1 6201 102 THE INFLAMMATORY MICROENVIRONMENT AND MICROBIOME IN PROSTATE CANCER DEVELOPMENT. CHRONIC INFLAMMATION PROMOTES THE DEVELOPMENT OF SEVERAL TYPES OF SOLID CANCERS AND MIGHT CONTRIBUTE TO PROSTATE CARCINOGENESIS. THIS HYPOTHESIS PARTLY ORIGINATES IN THE FREQUENT OBSERVATION OF INFLAMMATORY CELLS IN THE PROSTATE MICROENVIRONMENT OF ADULT MEN. INFLAMMATION IS ASSOCIATED WITH PUTATIVE PROSTATE CANCER PRECURSOR LESIONS, TERMED PROLIFERATIVE INFLAMMATORY ATROPHY. INFLAMMATION MIGHT DRIVE PROSTATE CARCINOGENESIS VIA OXIDATIVE STRESS AND GENERATION OF REACTIVE OXYGEN SPECIES THAT INDUCE MUTAGENESIS. ADDITIONALLY, INFLAMMATORY STRESS MIGHT CAUSE EPIGENETIC ALTERATIONS THAT PROMOTE NEOPLASTIC TRANSFORMATION. PROLIFERATIVE INFLAMMATORY ATROPHY IS ENRICHED FOR PROLIFERATIVE LUMINAL EPITHELIAL CELLS OF INTERMEDIATE PHENOTYPE THAT MIGHT BE PRONE TO GENOMIC ALTERATIONS LEADING TO PROSTATIC INTRAEPITHELIAL NEOPLASIA AND PROSTATE CANCER. STUDIES IN ANIMALS SUGGEST THAT INFLAMMATORY CHANGES IN THE PROSTATE MICROENVIRONMENT CONTRIBUTE TO REPROGRAMMING OF PROSTATE EPITHELIAL CELLS, A POSSIBLE STEP IN TUMOUR INITIATION. PROSTATIC INFECTION, CONCURRENT WITH EPITHELIAL BARRIER DISRUPTION, MIGHT BE A KEY DRIVER OF AN INFLAMMATORY MICROENVIRONMENT; THE DISCOVERY OF A URINARY MICROBIOME INDICATES A POTENTIAL SOURCE OF FREQUENT EXPOSURE OF THE PROSTATE TO A DIVERSE NUMBER OF MICROORGANISMS. HENCE, CURRENT EVIDENCE SUGGESTS THAT INFLAMMATION AND ATROPHY ARE INVOLVED IN PROSTATE CARCINOGENESIS AND SUGGESTS A ROLE FOR THE MICROBIOME IN ESTABLISHING AN INFLAMMATORY PROSTATE MICROENVIRONMENT THAT MIGHT PROMOTE PROSTATE CANCER DEVELOPMENT AND PROGRESSION. 2018 2 4666 38 NEW INSIGHTS AND OPTIONS INTO THE MECHANISMS AND EFFECTS OF COMBINED TARGETED THERAPY AND IMMUNOTHERAPY IN PROSTATE CANCER. CHRONIC INFLAMMATION IS BELIEVED TO DRIVE PROSTATE CARCINOGENESIS BY PRODUCING REACTIVE OXYGEN SPECIES OR REACTIVE NITROGEN SPECIES TO INDUCE DNA DAMAGE. THIS EFFECT MIGHT SUBSEQUENTLY CAUSE EPIGENETIC AND GENOMIC ALTERATIONS, LEADING TO MALIGNANT TRANSFORMATION. ALTHOUGH ESTABLISHED THERAPEUTIC ADVANCES HAVE EXTENDED OVERALL SURVIVAL, TUMORS IN PATIENTS WITH ADVANCED PROSTATE CANCER ARE PRONE TO METASTASIS, TRANSFORMATION INTO METASTATIC CASTRATION-RESISTANT PROSTATE CANCER, AND THERAPEUTIC RESISTANCE. THE TUMOR MICROENVIRONMENT (TME) OF PROSTATE CANCER IS INVOLVED IN CARCINOGENESIS, INVASION AND DRUG RESISTANCE. A PLETHORA OF PRECLINICAL STUDIES HAVE FOCUSED ON IMMUNE-BASED THERAPIES. UNDERSTANDING THE INTRICATE TME SYSTEM IN PROSTATE CANCER MAY HOLD MUCH PROMISE FOR DEVELOPING NOVEL THERAPIES, DESIGNING COMBINATIONAL THERAPEUTIC STRATEGIES, AND FURTHER OVERCOMING RESISTANCE TO ESTABLISHED TREATMENTS TO IMPROVE THE LIVES OF PROSTATE CANCER PATIENTS. IN THIS REVIEW, WE DISCUSS NONIMMUNE COMPONENTS AND VARIOUS IMMUNE CELLS WITHIN THE TME AND THEIR PUTATIVE ROLES DURING PROSTATE CANCER INITIATION, PROGRESSION, AND METASTASIS. WE ALSO OUTLINE THE UPDATED FUNDAMENTAL RESEARCH FOCUSING ON THERAPEUTIC ADVANCES OF TARGETED THERAPY AS WELL AS COMBINATIONAL OPTIONS FOR PROSTATE CANCER. 2023 3 3683 34 INFLAMMATION, MICROBIOTA, AND PROSTATE CANCER. CONTEXT: CHRONIC INFLAMMATION OF THE PROSTATE HAS BEEN ASSOCIATED WITH PRENEOPLASTIC LESIONS AND CANCER DEVELOPMENT. MULTIPLE CAUSES HAVE BEEN CONSIDERED FOR CHRONIC INFLAMMATION OF THE PROSTATE. INFLAMMATORY CYTOKINES SUCH AS INTERLEUKINS ARE IMPLICATED IN PROSTATE CARCINOGENESIS AND DEVELOPMENT. OBJECTIVE: TO EVALUATE LITERATURE PUBLISHED ON ETIOLOGICAL FACTORS, URINARY MICROBIOTA, MORPHOLOGICAL FEATURES OF PROLIFERATIVE INFLAMMATORY ATROPHY AND HIGH-GRADE PROSTATE INTRAEPITHELIAL NEOPLASIA, GENETIC POLYMORPHISMS, INFLAMMATORY STRESS, AND CYTOKINE SIGNALING. EVIDENCE ACQUISITION: WE SEARCHED LITERATURE FROM PUBMED FROM 2010 AND ALSO INCLUDED THE MOST IMPORTANT PUBLICATIONS FROM THE PREVIOUS PERIOD. EVIDENCE SYNTHESIS: PROSTATE CANCER INFLAMMATION AND PREMALIGNANT LESIONS HAVE BEEN FREQUENTLY DISCUSSED IN SCIENTIFIC LITERATURE. A LIMITED NUMBER OF MODELS ARE AVAILABLE FOR STUDYING INFLAMMATION AND PREMALIGNANT LESIONS. HOWEVER, MORPHOLOGICAL PATHOLOGY COULD BE COMPLEMENTED BY ANALYSIS OF GENE POLYMORPHISMS IN THESE PATIENTS AND APPROPRIATE FUNCTIONAL STUDIES. CONCLUSIONS: PROSTATITIS COULD BE CAUSED BY BACTERIAL OR VIRAL INFECTIONS, DIETARY COMPOUNDS, AND CHANGES IN TESTOSTERONE:ESTRADIOL RATIO. IN SOME CASES, THE MICROBIOTA CAN EXERT DIRECT EFFECTS ON CANCER DEVELOPMENT. PROSTATE INFLAMMATORY ATROPHY OR HIGH GRADE PROSTATE INTRAEPITHELIAL NEOPLASIA HAVE BEEN ASSOCIATED WITH RESPONSE TO CELLULAR STRESS AND HAVE BEEN DISCUSSED IN CONNECTION TO EARLY CANCER DEVELOPMENT. A LARGE NUMBER OF GENETIC POLYMORPHISMS HAVE BEEN IDENTIFIED IN INFLAMMATORY PROSTATE. GENETIC AND EPIGENETIC ALTERATIONS MAY BE A CONSEQUENCE OF THE PROINFLAMMATORY STRESS IN THE PROSTATE. PROINFLAMMATORY CYTOKINES INTERLEUKIN-6 AND -8 CONTRIBUTE TO PROSTATE MALIGNANCY; HOWEVER, THEIR FUNCTION WAS MORE FREQUENTLY INVESTIGATED IN CANCER TISSUE RATHER THAN IN INFLAMMATION. PATIENT SUMMARY: WE PERFORMED A REVIEW OF RECENT LITERATURE RELATED TO PROSTATE INFLAMMATION, MICROBIOTA, AND PROSTATE CANCER. NEW FUNCTIONAL APPROACHES ARE REQUIRED FOR A BETTER UNDERSTANDING OF THE ROLE OF INFLAMMATION AND CANCER DEVELOPMENT. 2016 4 6068 39 THE DIET AS A CAUSE OF HUMAN PROSTATE CANCER. ASYMPTOMATIC PROSTATE INFLAMMATION AND PROSTATE CANCER HAVE REACHED EPIDEMIC PROPORTIONS AMONG MEN IN THE DEVELOPED WORLD. ANIMAL MODEL STUDIES IMPLICATE DIETARY CARCINOGENS, SUCH AS THE HETEROCYCLIC AMINES FROM OVER-COOKED MEATS AND SEX STEROID HORMONES, PARTICULARLY ESTROGENS, AS CANDIDATE ETIOLOGIES FOR PROSTATE CANCER. EACH ACTS BY CAUSING EPITHELIAL CELL DAMAGE, TRIGGERING AN INFLAMMATORY RESPONSE THAT CAN EVOLVE INTO A CHRONIC OR RECURRENT CONDITION. THIS MILIEU APPEARS TO SPAWN PROLIFERATIVE INFLAMMATORY ATROPHY (PIA) LESIONS, A TYPE OF FOCAL ATROPHY THAT REPRESENTS THE EARLIEST OF PROSTATE CANCER PRECURSOR LESIONS. RARE PIA LESIONS CONTAIN CELLS WHICH EXHIBIT HIGH C-MYC EXPRESSION, SHORTENED TELOMERE SEGMENTS, AND EPIGENETIC SILENCING OF GENES SUCH AS GSTP1, ENCODING THE PI-CLASS GLUTATHIONE S-TRANSFERASE, ALL CHARACTERISTIC OF PROSTATIC INTRAEPITHELIAL NEOPLASIA (PIN) AND PROSTATE CANCER. SUBSEQUENT GENETIC CHANGES, SUCH AS THE GENE TRANSLOCATIONS/DELETIONS THAT GENERATE FUSION TRANSCRIPTS BETWEEN ANDROGEN-REGULATED GENES (SUCH AS TMPRSS2) AND GENES ENCODING ETS FAMILY TRANSCRIPTION FACTORS (SUCH AS ERG1), ARISE IN PIN LESIONS AND MAY PROMOTE INVASIVENESS CHARACTERISTIC OF PROSTATIC ADENOCARCINOMA CELLS. LETHAL PROSTATE CANCERS CONTAIN MARKEDLY CORRUPTED GENOMES AND EPIGENOMES. EPIGENETIC SILENCING, WHICH SEEMS TO ARISE IN RESPONSE TO THE INFLAMED MICROENVIRONMENT GENERATED BY DIETARY CARCINOGENS AND/OR ESTROGENS AS PART OF AN EPIGENETIC "CATASTROPHE" AFFECTING HUNDREDS OF GENES, PERSISTS TO DRIVE CLONAL EVOLUTION THROUGH METASTATIC DISSEMINATION. THE CAUSE OF THE INITIAL EPIGENETIC "CATASTROPHE" HAS NOT BEEN DETERMINED BUT LIKELY INVOLVES DEFECTIVE CHROMATIN STRUCTURE MAINTENANCE BY OVER-EXUBERANT DNA METHYLATION OR HISTONE MODIFICATION. WITH DIETARY CARCINOGENS AND ESTROGENS DRIVING PRO-CARCINOGENIC INFLAMMATION IN THE DEVELOPED WORLD, IT IS TEMPTING TO SPECULATE THAT DIETARY COMPONENTS ASSOCIATED WITH DECREASED PROSTATE CANCER RISK, SUCH AS INTAKE OF FRUITS AND VEGETABLES, ESPECIALLY TOMATOES AND CRUCIFERS, MIGHT ACT TO ATTENUATE THE RAVAGES OF THE CHRONIC OR RECURRENT INFLAMMATORY PROCESSES. SPECIFICALLY, NUTRITIONAL AGENTS MIGHT PREVENT PIA LESIONS OR REDUCE THE PROPENSITY OF PIA LESIONS TO SUFFER "CATASTROPHIC" EPIGENOME CORRUPTION. 2014 5 5292 34 PROSTATIC INFLAMMATION ENHANCES BASAL-TO-LUMINAL DIFFERENTIATION AND ACCELERATES INITIATION OF PROSTATE CANCER WITH A BASAL CELL ORIGIN. CHRONIC INFLAMMATION HAS BEEN SHOWN TO PROMOTE THE INITIATION AND PROGRESSION OF DIVERSE MALIGNANCIES BY INDUCING GENETIC AND EPIGENETIC ALTERATIONS. IN THIS STUDY, WE INVESTIGATE AN ALTERNATIVE MECHANISM THROUGH WHICH INFLAMMATION PROMOTES THE INITIATION OF PROSTATE CANCER. ADULT MURINE PROSTATE EPITHELIA ARE COMPOSED PREDOMINANTLY OF BASAL AND LUMINAL CELLS. PREVIOUS STUDIES REVEALED THAT THE TWO LINEAGES ARE LARGELY SELF-SUSTAINED WHEN RESIDING IN THEIR NATIVE MICROENVIRONMENT. TO INTERROGATE WHETHER TISSUE INFLAMMATION ALTERS THE DIFFERENTIATION PROGRAM OF BASAL CELLS, WE CONDUCTED LINEAGE TRACING OF BASAL CELLS USING A K14-CREER;MTMG MODEL IN CONCERT WITH A MURINE MODEL OF PROSTATITIS INDUCED BY INFECTION FROM THE UROPATHOGENIC BACTERIA CP9. WE SHOW THAT ACUTE PROSTATITIS CAUSES TISSUE DAMAGE AND CREATES A TISSUE MICROENVIRONMENT THAT INDUCES THE DIFFERENTIATION OF BASAL CELLS INTO LUMINAL CELLS, AN ALTERATION THAT RARELY OCCURS UNDER NORMAL PHYSIOLOGICAL CONDITIONS. PREVIOUSLY WE SHOWED THAT A MOUSE MODEL WITH PROSTATE BASAL CELL-SPECIFIC DELETION OF PHOSPHATASE AND TENSIN HOMOLOG (K14-CREER;PTEN(FL/FL)) DEVELOPS PROSTATE CANCER WITH A LONG LATENCY, BECAUSE DISEASE INITIATION IN THIS MODEL REQUIRES AND IS LIMITED BY THE DIFFERENTIATION OF TRANSFORMATION-RESISTANT BASAL CELLS INTO TRANSFORMATION-COMPETENT LUMINAL CELLS. HERE, WE SHOW THAT CP9-INDUCED PROSTATITIS SIGNIFICANTLY ACCELERATES THE INITIATION OF PROSTATIC INTRAEPITHELIAL NEOPLASIA IN THIS MODEL. OUR RESULTS DEMONSTRATE THAT INFLAMMATION RESULTS IN A TISSUE MICROENVIRONMENT THAT ALTERS THE NORMAL PROSTATE EPITHELIAL CELL DIFFERENTIATION PROGRAM AND THAT THROUGH THIS CELLULAR PROCESS INFLAMMATION ACCELERATES THE INITIATION OF PROSTATE CANCER WITH A BASAL CELL ORIGIN. 2014 6 723 35 CAN EPIGENETIC AND INFLAMMATORY BIOMARKERS IDENTIFY CLINICALLY AGGRESSIVE PROSTATE CANCER? PROSTATE CANCER (PCA) IS A HIGHLY PREVALENT MALIGNANCY AND CONSTITUTES A MAJOR CAUSE OF CANCER-RELATED MORBIDITY AND MORTALITY. IT EMERGES THROUGH THE ACQUISITION OF GENETIC AND EPIGENETIC ALTERATIONS. EPIGENETIC MODIFICATIONS INCLUDE DNA METHYLATION, HISTONE MODIFICATIONS AND MICRORNA DEREGULATION. THESE GENERATE HERITABLE TRANSFORMATIONS IN THE EXPRESSION OF GENES BUT DO NOT CHANGE THE DNA SEQUENCE. ALTERATIONS IN DNA METHYLATION (HYPO AND HYPERMETHYLATION) ARE THE MOST CHARACTERIZED IN PCA. THEY LEAD TO GENOMIC INSTABILITY AND INADEQUATE GENE EXPRESSION. MAJOR AND MINOR-SPECIFIC MODIFICATIONS IN CHROMATIN RECASTING ARE INVOLVED IN PCA, WITH SIGNS SUGGESTING A DYSFUNCTION OF ENZYMES MODIFIED BY HISTONES. MICRORNA DEREGULATION ALSO CONTRIBUTES TO THE INITIATION OF PCA, INCLUDING INVOLVEMENT IN ANDROGEN RECEPTOR SIGNALIZATION AND APOPTOSIS. THE INFLUENCE OF INFLAMMATION ON PROSTATE TUMOR CARCINOGENESIS IS CURRENTLY MUCH BETTER KNOWN. RECENT DISCOVERIES ABOUT MICROBIAL SPECIES RESIDENT IN THE URINARY TRACT SUGGEST THAT THESE ARE THE INITIATORS OF CHRONIC INFLAMMATION, PROMOTING PROSTATE INFLAMMATORY ATROPHY AND EVENTUALLY LEADING TO PCA. COMPLETE CHARACTERIZATION OF THE RELATIONSHIP BETWEEN THE URINARY MICROBIOME AND PROSTATIC CHRONIC INFLAMMATION WILL BE CRUCIAL TO DEVELOP PLANS FOR THE PREVENTION OF PCA. THE PREVALENT NATURE OF EPIGENETIC AND INFLAMMATORY ALTERATIONS MAY PROVIDE POTENTIAL BIOMARKERS FOR PCA DIAGNOSIS, TREATMENT DECISIONS, EVALUATION OF PROGNOSIS AND POSTTREATMENT SURVEILLANCE. 2020 7 5291 29 PROSTATE CARCINOGENESIS: INSIGHTS IN RELATION TO EPIGENETICS AND INFLAMMATION. PROSTATE CANCER IS A MULTIFACTORIAL DISEASE THAT MAINLY OCCURS DUE TO THE ACCUMULATION OF SOMATIC, GENETIC, AND EPIGENETIC CHANGES, RESULTING IN THE INACTIVATION OF TUMOR-SUPPRESSOR GENES AND ACTIVATION OF ONCOGENES. MUTATIONS IN GENES, SPECIFICALLY THOSE THAT CONTROL CELL GROWTH AND DIVISION OR THE REPAIR OF DAMAGED DNA, MAKE THE CELLS GROW AND DIVIDE UNCONTROLLABLY TO FORM A TUMOR. THE RISK OF DEVELOPING PROSTATE CANCER DEPENDS UPON THE GENE THAT HAS UNDERGONE THE MUTATION. IDENTIFYING SUCH GENETIC RISK FACTORS FOR PROSTATE CANCER POSES A CHALLENGE FOR THE RESEARCHERS. BESIDES GENETIC MUTATIONS, MANY EPIGENETIC ALTERATIONS, INCLUDING DNA METHYLATION, HISTONE MODIFICATIONS (METHYLATION, ACETYLATION, UBIQUITYLATION, SUMOYLATION, AND PHOSPHORYLATION) NUCLEOSOMAL REMODELING, AND CHROMOSOMAL LOOPING, HAVE SIGNIFICANTLY CONTRIBUTED TO THE ONSET OF PROSTATE CANCER AS WELL AS THE PROGNOSIS, DIAGNOSIS, AND TREATMENT OF PROSTATE CANCER. CHRONIC INFLAMMATION ALSO PLAYS A MAJOR ROLE IN THE ONSET AND PROGRESSION OF HUMAN CANCER, VIA MODIFICATIONS IN THE TUMOR MICROENVIRONMENT BY INITIATING EPITHELIALMESENCHYMAL TRANSITION AND REMODELING THE EXTRACELLULAR MATRIX. IN THIS ARTICLE, THE AUTHORS PRESENT A BRIEF HISTORY OF THE MECHANISMS AND POTENTIAL LINKS BETWEEN THE GENETIC ABERRATIONS, EPIGENETIC CHANGES, INFLAMMATION, AND INFLAMMASOMES THAT ARE KNOWN TO CONTRIBUTE TO THE PROGNOSIS OF PROSTATE CANCER. FURTHERMORE, THE AUTHORS EXAMINE AND DISCUSS THE CLINICAL POTENTIAL OF PROSTATE CARCINOGENESIS IN RELATION TO EPIGENETICS AND INFLAMMATION FOR ITS DIAGNOSIS AND TREATMENT.. 2021 8 6154 30 THE GENE EXPRESSION PROGRAM OF PROSTATE FIBROBLAST SENESCENCE MODULATES NEOPLASTIC EPITHELIAL CELL PROLIFERATION THROUGH PARACRINE MECHANISMS. THE GREATEST RISK FACTOR FOR DEVELOPING CARCINOMA OF THE PROSTATE IS ADVANCED AGE. POTENTIAL MOLECULAR AND PHYSIOLOGIC CONTRIBUTORS TO THE FREQUENCY OF CANCER OCCURRENCE IN OLDER INDIVIDUALS INCLUDE THE ACCUMULATION OF SOMATIC MUTATIONS THROUGH DEFECTS IN GENOME MAINTENANCE, EPIGENETIC GENE SILENCING, OXIDATIVE STRESS, LOSS OF IMMUNE SURVEILLANCE, TELOMERE DYSFUNCTION, CHRONIC INFLAMMATION, AND ALTERATIONS IN TISSUE MICROENVIRONMENT. IN THIS CONTEXT, THE PROCESS OF PROSTATE CARCINOGENESIS CAN BE INFLUENCED THROUGH INTERACTIONS BETWEEN INTRINSIC CELLULAR ALTERATIONS AND THE EXTRINSIC MICROENVIRONMENT AND MACROENVIRONMENT, BOTH OF WHICH CHANGE SUBSTANTIALLY AS A CONSEQUENCE OF AGING. IN THIS STUDY, WE SOUGHT TO CHARACTERIZE THE MOLECULAR ALTERATIONS THAT OCCUR DURING THE PROCESS OF PROSTATE FIBROBLAST SENESCENCE TO IDENTIFY FACTORS IN THE AGED TISSUE MICROENVIRONMENT CAPABLE OF PROMOTING THE PROLIFERATION AND POTENTIALLY THE NEOPLASTIC PROGRESSION OF PROSTATE EPITHELIUM. WE EVALUATED THREE MECHANISMS LEADING TO CELL SENESCENCE: OXIDATIVE STRESS, DNA DAMAGE, AND REPLICATIVE EXHAUSTION. WE IDENTIFIED A CONSISTENT PROGRAM OF GENE EXPRESSION THAT INCLUDES A SUBSET OF PARACRINE FACTORS CAPABLE OF INFLUENCING ADJACENT PROSTATE EPITHELIAL GROWTH. BOTH DIRECT COCULTURE AND CONDITIONED MEDIUM FROM SENESCENT PROSTATE FIBROBLASTS STIMULATED EPITHELIAL CELL PROLIFERATION, 3-FOLD AND 2-FOLD, RESPECTIVELY. THE PARACRINE-ACTING PROTEINS FIBROBLAST GROWTH FACTOR 7, HEPATOCYTE GROWTH FACTOR, AND AMPHIREGULIN (AREG) WERE ELEVATED IN THE EXTRACELLULAR ENVIRONMENT OF SENESCENT PROSTATE FIBROBLASTS. EXOGENOUS AREG ALONE STIMULATED PROSTATE EPITHELIAL CELL GROWTH, AND NEUTRALIZING ANTIBODIES AND SMALL INTERFERING RNA TARGETING AREG ATTENUATED, BUT DID NOT COMPLETELY ABROGATE THE GROWTH-PROMOTING EFFECTS OF SENESCENT FIBROBLAST CONDITIONED MEDIUM. THESE RESULTS SUPPORT THE CONCEPT THAT AGING-RELATED CHANGES IN THE PROSTATE MICROENVIRONMENT MAY CONTRIBUTE TO THE PROGRESSION OF PROSTATE NEOPLASIA. 2006 9 4769 34 NUCLEAR MORPHOMETRY, NUCLEOMICS AND PROSTATE CANCER PROGRESSION. PROSTATE CANCER (PCA) RESULTS FROM A MULTISTEP PROCESS. THIS PROCESS INCLUDES INITIATION, WHICH OCCURS THROUGH VARIOUS AGING EVENTS AND MULTIPLE INSULTS (SUCH AS CHRONIC INFECTION, INFLAMMATION AND GENETIC INSTABILITY THROUGH REACTIVE OXYGEN SPECIES CAUSING DNA DOUBLE-STRAND BREAKS), FOLLOWED BY A MULTISTEP PROCESS OF PROGRESSION. THESE STEPS INCLUDE SEVERAL GENETIC AND EPIGENETIC ALTERATIONS, AS WELL AS ALTERATIONS TO THE CHROMATIN STRUCTURE, WHICH OCCUR IN RESPONSE TO THE CARCINOGENIC STRESS-RELATED EVENTS THAT SUSTAIN PROLIFERATIVE SIGNALING. EVENTS SUCH AS EVADING GROWTH SUPPRESSORS, RESISTING CELL DEATH, ENABLING REPLICATIVE IMMORTALITY, INDUCING ANGIOGENESIS, AND ACTIVATING INVASION AND METASTASIS ARE READILY OBSERVED. IN ADDITION, IN CONJUNCTION WITH THESE CRITICAL DRIVERS OF CARCINOGENESIS, OTHER FACTORS RELATED TO THE ETIOPATHOGENESIS OF PCA, INVOLVING ENERGY METABOLISM AND EVASION OF THE IMMUNE SURVEILLANCE SYSTEM, APPEAR TO BE INVOLVED. IN ADDITION, WHEN CANCER SPREAD AND METASTASIS OCCUR, THE 'TUMOR MICROENVIRONMENT' IN THE BONE OF PCA PATIENTS MAY PROVIDE A WAY TO SUSTAIN DORMANCY OR SENESCENCE AND EVENTUALLY ESTABLISH A 'SEED AND SOIL' SITE WHERE PCA PROLIFERATION AND GROWTH MAY OCCUR OVER TIME. WHEN PCA IS INITIATED AND PROGRESSION ENSUES, SIGNIFICANT ALTERATIONS IN NUCLEAR SIZE, SHAPE AND HETEROCHROMATIN (DNA TRANSCRIPTION) ORGANIZATION ARE FOUND, AND KEY NUCLEAR TRANSCRIPTIONAL AND STRUCTURAL PROTEINS, AS WELL AS MULTIPLE NUCLEAR BODIES CAN LEAD TO PRECANCEROUS AND MALIGNANT CHANGES. THESE SERIES OF CELLULAR AND TISSUE-RELATED MALIGNANCY-ASSOCIATED EVENTS CAN BE QUANTIFIED TO ASSESS DISEASE PROGRESSION AND MANAGEMENT. 2012 10 6865 31 [OXIDATIVE STRESS IN PROSTATE HYPERTROPHY AND CARCINOGENESIS]. AGING, SIGNIFICANT IMPAIRMENT OF THE OXIDATION/REDUCTION BALANCE, INFECTION, AND INFLAMMATION ARE RECOGNIZED RISK FACTORS OF BENIGN HYPERPLASIA AND PROSTATE CANCER. CHRONIC SYMPTOMATIC AND ASYMPTOMATIC PROSTATE INFLAMMATORY PROCESSES GENERATE SIGNIFICANTLY ELEVATED LEVELS OF REACTIVE OXYGEN AND NITROGEN SPECIES, AND HALOGENATED COMPOUNDS. PROSTATE CANCER PATIENTS SHOWED SIGNIFICANTLY HIGHER LIPID PEROXIDATION AND LOWER ANTIOXIDANT LEVELS IN PERIPHERAL BLOOD THAN HEALTHY CONTROLS, WHEREAS PATIENTS WITH PROSTATE HYPERPLASIA DID NOT SHOW SUCH SYMPTOMS. OXIDATIVE/NITROSATIVE/HALOGENATIVE STRESS CAUSES DNA MODIFICATIONS LEADING TO GENOME INSTABILITY THAT MAY INITIATE CARCINOGENESIS; HOWEVER, IT WAS SHOWN THAT OXIDATIVE DAMAGE ALONE IS NOT SUFFICIENT TO INITIATE THIS PROCESS. PEROXIDATION PRODUCTS INDUCED BY REACTIVE OXYGEN AND NITROGEN SPECIES SEEM TO TAKE PART IN EPIGENETIC MECHANISMS REGULATING GENOME ACTIVITY. ONE OF THE MOST COMMON CHANGES OCCURRING IN MORE THAN 90% OF ALL ANALYZED PROSTATE CANCERS IS THE SILENCING OF GSTP1 GENE ACTIVITY. THE GENE ENCODES GLUTATHIONE TRANSFERASE, AN ENZYME PARTICIPATING IN DETOXIFICATION PROCESSES. PROSTATE HYPERPLASIA IS OFTEN ACCOMPANIED BY CHRONIC INFLAMMATION AND SUCH A RELATIONSHIP WAS NOT OBSERVED IN PROSTATE CANCER. THE PARTICIPATION OF INFECTION AND INFLAMMATION IN THE DEVELOPMENT OF HYPERPLASIA IS UNQUESTIONABLE AND THESE FACTORS PROBABLY ALSO TAKE PART IN INITIATING THE EARLY STAGES OF PROSTATE CARCINOGENESIS. THUS IT SEEMS THAT THERAPEUTIC STRATEGIES THAT PREVENT GENOME OXIDATIVE DAMAGE IN SITUATIONS INVOLVING OXIDATIVE/NITROSATIVE/HALOGENATIVE STRESS, I.E. USE OF ANTIOXIDANTS, PLANT STEROIDS, ANTIBIOTICS, AND NON-STEROIDAL ANTI-INFLAMMATORY DRUGS, COULD HELP PREVENT CARCINOGENESIS. 2009 11 2823 29 FLAVONOIDS AS EPIGENETIC MODULATORS FOR PROSTATE CANCER PREVENTION. PROSTATE CANCER (PCA) IS A MULTIFACTORIAL DISEASE WITH AN UNCLEAR ETIOLOGY. DUE TO ITS HIGH PREVALENCE, LONG LATENCY, AND SLOW PROGRESSION, PCA IS AN IDEAL TARGET FOR CHEMOPREVENTION STRATEGIES. MANY RESEARCH STUDIES HAVE HIGHLIGHTED THE POSITIVE EFFECTS OF NATURAL FLAVONOIDS ON CHRONIC DISEASES, INCLUDING PCA. DIFFERENT CLASSES OF DIETARY FLAVONOIDS EXHIBIT ANTI-OXIDATIVE, ANTI-INFLAMMATORY, ANTI-MUTAGENIC, ANTI-AGING, CARDIOPROTECTIVE, ANTI-VIRAL/BACTERIAL AND ANTI-CARCINOGENIC PROPERTIES. WE OVERVIEWED THE MOST RECENT EVIDENCE OF THE ANTITUMORAL EFFECTS EXERTED BY DIETARY FLAVONOIDS, WITH A SPECIAL FOCUS ON THEIR EPIGENETIC ACTION IN PCA. EPIGENETIC ALTERATIONS HAVE BEEN IDENTIFIED AS KEY INITIATING EVENTS IN SEVERAL KINDS OF CANCER. MANY DIETARY FLAVONOIDS HAVE BEEN FOUND TO REVERSE DNA ABERRATIONS THAT PROMOTE NEOPLASTIC TRANSFORMATION, PARTICULARLY FOR PCA. THE EPIGENETIC TARGETS OF THE ACTIONS OF FLAVONOIDS INCLUDE ONCOGENES AND TUMOR SUPPRESSOR GENES, INDIRECTLY CONTROLLED THROUGH THE REGULATION OF EPIGENETIC ENZYMES SUCH AS DNA METHYLTRANSFERASE (DNMT), HISTONE ACETYLTRANSFERASE (HAT), AND HISTONE DEACETYLASE (HDAC). IN ADDITION, FLAVONOIDS WERE FOUND CAPABLE OF RESTORING MIRNA AND LNCRNA EXPRESSION THAT IS ALTERED DURING DISEASES. THE OPTIMIZATION OF THE USE OF FLAVONOIDS AS NATURAL EPIGENETIC MODULATORS FOR CHEMOPREVENTION AND AS A POSSIBLE TREATMENT OF PCA AND OTHER KINDS OF CANCERS COULD REPRESENT A PROMISING AND VALID STRATEGY TO INHIBIT CARCINOGENESIS AND FIGHT CANCER. 2020 12 4523 39 MULTIDISCIPLINARY APPROACH TO PROSTATITIS. THE MODERN CLINICAL RESEARCH ON PROSTATITIS STARTED WITH THE WORK OF STAMEY AND COWORKERS WHO DEVELOPED THE BASIC PRINCIPLES WE ARE STILL USING. THEY ESTABLISHED THE SEGMENTED CULTURE TECHNIQUE FOR LOCALIZING THE INFECTIONS IN THE MALES TO THE URETHRA, THE BLADDER, OR THE PROSTATE AND TO DIFFERENTIATE THE MAIN CATEGORIES OF PROSTATITIS. SUCH CATEGORIES WITH SLIGHT MODIFICATIONS ARE STILL USED ACCORDING TO THE NIH CLASSIFICATION: ACUTE BACTERIAL PROSTATITIS, CHRONIC BACTERIAL PROSTATITIS, CHRONIC PELVIC PAIN SYNDROME (CPPS) AND ASYMPTOMATIC PROSTATITIS. PROSTATIC INFLAMMATION IS CONSIDERED AN IMPORTANT FACTOR IN INFLUENCING BOTH PROSTATIC GROWTH AND PROGRESSION OF SYMPTOMS OF BENIGN PROSTATIC HYPERPLASIA AND PROSTATITIS. CHRONIC INFLAMMATION/NEUROINFLAMMATION IS A RESULT OF A DEREGULATED ACUTE PHASE RESPONSE OF THE INNATE IMMUNE SYSTEM AFFECTING SURROUNDING NEURAL TISSUE AT MOLECULAR, STRUCTURAL AND FUNCTIONAL LEVELS. CLINICAL OBSERVATIONS SUGGEST THAT CHRONIC INFLAMMATION CORRELATES WITH CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME (CP/CPPS) AND BENIGN PROSTATIC HYPERPLASIA (BPH) AND AN HISTORY OF CLINICAL CHRONIC PROSTATITIS SIGNIFICANTLY INCREASES THE ODDS FOR PROSTATE CANCER. THE NIHNIDDK CLASSIFICATION BASED ON THE USE OF THE MICROBIOLOGICAL 4- GLASSES LOCALIZATION TEST OR SIMPLIFIED 2-GLASSES TEST, IS CURRENTLY ACCEPTED WORLDWIDE. THE UPOINT SYSTEM IDENTIFIES GROUPS OF CLINICIANS WITH HOMOGENEOUS CLINICAL PRESENTATION AND IS USED TO RECOGNIZE PHENOTYPES TO BE SUBMITTED TO SPECIFIC TREATMENTS. THE UPOINTS ALGORITHM IMPLEMENTED THE ORIGINAL UPOINT ADDING TO THE URINARY DOMAINS (U), PSYCHO-SOCIAL (P), ORGANSPECIFIC (O), INFECTION (I), NEUROLOGICAL (N), MUSCLE TENSION AND TENDERNESS (T) A FURTHER DOMAIN RELATED TO SEXUALITY (S). IN FACT SEXUAL DYSFUNCTION (ERECTILE, EJACULATORY, LIBIDO LOSS) HAS BEEN DESCRIBED IN 46-92% OF CASES WITH A HIGH IMPACT ON THE QUALITY OF LIFE OF PATIENTS WITH CP/CPPS. PROSTATIC ULTRASOUND REPRESENTS THE MOST POPULAR IMAGING TEST IN THE WORK-UP OF EITHER ACUTE AND CHRONIC PROSTATITIS ALTHOUGH NO SPECIFIC HYPO-HYPERECHOIC PATTERN HAS BEEN CLEARLY ASSOCIATED WITH CHRONIC BACTERIAL PROSTATITIS AND CPPS. USE OF A DIGITAL-PROCESSING SOFTWARE TO CALCULATE THE EXTENSION OF PROSTATIC CALCIFICATION AREA AT ULTRASOUND DEMONSTRATED A HIGHER PERCENTAGE OF PROSTATIC CALCIFICATION IN PATIENTS WITH CHRONIC BACTERIAL PROSTATITIS. MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING (MPMRI) IS THE CURRENT STATE-OF-THE ART IMAGING MODALITY IN THE ASSESSMENT OF PATIENTS WITH PROSTATE CANCER ALTHOUGH A VARIETY OF BENIGN CONDITIONS, INCLUDING INFLAMMATION, MAY MIMIC PROSTATE CANCER AND ACT AS CONFOUNDING FACTORS IN THE DISCRIMINATION BETWEEN NEOPLASTIC AND NON-NEOPLASTIC LESIONS. BACTERIA CAN INFECT PROSTATE GLAND BY: ASCENDING THE URETHRA, REFLUX OF URINE INTO THE PROSTATIC DUCTS, DIRECT INOCULATION OF BACTERIA THROUGH INSERTED BIOPSY NEEDLES OR HEMATOGENOUS SEEDING. ENTEROBACTERIACEAE ARE THE PREDOMINANT PATHOGENS IN ACUTE AND CHRONIC BACTERIAL PROSTATITIS, BUT AN INCREASING ROLE OF ENTEROCOCCI HAS BEEN REPORTED. MANY STRAINS OF THESE UROPATHOGENS EXHIBIT THE ABILITY TO FORM BIOFILM AND MULTIDRUG- RESISTANCE. SEXUALLY TRANSMITTED INFECTIONS (STI) AGENTS, IN PARTICULAR CHLAMYDIA TRACHOMATIS AND MYCOPLASMA GENITALIUM, HAVE BEEN ALSO CONSIDERED AS CAUSATIVE PATHOGENS OF CHRONIC BACTERIAL PROSTATITIS. ON THE CONTRARY THE EFFECTIVE ROLE IN GENITAL DISEASES OF OTHER "GENITAL MYCOPLASMAS" IS STILL A MUCH DEBATED ISSUE. SEXUALLY TRANSMITTED INFECTIONS AGENTS SHOULD BE INVESTIGATED BY MOLECULAR METHODS IN BOTH PATIENT AND SEXUAL PARTNER. "NEXT GENERATION" INVESTIGATIONS, SUCH AS CYTOKINE ANALYSIS, CYTOLOGICAL TYPING OF IMMUNE CELLS COULD HELP STRATIFYING THE IMMUNE RESPONSE. EPIGENETIC DYSREGULATION OF INFLAMMATORY FACTORS SHOULD BE INVESTIGATED ACCORDING TO SYSTEMIC AND COMPARTMENT-SPECIFIC SIGNALS. THE SEARCH FOR BIOMARKERS SHOULD ALSO INCLUDE EVALUATION OF HORMONAL PATHWAYS, AS MEASUREMENT OF ESTROGEN LEVELS IN SEMEN. ANTIMICROBIALS ARE THE FIRST LINE AGENTS FOR THE TREATMENT OF BACTERIAL PROSTATITIS. THE SUCCESS OF ANTIMICROBIAL TREATMENT DEPENDS ON THE ANTIBACTERIAL ACTIVITY AND THE PHARMACOKINETIC CHARACTERISTICS OF THE DRUG WHICH MUST REACH HIGH CONCENTRATIONS IN PROSTATE SECRETION AND PROSTATE TISSUE. ACUTE BACTERIAL PROSTATITIS CAN BE A SERIOUS INFECTION WITH A POTENTIAL RISK FOR UROSEPSIS FOR IINITIAL TREATMENT OF SEVERELY ILL PATIENTS, INTRAVENOUS ADMINISTRATION OF HIGH DOSES OF BACTERICIDAL ANTIMICROBIALS, SUCH AS BROAD-SPECTRUM PENICILLINS, THIRD-GENERATION CEPHALOSPORINS OR FLUOROQUINOLONES, IS RECOMMENDED IN COMBINATION WITH AN AMINOGLYCOSIDE. USE OF PIPERACILLIN-TAZOBACTAM AND MEROPENEM IS JUSTIFIED IN PRESENCE OF MULTIRESISTANT GRAMNEGATIVE PATHOGENS. THE ANTIBIOTIC TREATMENT OF CHRONIC PROSTATITIS IS CURRENTLY BASED ON THE USE OF FLUOROQUINOLONES THAT, GIVEN FOR 2 TO 4 WEEKS, CURED ABOUT 70% OF MEN WITH CHRONIC BACTERIAL PROSTATITIS. FOR THE TREATMENT OF CHLAMYDIAL PROSTATITIS MACROLIDES WERE SHOWN TO BE MORE EFFECTIVE THAN FLUOROQUINOLONES, WHEREAS NO DIFFERENCES WERE OBSERVED IN MICROBIOLOGICAL AND CLINICAL EFFICACY BETWEEN MACROLIDES AND TETRACYCLINES FOR THE TREATMENT OF INFECTIONS CAUSED BY INTRACELLULAR PATHOGENS. AMINOGLYCOSIDES AND FOSFOMYCIN COULD BE CONSIDERED AS A THERAPEUTIC ALTERNATIVE FOR THE TREATMENT OF QUINOLONE RESISTANT PROSTATITIS. USE OF ALPHA-BLOCKERS IN CP/CPPS PATIENTS WITH URINARY SYMPTOMS AND ANALGESICS +/- NON STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAID), IN PRESENCE OF PAIN DEMONSTRATED A REDUCTION OF SYMPTOMS REDUCTION AND AN IMPROVEMENT OF QUALITY OF LIFE, ALTHOUGH LONG TERM USE OF NSAID IS LIMITED BY SIDE EFFECT PROFILE. HOWEVER, THE MULTIMODAL THERAPEUTIC REGIMEN BY CONTEMPORARY USE OF ALPHABLOCKERS, ANTIBIOTICS AND ANTI-INFLAMMATORY SHOWED A BETTER CONTROL OF PROSTATITIS SYMPTOMS THAN SINGLE DRUG TREATMENT. NOVEL THERAPEUTIC SUBSTANCES FOR THE TREATMENT OF PAIN, SUCH AS THE CANNABINOID ANANDAMIDE WOULD BE HIGHLY INTERESTING TO TEST. AN ALTERNATIVE FOR THE TREATMENT OF CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME IS PHYTOTHERAPY, AS PRIMARY THERAPY OR IN ASSOCIATION WITH OTHER DRUGS. QUERCETIN, POLLEN EXTRACT, EXTRACT OF SERENOA REPENS AND OTHER MIXTURES OF HERBAL EXTRACTS SHOWED A POSITIVE EFFECT ON SYMPTOMS AND QUALITY OF LIFE WITHOUT SIDE EFFECTS. THE ASSOCIATION OF CP/CPPS WITH ALTERATIONS OF INTESTINAL FUNCTION HAS BEEN DESCRIBED. DIET HAS ITS EFFECTS ON INFLAMMATION BY REGULATION OF THE COMPOSITION OF INTESTINAL FLORA AND DIRECT ACTION ON THE INTESTINAL CELLS (STERILE INFLAMMATION). INTESTINAL BACTERIA (MICROBIOTA) INTERACTS WITH FOOD INFLUENCING THE METABOLIC, IMMUNE AND INFLAMMATORY RESPONSE OF THE ORGANISM. THE INTESTINAL MICROBIOTA HAS PROTECTIVE FUNCTION AGAINST PATHOGENIC BACTERIA, METABOLIC FUNCTION BY SYNTHESIS OF VITAMINS, DECOMPOSITION OF BILE ACIDS AND PRODUCTION OF TROPHIC FACTORS (BUTYRATE), AND MODULATION OF THE INTESTINAL IMMUNE SYSTEM. THE ALTERATION OF THE MICROBIOTA IS CALLED "DYSBIOSIS" CAUSING INVASIVE INTESTINAL DISEASES PATHOLOGIES (LEAKY GUT SYNDROME AND FOOD INTOLERANCES, IRRITABLE BOWEL SYNDROME OR CHRONIC INFLAMMATORY BOWEL DISEASES) AND CORRELATING WITH NUMEROUS SYSTEMIC DISEASES INCLUDING ACUTE AND CHRONIC PROSTATITIS. ADMINISTRATION OF LIVE PROBIOTICS BACTERIA CAN BE USED TO REGULATE THE BALANCE IF INTESTINAL FLORA. SESSIONS OF HYDROCOLONTHERAPY CAN REPRESENT AN INTEGRATION TO THIS THERAPEUTIC APPROACH. FINALLY, MICROBIOLOGICAL EXAMINATION OF SEXUAL PARTNERS CAN OFFER SUPPLEMENTARY INFORMATION FOR TREATMENT. 2019 13 6105 29 THE EMERGING ROLE OF LNCRNA FENDRR IN MULTIPLE CANCERS: A REVIEW. LONG NONCODING RNAS (LNCRNAS) ARE PROMINENT AS CRUCIAL REGULATORS OF TUMOR ESTABLISHMENT AND ARE REPEATEDLY DYSREGULATED IN MULTIPLE CANCERS. THEREFORE, LNCRNAS HAVE BEEN IDENTIFIED TO PLAY AN ESSENTIAL FUNCTION IN CARCINOGENESIS AND PROGRESSION OF CANCER AT GENETIC AND EPIGENETIC LEVELS. FENDRR (FETAL-LETHAL NONCODING DEVELOPMENTAL REGULATORY RNA) AS A LNCRNA IS A HALLMARK OF VARIOUS MALIGNANCIES. FENDRR IS CRUCIAL FOR MULTIPLE ORGANS' DEVELOPMENT, SUCH AS THE LUNG AND HEART. THE EFFECTS OF FENDRR UNDER SIGNALING PATHWAYS IN DIFFERENT CANCERS HAVE BEEN IDENTIFIED. IN ADDITION, IT HAS BEEN VERIFIED THAT FENDRR CAN AFFECT THE DEVELOPMENT AND PROGRESSION OF VARIOUS CANCERS. IN ADDITION, FENDRR EXPRESSION HAS BEEN ASSOCIATED WITH EPIGENETIC REGULATION OF TARGET GENES PARTICIPATING IN TUMOR IMMUNITY. FURTHERMORE, FENDRR DOWNREGULATION WAS OBSERVED IN VARIOUS TYPES OF CANCERS, INCLUDING COLORECTAL CANCER, GASTRIC CANCER, PANCREATIC CANCER, CHOLANGIOCARCINOMA, LIVER CANCER, GALLBLADDER CANCER, LUNG CANCER, BREAST CANCER, ENDOMETRIAL CANCER, PROSTATE CANCER, CHRONIC MYELOID LEUKEMIA, OSTEOSARCOMA, AND CUTANEOUS MALIGNANT MELANOMA CELLS. HERE, WE REVIEW THE BIOLOGICAL FUNCTIONS AND MOLECULAR MECHANISMS OF FENDRR IN SEVERAL CANCERS, AND WE WILL DISCUSS ITS POTENTIAL AS A CANCER BIOMARKER AND AS A PROBABLE OPTION FOR CANCER TREATMENT. 2023 14 419 27 ANDROGEN AXIS IN PROSTATE CANCER. ENDOCRINE THERAPY FOR ADVANCED PROSTATE CANCER IS BASED ON ANDROGEN ABLATION OR BLOCKADE OF THE ANDROGEN RECEPTOR (AR). AR ACTION IN PROSTATE CANCER HAS BEEN INVESTIGATED IN A NUMBER OF CELL LINES, THEIR DERIVATIVES, AND TRANSGENIC ANIMALS. AR EXPRESSION IS HETEROGENOUS IN PROSTATE CANCER IN VIVO; IT COULD BE DETECTED IN MOST PRIMARY TUMORS AND THEIR METASTASES. HOWEVER, SOME CELLS LACK THE AR BECAUSE OF EPIGENETIC CHANGES IN THE GENE PROMOTER. AR EXPRESSION INCREASES AFTER CHRONIC ANDROGEN ABLATION IN VITRO. IN SEVERAL XENOGRAFTS, AR UPREGULATION IS THE MOST CONSISTENT CHANGE IDENTIFIED DURING PROGRESSION TOWARDS THERAPY RESISTANCE. IN CONTRAST, THE AR PATHWAY MAY BE BY-PASSED DURING CHRONIC TREATMENT WITH A NONSTEROIDAL ANTI-ANDROGEN. AR SENSITIVITY IN PROSTATE CANCER INCREASES AS A RESULT OF ACTIVATION OF THE RAS/MITOGEN-ACTIVATED PROTEIN KINASE PATHWAY. ONE OF THE MAJOR DIFFICULTIES IN ENDOCRINE THERAPY FOR PROSTATE CANCER IS ACQUISITION OF AGONISTIC PROPERTIES OF AR ANTAGONISTS OBSERVED IN THE PRESENCE OF MUTATED AR. ENHANCEMENT OF AR FUNCTION BY ASSOCIATED COACTIVATOR PROTEINS HAS BEEN EXTENSIVELY INVESTIGATED. COFACTORS SRC-1, RAC3, P300/CBP, TIF-2, AND TIP60 ARE UPREGULATED IN ADVANCED PROSTATE CANCER. MOST STUDIES ON LIGAND-INDEPENDENT ACTIVATION OF THE AR ARE FOCUSED ON HER-2/NEU AND INTERLEUKIN-6 (IL-6). ON THE BASIS OF STUDIES THAT SHOWED OVEREXPRESSION AND ACTIVATION OF THE AR IN ADVANCED PROSTATE CANCER, IT WAS SUGGESTED THAT NOVEL THERAPIES THAT REDUCE AR EXPRESSION WILL PROVIDE A BENEFIT TO PATIENTS. THERE IS EXPERIMENTAL EVIDENCE SHOWING THAT PROSTATE TUMOR GROWTH IN VITRO AND IN VIVO IS INHIBITED FOLLOWING ADMINISTRATION OF CHEMOPREVENTIVE DRUGS OR ANTISENSE OLIGONUCLEOTIDES THAT DOWNREGULATE AR MRNA AND PROTEIN EXPRESSION. 2006 15 2656 22 EPIMUTATION AND CANCER: A NEW CARCINOGENIC MECHANISM OF LYNCH SYNDROME (REVIEW). EPIMUTATION IS DEFINED AS ABNORMAL TRANSCRIPTIONAL REPRESSION OF ACTIVE GENES AND/OR ABNORMAL ACTIVATION OF USUALLY REPRESSED GENES CAUSED BY ERRORS IN EPIGENETIC GENE REPRESSION. EPIMUTATION ARISES IN SOMATIC CELLS AND THE GERMLINE, AND CONSTITUTIONAL EPIMUTATION MAY ALSO OCCUR. EPIMUTATION IS THE FIRST STEP OF TUMORIGENESIS AND CAN BE A DIRECT CAUSE OF CARCINOGENESIS. CANCERS ASSOCIATED WITH EPIMUTATION INCLUDE LYNCH SYNDROME (HEREDITARY NON-POLYPOSIS COLORECTAL CANCER, HNPCC), CHRONIC LYMPHOCYTIC LEUKEMIA, BREAST CANCER AND OVARIAN CANCER. EPIMUTATION HAS BEEN SHOWN FOR MANY TUMOR SUPPRESSOR GENES, INCLUDING RB, VHL, HMLH1, APC AND BRCA1, IN SPORADIC CANCERS. METHYLATION HAS RECENTLY BEEN SHOWN IN DNA FROM NORMAL TISSUES AND PERIPHERAL BLOOD IN CASES OF SPORADIC COLORECTAL CANCER AND MANY STUDIES SHOW CONSTITUTIVE EPIMUTATION IN CANCERS. EPIMUTATION OF DNA MISMATCH REPAIR (MMR) GENES (BRCA1, HMLH1 AND HMSH2) INVOLVED IN DEVELOPMENT FAMILIAL CANCERS HAS ALSO BEEN FOUND. THESE RESULTS HAVE LED TO A FOCUS ON EPIMUTATION AS A NOVEL ONCOGENIC MECHANISM. 2012 16 5181 22 PREMALIGNANT LESIONS IN GASTRIC CANCER. DESPITE A PLATEAU IN INCIDENCE, GASTRIC CANCER IS ONE OF THE MOST COMMON CANCERS WORLDWIDE AND CAUSES CONSIDERABLE MORBIDITY AND MORTALITY. PREMALIGNANT GASTRIC LESIONS ARE WELL KNOWN RISK FACTORS FOR THE DEVELOPMENT OF INTESTINAL-TYPE GASTRIC ADENOCARCINOMAS. IN THIS MULTISTEP MODEL OF GASTRIC CARCINOGENESIS, HELICOBACTER PYLORI CAUSES CHRONIC ACTIVE INFLAMMATION OF THE GASTRIC MUCOSA, WHICH SLOWLY PROGRESSES THROUGH THE PREMALIGNANT STAGES OF ATROPHIC GASTRITIS, INTESTINAL METAPLASIA, AND ADENOMA/DYSPLASIA TO GASTRIC CARCINOMA. THIS PROGRESSION IS PARALLELED BY A STEPWISE ACCUMULATION OF MULTIPLE GENETIC AND EPIGENETIC ABNORMALITIES. DETECTION, TREATMENT, AND MOLECULAR ANALYSES OF PREMALIGNANT LESIONS MAY THUS PROVIDE A BASIS FOR GASTRIC CANCER PREVENTION. THIS REVIEW DESCRIBES AN OVERVIEW OF CURRENT KNOWLEDGE ON PREMALIGNANT GASTRIC LESIONS. IT ALSO REVIEWS THE ISSUE OF SURVEILLANCE OF PATIENTS WITH PREMALIGNANT LESIONS IN ORDER TO IMPROVE THE SURVIVAL OF PATIENTS WITH GASTRIC CANCER. 2010 17 1101 20 COMBINATION THERAPY USING LHRH AND SOMATOSTATIN ANALOGUES PLUS DEXAMETHASONE IN ANDROGEN ABLATION REFRACTORY PROSTATE CANCER PATIENTS WITH BONE INVOLVEMENT: A BENCH TO BEDSIDE APPROACH. THE DEVELOPMENT OF RESISTANCE TO ANTICANCER THERAPIES IS A MAJOR HURDLE IN PREVENTING LONG-LASTING CLINICAL RESPONSES TO CONVENTIONAL THERAPIES IN HORMONE-REFRACTORY PROSTATE CANCER. HEREIN, THE MOLECULAR EVIDENCE DOCUMENTING THAT BONE METASTASIS MICROENVIRONMENT SURVIVAL FACTORS (MAINLY THE PARACRINE GROWTH HORMONE-INDEPENDENT, UROKINASE-TYPE PLASMINOGEN ACTIVATOR-MEDIATED INCREASE OF IGF-1 AND THE ENDOCRINE PRODUCTION OF GROWTH HORMONE-DEPENDENT IGF-1, MAINLY LIVER-DERIVED IGF-1 PRODUCTION) PRODUCE AN EPIGENETIC FORM OF PROSTATE CANCER CELLS THAT ARE RESISTANT TO PROAPOPTOTIC THERAPIES IS REVIEWED. CONSEQUENTLY, THE AUTHORS PRESENT THE CONCEPTUAL FRAMEWORK OF A NOVEL ANTIBONE MICROENVIRONMENT SURVIVAL FACTOR, MAINLY AN ANTI-IGF-1 HORMONAL MANIPULATION FOR ANDROGEN ABLATION REFRACTORY PROSTATE CANCER (A COMBINATION OF CONVENTIONAL ANDROGEN ABLATION THERAPY [LUTEINISING HORMONE-RELEASING HORMONE AGONIST-A OR ORCHIECTOMY]) WITH DEXAMETHASONE PLUS SOMATOSTATIN ANALOGUE, WHICH YIELDED DURABLE OBJECTIVE RESPONSES AND MAJOR IMPROVEMENT OF BONE PAIN AND PERFORMANCE STATUS IN STAGE D3 PROSTATE CANCER PATIENTS. 2006 18 3688 38 INFLAMMATION: GEARING THE JOURNEY TO CANCER. CHRONIC INFLAMMATION PLAYS A MULTIFACETED ROLE IN CARCINOGENESIS. MOUNTING EVIDENCE FROM PRECLINICAL AND CLINICAL STUDIES SUGGESTS THAT PERSISTENT INFLAMMATION FUNCTIONS AS A DRIVING FORCE IN THE JOURNEY TO CANCER. THE POSSIBLE MECHANISMS BY WHICH INFLAMMATION CAN CONTRIBUTE TO CARCINOGENESIS INCLUDE INDUCTION OF GENOMIC INSTABILITY, ALTERATIONS IN EPIGENETIC EVENTS AND SUBSEQUENT INAPPROPRIATE GENE EXPRESSION, ENHANCED PROLIFERATION OF INITIATED CELLS, RESISTANCE TO APOPTOSIS, AGGRESSIVE TUMOR NEOVASCULARIZATION, INVASION THROUGH TUMOR-ASSOCIATED BASEMENT MEMBRANE AND METASTASIS, ETC. INFLAMMATION-INDUCED REACTIVE OXYGEN AND NITROGEN SPECIES CAUSE DAMAGE TO IMPORTANT CELLULAR COMPONENTS (E.G., DNA, PROTEINS AND LIPIDS), WHICH CAN DIRECTLY OR INDIRECTLY CONTRIBUTE TO MALIGNANT CELL TRANSFORMATION. OVEREXPRESSION, ELEVATED SECRETION, OR ABNORMAL ACTIVATION OF PROINFLAMMATORY MEDIATORS, SUCH AS CYTOKINES, CHEMOKINES, CYCLOOXYGENASE-2, PROSTAGLANDINS, INDUCIBLE NITRIC OXIDE SYNTHASE, AND NITRIC OXIDE, AND A DISTINCT NETWORK OF INTRACELLULAR SIGNALING MOLECULES INCLUDING UPSTREAM KINASES AND TRANSCRIPTION FACTORS FACILITATE TUMOR PROMOTION AND PROGRESSION. WHILE INFLAMMATION PROMOTES DEVELOPMENT OF CANCER, COMPONENTS OF THE TUMOR MICROENVIRONMENT, SUCH AS TUMOR CELLS, STROMAL CELLS IN SURROUNDING TISSUE AND INFILTRATED INFLAMMATORY/IMMUNE CELLS GENERATE AN INTRATUMORAL INFLAMMATORY STATE BY ABERRANT EXPRESSION OR ACTIVATION OF SOME PROINFLAMMATORY MOLECULES. MANY OF PROINFLAMMATORY MEDIATORS, ESPECIALLY CYTOKINES, CHEMOKINES AND PROSTAGLANDINS, TURN ON THE ANGIOGENIC SWITCHES MAINLY CONTROLLED BY VASCULAR ENDOTHELIAL GROWTH FACTOR, THEREBY INDUCING INFLAMMATORY ANGIOGENESIS AND TUMOR CELL-STROMA COMMUNICATION. THIS WILL END UP WITH TUMOR ANGIOGENESIS, METASTASIS AND INVASION. MOREOVER, CELLULAR MICRORNAS ARE EMERGING AS A POTENTIAL LINK BETWEEN INFLAMMATION AND CANCER. THE PRESENT ARTICLE HIGHLIGHTS THE ROLE OF VARIOUS PROINFLAMMATORY MEDIATORS IN CARCINOGENESIS AND THEIR PROMISE AS POTENTIAL TARGETS FOR CHEMOPREVENTION OF INFLAMMATION-ASSOCIATED CARCINOGENESIS. 2008 19 1815 21 EFFECTS OF CHRONIC EXPOSURE TO ARSENIC AND ESTROGEN ON EPIGENETIC REGULATORY GENES EXPRESSION AND EPIGENETIC CODE IN HUMAN PROSTATE EPITHELIAL CELLS. CHRONIC EXPOSURES TO ARSENIC AND ESTROGEN ARE KNOWN RISK FACTORS FOR PROSTATE CANCER. THOUGH THE EVIDENCE SUGGESTS THAT EXPOSURE TO ARSENIC OR ESTROGENS CAN DISRUPT NORMAL DNA METHYLATION PATTERNS AND HISTONE MODIFICATIONS, THE MECHANISMS BY WHICH THESE CHEMICALS INDUCE EPIGENETIC CHANGES ARE NOT FULLY UNDERSTOOD. MOREOVER, THE EPIGENETIC EFFECTS OF CO-EXPOSURE TO THESE TWO CHEMICALS ARE NOT KNOWN. THEREFORE, THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THE EFFECTS OF CHRONIC EXPOSURE TO ARSENIC AND ESTROGEN, BOTH ALONE AND IN COMBINATION, ON THE EXPRESSION OF EPIGENETIC REGULATORY GENES, THEIR CONSEQUENCES ON DNA METHYLATION, AND HISTONE MODIFICATIONS. HUMAN PROSTATE EPITHELIAL CELLS, RWPE-1, CHRONICALLY EXPOSED TO ARSENIC AND ESTROGEN ALONE AND IN COMBINATION WERE USED FOR ANALYSIS OF EPIGENETIC REGULATORY GENES EXPRESSION, GLOBAL DNA METHYLATION CHANGES, AND HISTONE MODIFICATIONS AT PROTEIN LEVEL. THE RESULT OF THIS STUDY REVEALED THAT EXPOSURE TO ARSENIC, ESTROGEN, AND THEIR COMBINATION ALTERS THE EXPRESSION OF EPIGENETIC REGULATORY GENES AND CHANGES GLOBAL DNA METHYLATION AND HISTONE MODIFICATION PATTERNS IN RWPE-1 CELLS. THESE CHANGES WERE SIGNIFICANTLY GREATER IN ARSENIC AND ESTROGEN COMBINATION TREATED GROUP THAN INDIVIDUALLY TREATED GROUP. THE FINDINGS OF THIS STUDY WILL HELP EXPLAIN THE EPIGENETIC MECHANISM OF ARSENIC- AND/OR ESTROGEN-INDUCED PROSTATE CARCINOGENESIS. 2012 20 6369 28 THE ROLE OF MICRORNAS IN HELICOBACTER PYLORI PATHOGENESIS AND GASTRIC CARCINOGENESIS. GASTRIC CARCINOGENESIS IS A MULTISTEP PROCESS ORCHESTRATED BY ABERRANCIES IN THE GENETIC AND EPIGENETIC REGULATION OF ONCOGENES AND TUMOR SUPPRESSOR GENES. CHRONIC INFECTION WITH HELICOBACTER PYLORI IS THE STRONGEST KNOWN RISK FACTOR FOR THE DEVELOPMENT OF GASTRIC CANCER. H. PYLORI EXPRESSES A SPECTRUM OF VIRULENCE FACTORS THAT DYSREGULATE HOST INTRACELLULAR SIGNALING PATHWAYS THAT LOWER THE THRESHOLD FOR NEOPLASTIC TRANSFORMATION. IN ADDITION TO BACTERIAL DETERMINANTS, NUMEROUS HOST AND ENVIRONMENTAL FACTORS INCREASE THE RISK OF GASTRIC CARCINOGENESIS. RECENT DISCOVERIES HAVE SHED NEW LIGHT ON THE INVOLVEMENT OF MICRORNAS (MIRNAS) IN GASTRIC CARCINOGENESIS. MIRNAS REPRESENT AN ABUNDANT CLASS OF SMALL, NON-CODING RNAS INVOLVED IN GLOBAL POST-TRANSCRIPTIONAL REGULATION AND, CONSEQUENTLY, PLAY AN INTEGRAL ROLE AT MULTIPLE STEPS IN CARCINOGENESIS, INCLUDING CELL CYCLE PROGRESSION, PROLIFERATION, APOPTOSIS, INVASION, AND METASTASIS. EXPRESSION LEVELS OF MIRNAS ARE FREQUENTLY ALTERED IN MALIGNANCIES, WHERE THEY FUNCTION AS EITHER ONCOGENIC MIRNAS OR TUMOR SUPPRESSOR MIRNAS. THIS REVIEW FOCUSES ON MIRNAS DYSREGULATED BY H. PYLORI AND POTENTIAL ETIOLOGIC ROLES THEY PLAY IN H. PYLORI-MEDIATED GASTRIC CARCINOGENESIS. 2011