSICAL) OR M2 (ALTERNATIVE) ACTIVATION, WHICH REPRESENT EXTREMES OF A CONTINUUM IN A UNIVERSE OF ACTIVATION STATES. PROGRESS HAS NOW BEEN MADE IN DEFINING THE SIGNALING PATHWAYS, TRANSCRIPTIONAL NETWORKS, AND EPIGENETIC MECHANISMS UNDERLYING M1-M2 OR M2-LIKE POLARIZED ACTIVATION. FUNCTIONAL SKEWING OF MONONUCLEAR PHAGOCYTES OCCURS IN VIVO UNDER PHYSIOLOGICAL CONDITIONS (E.G., ONTOGENESIS AND PREGNANCY) AND IN PATHOLOGY (ALLERGIC AND CHRONIC INFLAMMATION, TISSUE REPAIR, INFECTION, AND CANCER). HOWEVER, IN SELECTED PRECLINICAL AND CLINICAL CONDITIONS, COEXISTENCE OF CELLS IN DIFFERENT ACTIVATION STATES AND UNIQUE OR MIXED PHENOTYPES HAVE BEEN OBSERVED, A REFLECTION OF DYNAMIC CHANGES AND COMPLEX TISSUE-DERIVED SIGNALS. THE IDENTIFICATION OF MECHANISMS AND MOLECULES ASSOCIATED WITH MACROPHAGE PLASTICITY AND POLARIZED ACTIVATION PROVIDES A BASIS FOR MACROPHAGE-CENTERED DIAGNOSTIC AND THERAPEUTIC STRATEGIES. 2012 6 4563 32 MYELOID DNA METHYLTRANSFERASE3B DEFICIENCY AGGRAVATES PULMONARY FIBROSIS BY ENHANCING PROFIBROTIC MACROPHAGE ACTIVATION. BACKGROUND: IDIOPATHIC PULMONARY FIBROSIS (IPF) IS A CHRONIC, PROGRESSIVE AND SEVERE DISEASE CHARACTERIZED BY EXCESSIVE MATRIX DEPOSITION IN THE LUNGS. MACROPHAGES PLAY CRUCIAL ROLES IN MAINTAINING LUNG HOMEOSTASIS BUT ARE ALSO CENTRAL IN THE PATHOGENESIS OF LUNG DISEASES LIKE PULMONARY FIBROSIS. ESPECIALLY, MACROPHAGE POLARIZATION/ACTIVATION SEEMS TO PLAY A CRUCIAL ROLE IN PATHOLOGY AND EPIGENETIC REPROGRAMING IS WELL-KNOWN TO REGULATE MACROPHAGE POLARIZATION. DNA METHYLATION ALTERATIONS IN IPF LUNGS HAVE BEEN WELL DOCUMENTED, BUT THE ROLE OF DNA METHYLATION IN SPECIFIC CELL TYPES, ESPECIALLY MACROPHAGES, IS POORLY DEFINED. METHODS: IN ORDER TO DETERMINE THE ROLE OF DNA METHYLATION IN MACROPHAGES DURING PULMONARY FIBROSIS, WE SUBJECTED MACROPHAGE SPECIFIC DNA METHYLTRANSFERASE (DNMT)3B, WHICH MEDIATES THE DE NOVO DNA METHYLATION, DEFICIENT MICE TO THE BLEOMYCIN-INDUCED PULMONARY FIBROSIS MODEL. MACROPHAGE POLARIZATION AND FIBROTIC PARAMETERS WERE EVALUATED AT 21 DAYS AFTER BLEOMYCIN ADMINISTRATION. DNMT3B KNOCKOUT AND WILD TYPE BONE MARROW-DERIVED MACROPHAGES WERE STIMULATED WITH EITHER INTERLEUKIN (IL)4 OR TRANSFORMING GROWTH FACTOR BETA 1 (TGFB1) IN VITRO, AFTER WHICH PROFIBROTIC GENE EXPRESSION AND DNA METHYLATION AT THE ARG1 PROMOTOR WERE DETERMINED. RESULTS: WE SHOW THAT DNMT3B DEFICIENCY PROMOTES ALTERNATIVE MACROPHAGE POLARIZATION INDUCED BY IL4 AND TGFB1 IN VITRO AND ALSO ENHANCES PROFIBROTIC MACROPHAGE POLARIZATION IN THE ALVEOLAR SPACE DURING PULMONARY FIBROSIS IN VIVO. MOREOVER, MYELOID SPECIFIC DELETION OF DNMT3B PROMOTED THE DEVELOPMENT OF EXPERIMENTAL PULMONARY FIBROSIS. CONCLUSIONS: IN SUMMARY, THESE DATA SUGGEST THAT MYELOID DNMT3B REPRESSES FIBROTIC MACROPHAGE POLARIZATION AND PROTECTS AGAINST BLEOMYCIN INDUCED PULMONARY FIBROSIS. 2022 7 2342 31 EPIGENETIC REGULATION OF MACROPHAGE POLARIZATION AND FUNCTION. MACROPHAGE POLARIZATION REFERS TO DEVELOPMENT OF A SPECIFIC PHENOTYPE IMPORTANT FOR TISSUE HOMEOSTASIS OR HOST DEFENSE IN RESPONSE TO ENVIRONMENTAL CUES. ENVIRONMENTAL FACTORS THAT INDUCE MACROPHAGE POLARIZATION INCLUDE CYTOKINES AND MICROBIAL FACTORS PRODUCED BY PATHOGENS OR COMMENSAL MICROBIOTA. SIGNALING PATHWAYS UTILIZED BY THESE POLARIZING FACTORS HAVE BEEN WELL CHARACTERIZED, BUT IT IS LESS CLEAR HOW SIGNALS ARE CONVERTED INTO COMPLEX AND SUSTAINED PATTERNS OF GENE EXPRESSION, AND HOW MACROPHAGES ARE REPROGRAMMED DURING POLARIZATION TO ALTER THEIR RESPONSES TO SUBSEQUENT ENVIRONMENTAL CHALLENGES. EMERGING EVIDENCE, REVIEWED HERE, SUGGESTS AN IMPORTANT ROLE FOR EPIGENETIC MECHANISMS IN MODULATING AND TRANSMITTING SIGNALS DURING MACROPHAGE POLARIZATION AND REPROGRAMMING. DEEPER UNDERSTANDING OF EPIGENETIC REGULATION OF MACROPHAGE PHENOTYPE WILL ENABLE DEVELOPMENT OF GENE-SPECIFIC THERAPEUTIC APPROACHES TO ENHANCE HOST DEFENSE WHILE PRESERVING TISSUE INTEGRITY AND PREVENTING CHRONIC INFLAMMATORY DISEASES. 2013 8 6591 23 TUMOR-ASSOCIATED MACROPHAGES AS A PARADIGM OF MACROPHAGE PLASTICITY, DIVERSITY, AND POLARIZATION: LESSONS AND OPEN QUESTIONS. MACROPHAGES ARE PRESENT IN ALL BODY COMPARTMENTS, INCLUDING CANCEROUS TISSUES, AND THEIR FUNCTIONS ARE PROFOUNDLY AFFECTED BY SIGNALS FROM THE MICROENVIRONMENT UNDER HOMEOSTATIC AND PATHOLOGICAL CONDITIONS. TUMOR-ASSOCIATED MACROPHAGES ARE A MAJOR CELLULAR COMPONENT OF CANCER-RELATED INFLAMMATION AND HAVE SERVED AS A PARADIGM FOR THE PLASTICITY AND FUNCTIONAL POLARIZATION OF MONONUCLEAR PHAGOCYTES. TUMOR-ASSOCIATED MACROPHAGES CAN EXERT DUAL INFLUENCE OF CANCER DEPENDING ON THE ACTIVATION STATE, WITH CLASSICALLY ACTIVATED (M1) AND ALTERNATIVELY ACTIVATED (M2) CELLS GENERALLY EXERTING ANTITUMORAL AND PROTUMORAL FUNCTIONS, RESPECTIVELY. THESE ARE EXTREMES IN A CONTINUUM OF POLARIZATION STATES IN A UNIVERSE OF DIVERSITY. TUMOR-ASSOCIATED MACROPHAGES AFFECT VIRTUALLY ALL ASPECTS OF TUMOR TISSUES, INCLUDING STEM CELLS, METABOLISM, ANGIOGENESIS, INVASION, AND METASTASIS. PROGRESS HAS BEEN MADE IN DEFINING SIGNALING MOLECULES, TRANSCRIPTION FACTORS, EPIGENETIC CHANGES, AND REPERTOIRE OF MICRORNAS UNDERLYING MACROPHAGE POLARIZATION. PRECLINICAL AND EARLY CLINICAL DATA SUGGEST THAT MACROPHAGES MAY SERVE AS TOOLS FOR THE DEVELOPMENT OF INNOVATIVE DIAGNOSTIC AND THERAPEUTIC STRATEGIES IN CANCER AND CHRONIC NONRESOLVING INFLAMMATORY DISEASES. 2013 9 4307 40 MICRORNA-30 MODULATES METABOLIC INFLAMMATION BY REGULATING NOTCH SIGNALING IN ADIPOSE TISSUE MACROPHAGES. BACKGROUND/OBJECTIVES: OBESITY IS A PANDEMIC DISORDER THAT IS CHARACTERIZED BY ACCUMULATION OF ADIPOSE TISSUE AND CHRONIC LOW-GRADE INFLAMMATION THAT IS DRIVEN PRIMARILY BY ADIPOSE TISSUE MACROPHAGES (ATMS). WHILE ATM POLARIZATION FROM PRO-(M1) TO ANTI-(M2) INFLAMMATORY PHENOTYPE INFLUENCES INSULIN SENSITIVITY AND ENERGY EXPENDITURE, THE MECHANISMS OF SUCH A SWITCH ARE UNCLEAR. IN THE CURRENT STUDY, WE IDENTIFIED EPIGENETIC PATHWAYS INCLUDING MICRORNAS (MIR) IN ATMS THAT REGULATE OBESITY-INDUCED INFLAMMATION. SUBJECTS/METHODS: MALE C57BL/6J MICE WERE FED NORMAL CHOW DIET (NCD) OR HIGH-FAT DIET (HFD) FOR 16 WEEKS TO DEVELOP LEAN AND DIET-INDUCED OBESE MICE, RESPECTIVELY. TRANSCRIPTOME MICROARRAYS, MICRORNA MICROARRAYS, AND MEDIP-SEQ WERE PERFORMED ON ATMS ISOLATED FROM VISCERAL FAT. PATHWAY ANALYSIS AND BONE MARROW-DERIVED MACROPHAGE (BMDM) TRANSFECTIONS FURTHER ALLOWED COMPUTATIONAL AND FUNCTIONAL ANALYSIS OF MIRNA-MEDIATED ATM POLARIZATION. RESULTS: ATMS FROM HFD-FED MICE WERE SKEWED TOWARD M1 INFLAMMATORY PHENOTYPE. CONCURRENTLY, THE EXPRESSION OF MIRS 30A-5P, 30C-5P, AND 30E-5P WAS DOWNREGULATED IN ATMS FROM HFD MICE WHEN COMPARED TO MICE FED NCD. THE MIR-30 FAMILY WAS SHOWN TO TARGET DELTA-LIKE-4, A NOTCH1 LIGAND, WHOSE EXPRESSION WAS INCREASED IN HFD ATMS. INHIBITION OF MIR-30 IN CONDITIONED BMDM TRIGGERED NOTCH1 SIGNALING, PRO-INFLAMMATORY CYTOKINE PRODUCTION, AND M1 MACROPHAGE POLARIZATION. IN ADDITION, DNA HYPERMETHYLATION WAS OBSERVED IN MIR30-ASSOCIATED CPG ISLANDS, SUGGESTING THAT HFD DOWNREGULATES MIR-30 THROUGH EPIGENETIC MODIFICATIONS. CONCLUSIONS: HFD-INDUCED OBESITY DOWNREGULATES MIR-30 BY DNA METHYLATION THEREBY INDUCING NOTCH1 SIGNALING IN ATMS AND THEIR POLARIZATION TO M1 MACROPHAGES. THESE FINDINGS IDENTIFY MIR-30 AS A REGULATOR OF PRO-INFLAMMATORY ATM POLARIZATION AND SUGGEST THAT MIR-30 MANIPULATION COULD BE A THERAPEUTIC TARGET FOR OBESITY-INDUCED INFLAMMATION. 2018 10 2067 39 EPIGENETIC CONTROL OF MACROPHAGE SHAPE TRANSITION TOWARDS AN ATYPICAL ELONGATED PHENOTYPE BY HISTONE DEACETYLASE ACTIVITY. INFLAMMATORY CHRONIC PATHOLOGIES ARE COMPLEX PROCESSES CHARACTERIZED BY AN IMBALANCE BETWEEN THE RESOLUTION OF THE INFLAMMATORY PHASE AND THE ESTABLISHMENT OF TISSUE REPAIR. THE MAIN PLAYERS IN THESE INFLAMMATORY PATHOLOGIES ARE BONE MARROW DERIVED MONOCYTES (BMDMS). HOWEVER, HOW MONOCYTE DIFFERENTIATION IS MODULATED TO GIVE RISE TO SPECIFIC MACROPHAGE SUBPOPULATIONS (M1 OR M2) THAT MAY EITHER MAINTAIN THE CHRONIC INFLAMMATORY PROCESS OR LEAD TO WOUND HEALING IS STILL UNCLEAR. CONSIDERING THAT INHIBITORS OF HISTONE DEACETYLASE (HDAC) HAVE AN ANTI-INFLAMMATORY ACTIVITY, WE ASKED WHETHER THIS ENZYME WOULD PLAY A ROLE ON MONOCYTE DIFFERENTIATION INTO M1 OR M2 PHENOTYPE AND IN THE CELL SHAPE TRANSITION THAT FOLLOWS. WE THEN INDUCED MURINE BONE MARROW PROGENITORS INTO MONOCYTE/MACROPHAGE DIFFERENTIATION PATHWAY USING MEDIA CONTAINING GM-CSF AND THE HDAC BLOCKER, TRICHOSTATIN A (TSA). WE FOUND THAT THE PHARMACOLOGICAL INHIBITION OF HDAC ACTIVITY LED TO A SHAPE TRANSITION FROM THE TYPICAL MACROPHAGE PANCAKE-LIKE SHAPE INTO AN ELONGATED MORPHOLOGY, WHICH WAS CORRELATED TO A MIXED M1/M2 PROFILE OF CYTOKINE AND CHEMOKINE SECRETION. OUR RESULTS PRESENT, FOR THE FIRST TIME, THAT HDAC ACTIVITY ACTS AS A REGULATOR OF MACROPHAGE DIFFERENTIATION IN THE ABSENCE OF LYMPHOCYTE STIMULI. WE PROPOSE THAT HDAC ACTIVITY DOWN REGULATES MACROPHAGE PLASTICITY FAVORING THE PRO-INFLAMMATORY PHENOTYPE. 2015 11 744 42 CANNABINOID WIN55,212-2 REPROGRAMS MONOCYTES AND MACROPHAGES TO INHIBIT LPS-INDUCED INFLAMMATION. INTRODUCTION: CHRONIC OR UNCONTROLLED ACTIVATION OF MYELOID CELLS INCLUDING MONOCYTES, MACROPHAGES AND DENDRITIC CELLS (DCS) IS A HALLMARK OF IMMUNE-MEDIATED INFLAMMATORY DISORDERS. THERE IS AN URGENT NEED FOR THE DEVELOPMENT OF NOVEL DRUGS WITH THE CAPACITY TO IMPAIR INNATE IMMUNE CELL OVERACTIVATION UNDER INFLAMMATORY CONDITIONS. COMPELLING EVIDENCE POINTED OUT CANNABINOIDS AS POTENTIAL THERAPEUTIC TOOLS WITH ANTI-INFLAMMATORY AND IMMUNOMODULATORY CAPACITY. WIN55,212-2, A NON-SELECTIVE SYNTHETIC CANNABINOID AGONIST, DISPLAYS PROTECTIVE EFFECTS IN SEVERAL INFLAMMATORY CONDITIONS BY MECHANISMS PARTIALLY DEPENDING ON THE GENERATION OF TOLEROGENIC DCS ABLE TO INDUCE FUNCTIONAL REGULATORY T CELLS (TREGS). HOWEVER, ITS IMMUNOMODULATORY CAPACITY ON OTHER MYELOID CELLS SUCH AS MONOCYTES AND MACROPHAGES REMAINS INCOMPLETELY UNDERSTOOD. METHODS: HUMAN MONOCYTE-DERIVED DCS (HMODCS) WERE DIFFERENTIATED IN THE ABSENCE (CONVENTIONAL HMODCS) OR PRESENCE OF WIN55,212-2 (WIN-HMODCS). CELLS WERE STIMULATED WITH LPS, COCULTURED WITH NAIVE T LYMPHOCYTES AND THEIR CYTOKINE PRODUCTION AND ABILITY TO INDUCE T CELL RESPONSES WERE ANALYSED BY ELISA OR FLOW CYTOMETRY. TO EVALUATE THE EFFECT OF WIN55,212-2 IN MACROPHAGE POLARIZATION, HUMAN AND MURINE MACROPHAGES WERE ACTIVATED WITH LPS OR LPS/IFNGAMMA, IN THE PRESENCE OR ABSENCE OF THE CANNABINOID. CYTOKINE, COSTIMULATORY MOLECULES AND INFLAMMASOME MARKERS WERE ASSAYED. METABOLIC AND CHROMATIN IMMUNOPRECIPITATION ASSAYS WERE ALSO PERFORMED. FINALLY, THE PROTECTIVE CAPACITY OF WIN55,212-2 WAS STUDIED IN VIVO IN BALB/C MICE AFTER INTRAPERITONEAL INJECTION WITH LPS. RESULTS: WE SHOW FOR THE FIRST TIME THAT THE DIFFERENTIATION OF HMODCS IN THE PRESENCE OF WIN55,212-2 GENERATES TOLEROGENIC WIN-HMODCS THAT ARE LESS RESPONSIVE TO LPS STIMULATION AND ABLE TO PRIME TREGS. WIN55,212-2 ALSO IMPAIRS THE PRO-INFLAMMATORY POLARIZATION OF HUMAN MACROPHAGES BY INHIBITING CYTOKINE PRODUCTION, INFLAMMASOME ACTIVATION AND RESCUING MACROPHAGES FROM PYROPTOTIC CELL DEATH. MECHANISTICALLY, WIN55,212-2 INDUCED A METABOLIC AND EPIGENETIC SHIFT IN MACROPHAGES BY DECREASING LPS-INDUCED MTORC1 SIGNALING, COMMITMENT TO GLYCOLYSIS AND ACTIVE HISTONE MARKS IN PRO-INFLAMMATORY CYTOKINE PROMOTERS. WE CONFIRMED THESE DATA IN EX VIVO LPS-STIMULATED PERITONEAL MACROPHAGES (PMPHIS), WHICH WERE ALSO SUPPORTED BY THE IN VIVO ANTI-INFLAMMATORY CAPACITY OF WIN55,212-2 IN A LPS-INDUCED SEPSIS MOUSE MODEL. CONCLUSION: OVERALL, WE SHED LIGHT INTO THE MOLECULAR MECHANISMS BY WHICH CANNABINOIDS EXERT ANTI-INFLAMMATORY PROPERTIES IN MYELOID CELLS, WHICH MIGHT WELL CONTRIBUTE TO THE FUTURE RATIONAL DESIGN OF NOVEL THERAPEUTIC STRATEGIES FOR INFLAMMATORY DISORDERS. 2023 12 2026 35 EPIGENETIC CHANGES IN BONE MARROW PROGENITOR CELLS INFLUENCE THE INFLAMMATORY PHENOTYPE AND ALTER WOUND HEALING IN TYPE 2 DIABETES. CLASSICALLY ACTIVATED (M1) MACROPHAGES ARE KNOWN TO PLAY A ROLE IN THE DEVELOPMENT OF CHRONIC INFLAMMATION ASSOCIATED WITH IMPAIRED WOUND HEALING IN TYPE 2 DIABETES (T2D); HOWEVER, THE MECHANISM RESPONSIBLE FOR THE DOMINANT PROINFLAMMATORY (M1) MACROPHAGE PHENOTYPE IN T2D WOUNDS IS UNKNOWN. SINCE EPIGENETIC ENZYMES CAN DIRECT MACROPHAGE PHENOTYPES, WE ASSESSED THE ROLE OF HISTONE METHYLATION IN BONE MARROW (BM) STEM/PROGENITOR CELLS IN THE PROGRAMMING OF MACROPHAGES TOWARD A PROINFLAMMATORY PHENOTYPE. WE HAVE FOUND THAT A REPRESSIVE HISTONE METHYLATION MARK, H3K27ME3, IS DECREASED AT THE PROMOTER OF THE IL-12 GENE IN BM PROGENITORS AND THIS EPIGENETIC SIGNATURE IS PASSED DOWN TO WOUND MACROPHAGES IN A MURINE MODEL OF GLUCOSE INTOLERANCE (DIET-INDUCED OBESE). THESE EPIGENETICALLY "PREPROGRAMMED" MACROPHAGES RESULT IN POISED MACROPHAGES IN PERIPHERAL TISSUE AND NEGATIVELY IMPACT WOUND REPAIR. WE FOUND THAT IN DIABETIC CONDITIONS THE H3K27 DEMETHYLASE JMJD3 DRIVES IL-12 PRODUCTION IN MACROPHAGES AND THAT IL-12 PRODUCTION CAN BE MODULATED BY INHIBITING JMJD3. USING HUMAN T2D TISSUE AND MURINE MODELS, WE HAVE IDENTIFIED A PREVIOUSLY UNRECOGNIZED MECHANISM BY WHICH MACROPHAGES ARE PROGRAMMED TOWARD A PROINFLAMMATORY PHENOTYPE, ESTABLISHING A PATTERN OF UNRESTRAINED INFLAMMATION ASSOCIATED WITH NONHEALING WOUNDS. HENCE, HISTONE DEMETHYLASE INHIBITOR-BASED THERAPY MAY REPRESENT A NOVEL TREATMENT OPTION FOR DIABETIC WOUNDS. 2015 13 5423 23 REGULATION OF MACROPHAGE ACTIVATION AND DIFFERENTIATION IN ATHEROSCLEROSIS. CHRONIC INFLAMMATION IS A HALLMARK OF ATHEROSCLEROSIS AND MACROPHAGES PLAY A CENTRAL ROLE IN CONTROLLING INFLAMMATION AT ALL STAGES OF ATHEROSCLEROSIS. IN ATHEROSCLEROSIS, MACROPHAGES AND MONOCYTE-DERIVED MACROPHAGES ARE CONTINUOUSLY EXPOSED TO CHOLESTEROL, OXIDIZED LIPIDS, CELL DEBRIS, CYTOKINES, AND CHEMOKINES. NOT ONLY DO THESE STIMULI INDUCE A SPECIFIC MACROPHAGE PHENOTYPE, BUT THEY ALSO INTERACT EXTENSIVELY, LEADING TO MACROPHAGE HETEROGENEITY IN ATHEROSCLEROTIC PLAQUES. HEREIN, WE REVIEW THE DIVERSE PHENOTYPES OF MACROPHAGES, THE MECHANISMS UNDERLYING MACROPHAGE ACTIVATION, AND THE CONTRIBUTIONS OF MACROPHAGES TO ATHEROSCLEROSIS IN THIS CONTEXT. WE ALSO SUMMARIZE RECENT STUDIES ON FOAMY MACROPHAGES AND MONOCYTE-DERIVED MACROPHAGES IN PLAQUE DURING DISEASE PROGRESSION. WE PROVIDE A COMPREHENSIVE OVERVIEW OF TRANSCRIPTIONAL, EPIGENETIC, AND METABOLIC REPROGRAMMING OF MACROPHAGES AND DISCUSS THE EMERGING CONCEPTS OF TARGETING CYTOKINES AND MACROPHAGES TO MODULATE ATHEROSCLEROSIS. 2021 14 2370 29 EPIGENETIC REGULATION OF THE ALTERNATIVELY ACTIVATED MACROPHAGE PHENOTYPE. ALTERNATIVELY ACTIVATED (M2) MACROPHAGES PLAY CRITICAL ROLES IN DIVERSE CHRONIC DISEASES, INCLUDING PARASITE INFECTIONS, CANCER, AND ALLERGIC RESPONSES. HOWEVER, LITTLE IS KNOWN ABOUT THE ACQUISITION AND MAINTENANCE OF THEIR PHENOTYPE. WE REPORT THAT M2-MACROPHAGE MARKER GENES ARE EPIGENETICALLY REGULATED BY RECIPROCAL CHANGES IN HISTONE H3 LYSINE-4 (H3K4) AND HISTONE H3 LYSINE-27 (H3K27) METHYLATION; AND THE LATTER METHYLATION MARKS ARE REMOVED BY THE H3K27 DEMETHYLASE JUMONJI DOMAIN CONTAINING 3 (JMJD3). WE FOUND THAT CONTINUOUS INTERLEUKIN-4 (IL-4) TREATMENT LEADS TO DECREASED H3K27 METHYLATION, AT THE PROMOTER OF M2 MARKER GENES, AND A CONCOMITANT INCREASE IN JMJD3 EXPRESSION. FURTHERMORE, WE DEMONSTRATE THAT IL-4-DEPENDENT JMJD3 EXPRESSION IS MEDIATED BY STAT6, A MAJOR TRANSCRIPTION FACTOR OF IL-4-MEDIATED SIGNALING. AFTER IL-4 STIMULATION, ACTIVATED STAT6 IS INCREASED AND BINDS TO CONSENSUS SITES AT THE JMJD3 PROMOTER. INCREASED JMJD3 CONTRIBUTES TO THE DECREASE OF H3K27 DIMETHYLATION AND TRIMETHYLATION (H3K27ME2/3) MARKS AS WELL AS THE TRANSCRIPTIONAL ACTIVATION OF SPECIFIC M2 MARKER GENES. THE DECREASE IN H3K27ME2/3 AND INCREASE IN JMJD3 RECRUITMENT WERE CONFIRMED BY IN VIVO STUDIES USING A SCHISTOSOMA MANSONI EGG-CHALLENGED MOUSE MODEL, A WELL-STUDIED SYSTEM KNOWN TO SUPPORT AN M2 PHENOTYPE. COLLECTIVELY, THESE DATA INDICATE THAT CHROMATIN REMODELING IS MECHANISTICALLY IMPORTANT IN THE ACQUISITION OF THE M2-MACROPHAGE PHENOTYPE. 2009 15 3342 36 HISTONE DEACETYLASE9 REPRESENTS THE EPIGENETIC PROMOTION OF M1 MACROPHAGE POLARIZATION AND INFLAMMATORY RESPONSE VIA TLR4 REGULATION. ATHEROSCLEROSIS IS A CHRONIC INFLAMMATORY RESPONSE MEDIATED BY VARIOUS FACTORS, WHERE EPIGENETIC REGULATION INVOLVING HISTONE DEACETYLATION IS ENVISAGED TO MODULATE THE EXPRESSION OF RELATED PROTEINS BY REGULATING THE BINDING OF TRANSCRIPTION FACTORS TO DNA, THEREBY INFLUENCING THE DEVELOPMENT OF ATHEROSCLEROSIS. THE MECHANISM OF ATHEROSCLEROSIS BY HISTONE DEACETYLATION IS PARTLY KNOWN; HENCE, THIS PROJECT AIMED AT INVESTIGATING THE ROLE OF HISTONE DEACETYLASE 9 (HDAC9) IN ATHEROSCLEROSIS. FOR THIS PURPOSE, SERUM WAS SEPARATED FROM BLOOD SAMPLES FOLLOWING CLOTTING AND CENTRIFUGATION FROM ATHEROSCLEROTIC AND HEALTHY PATIENTS (N = 40 EACH), AND THEN, VARIOUS TESTS WERE PERFORMED. THE RESULTS INDICATED THAT TOLL-LIKE RECEPTOR 4 (TLR4) WAS NOT ONLY POSITIVELY CORRELATED TO THE HDAC9 GENE, BUT WAS ALSO UPREGULATED IN ATHEROSCLEROSIS, WHERE IT WAS ALSO SIGNIFICANTLY UPREGULATED IN THE ATHEROSCLEROSIS CELL MODEL OF OXIDIZED LOW-DENSITY LIPOPROTEIN-INDUCED MACROPHAGES. CONVERSELY, THE TLR4 WAS SIGNIFICANTLY DOWNREGULATED IN INSTANCES OF LOSS OF HDAC9 FUNCTION, CEMENTING THE BRIDGING RELATIONSHIP BETWEEN HDAC9 AND MACROPHAGE POLARIZATION, WHERE THE HDAC9 WAS FOUND TO UPREGULATE M1 MACROPHAGE POLARIZATION WHICH TRANSLATED INTO THE RELEASE OF HIGHER CONTENT OF PROINFLAMMATORY CYTOKINES SUCH AS INTERLEUKIN-1BETA (IL-1BETA) AND TUMOR NECROSIS FACTOR-ALPHA (TNF-ALPHA), WHICH TEND TO SIGNIFICANTLY DECREASE FOLLOWING THE DELETION OF TLR4. HENCE, THIS STUDY REPORTS NOVEL RELATION BETWEEN EPIGENETIC CONTROL AND ATHEROSCLEROSIS, WHICH COULD PARTLY BE EXPLAINED BY HISTONE DEACETYLATION. 2022 16 4041 43 MACROPHAGE PLASTICITY IN DUCHENNE MUSCULAR DYSTROPHY: A NEXUS OF PATHOLOGICAL REMODELLING WITH THERAPEUTIC IMPLICATIONS. DUCHENNE MUSCULAR DYSTROPHY (DMD) IS CHARACTERIZED BY CHRONIC SKELETAL MUSCLE NECROSIS, LEADING TO MUSCLE REGENERATION FAILURE AND FIBROSIS. ALTHOUGH MACROPHAGES (MPS) ARE NORMALLY ESSENTIAL FOR MUSCLE REGENERATION, DYSREGULATED MP FUNCTION PROMOTES PATHOLOGICAL MUSCLE REMODELLING. INFILTRATING MPS CAN BE PREDOMINANTLY PRO-INFLAMMATORY (M1 BIASED), ANTI-INFLAMMATORY (M2 BIASED) OR OF A MIXED PHENOTYPE AND CAN ORIGINATE FROM THE ADULT BONE MARROW (MONOCYTE DEPENDENT) OR EMBRYONIC PRECURSORS (MONOCYTE INDEPENDENT). IN MDX MICE (GENETIC MODEL OF DMD) LACKING EITHER TOLL-LIKE RECEPTOR (TLR) 2 OR TLR4, IT IS FOUND THAT MP INFILTRATION OF DYSTROPHIC MUSCLE IS SIGNIFICANTLY REDUCED AND THAT THE MP PHENOTYPE IS SHIFTED TOWARD A MORE ANTI-INFLAMMATORY PROFILE. THIS IS ACCOMPANIED BY SIGNIFICANT IMPROVEMENTS IN MUSCLE HISTOLOGY AND FORCE PRODUCTION. LACK OF THE CHEMOKINE RECEPTOR CCR2, WHICH IMPEDES MONOCYTE RELEASE FROM THE BONE MARROW, LEADS TO SIMILAR BENEFICIAL EFFECTS IN MDX MICE. EVIDENCE WAS ALSO FOUND FOR TLR4-REGULATED INDUCTION OF TRAINED INNATE IMMUNITY IN MPS CULTURED FROM THE BONE MARROW OF MDX MICE BEFORE THEIR ENTRY INTO THE MUSCLE. THESE MPS EXHIBIT EPIGENETIC AND METABOLIC ALTERATIONS, ACCOMPANIED BY NON-SPECIFIC HYPER-RESPONSIVENESS TO MULTIPLE STIMULI, WHICH IS MANIFESTED BY POTENTIATED UPREGULATION OF BOTH PRO- AND ANTI-INFLAMMATORY GENES. IN SUMMARY, EXAGGERATED RECRUITMENT OF MONOCYTE-DERIVED MPS AND SIGNS OF TRAINED INNATE IMMUNITY AT THE LEVEL OF THE BONE MARROW ARE FEATURES OF THE IMMUNOPHENOTYPE ASSOCIATED WITH DYSTROPHIC MUSCLE DISEASE. THESE PHENOMENA ARE REGULATED BY TOLL-LIKE RECEPTORS THAT BIND ENDOGENOUS DAMAGE-ASSOCIATED MOLECULAR PATTERN (DAMP) MOLECULES, SUGGESTING THAT DAMP RELEASE FROM DYSTROPHIC MUSCLES MODULATES MP PLASTICITY AT THE BONE MARROW LEVEL THROUGH TOLL-LIKE RECEPTOR-DRIVEN MECHANISMS. 2022 17 1472 29 DISTINCT MECHANISMS REGULATE IL1B GENE TRANSCRIPTION IN LYMPHOID CD4 T CELLS AND MONOCYTES. INTERLEUKIN 1BETA IS A PRO-INFLAMMATORY CYTOKINE IMPORTANT FOR BOTH NORMAL IMMUNE RESPONSES AND CHRONIC INFLAMMATORY DISEASES. THE REGULATION OF THE 31 KDA PROIL-1BETA PRECURSOR CODED BY THE IL1B GENE HAS BEEN EXTENSIVELY STUDIED IN MYELOID CELLS, BUT NOT IN LYMPHOID-DERIVED CD4 T CELLS. SURPRISINGLY, WE FOUND THAT SOME CD4 T CELL SUBSETS EXPRESS HIGHER LEVELS OF PROIL-1BETA THAN UNSTIMULATED MONOCYTES, DESPITE RELATIVELY LOW IL1B MRNA LEVELS. WE OBSERVED A SIGNIFICANT INCREASE IN IL1B TRANSCRIPTION AND TRANSLATION IN CD4 T CELLS UPON EX VIVO CD3/CD28 ACTIVATION, AND A SIMILAR ELEVATION IN THE CCR5+ EFFECTOR MEMORY POPULATION COMPARED TO CCR5- T CELLS IN VIVO. THE RAPID AND VIGOROUS INCREASE IN IL1B GENE TRANSCRIPTION FOR STIMULATED MONOCYTES HAS PREVIOUSLY BEEN ASSOCIATED WITH THE PRESENCE OF SPI-1/PU.1 (SPI1), A MYELOID-LINEAGE TRANSCRIPTION FACTOR, PRE-BOUND TO THE PROMOTER. IN THE CASE OF CD4 T CELLS, THIS INCREASE OCCURRED DESPITE THE LACK OF DETECTABLE SPI1 AT THE IL1B PROMOTER. ADDITIONALLY, WE FOUND ALTERED EPIGENETIC REGULATION OF THE IL1B LOCUS IN CD3/CD28-ACTIVATED CD4 T CELLS. UNLIKE MONOCYTES, ACTIVATED CD4 T CELLS POSSESS BIVALENT H3K4ME3+/H3K27ME3+ NUCLEOSOME MARKS AT THE IL1B PROMOTER, REFLECTING LOW TRANSCRIPTIONAL ACTIVITY. THESE RESULTS SUPPORT A MODEL IN WHICH THE IL1B GENE IN CD4 T CELLS IS TRANSCRIBED FROM A LOW-ACTIVITY BIVALENT PROMOTER INDEPENDENT OF SPI1. ACCUMULATED CYTOPLASMIC PROIL-1BETA MAY ULTIMATELY BE CLEAVED TO MATURE 17 KDA BIOACTIVE IL-1BETA, REGULATING T CELL POLARIZATION AND PATHOGENIC CHRONIC INFLAMMATION. 2018 18 6293 30 THE PRO- AND ANTI-INFLAMMATORY POTENTIAL OF IL-12: THE DUAL ROLE OF TH1 CELLS. THE DIFFERENTIATION OF T-HELPER (TH) LYMPHOCYTES INTO VARIOUS TYPES OF T-HELPER EFFECTOR AND MEMORY CELLS WITH DISTINCT FUNCTIONS DEPENDING ON THE TYPE OF CONCOMITANT SIGNALS THEY RECEIVE UPON ACTIVATION IS A CRITICAL EVENT DETERMINING THE COURSE OF AN IMMUNE REACTION. TH1 CELLS CHARACTERIZED BY THE EXPRESSION OF IFN-GAMMA AND THE RECENTLY DESCRIBED TH17 CELLS PROMOTE INFLAMMATION AND ARE CRITICALLY INVOLVED IN THE INDUCTION AND MAINTENANCE OF AUTOIMMUNITY, WHEREAS THE SECRETION OF IL-4 IS A HALLMARK OF TH2 CELLS MEDIATING PROTECTION FROM PARASITES AND ALLERGY. ORIGINAL STIMULATION IN THE PRESENCE OF IL-12 RESULTS IN THE IMPRINTING OF TH1 MEMORY CELLS FOR THE EXPRESSION OF IFN-GAMMA BY EXPRESSION OF THE TRANSCRIPTION FACTOR T-BET AND EPIGENETIC MODIFICATION OF THE IFNGAMMA GENE. IT HAS BEEN DEMONSTRATED THAT TH1 CELLS ARE POTENT INDUCERS OF INFLAMMATION. HOWEVER, IN THE CHRONIC PHASE OF SUCH INFLAMMATION, THE REGULATORY POTENTIAL OF IL-12 AND TH1 CELLS THEMSELVES MAY PLAY AN IMPORTANT ROLE IN LIMITING IMMUNOPATHOLOGY. 2007 19 1482 25 DIVERSITY, MECHANISMS, AND SIGNIFICANCE OF MACROPHAGE PLASTICITY. MACROPHAGES ARE A DIVERSE SET OF CELLS PRESENT IN ALL BODY COMPARTMENTS. THIS DIVERSITY IS IMPRINTED BY THEIR ONTOGENETIC ORIGIN (EMBRYONAL VERSUS ADULT BONE MARROW-DERIVED CELLS); THE ORGAN CONTEXT; BY THEIR ACTIVATION OR DEACTIVATION BY VARIOUS SIGNALS IN THE CONTEXTS OF MICROBIAL INVASION, TISSUE DAMAGE, AND METABOLIC DERANGEMENT; AND BY POLARIZATION OF ADAPTIVE T CELL RESPONSES. CLASSIC ADAPTIVE RESPONSES OF MACROPHAGES INCLUDE TOLERANCE, PRIMING, AND A WIDE SPECTRUM OF ACTIVATION STATES, INCLUDING M1, M2, OR M2-LIKE. MOREOVER, MACROPHAGES CAN RETAIN LONG-TERM IMPRINTING OF MICROBIAL ENCOUNTERS (TRAINED INNATE IMMUNITY). SINGLE-CELL ANALYSIS OF MONONUCLEAR PHAGOCYTES IN HEALTH AND DISEASE HAS ADDED A NEW DIMENSION TO OUR UNDERSTANDING OF THE DIVERSITY OF MACROPHAGE DIFFERENTIATION AND ACTIVATION. EPIGENETIC LANDSCAPES, TRANSCRIPTION FACTORS, AND MICRORNA NETWORKS UNDERLIE THE ADAPTABILITY OF MACROPHAGES TO DIFFERENT ENVIRONMENTAL CUES. MACROPHAGE PLASTICITY, AN ESSENTIAL COMPONENT OF CHRONIC INFLAMMATION, AND ITS INVOLVEMENT IN DIVERSE HUMAN DISEASES, MOST NOTABLY CANCER, IS DISCUSSED HERE AS A PARADIGM. 2020 20 6887 40 [ROLE OF METAFLAMMATION AS A SYSTEMIC MANIFESTATION OF METABOLIC DISEASES]. VISCERAL OBESITY AS A COMPONENT OF THE METABOLIC SYNDROME IS CHARACTERIZED BY SYSTEMIC AND LOCAL INFLAMMATION, WHICH CAN BE QUANTIFIED IN ORGANS (METAFLAMMATION). THIS PROCESS CAN BE REGARDED AS A CHRONIC, STERILE, AND LOW-GRADE STATE OF INFLAMMATION WITHOUT INFECTION, TRAUMA, TUMOR OR AUTOIMMUNITY. IT IS CAUSED BY AN INFLAMMATION OF THE VISCERAL ADIPOSE TISSUE (ADIPOSE INFLAMMATION OR ADIPOFLAMMATION) DUE TO ADIPOCYTE HYPERTROPHY AND HYPERPLASIA WITH INCREASED INFILTRATION BY MONOCYTES AND MACROPHAGES. IMPORTANT IS THE PRESENCE OF PROINFLAMMATORY, SO-CALLED POLARIZED M1 MACROPHAGES THAT ARE INDUCED BY INTERFERON GAMMA (IFN-GAMMA) AND LIPOPOLYSACCHARIDES (LPS) WITH SECRETION OF INTERLEUKIN (IL)-6, TUMOR NECROSIS FACTOR (TNF) AND IL?1. IN CONTRAST, THE ANTI-INFLAMMATORY, SO-CALLED POLARIZED M2 MACROPHAGES INDUCED BY IL?4 AND IL-13 WITH SECRETION OF IL?8 AND IL-10 DECREASE. IN ADDITION, THE SECRETED ADIPOKINE PATTERN CHANGES FROM ANTI-INFLAMMATORY TO PROINFLAMMATORY. ADIPOCYTE NECROSIS, LOCAL HYPOXIA, DYSREGULATED AUTOPHAGY, ACTIVATION OF INFLAMMASOMES, MODULATION OF TOLL-LIKE RECEPTORS, AND EPIGENETIC FACTORS PLAY A COMPLEX ROLE. THIS MECHANISM RESULTS IN LOCAL INSULIN RESISTANCE AND SUBSEQUENTLY A SYSTEMIC INSULIN RESISTANCE OF PERIPHERAL ORGANS AS WELL AS A SPILLOVER OF LOCAL MEDIATORS OF INFLAMMATION INTO THE SYSTEMIC CIRCULATION (MEASURED AS OBESITY C?REACTIVE PROTEIN, CRP). THE ACTIVATION OF INFLAMMATORY SIGNAL TRANSDUCTION CASCADES LEADS TO INHIBITORY PHOSPHORYLATION OF THE INSULIN SIGNALING PATHWAY AND A WEAKENING OF THE EFFECT OF INSULIN. IN PARALLEL, ECTOPIC LIPID ACCUMULATION OCCURS IN THE LIVER, MUSCULATURE, PANCREAS, PERICARDIUM AND LUNGS. DIACYLGLYCEROL (DAG) ACTIVATES SPECIFIC ISOFORMS OF PROTEIN KINASE C (EPSILON IN THE LIVER AND TAU IN THE MUSCULATURE), WHICH IN TURN LEAD TO INHIBITION OF THE INSULIN SIGNALING PATHWAY. INSULIN RESISTANCE IN OBESITY AND TYPE 2 DIABETES MELLITUS IS AN INFLAMMATORY DISEASE. THE AIM OF FUTURE TRANSLATIONAL APPROACHES IS AN ANTI-INFLAMMATORY, MOLECULARLY INDIVIDUALIZED (PRECISION MEDICINE) TREATMENT IN ADIPOSE TISSUE (TARGETED THERAPY) AND IN ORGANS OF INSULIN RESISTANCE. 2023