1 3275 93 HEPATOCELLULAR CARCINOMA: THERAPEUTIC ADVANCES IN SIGNALING, EPIGENETIC AND IMMUNE TARGETS. HEPATOCELLULAR CARCINOMA (HCC) REMAINS A GLOBAL MEDICAL BURDEN WITH RISING INCIDENCE DUE TO CHRONIC VIRAL HEPATITIS AND NON-ALCOHOLIC FATTY LIVER DISEASES. TREATMENT OF ADVANCED DISEASE STAGES IS STILL UNSATISFYING. BESIDES FIRST AND SECOND GENERATION TYROSINE KINASE INHIBITORS, IMMUNE CHECKPOINT INHIBITORS HAVE BECOME CENTRAL FOR THE TREATMENT OF HCC. NEW MODALITIES LIKE EPIGENETIC THERAPY USING HISTONE DEACETYLASE INHIBITORS (HDACI) AND CELL THERAPY APPROACHES WITH CHIMERIC ANTIGEN RECEPTOR T CELLS (CAR-T CELLS) ARE CURRENTLY UNDER INVESTIGATION IN CLINICAL TRIALS. DEVELOPMENT OF SUCH NOVEL DRUGS IS CLOSELY LINKED TO THE AVAILABILITY AND IMPROVEMENT OF NOVEL PRECLINICAL AND ANIMAL MODELS AND THE IDENTIFICATION OF PREDICTIVE BIOMARKERS. THE CURRENT STATUS OF TREATMENT OPTIONS FOR ADVANCED HCC, EMERGING NOVEL THERAPEUTIC APPROACHES AND DIFFERENT PRECLINICAL MODELS FOR HCC DRUG DISCOVERY AND DEVELOPMENT ARE REVIEWED HERE. 2019 2 251 30 ADVANCED THERAPEUTIC MODALITIES IN HEPATOCELLULAR CARCINOMA: NOVEL INSIGHTS. HEPATOCELLULAR CARCINOMA (HCC), THE MOST COMMON TYPE OF LIVER CANCER, IS USUALLY A LATENT AND ASYMPTOMATIC MALIGNANCY CAUSED BY DIFFERENT AETIOLOGIES, WHICH IS A RESULT OF VARIOUS ABERRANT MOLECULAR HETEROGENEITY AND OFTEN DIAGNOSED AT ADVANCED STAGES. THE INCIDENCE AND PREVALENCE HAVE SIGNIFICANTLY INCREASED BECAUSE OF SEDENTARY LIFESTYLE, DIABETES, CHRONIC INFECTION WITH HEPATOTROPIC VIRUSES AND EXPOSURE TO AFLATOXINS. DUE TO ADVANCED INTRA- OR EXTRAHEPATIC METASTASIS, RECURRENCE IS VERY COMMON EVEN AFTER RADICAL RESECTION. IN THIS PAPER, WE HIGHLIGHTED NOVEL THERAPEUTIC MODALITIES, SUCH AS MOLECULAR-TARGETED THERAPIES, TARGETED RADIONUCLIDE THERAPIES AND EPIGENETIC MODIFICATION-BASED THERAPIES. THESE TOPICS ARE TRENDING HEADLINES AND THEIR COMBINATION WITH CELL-BASED IMMUNOTHERAPIES, AND GENE THERAPY HAS PROVIDED PROMISING PROSPECTS FOR THE FUTURE OF HCC TREATMENT. MOREOVER, A COMPREHENSIVE OVERVIEW OF CURRENT AND ADVANCED THERAPEUTIC APPROACHES IS DISCUSSED AND THE ADVANTAGES AND LIMITATIONS OF EACH STRATEGY ARE DESCRIBED. FINALLY, VERY RECENT AND APPROVED NOVEL COMBINED THERAPIES AND THEIR PROMISING RESULTS IN HCC TREATMENT HAVE BEEN INTRODUCED. 2021 3 700 26 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 4 1867 21 EMERGING GENE-EDITING MODALITIES FOR OSTEOARTHRITIS. OSTEOARTHRITIS (OA) IS A PATHOLOGICAL DEGENERATIVE CONDITION OF THE JOINTS THAT IS WIDELY PREVALENT WORLDWIDE, RESULTING IN SIGNIFICANT PAIN, DISABILITY, AND IMPAIRED QUALITY OF LIFE. THE DIVERSE ETIOLOGY AND PATHOGENESIS OF OA CAN EXPLAIN THE PAUCITY OF VIABLE PREVENTIVE AND DISEASE-MODIFYING STRATEGIES TO COUNTER IT. ADVANCES IN GENOME-EDITING TECHNIQUES MAY IMPROVE DISEASE-MODIFYING SOLUTIONS BY ADDRESSING INHERITED PREDISPOSING RISK FACTORS AND THE ACTIVITY OF INFLAMMATORY MODULATORS. RECENT PROGRESS ON TECHNOLOGIES SUCH AS CRISPR/CAS9 AND CELL-BASED GENOME-EDITING THERAPIES TARGETING THE GENETIC AND EPIGENETIC ALTERNATIONS IN OA OFFER PROMISING AVENUES FOR EARLY DIAGNOSIS AND THE DEVELOPMENT OF PERSONALIZED THERAPIES. THE PURPOSE OF THIS LITERATURE REVIEW WAS TO CONCISELY SUMMARIZE THE GENOME-EDITING OPTIONS AGAINST CHRONIC DEGENERATIVE JOINT CONDITIONS SUCH AS OA WITH A FOCUS ON THE MORE RECENTLY EMERGING MODALITIES, ESPECIALLY CRISPR/CAS9. FUTURE ADVANCEMENTS IN NOVEL GENOME-EDITING THERAPIES MAY IMPROVE THE EFFICACY OF SUCH TARGETED TREATMENTS. 2020 5 1688 28 DUAL BET/HDAC INHIBITION TO RELIEVE NEUROPATHIC PAIN: RECENT ADVANCES, PERSPECTIVES, AND FUTURE OPPORTUNITIES. DESPITE THE INTENSE RESEARCH ON DEVELOPING NEW THERAPIES FOR NEUROPATHIC PAIN STATES, AVAILABLE TREATMENTS HAVE LIMITED EFFICACY AND UNFAVORABLE SAFETY PROFILES. EPIGENETIC ALTERATIONS HAVE A GREAT INFLUENCE ON THE DEVELOPMENT OF CANCER AND NEUROLOGICAL DISEASES, AS WELL AS NEUROPATHIC PAIN. HISTONE ACETYLATION HAS PREVAILED AS ONE OF THE WELL INVESTIGATED EPIGENETIC MODIFICATIONS IN THESE DISEASES. ALTERED SPINAL ACTIVITY OF HISTONE DEACETYLASE (HDAC) AND BROMO AND EXTRA TERMINAL DOMAIN (BET) HAVE BEEN DESCRIBED IN NEUROPATHIC PAIN MODELS AND RESTORATION OF THESE ABERRANT EPIGENETIC MODIFICATIONS SHOWED PAIN-RELIEVING ACTIVITY. OVER THE LAST DECADES HDACS AND BETS HAVE BEEN THE FOCUS OF DRUG DISCOVERY STUDIES, LEADING TO THE DEVELOPMENT OF NUMEROUS SMALL-MOLECULE INHIBITORS. CLINICAL TRIALS TO EVALUATE THEIR ANTICANCER ACTIVITY SHOWED GOOD EFFICACY BUT RAISED TOXICITY CONCERNS THAT LIMITED TRANSLATION TO THE CLINIC. TO MAXIMIZE ACTIVITY AND MINIMIZE TOXICITY, THESE COMPOUNDS CAN BE APPLIED IN COMBINATION OF SUB-MAXIMAL DOSES TO PRODUCE ADDITIVE OR SYNERGISTIC INTERACTIONS (COMBINATION THERAPY). RECENTLY, OF PARTICULAR INTEREST, DUAL BET/HDAC INHIBITORS (MULTI-TARGET DRUGS) HAVE BEEN DEVELOPED TO ASSURE SIMULTANEOUS MODULATION OF BET AND HDAC ACTIVITY BY A SINGLE MOLECULE. THIS REVIEW WILL SUMMARIZE THE MOST RECENT ADVANCES WITH THESE STRATEGIES, DESCRIBING ADVANTAGES AND LIMITATIONS OF SINGLE DRUG TREATMENT VS COMBINATION REGIMENS. THIS REVIEW WILL ALSO PROVIDE A FOCUS ON DUAL BET/HDAC DRUG DISCOVERY INVESTIGATIONS AS FUTURE THERAPEUTIC OPPORTUNITY FOR HUMAN THERAPY OF NEUROPATHIC PAIN. 2021 6 6320 32 THE ROCKY ROAD TO PERSONALIZED MEDICINE IN ACUTE MYELOID LEUKAEMIA. ACUTE MYELOID LEUKAEMIA (AML) IS A MALIGNANT DISORDER OF THE MYELOID BLOOD LINEAGE CHARACTERIZED BY IMPAIRED DIFFERENTIATION AND INCREASED PROLIFERATION OF HEMATOPOIETIC PRECURSOR CELLS. RECENT TECHNOLOGICAL ADVANCES HAVE LED TO AN IMPROVED UNDERSTANDING OF AML BIOLOGY BUT ALSO UNCOVERED THE ENORMOUS CYTOGENETIC AND MOLECULAR HETEROGENEITY OF THE DISEASE. DESPITE THIS HETEROGENEITY, AML IS MOSTLY MANAGED BY A 'ONE-SIZE-FITS-ALL' APPROACH CONSISTING OF INTENSIVE, HIGHLY TOXIC INDUCTION AND CONSOLIDATION CHEMOTHERAPY. THESE TREATMENT PROTOCOLS HAVE REMAINED LARGELY UNCHANGED FOR THE PAST SEVERAL DECADES AND ONLY LEAD TO A CURE IN APPROXIMATELY 30-35% OF CASES. THE ADVENT OF TARGETED THERAPIES IN CHRONIC MYELOID LEUKAEMIA AND OTHER MALIGNANCIES HAS SPARKED HOPE TO IMPROVE PATIENT OUTCOME IN AML. HOWEVER, THE IMPLEMENTATION OF TARGETED AGENTS IN AML THERAPY HAS BEEN UNEXPECTEDLY CUMBERSOME AND REMAINS A DIFFICULT TASK DUE TO A VARIETY OF DISEASE- AND PATIENT-SPECIFIC FACTORS. IN THIS REVIEW, WE DESCRIBE CURRENT STANDARD AND INVESTIGATIONAL THERAPEUTIC STRATEGIES WITH A FOCUS ON TARGETED AGENTS AND HIGHLIGHT POTENTIAL TOOLS THAT MIGHT FACILITATE THE DEVELOPMENT OF TARGETED THERAPIES FOR THIS FATAL DISEASE. THE CLASSES OF AGENTS DESCRIBED IN THIS REVIEW INCLUDE CONSTITUTIVELY ACTIVATED SIGNALLING PATHWAY INHIBITORS, SURFACE RECEPTOR TARGETS, EPIGENETIC MODIFIERS, DRUGS TARGETING THE INTERACTION OF THE HEMATOPOIETIC PROGENITOR CELL WITH THE STROMA AND DRUGS THAT TARGET THE APOPTOTIC MACHINERY. THE CLINICAL CONTEXT AND OUTCOME WITH THESE AGENTS WILL BE EXAMINED TO GAIN INSIGHT ABOUT THEIR OPTIMAL UTILIZATION. 2018 7 5013 28 PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR-GAMMA AS A THERAPEUTIC TARGET FOR HEPATIC FIBROSIS: FROM BENCH TO BEDSIDE. HEPATIC FIBROSIS IS A DYNAMIC CHRONIC LIVER DISEASE OCCURRING AS A CONSEQUENCE OF WOUND-HEALING RESPONSES TO VARIOUS HEPATIC INJURIES. THIS DISORDER IS ONE OF PRIMARY PREDICTORS FOR LIVER-ASSOCIATED MORBIDITY AND MORTALITY WORLDWIDE. TO DATE, NO PHARMACOLOGICAL AGENT HAS BEEN APPROVED FOR HEPATIC FIBROSIS OR COULD BE RECOMMENDED FOR ROUTINE USE IN CLINICAL CONTEXT. CELLULAR AND MOLECULAR UNDERSTANDING OF HEPATIC FIBROSIS HAS REVEALED THAT PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR-GAMMA (PPARGAMMA), THE FUNCTIONING RECEPTOR FOR ANTIDIABETIC THIAZOLIDINEDIONES, PLAYS A PIVOTAL ROLE IN THE PATHOBIOLOGY OF HEPATIC STELLATE CELLS (HSCS), WHOSE ACTIVATION IS THE CENTRAL EVENT IN THE PATHOGENESIS OF HEPATIC FIBROSIS. ACTIVATION OF PPARGAMMA INHIBITS HSC COLLAGEN PRODUCTION AND MODULATES HSC ADIPOGENIC PHENOTYPE AT TRANSCRIPTIONAL AND EPIGENETIC LEVELS. THESE MOLECULAR INSIGHTS INDICATE PPARGAMMA AS A PROMISING DRUG TARGET FOR ANTIFIBROTIC CHEMOTHERAPY. INTENSIVE ANIMAL STUDIES HAVE DEMONSTRATED THAT STIMULATION OF PPARGAMMA REGULATORY SYSTEM THROUGH GENE THERAPY APPROACHES AND PPARGAMMA LIGANDS HAS THERAPEUTIC PROMISE FOR HEPATIC FIBROSIS INDUCED BY A VARIETY OF ETIOLOGIES. AT THE SAME TIME, THIAZOLIDINEDIONE AGENTS HAVE BEEN INVESTIGATED FOR THEIR CLINICAL BENEFITS PRIMARILY IN PATIENTS WITH NONALCOHOLIC STEATOHEPATITIS, A COMMON METABOLIC LIVER DISORDER WITH HIGH POTENTIAL TO PROGRESS TO FIBROSIS AND LIVER-RELATED DEATH. ALTHOUGH SOME STUDIES HAVE SHOWN INITIAL PROMISE, NONE HAS ESTABLISHED LONG-TERM EFFICACY IN WELL-CONTROLLED RANDOMIZED CLINICAL TRIALS. THIS COMPREHENSIVE REVIEW COVERS THE 10-YEAR DISCOVERIES OF THE MOLECULAR BASIS FOR PPARGAMMA REGULATION OF HSC PATHOPHYSIOLOGY AND THEN FOCUSES ON THE ANIMAL INVESTIGATIONS AND CLINICAL TRIALS OF VARIOUS THERAPEUTIC MODALITIES TARGETING PPARGAMMA FOR HEPATIC FIBROSIS. 2013 8 757 26 CARTILAGE REPAIR BY MESENCHYMAL STEM CELLS: CLINICAL TRIAL UPDATE AND PERSPECTIVES. OSTEOARTHRITIS IS A DEGENERATIVE DISEASE OF JOINTS WITH DESTRUCTION OF ARTICULAR CARTILAGE ASSOCIATED WITH SUBCHONDRAL BONE HYPERTROPHY AND INFLAMMATION. OA IS THE LEADING CAUSE OF JOINT PAIN RESULTING IN SIGNIFICANT WORSENING OF THE QUALITY-OF-LIFE IN THE ELDERLY. NUMEROUS EFFORTS HAVE BEEN SPENT TO OVERCOME THE INHERENTLY POOR HEALING ABILITY OF ARTICULAR CARTILAGE. MESENCHYMAL STEM CELLS (MSCS) HAVE BEEN IN THE LIMELIGHT OF CELL-BASED THERAPIES TO PROMOTE CARTILAGE REPAIR. DESPITE PROGRESSIVE ADVANCEMENTS IN MSC MANIPULATION AND THE INTRODUCTION OF VARIOUS BIOACTIVE SCAFFOLDS AND GROWTH FACTORS IN PRECLINICAL STUDIES, CURRENT CLINICAL TRIALS ARE STILL AT EARLY STAGES WITH PRELIMINARY AIMS TO EVALUATE SAFETY, FEASIBILITY AND EFFICACY. THIS REVIEW SUMMARISES RECENTLY REPORTED MSC-BASED CLINICAL TRIALS AND DISCUSSES NEW RESEARCH DIRECTIONS WITH PARTICULAR FOCUS ON THE POTENTIAL APPLICATION OF MSC-DERIVED EXTRACELLULAR VEHICLES, MIRNAS AND ADVANCED GENE EDITING TECHNIQUES WHICH MAY SHED LIGHT ON THE DEVELOPMENT OF NOVEL TREATMENT STRATEGIES. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: THIS REVIEW SUMMARISES RECENT MSC-RELATED CLINICAL RESEARCH THAT FOCUSES ON CARTILAGE REPAIR. WE ALSO PROPOSE A NOVEL POSSIBLE TRANSLATIONAL DIRECTION FOR HYALINE CARTILAGE FORMATION AND A NEW PARADIGM MAKING USE OF EXTRA-CELLULAR SIGNALLING AND EPIGENETIC REGULATION IN THE APPLICATION OF MSCS FOR CARTILAGE REPAIR. 2017 9 4331 20 MICRORNAS: EMERGING BIOMARKERS AND THERAPEUTIC TARGETS OF BONE FRAGILITY IN CHRONIC KIDNEY DISEASE. BONE FRAGILITY IS HIGHLY PREVALENT, YET UNDERDIAGNOSED IN PATIENTS WITH CHRONIC KIDNEY DISEASE. INCOMPLETE UNDERSTANDING OF THE PATHOPHYSIOLOGY AND LIMITATIONS OF CURRENT DIAGNOSTICS CONTRIBUTE TO THERAPEUTIC HESITATION, IF NOT NIHILISM. THIS NARRATIVE REVIEW ADDRESSES THE QUESTION OF WHETHER MICRORNAS (MIRNAS) MAY IMPROVE THERAPEUTIC DECISION MAKING IN OSTEOPOROSIS AND RENAL OSTEODYSTROPHY. MIRNAS ARE KEY EPIGENETIC REGULATORS OF BONE HOMEOSTASIS AND SHOW PROMISE AS BOTH THERAPEUTIC TARGETS AND AS BIOMARKERS, PRIMARILY OF BONE TURNOVER. EXPERIMENTAL STUDIES SHOW THAT MIRNAS ARE INVOLVED IN SEVERAL OSTEOGENIC PATHWAYS. CLINICAL STUDIES EXPLORING THE USEFULNESS OF CIRCULATING MIRNAS FOR FRACTURE RISK STRATIFICATION AND FOR GUIDING AND MONITORING THERAPY ARE FEW AND, SO FAR, PROVIDE INCONCLUSIVE RESULTS. LIKELY, (PRE)ANALYTICAL HETEROGENEITY CONTRIBUTES TO THESE EQUIVOCAL RESULTS. IN CONCLUSION, MIRNAS ARE PROMISING IN METABOLIC BONE DISEASE, BOTH AS A DIAGNOSTIC TOOL AND AS THERAPEUTIC TARGETS, BUT NOT YET READY FOR CLINICAL PRIME TIME. 2023 10 3996 30 LOOKING FORWARD: NOVEL THERAPEUTIC APPROACHES IN CHRONIC AND ADVANCED PHASES OF MYELOFIBROSIS. MYELOFIBROSIS (MF) IS COMPLEX AT THE PATHOBIOLOGIC LEVEL AND HETEROGENEOUS AT THE CLINICAL LEVEL. THE ADVANCES IN MOLECULAR CHARACTERIZATION OF MF PROVIDE IMPORTANT INSIGHT INTO THE MECHANISMS DRIVING THIS CHRONIC MYELOID MALIGNANCY, REFINE RISK STRATIFICATION, OFFER NOVEL THERAPEUTIC TARGETS, AND SERVE TO MEASURE THERAPEUTIC RESPONSE. ALTHOUGH JAK2 INHIBITION HAS BEEN THE FOCUS OF LABORATORY AND CLINICAL EFFORTS OVER THE LAST DECADE, CURRENT EXPERIMENTAL THERAPEUTIC APPROACHES HAVE BROADENED TO INCLUDE INHIBITORS OF KEY ALTERNATIVE SIGNALING PATHWAYS, EPIGENETIC MODULATORS, ANTI-FIBROTICS, AND IMMUNOTHERAPIES. BASED ON COMPELLING PRECLINICAL RATIONALE, A NUMBER OF JAK2 INHIBITOR BASED COMBINATION THERAPIES ARE NOW ACTIVELY BEING EVALUATED IN THE CLINIC WITH THE GOAL OF DISEASE COURSE MODIFICATION. THE ROLE AND TIMING OF HEMATOPOIETIC STEM CELL TRANSPLANT (HSCT) FOR MF HAS BEEN CHALLENGED WITH THE AVAILABILITY OF COMMERCIAL RUXOLITINIB AND THE PLETHORA OF EXPERIMENTAL TREATMENT OPTIONS THAT EXIST. INTEGRATION OF PRECONDITIONING JAK2 INHIBITION, REDUCED INTENSITY CONDITIONING REGIMENS, AND ALTERNATIVE DONOR SOURCES ARE ALL BEING EXPLORED IN AN ATTEMPT TO OPTIMIZE THIS POTENTIALLY CURATIVE MODALITY. THIS REVIEW WILL SUMMARIZE MODERN MF RISK STRATIFICATION, CURRENT CLINICAL RESEARCH APPROACHES TO CHRONIC AND ADVANCE PHASE MF FOCUSING ON NOVEL AGENTS ALONE AND IN COMBINATION, AND UPDATE THE READER ON NEW DIRECTIONS IN HSCT. 2015 11 5053 30 PHARMACOLOGY OF PULMONARY ARTERIAL HYPERTENSION: AN OVERVIEW OF CURRENT AND EMERGING THERAPIES. PULMONARY ARTERIAL HYPERTENSION IS A RARE AND DEVASTATING DISEASE CHARACTERIZED BY AN ABNORMAL CHRONIC INCREASE IN PULMONARY ARTERIAL PRESSURE ABOVE 20 MMHG AT REST, WITH A POOR PROGNOSIS IF NOT TREATED. CURRENTLY, THERE IS NOT A SINGLE FULLY EFFECTIVE THERAPY, EVEN THOUGH A DOZEN OF DRUGS HAVE BEEN DEVELOPED IN THE LAST DECADES. PULMONARY ARTERIAL HYPERTENSION IS A MULTIFACTORIAL DISEASE, MEANING THAT SEVERAL MOLECULAR MECHANISMS ARE IMPLICATED IN ITS PATHOLOGY. THE MAIN MOLECULAR PATHWAYS REGULATING THE PULMONARY VASOMOTOR TONE-ENDOTHELIN, NITRIC OXIDE, AND PROSTACYCLIN-ARE THE MOST BIOLOGICALLY AND THERAPEUTICALLY EXPLORED TO DATE. HOWEVER, DRUGS TARGETING THESE PATHWAYS HAVE ALREADY FOUND THEIR LIMITATIONS. IN THE LAST YEARS, TRANSLATIONAL RESEARCH AND CLINICAL TRIALS HAVE MADE A STRONG EFFORT IN SUGGESTING AND TESTING NOVEL THERAPEUTIC STRATEGIES FOR THIS DISEASE. THESE APPROACHES INVOLVE TARGETING THE MAIN MOLECULAR PATHWAYS WITH NOVEL DRUGS, DRUG REPURPOSING FOR NOVEL TARGETS, AND ALSO USING COMBINATORIAL THERAPIES. IN THIS REVIEW, WE SUMMARIZE CURRENT STRATEGIES AND DRUGS TARGETING THE ENDOTHELIN, NITRIC OXIDE, AND PROSTACYCLIN PATHWAYS, AS WELL AS, THE EMERGING NEW DRUGS PROPOSED TO COPE WITH VASCULAR REMODELLING, METABOLIC SWITCH, PERIVASCULAR INFLAMMATION, EPIGENETIC MODIFICATIONS, ESTROGEN DEREGULATION, SEROTONIN, AND OTHER NEUROHUMORAL MECHANISMS CHARACTERISTIC OF THIS DISEASE. NOWADAYS, PULMONARY ARTERIAL HYPERTENSION REMAINS AN INCURABLE DISEASE; HOWEVER, THE INCOMING NEW KNOWLEDGE MAKES US BELIEVE THAT NEW PROMISING THERAPIES ARE COMING TO THE CLINICAL ARENA SOON. 2020 12 4681 23 NEW OPTIONS IN THE TREATMENT OF MYELODYSPLASTIC SYNDROME. MYELODYSPLASTIC SYNDROME (MDS) IS A HETEROGENEOUS GROUP OF PROGRESSIVE CHRONIC HEMATOPOIETIC DISORDERS, USUALLY PRESENTING AS REFRACTORY ANEMIA OR CYTOPENIA, WITH AN APPROXIMATELY 25% RISK OF PROGRESSION TOWARD ACUTE MYELOID LEUKAEIMA (AML), AND NO PROVEN CURATIVE TREATMENT. NOVEL BIOLOGICAL TREATMENT STRATEGIES TARGETING BOTH THE MALIGNANT BLOOD CELL AND ITS MICROENVIRONMENT CAN OVERCOME RESISTANCE TO CURRENT THERAPIES, AND REPRESENT A PROMISING TREATMENT PARADIGM FOR IMPROVING PATIENT OUTCOME. MANY OF THESE AGENTS HAVE MULTIPLE BIOLOGIC ACTIVITIES. THE OBJECTIVE OF THIS ARTICLE IS TO PRESENT A COMPARATIVE REVIEW OF CLASSIFICATION SYSTEMS IN MDS AND TO DISCUSS THE EVOLVING TRENDS IN THE TREATMENT OF MDS (IMMUNOSUPPRESIVE THERAPY, IMMUNOMODULATORY DRUGS, ARSENIC TRIOXIDE, PROTEASOME INHIBITORS, EPIGENETIC THERAPY). 2005 13 3958 30 LONG NON-CODING RNAS IN BONE METASTASIS: PROGRESSES AND PERSPECTIVES AS POTENTIAL DIAGNOSTIC AND PROGNOSTIC BIOMARKERS. IN A PRECISION MEDICINE PERSPECTIVE, AMONG THE BIOMARKERS POTENTIALLY USEFUL FOR EARLY DIAGNOSIS OF CANCERS, AS WELL AS TO DEFINE THEIR PROGNOSIS AND EVENTUALLY TO IDENTIFY NOVEL AND MORE EFFECTIVE THERAPEUTIC TARGETS, THERE ARE THE LONG NON-CODING RNAS (LNCRNAS). THE TERM LNCRNA IDENTIFIES A CLASS OF NON-CODING RNA MOLECULES INVOLVED IN THE REGULATION OF GENE EXPRESSION THAT INTERVENE AT THE TRANSCRIPTIONAL, POST-TRANSCRIPTIONAL, AND EPIGENETIC LEVEL. METASTASIS IS A NATURAL EVOLUTION OF SOME MALIGNANT TUMOURS, FREQUENTLY ENCOUNTERED IN PATIENTS WITH ADVANCED CANCERS. ONSET AND DEVELOPMENT OF METASTASIS REPRESENTS A DETRIMENTAL EVENT THAT WORSEN THE PATIENT'S PROGNOSIS BY PROFOUNDLY INFLUENCING THE QUALITY OF LIFE AND IS RESPONSIBLE FOR THE OMINOUS PROGRESSION OF THE DISEASE. DUE TO THE PECULIAR ENVIRONMENT AND THE BIOMECHANICAL PROPERTIES, BONE IS A PREFERENTIAL SITE FOR THE SECONDARY GROWTH OF BREAST, PROSTATE AND LUNG CANCERS. UNFORTUNATELY, ONLY PALLIATIVE AND PAIN THERAPIES ARE CURRENTLY AVAILABLE FOR PATIENTS WITH BONE METASTASES, WHILE NO EFFECTIVE AND DEFINITIVE TREATMENTS ARE AVAILABLE. THE UNDERSTANDING OF PATHOPHYSIOLOGICAL BASIS OF BONE METASTASIS FORMATION AND PROGRESSION, AS WELL AS THE IMPROVEMENT IN THE CLINICAL MANAGEMENT OF THE PATIENT, ARE CENTRAL BUT CHALLENGING TOPICS IN BASIC RESEARCH AND CLINICAL PRACTICE. THE IDENTIFICATION OF NEW MOLECULAR SPECIES THAT MAY HAVE A ROLE AS EARLY HALLMARKS OF THE METASTATIC PROCESS COULD OPEN THE DOOR TO THE DEFINITION OF NEW, AND MORE EFFECTIVE, THERAPEUTIC AND DIAGNOSTIC APPROACHES. NON-CODING RNAS SPECIES AND, PARTICULARLY, LNCRNAS ARE PROMISING COMPOUNDS IN THIS SETTING, AND THEIR STUDY MAY BRING TO THE IDENTIFICATION OF RELEVANT PROCESSES. IN THIS REVIEW, WE HIGHLIGHT THE ROLE OF LNCRNAS AS EMERGING MOLECULES IN MEDIATING THE FORMATION AND DEVELOPMENT OF BONE METASTASES, AS POSSIBLE BIOMARKERS FOR CANCER DIAGNOSIS AND PROGNOSIS, AND AS THERAPEUTIC TARGETS TO COUNTERACT CANCER SPREAD. 2023 14 3682 18 INFLAMMATION, FIBROSIS AND CANCER: MECHANISMS, THERAPEUTIC OPTIONS AND CHALLENGES. UNCONTROLLED INFLAMMATION IS A SALIENT FACTOR IN MULTIPLE CHRONIC INFLAMMATORY DISEASES AND CANCERS. IN THIS REVIEW, WE PROVIDED AN IN-DEPTH ANALYSIS OF THE RELATIONSHIPS AND DISTINCTIONS BETWEEN UNCONTROLLED INFLAMMATION, FIBROSIS AND CANCERS, WHILE EMPHASIZING THE CHALLENGES AND OPPORTUNITIES OF DEVELOPING NOVEL THERAPIES FOR THE TREATMENT AND/OR MANAGEMENT OF THESE DISEASES. WE DESCRIBED HOW DRUG DELIVERY SYSTEMS, COMBINATION THERAPY AND THE INTEGRATION OF TISSUE-TARGETED AND/OR PATHWAYS SELECTIVE STRATEGIES COULD OVERCOME THE CHALLENGES OF CURRENT AGENTS FOR MANAGING AND/OR TREATING CHRONIC INFLAMMATORY DISEASES AND CANCERS. WE ALSO RECOGNIZED THE VALUE OF THE RE-EVALUATION OF THE DISEASE-SPECIFIC ROLES OF MULTIPLE PATHWAYS IMPLICATED IN THE PATHOPHYSIOLOGY OF CHRONIC INFLAMMATORY DISEASES AND CANCERS-AS WELL AS THE APPLICATION OF DATA FROM SINGLE-CELL RNA SEQUENCING IN THE SUCCESS OF FUTURE DRUG DISCOVERY ENDEAVORS. 2022 15 3103 27 GENOMIC LANDSCAPE OF HCC. INTRODUCTION: HEPATOCELLULAR CARCINOMA (HCC) IS A LEADING CAUSE OF CANCER RELATED MORTALITY IN THE WORLD AND IT HAS LIMITED TREATMENT OPTIONS. UNDERSTANDING THE MOLECULAR DRIVERS OF HCC IS IMPORTANT TO DEVELOP NOVEL BIOMARKERS AND THERAPEUTICS. PURPOSE OF REVIEW: HCC ARISES IN A COMPLEX BACKGROUND OF CHRONIC HEPATITIS, FIBROSIS AND LIVER REGENERATION WHICH LEAD TO GENOMIC CHANGES. HERE, WE SUMMARIZE STUDIES THAT HAVE EXPANDED OUR UNDERSTANDING OF THE MOLECULAR LANDSCAPE OF HCC. RECENT FINDINGS: RECENT TECHNOLOGICAL ADVANCES IN NEXT GENERATION SEQUENCING (NGS) HAVE ELUCIDATED SPECIFIC GENETIC AND MOLECULAR PROGRAMS INVOLVED IN HEPATOCARCINOGENESIS. WE SUMMARIZE THE MAJOR SOMATIC MUTATIONS AND EPIGENETIC CHANGES HAVE BEEN IDENTIFIED IN NGS-BASED STUDIES. WE ALSO DESCRIBE PROMISING MOLECULAR THERAPIES AND IMMUNOTHERAPIES WHICH TARGET SPECIFIC GENETIC AND EPIGENETIC MOLECULAR EVENTS. SUMMARY: THE GENOMIC LANDSCAPE OF HCC IS INCREDIBLY COMPLEX AND HETEROGENEOUS. PROMISING NEW DEVELOPMENTS ARE HELPING US DECIPHER THE MOLECULAR DRIVERS OF HCC AND LEADING TO NEW THERAPIES. 2020 16 1127 16 COMPOUND COMBINATIONS TARGETING LONGEVITY: CHALLENGES AND PERSPECTIVES. AGING IS ONE OF THE WORLD'S GREATEST CONCERNS, REQUIRING URGENT, EFFECTIVE, LARGE-SCALE INTERVENTIONS TO DECREASE THE NUMBER OF LATE-LIFE CHRONIC DISEASES AND IMPROVE HUMAN HEALTHSPAN. ANTI-AGING DRUG THERAPY IS ONE OF THE MOST PROMISING STRATEGIES TO COMBAT THE EFFECTS OF AGING. HOWEVER, MOST GEROPROTECTIVE COMPOUNDS ARE KNOWN TO SUCCESSFULLY AFFECT ONLY A FEW AGING-RELATED TARGETS. GIVEN THIS, THERE IS A GREAT BIOLOGICAL RATIONALE FOR THE USE OF COMBINATIONS OF ANTI-AGING INTERVENTIONS. IN THIS REVIEW, WE CHARACTERIZE THE VARIOUS TYPES OF COMPOUND COMBINATIONS USED TO MODULATE LIFESPAN, DISCUSS THE EXISTING EVIDENCE ON THEIR ROLE IN LIFE EXTENSION, AND PRESENT SOME KEY POINTS ABOUT CURRENT CHALLENGES AND FUTURE PROSPECTS FOR THE DEVELOPMENT OF COMBINATION DRUG ANTI-AGING THERAPY. 2023 17 5026 29 PERSONALIZED MEDICINE IN IDIOPATHIC PULMONARY FIBROSIS: FACTS AND PROMISES. PURPOSE OF REVIEW: IN THIS ARTICLE, WE SUMMARIZE AND DISCUSS THE MOST RECENT LITERATURE ON PERSONALIZED MEDICINE IN IDIOPATHIC PULMONARY FIBROSIS (IPF), A CHRONIC PROGRESSIVE AND ALMOST INVARIABLY LETHAL DISEASE OF UNKNOWN CAUSE. THIS REVIEW IS TIMELY AS MAJOR ADVANCES IN OUR UNDERSTANDING OF DISEASE PATHOBIOLOGY AND IMPROVEMENTS IN MOLECULAR TECHNIQUES HAVE RECENTLY LED TO THE IDENTIFICATION OF POTENTIAL SURROGATES OF DIAGNOSIS, PROGNOSIS AND RESPONSE TO TREATMENT. RECENT FINDINGS: THE MOST PROMISING AND ADVANCED CANDIDATE BIOMARKERS ARE PRESENTED BASED ON THEIR PROPOSED MECHANISTIC PATHWAYS (E.G. ALVEOLAR EPITHELIAL CELL DYSFUNCTION, IMMUNE DYSREGULATION, MICROBIOME, EXTRACELLULAR MATRIX REMODELING AND FIBROPROLIFERATION, EPIGENETIC MARKERS AND METABOLOMICS). RECENT DATA SUGGEST THAT COMPONENTS OF THE IMMUNE SYSTEM MAY CONTRIBUTE TO THE DEVELOPMENT OF IPF. A POTENTIAL ROLE FOR INFECTIONS AS A COFACTOR IN DISEASE DEVELOPMENT AND PROGRESSION OR AS A TRIGGER IN DISEASE EXACERBATION HAS ALSO RECENTLY BEEN PROPOSED. SUMMARY: CLINICAL MANAGEMENT OF IPF IS UNSATISFACTORY BECAUSE OF LIMITED AVAILABILITY OF TRULY EFFECTIVE THERAPIES, LACK OF ACCURATE PREDICTORS OF DISEASE BEHAVIOR AND ABSENCE OF SIMPLE SHORT-TERM MEASURES OF THERAPEUTIC RESPONSE. A NUMBER OF PUTATIVE BIOMARKERS HAVE BEEN IDENTIFIED IN PATIENTS WITH IPF, ALTHOUGH NONE HAS BEEN VALIDATED TO THE STANDARD NECESSARY FOR THEIR USE IN EITHER THERAPEUTIC TRIALS OR CLINICAL PRACTICE. CURRENTLY, ONGOING PROSPECTIVE LONGITUDINAL STUDIES WILL HOPEFULLY PERMIT SUCH VALIDATION. 2015 18 4754 25 NOVEL THERAPEUTIC STRATEGIES FOR CHRONIC HEPATITIS B. THE LAST FEW YEARS HAVE SEEN A RESURGENCE OF ACTIVITY IN THE HEPATITIS B DRUG PIPELINE, WITH MANY COMPOUNDS IN VARIOUS STAGES OF DEVELOPMENT. THIS REVIEW AIMS TO PROVIDE A COMPREHENSIVE OVERVIEW OF THE LATEST ADVANCES IN THERAPEUTICS FOR CHRONIC HEPATITIS B (CHB). WE WILL DISCUSS THE BROAD SPECTRUM OF DIRECT-ACTING ANTIVIRALS IN CLINICAL DEVELOPMENT, INCLUDING CAPSIDS INHIBITORS, SIRNA, HBSAG AND POLYMERASE INHIBITORS. IN ADDITION, HOST-TARGETED THERAPIES (HTT) WILL BE EXTENSIVELY REVIEWED, FOCUSING ON THE LATEST PROGRESS IN IMMUNOTHERAPEUTICS SUCH AS TOLL-LIKE RECEPTORS AND RIG-1 AGONISTS, THERAPEUTIC VACCINES AND IMMUNE CHECKPOINTS MODULATORS. A GROWING NUMBER OF HTT IN PRE-CLINICAL DEVELOPMENT DIRECTLY TARGET THE KEY TO HBV PERSISTENCE, NAMELY THE COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) AND HOLD GREAT PROMISE FOR HBV CURE. THIS EXCITING AREA OF HBV RESEARCH WILL BE HIGHLIGHTED, AND MOLECULES SUCH AS CYCLOPHILINS INHIBITORS, APOBEC3 DEAMINASES AND EPIGENETIC MODIFIERS WILL BE DISCUSSED. 2022 19 6857 34 [NOVEL CONVENTIONAL THERAPIES IN ONCO-HEMATHOLOGY]. CYTOGENETIC, MOLECULAR AND PHENOTYPING FEATURES OF MALIGNANT HEMATOLOGIC DISEASES SUCCEEDED IN IMPROVING THEIR MANAGEMENT BY A MORE ACCURATE STRATIFICATION OF PATIENTS ACCORDING TO SEVERAL GROUPS OF RISK AND BY PROVIDING A RATIONAL FOR TARGETED THERAPY. THREE MAJOR TYPES OF TREATMENT (EXCLUDING CELLULAR THERAPY) ARE CURRENTLY AVAILABLE IN ONCO-HEMATOLOGY: CONVENTIONAL CHEMOTHERAPY, SMALL MOLECULES FOR TARGETED THERAPY AND MONOCLONAL ANTIBODIES. CONVENTIONAL CHEMOTHERAPY WITH OPTIMIZATION OF DOSES AND MULTIDRUG-BASED REGIMENS ALLOWED TO SUBSTANTIALLY IMPROVE SURVIVAL OF PATIENTS AND KEEPS A PLACE OF CHOICE IN TREATMENT OF THESE DISEASES. TARGETED TREATMENTS CAME FROM THE CYTOGENETIC AND MOLECULAR CHARACTERIZATION OF HEMOPATHIES. THUS, THE KINASE BCR-ABL, AS A RESULT OF THE TRANSLOCATION T(9;22)(Q34;Q11), HAS BEEN SUCCESSFULLY TARGETED BY TYROSINE KINASE INHIBITORS (TKI) IN CHRONIC MYELOID LEUKEMIA AND PH+ ACUTE LYMPHOBLASTIC LEUKEMIA. MOLECULAR ABNORMALITIES LIKE INTERNAL-TANDEM DUPLICATION/POINT ACTIVATING MUTATIONS IN FLT3 IN SOME ACUTE MYELOBLASTIC LEUKEMIA OR EPIGENETIC DYSREGULATIONS IN SOME BLOOD MALIGNANCIES CAN ALSO BE TARGETED BY SMALL MOLECULES. HEMATOPOIETIC MALIGNANT CELLS ARE PHENOTYPICALLY CHARACTERIZED BY EXPRESSION OF CLUSTER OF DIFFERENTIATION (CD) ON THEIR SURFACE. THESE CD ARE DETECTED BY FLOW CYTOMETRY USING SPECIFIC ANTIBODIES. MONOCLONAL ANTIBODIES TARGETING DIFFERENT CD HAVE BEEN DEVELOPED FOR TREATMENT. RITUXIMAB, AN ANTI-CD20 ANTIBODY, WAS THE FIRST MONOCLONAL ANTIBODY SUCCESSFULLY DEVELOPED FOR TREATMENT OF MALIGNANT HEMATOLOGIC DISEASES. SINCE RITUXIMAB, MANY OTHER MONOCLONAL ANTIBODIES ARE BEING DEVELOPED. TRENDS IN MALIGNANT HEMATOLOGIC DISEASES PRESENTED HERE WILL INCLUDE TREATMENTS, WHICH HAVE AT LEAST ENTERED PHASE I/II CLINICAL TRIALS IN ADULT OR CHILDHOOD LEUKEMIA. THEY INCLUDE SOME NOVEL DRUGS OF CONVENTIONAL CHEMOTHERAPY LIKE SECOND-GENERATION NUCLEOSIDE ANALOGUES. WE WILL GIVE AN OVERVIEW OF THE SMALL MOLECULES TARGETING THE DIFFERENT CELLULAR PATHWAYS AND WE WILL HIGHLIGHT THOSE APPEARING AS THE MOST PROMISING LIKE NOVEL TKIS. THE LARGE FIELD OF MONOCLONAL ANTIBODIES WILL BE ALSO APPROACHED FOCUSING ON ANTIBODIES DEVELOPED IN LEUKEMIAS. 2011 20 2276 20 EPIGENETIC REGULATION AS A PROMISING TOOL FOR TREATMENT OF ATHEROSCLEROSIS. ATHEROSCLEROSIS IS ONE OF THE LEADING CAUSES OF DEATH FROM CARDIOVASCULAR DISEASE (CVD) THAT PRIMARILY INVOLVES MID SIZE AND LARGE ARTERIES. ATHEROSCLEROSIS IS ASSOCIATED WITH DISRUPTION OF LIPID METABOLISM AND CHRONIC INFLAMMATORY PROCESSES. ONE APPROACH FOR TREATMENT OF ATHEROSCLEROSIS IS BY VIRTUE OF EPIGENETIC CONTROL BY NONCODING RNAS (NCRNA) INCLUDING MIRNA, SIRNA AND LNCRNA, COMMONLY EMPLOYING MIRNA ANTAGONISTS AND MIMIC COMPOUNDS. HERE, WE REVIEW SUCH USAGES AS WELL AS OTHER APPROACHES FOR CORRECTING THE MOLECULAR LESIONS OF ATHEROSCLEROSIS INCLUDING SPECIFIC ACTIVATION OF ATHEROPROTECTIVE MIRNAS, AS WELL AS USE OF SIRNAS AND LCRNA TO CONTROL ABERRANT LIPID METABOLISM. WE ALSO DISCUSS SOME OF THESE TECHNOLOGIES THAT HAVE ALREADY SHOWN TO BE EFFECTIVE IN CLINICAL TRIALS AND ARE LIKELY TO ENTER THE CLINICAL ARENA. 2020