1 471 147 ARISTOLOCHIC ACID CONTAINING HERBS INDUCE GENDER-RELATED ONCOLOGICAL DIFFERENCES IN UPPER TRACT UROTHELIAL CARCINOMA PATIENTS. BACKGROUND: IN CHINA, UPPER TRACT UROTHELIAL CARCINOMA (UTUC) IS LESS PREVALENT BUT MORE MALIGNANT IN MALES. THIS STUDY INVESTIGATES THE PROGNOSTIC FACTORS AND CAUSES OF GENDER-BASED DIFFERENCES IN CHINESE POPULATIONS. METHODS: BETWEEN 1999 AND 2011, 687 UTUC PATIENTS WHO UNDERWENT SURGERY WERE UTILIZED FOR THIS STUDY. WE EVALUATED THE DIFFERENCES IN ONCOLOGICAL CHARACTERISTICS, EPIGENETIC BIOMARKERS, CANCER-SPECIFIC SURVIVAL (CSS), BLADDER RECURRENCE (BR) RATE, AND CONTRALATERAL UPPER TRACT RECURRENCE (CUTR) RATE. SMOKING HISTORY, BENZENE EXPOSURE HISTORY, AND THE HISTORY OF USING ARISTOLOCHIC ACID (AA) CONTAINING HERBS WERE ANALYZED IN DETAIL. RESULTS: COMPARED WITH MALE PATIENTS, FEMALE PATIENTS SHOWED POORER RENAL FUNCTION, LOWER PROPORTIONS OF TUMOR STAGE III/IV, AND SMALLER TUMOR DIAMETERS. THE CSS IN MALE PATIENTS WAS LOWER THAN THAT IN FEMALE PATIENTS. SIGNIFICANT GENDER-RELATED DIFFERENCES WERE OBSERVED CONCERNING VARIOUS PROGNOSTIC FACTORS. IN FEMALE PATIENTS, POORER SURVIVAL RATES WERE ATTRIBUTED TO THE PRIMARY TUMOR LOCATION IN THE URETER, LARGE DIAMETER PRIMARY TUMORS, SEVERE CHRONIC KIDNEY DISEASE, PAPILLARY TUMOR ARCHITECTURE, HIGH TUMOR STAGES, POSITIVE N STATUS, AND METHYLATED ABCC6 PROMOTERS. IN MALE PATIENTS, OLDER AGE, IPSILATERAL HYDRONEPHROSIS, LARGE TUMOR DIAMETERS, SESSILE TUMOR ARCHITECTURE, HIGH TUMOR STAGES, AND METHYLATED TMEFF2 PROMOTERS WERE ASSOCIATED WITH HIGHER CANCER-SPECIFIC MORTALITY. AA MIGHT BE THE MAIN CAUSE OF THESE GENDER-BASED DIFFERENCES. THE AA-INDUCED UTUC PATIENTS PRESENTED SMALLER TUMOR DIAMETERS, LOWER TUMOR STAGES, FEWER POSITIVE N STATUSES, MORE MULTIFOCAL TUMORS, LOWER METHYLATION INDICES, AND POORER RENAL FUNCTION. ALTHOUGH AA-INDUCED UTUC PATIENTS EXHIBITED BETTER SURVIVAL RATES, BR AND CUTR RATES WERE SIGNIFICANTLY WORSE. CONCLUSION: IN CHINA, THERE EXIST SIGNIFICANT AA-INDUCED DIFFERENCES BETWEEN MALE AND FEMALE UTUC PATIENTS. THE BLADDERS AND CONTRALATERAL UPPER URINARY TRACTS OF AA-INDUCED UTUC PATIENTS SHOULD BE CAREFULLY MONITORED AFTER SURGERY. 2018 2 2296 16 EPIGENETIC REGULATION OF ABIOTIC STRESS MEMORY: MAINTAINING THE GOOD THINGS WHILE THEY LAST. AS SESSILE ORGANISMS, PLANTS HAVE EVOLVED SOPHISTICATED WAYS TO CONSTANTLY GAUGE AND ADAPT TO CHANGING ENVIRONMENTAL CONDITIONS INCLUDING EXTREMES THAT MAY BE HARMFUL TO THEIR GROWTH AND DEVELOPMENT AND ARE THUS PERCEIVED AS STRESS. IN NATURE, STRESSFUL EVENTS ARE OFTEN CHRONIC OR RECURRING AND THUS AN INITIAL STRESS MAY PRIME A PLANT TO RESPOND MORE EFFICIENTLY TO A SUBSEQUENT STRESS EVENT. AN EPIGENETIC BASIS OF SUCH STRESS MEMORY WAS LONG POSTULATED AND IN RECENT YEARS IT HAS BEEN SHOWN THAT THIS IS INDEED THE CASE. HIGH TEMPERATURE STRESS HAS PROVEN AN EXCELLENT SYSTEM TO UNPICK THE MOLECULAR BASIS OF SOMATIC STRESS MEMORY, WHICH INCLUDES HISTONE MODIFICATIONS AND NUCLEOSOME OCCUPANCY. THIS REVIEW DISCUSSES RECENT FINDINGS AND PINPOINTS OPEN QUESTIONS IN THE FIELD. 2021 3 6898 15 [THE ADVANCE OF MODEL OF ACTION IN LOW-DOSE CHRONIC BENZENE EXPOSURE INDUCED HEMATOTOXICITY]. BENZENE IS CLASSIFIED AS GROUP 1 CARCINOGEN BY IARC. IT HAS BEEN FOUND THAT BENZENE INDUCES HEMATOTOXICITY EVEN IN LOW DOSE EXPOSURE. THE IDENTIFICATION OF KEY EVENTS DURING BENZENE INDUCED HEMATOTOXICTY LEADS TO ADJUSTMENT OF OCCUPATIONAL EXPOSURE LIMITS OF BENZENE. IN THIS REVIEW, WE FOCUS ON THE EXPOSURE, METABOLISM, TARGET ORGANS, KEY EPIGENETIC CHANGES, TOXICTY EFFECTS AND END POINTS OF LOW-DOSE CHRONIC BENZENE EXPOSURE INDUCED HEMATOTOXICITY AND FINALLY DISCUSS THE PERSPECTIVES ON THE FUTURE STUDY OF THIS AREA. 2015 4 448 32 APABETALONE MEDIATED EPIGENETIC MODULATION IS ASSOCIATED WITH FAVORABLE KIDNEY FUNCTION AND ALKALINE PHOSPHATASE PROFILE IN PATIENTS WITH CHRONIC KIDNEY DISEASE. BACKGROUND/AIMS: THE ASSOCIATION BETWEEN SERUM ALKALINE PHOSPHATASE (ALP) WITH ADVERSE CARDIOVASCULAR OUTCOMES, IN CHRONIC KIDNEY DISEASE (CKD) PATIENTS HAS PREVIOUSLY BEEN REPORTED AND MAY BE A RESULT OF INCREASED VASCULAR CALCIFICATION AND INFLAMMATION. HERE WE REPORT, FOR THE FIRST TIME, THE EFFECTS OF PHARMACOLOGIC EPIGENETIC MODULATION ON LEVELS OF ALP AND KIDNEY FUNCTION VIA A NOVEL ORAL SMALL MOLECULE BET INHIBITOR, APABETALONE, IN CKD PATIENTS. METHODS: A POST-HOC ANALYSIS EVALUATED PATIENTS WITH ESTIMATED GLOMERULAR FILTRATION RATE (EGFR) <60 ML/MIN/1.73M2, WHO PARTICIPATED IN THE APABETALONE PHASE 2 RANDOMIZED CONTROLLED TRIALS (SUSTAIN AND ASSURE). 48 CKD SUBJECTS WITH A HISTORY OF CARDIOVASCULAR DISEASE (CVD) WERE TREATED WITH 100MG TWICE-DAILY OF 24 AND 26 WEEKS OF APABETALONE OR PLACEBO. ALP AND EGFR WERE MEASURED PRIOR TO RANDOMIZATION AND AT FINAL VISITS. RESULTS: PATIENTS WHO RECEIVED APABETALONE (N=35) VERSUS PLACEBO (N=13) OVER 6 MONTHS SHOWED SIGNIFICANTLY (P=0.02) LOWERED SERUM ALP -14.0% (P<0.0001 VERSUS BASELINE) VERSUS -6.3% (P=0.9 VERSUS BASELINE). THE EGFR IN THE APABETALONE GROUP INCREASED BY 3.4% (1.7 ML/MIN/1.73 M2) (P=0.04 VERSUS BASELINE) AND DECREASED BY 5.8% (2.9 ML/MIN/1.73 M2) (P=0.6 VERSUS BASELINE) IN THE PLACEBO GROUP. APABETALONE WAS WELL TOLERATED. CONCLUSION: A POST-HOC ANALYSIS OF CKD SUBJECTS FROM THE SUSTAIN AND ASSURE RANDOMIZED CONTROLLED TRIALS DEMONSTRATED FAVORABLE EFFECTS OF APABETALONE ON ALP AND EGFR, AND GENERATED THE HYPOTHESIS THAT EPIGENETIC MODULATION BY BET INHIBITION MAY POTENTIALLY OFFER A NOVEL THERAPEUTIC STRATEGY TO TREAT CVD AND PROGRESSIVE KIDNEY FUNCTION LOSS IN CKD PATIENTS. THIS IS BEING EXAMINED IN THE PHASE III TRIAL BETONMACE. 2018 5 1785 26 EFFECT OF APABETALONE ON CARDIOVASCULAR EVENTS IN DIABETES, CKD, AND RECENT ACUTE CORONARY SYNDROME: RESULTS FROM THE BETONMACE RANDOMIZED CONTROLLED TRIAL. BACKGROUND AND OBJECTIVES: CKD AND TYPE 2 DIABETES MELLITUS INTERACT TO INCREASE THE RISK OF MAJOR ADVERSE CARDIOVASCULAR EVENTS (I.E., CARDIOVASCULAR DEATH, NONFATAL MYOCARDIAL INFARCTION, OR STROKE) AND CONGESTIVE HEART FAILURE. A MALADAPTIVE EPIGENETIC RESPONSE MAY BE A CARDIOVASCULAR RISK DRIVER AND AMENABLE TO MODIFICATION WITH APABETALONE, A SELECTIVE MODULATOR OF THE BROMODOMAIN AND EXTRATERMINAL DOMAIN TRANSCRIPTION SYSTEM. WE EXAMINED THIS QUESTION IN A PRESPECIFIED ANALYSIS OF BETONMACE, A PHASE 3 TRIAL. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: BETONMACE WAS AN EVENT-DRIVEN, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL COMPARING EFFECTS OF APABETALONE VERSUS PLACEBO ON MAJOR ADVERSE CARDIOVASCULAR EVENTS AND HEART FAILURE HOSPITALIZATIONS IN 2425 PARTICIPANTS WITH TYPE 2 DIABETES AND A RECENT ACUTE CORONARY SYNDROME, INCLUDING 288 PARTICIPANTS WITH CKD WITH EGFR <60 ML/MIN PER 1.73 M(2) AT BASELINE. THE PRIMARY END POINT IN BETONMACE WAS THE TIME TO THE FIRST MAJOR ADVERSE CARDIOVASCULAR EVENT, WITH A SECONDARY END POINT OF TIME TO HOSPITALIZATION FOR HEART FAILURE. RESULTS: MEDIAN FOLLOW-UP WAS 27 MONTHS (INTERQUARTILE RANGE, 20-32 MONTHS). IN PARTICIPANTS WITH CKD, APABETALONE COMPARED WITH PLACEBO WAS ASSOCIATED WITH FEWER MAJOR ADVERSE CARDIOVASCULAR EVENTS (13 EVENTS IN 124 PATIENTS [11%] VERSUS 35 EVENTS IN 164 PATIENTS [21%]; HAZARD RATIO, 0.50; 95% CONFIDENCE INTERVAL, 0.26 TO 0.96) AND FEWER HEART FAILURE-RELATED HOSPITALIZATIONS (THREE HOSPITALIZATIONS IN 124 PATIENTS [3%] VERSUS 14 HOSPITALIZATIONS IN 164 PATIENTS [9%]; HAZARD RATIO, 0.48; 95% CONFIDENCE INTERVAL, 0.26 TO 0.86). IN THE NON-CKD GROUP, THE CORRESPONDING HAZARD RATIO VALUES WERE 0.96 (95% CONFIDENCE INTERVAL, 0.74 TO 1.24) FOR MAJOR ADVERSE CARDIOVASCULAR EVENTS, AND 0.76 (95% CONFIDENCE INTERVAL, 0.46 TO 1.27) FOR HEART FAILURE-RELATED HOSPITALIZATION. INTERACTION OF CKD ON TREATMENT EFFECT WAS P=0.03 FOR MAJOR ADVERSE CARDIOVASCULAR EVENTS, AND P=0.12 FOR HEART FAILURE-RELATED HOSPITALIZATION. PARTICIPANTS WITH CKD SHOWED SIMILAR NUMBERS OF ADVERSE EVENTS, REGARDLESS OF RANDOMIZATION TO APABETALONE OR PLACEBO (119 [73%] VERSUS 88 [71%] PATIENTS), AND THERE WERE FEWER SERIOUS ADVERSE EVENTS (29% VERSUS 43%; P=0.02) IN THE APABETALONE GROUP. CONCLUSIONS: APABETALONE MAY REDUCE THE INCIDENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WITH CKD AND TYPE 2 DIABETES WHO HAVE A HIGH BURDEN OF CARDIOVASCULAR DISEASE. 2021 6 447 28 APABETALONE LOWERS SERUM ALKALINE PHOSPHATASE AND IMPROVES CARDIOVASCULAR RISK IN PATIENTS WITH CARDIOVASCULAR DISEASE. BACKGROUND AND AIMS: IN PATIENTS WITH CARDIOVASCULAR DISEASE, CONSIDERABLE RESIDUAL RISK REMAINS DESPITE EVIDENCE-BASED SECONDARY PREVENTION MEASURES. ALKALINE PHOSPHATASE (ALP) HAS BEEN SUGGESTED AS A MODIFIABLE CARDIOVASCULAR RISK FACTOR. WE SOUGHT TO DETERMINE WHETHER CARDIOVASCULAR RISK REDUCTION BY THE BROMODOMAIN AND EXTRA-TERMINAL (BET) PROTEIN INHIBITOR APABETALONE IS ASSOCIATED WITH THE CONCOMITANT LOWERING OF SERUM ALP. METHODS: IN A POST-HOC ANALYSIS OF 795 PATIENTS WITH ESTABLISHED CORONARY HEART DISEASE AND STATIN TREATMENT, WHO PARTICIPATED IN PHASE 2 PLACEBO-CONTROLLED TRIALS OF APABETALONE, WE DETERMINED THE EFFECT OF ASSIGNED TREATMENT FOR UP TO 24 WEEKS ON THE INCIDENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) AND SERUM ALP. RESULTS: BASELINE ALP (MEDIAN 72 U/L) PREDICTED MACE (DEATH, NON-FATAL MYOCARDIAL INFARCTION, CORONARY REVASCULARIZATION, OR HOSPITALIZATION FOR CARDIOVASCULAR CAUSES), INDEPENDENT OF HIGH-SENSITIVITY C-REACTIVE PROTEIN (HSCRP), SEX, AGE, RACE, STUDY, CARDIOVASCULAR RISK FACTORS, CHRONIC KIDNEY DISEASE (CKD), LIVER FUNCTION MARKERS AND TREATMENT ALLOCATION (HAZARD RATIO [HR] PER STANDARD DEVIATION [SD] 1.6, 95% CI 1.19-2.16, P = 0.002). MEAN PLACEBO-CORRECTED DECREASES IN ALP FROM BASELINE WERE 9.2% (P < 0.001) AFTER 12-14 WEEKS AND 7.7% (P < 0.001) AFTER 24-26 WEEKS OF APABETALONE TREATMENT. IN THE APABETALONE GROUP, A 1-SD REDUCTION IN ALP WAS ASSOCIATED WITH A HR FOR MACE OF 0.64 (95% CI 0.46-0.90, P = 0.009). CONCLUSIONS: SERUM ALP PREDICTS RESIDUAL CARDIOVASCULAR RISK, INDEPENDENT OF HSCRP, ESTABLISHED CARDIOVASCULAR RISK FACTORS AND CKD, IN PATIENTS WITH CARDIOVASCULAR DISEASE ON STATIN TREATMENT. APABETALONE LOWERS SERUM ALP, WHICH WAS ASSOCIATED WITH A LOWER RISK OF CARDIOVASCULAR EVENTS. WHETHER THE BENEFICIAL CARDIOVASCULAR EFFECTS OF APABETALONE ARE CAUSALLY RELATED TO ALP REDUCTION REMAINS UNDETERMINED. 2019 7 2960 24 GENETIC AND EPIGENETIC MARKERS IN THE EVALUATION OF PANCREATIC MASSES. BACKGROUND: METHYLATION MARKERS HAVE SHOWN PROMISE IN THE EARLY DIAGNOSIS OF PANCREATIC CARCINOMA. THE AIM OF THIS STUDY WAS TO ASSESS THE DIAGNOSTIC UTILITY OF HYPERMETHYLATION STATUS OF CANDIDATE GENES IN COMBINATION WITH KRAS MUTATION DETECTION IN THE EVALUATION OF PANCREATIC MASSES. EXPERIMENTAL DESIGN: SIXTY-ONE FINE NEEDLE ASPIRATES OF PANCREATIC MASSES (43 PANCREATIC ADENOCARCINOMAS AND 18 CHRONIC PANCREATITIS) WERE STUDIED. METHYLATION STATUS OF HRH2, EN1, SPARC, CDH13 AND APC WERE ANALYSED USING MELTING CURVE ANALYSIS AFTER DNA BISULFITE TREATMENT. KRAS MUTATIONS WERE ALSO ANALYSED. RESULTS: THE METHYLATION PANEL HAD A SENSITIVITY OF 73% (27 OF 37, CI 95% 56 TO 86%) AND A SPECIFICITY OF 100% WHENEVER TWO OR MORE PROMOTERS WERE FOUND HYPERMETHYLATED. KRAS MUTATIONS SHOWED A SENSITIVITY OF 77% (33 OF 43, CI 95% 62 TO 88%) AND A SPECIFICITY OF 100%. BOTH MOLECULAR ANALYSES ADDED USEFUL INFORMATION TO CYTOLOGY BY INCREASING THE NUMBER OF INFORMATIVE CASES. WHEN GENETIC AND EPIGENETIC ANALYSES WERE COMBINED SENSITIVITY WAS 84% (36 OF 43 CI 95% 69 TO 93%) MAINTAINING A 100% SPECIFICITY. CONCLUSIONS: ANALYSIS OF HYPERMETHYLATION STATUS OF A PANEL OF GENES AND KRAS MUTATION DETECTION OFFER A SIMILAR DIAGNOSTIC YIELD IN THE EVALUATION OF PANCREATIC MASSES. THE COMBINED MOLECULAR ANALYSIS INCREASES THE NUMBER OF INFORMATIVE CASES WITHOUT DIMINISHING SPECIFICITY. 2013 8 1955 37 EPIGENETIC AGE ACCELERATION PREDICTS CANCER, CARDIOVASCULAR, AND ALL-CAUSE MORTALITY IN A GERMAN CASE COHORT. BACKGROUND: PREVIOUS STUDIES HAVE DEVELOPED MODELS PREDICTING METHYLATION AGE FROM DNA METHYLATION IN BLOOD AND OTHER TISSUES (EPIGENETIC CLOCK) AND SUGGESTED THE DIFFERENCE BETWEEN DNA METHYLATION AND CHRONOLOGICAL AGES AS A MARKER OF HEALTHY AGING. THE GOAL OF THIS STUDY WAS TO CONFIRM AND EXPAND SUCH OBSERVATIONS BY INVESTIGATING WHETHER DIFFERENT CONCEPTS OF THE EPIGENETIC CLOCKS IN A POPULATION-BASED COHORT ARE ASSOCIATED WITH CANCER, CARDIOVASCULAR, AND ALL-CAUSE MORTALITY. RESULTS: DNA METHYLATION AGE WAS ESTIMATED IN A COHORT OF 1863 OLDER PEOPLE, AND THE DIFFERENCE BETWEEN AGE PREDICTED BY DNA METHYLATION AND CHRONOLOGICAL AGE (DELTAAGE) WAS CALCULATED. A CASE-COHORT DESIGN AND WEIGHTED PROPORTIONAL COX HAZARD MODELS WERE USED TO ESTIMATE ASSOCIATIONS OF DELTAAGE WITH CANCER, CARDIOVASCULAR, AND ALL-CAUSE MORTALITY. HAZARD RATIOS FOR DELTAAGE (PER 5 YEARS) CALCULATED USING THE EPIGENETIC CLOCK DEVELOPED BY HORVATH WERE 1.23 (95 % CI 1.10-1.38) FOR ALL-CAUSE MORTALITY, 1.22 (95 % CI 1.03-1.45) FOR CANCER MORTALITY, AND 1.19 (95 % CI 0.98-1.43) FOR CARDIOVASCULAR MORTALITY AFTER ADJUSTMENT FOR BATCH EFFECTS, AGE, SEX, EDUCATIONAL LEVEL, HISTORY OF CHRONIC DISEASES, HYPERTENSION, SMOKING STATUS, BODY MASS INDEX, AND LEUCOCYTE DISTRIBUTION. ASSOCIATIONS WERE SIMILAR BUT WEAKER FOR DELTAAGE CALCULATED USING THE EPIGENETIC CLOCK DEVELOPED BY HANNUM. CONCLUSIONS: THESE RESULTS SHOW THAT AGE ACCELERATION IN TERMS OF THE DIFFERENCE BETWEEN AGE PREDICTED BY DNA METHYLATION AND CHRONOLOGICAL AGE IS AN INDEPENDENT PREDICTOR OF ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY AND MAY BE USEFUL AS A GENERAL MARKER OF HEALTHY AGING. 2016 9 1959 31 EPIGENETIC AGING AND HEMATOPOIETIC CELL TRANSPLANTATION IN PATIENTS WITH SEVERE APLASTIC ANEMIA. CELLULAR AGING IN HEMATOPOIETIC CELL TRANSPLANTATION (HCT) IS IMPORTANT IN THE CONTEXT OF IMMUNE RECONSTITUTION AND AGE-RELATED COMPLICATIONS. RECENTLY, SEVERAL DNA-METHYLATION (DNAM)-BASED BIOMARKERS OF AGING KNOWN AS "EPIGENETIC CLOCKS" HAVE BEEN INTRODUCED AS NOVEL TOOLS TO PREDICT CELLULAR AGE. HERE, WE USED COX PROPORTIONAL HAZARDS MODELS TO ASSESS THE POSSIBLE ASSOCIATIONS OF DONOR PRE-HCT DNAM AGE, AND ITS POST-HCT CHANGES, USING THE RECENTLY PUBLISHED LIFESPAN-ASSOCIATED EPIGENETIC CLOCK KNOWN AS "DNAM-GRIMAGE," WITH OUTCOMES AMONG PATIENTS WITH SEVERE APLASTIC ANEMIA (SAA). THE STUDY INCLUDED 732 SAA PATIENTS FROM THE TRANSPLANT OUTCOMES IN APLASTIC ANEMIA PROJECT, WHO UNDERWENT UNRELATED DONOR HCT AND FOR WHOM A DONOR PRE-HCT BLOOD DNA SAMPLE WAS AVAILABLE; 41 ALSO HAD A POST-HCT SAMPLE COLLECTED AT DAY 100. IN MULTIVARIABLE ANALYSES, WE FOUND SIMILAR ASSOCIATIONS FOR DONOR CHRONOLOGICAL AGE AND PRE-HCT DNAM-GRIMAGE WITH POST-HCT SURVIVAL (HAZARD RATIO [HR] PER DECADE = 1.13; 95% CONFIDENCE INTERVAL [CI], 0.99-1.28; P = .07 AND HR = 1.14; 95% CI, 0.99-1.28; P = .06, RESPECTIVELY). IN DONORS WITH 10+ YEARS OF GRIMAGE ACCELERATION (IE, DEVIATION FROM EXPECTED DNAM AGE FOR CHRONOLOGICAL AGE), ELEVATED RISKS OF CHRONIC GRAFT VERSUS HOST DISEASE (HR = 2.4; 95% CI, 1.21-4.65; P = .01) AND POSSIBLY POST-HCT MORTALITY (HR = 1.79; 95% CI, 0.96-3.33; P = .07) WERE OBSERVED. IN THE SUBSET WITH POST-HCT SAMPLES, WE OBSERVED A SIGNIFICANT INCREASE IN DNAM-GRIMAGE IN THE FIRST 100 DAYS AFTER HCT (MEDIAN CHANGE 12.5 YEARS, RANGE 1.4 TO 26.4). HIGHER DNAM-GRIMAGE AFTER HCT WAS ASSOCIATED WITH INFERIOR SURVIVAL (HR PER YEAR = 1.11; 95% CI, 1.02-1.21; P = .01), PREDOMINANTLY WITHIN THE FIRST YEAR AFTER HCT. THIS STUDY HIGHLIGHTS THE POSSIBLE ROLE CELLULAR AGING MAY PLAY IN HCT OUTCOMES. 2021 10 6043 34 THE COMBINED PROGNOSTIC SIGNIFICANCE OF ALKALINE PHOSPHATASE AND INTRACRANIAL ARTERIAL CALCIFICATIONS IN HEMODIALYSIS PATIENTS. INTRODUCTION: THE PREVALENCE OF INTRACRANIAL ARTERIAL CALCIFICATION (ICAC) IN MAINTENANCE HEMODIALYSIS (MHD) PATIENTS IS ABOUT 90%, AND ITS SEVERITY IS CORRELATED WITH AGE, HEMODIALYSIS VINTAGE, AND MINERAL BONE DISEASE. ELEVATED CONCENTRATIONS OF CALCIUM AND PHOSPHORUS ARE NOT SUFFICIENT FOR MEDIAL CALCIFICATION BECAUSE OF INHIBITION BY PYROPHOSPHATE. ALKALINE PHOSPHATASE (ALP) PROMOTES CALCIFICATION BY HYDROLYZING EXTRACELLULAR PYROPHOSPHATE. EPIGENETIC MECHANISMS INVOLVING ALP INHIBITION BY APABETALONE WERE INVESTIGATED AS A POTENTIAL TARGET FOR PREVENTING VASCULAR CALCIFICATIONS (VCS). THIS STUDY ASSESSED THE COMBINED IMPACT OF VCS AND ELEVATED SERUM ALP ON MORTALITY AMONG CHRONIC HD PATIENTS. METHODS: VCS REPRESENTED BY ICAC WERE MEASURED SIMULTANEOUSLY WITH MINERAL BONE DISEASE PARAMETERS INCLUDING SERUM ALP OF MHD PATIENTS WHO UNDERWENT NONCONTRAST BRAIN COMPUTED TOMOGRAPHY FROM 2015 TO 2018 IN OUR INSTITUTION. RESULTS: THIS RETROSPECTIVE STUDY INCLUDED 150 MHD PATIENTS (MEAN AGE 71.3 +/- 12.1 YEARS, 60.1% MALE). OF THE TOTAL COHORT, 12 (7.8%) HAD NO BRAIN CALCIFICATIONS AND 69 (45.1%) HAD MULTIPLE INTRACRANIAL CALCIFICATIONS. CONSIDERING THE PATIENTS WITH NORMAL ALP AND NO CALCIFICATION AS THE REFERENCE GROUP YIELDED ADJUSTED ODDS RATIOS FOR ALL-CAUSE MORTALITY OF 4.6 (95% CI: 1.7-12.7) AMONG PATIENTS WITH BRAIN CALCIFICATIONS AND NORMAL ALP (P = 0.003) AND ODDS RATIOS FOR ALL-CAUSE MORTALITY OF 6.1 (95% CI: 2.1-17.7) AMONG PATIENTS WITH BRAIN CALCIFICATIONS AND ELEVATED ALP (P= 0.001). CONCLUSION: WE FOUND AN INDEPENDENT ASSOCIATION BETWEEN ICAC AND THE RISK OF DEATH AMONG MHD PATIENTS. THE COMBINED EFFECT OF ICAC AND ELEVATED ALP WAS ASSOCIATED WITH A HIGHER ODDS RATIO FOR ALL-CAUSE MORTALITY IN MHD PATIENTS AND MAY CONTRIBUTE TO THE RISK STRATIFICATION OF THESE PATIENTS. 2021 11 5446 22 REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION REDUCES DEPRESSIVE-LIKE BEHAVIORS, MODIFIES DENDRITIC PLASTICITY, AND GENERATES GLOBAL EPIGENETIC CHANGES IN THE FRONTAL CORTEX AND HIPPOCAMPUS IN A RODENT MODEL OF CHRONIC STRESS. DEPRESSION IS THE MOST COMMON AFFECTIVE DISORDER WORLDWIDE, ACCOUNTING FOR 4.4% OF THE GLOBAL POPULATION, A FIGURE THAT COULD INCREASE IN THE COMING DECADES. IN DEPRESSION, THERE EXISTS A REDUCTION IN THE AVAILABILITY OF DENDRITIC SPINES IN THE FRONTAL CORTEX (FC) AND HIPPOCAMPUS (HP). IN ADDITION, HISTONE MODIFICATION AND DNA METHYLATION ARE ALSO DYSREGULATED EPIGENETIC MECHANISMS IN DEPRESSION. REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) IS A TECHNIQUE THAT IS USED TO TREAT DEPRESSION. HOWEVER, THE EPIGENETIC MECHANISMS OF ITS THERAPEUTIC EFFECT ARE STILL NOT KNOWN. THEREFORE, IN THIS STUDY, WE EVALUATED THE ANTIDEPRESSANT EFFECT OF 5 HZ RTMS AND EXAMINED ITS EFFECT ON DENDRITIC REMODELING, IMMUNOREACTIVITY OF SYNAPSE PROTEINS, HISTONE MODIFICATION, AND DNA METHYLATION IN THE FC AND HP IN A MODEL OF CHRONIC MILD STRESS. OUR DATA INDICATED THAT STRESS GENERATED DEPRESSIVE-LIKE BEHAVIORS AND THAT RTMS REVERSES THIS EFFECT, ROMOTES THE FORMATION OF DENDRITIC SPINES, AND FAVORS THE PRESYNAPTIC CONNECTION IN THE FC AND DG (DENTATE GYRUS), IN ADDITION TO INCREASING HISTONE H3 TRIMETHYLATION AND DNA METHYLATION. THESE RESULTS SUGGEST THAT THE ANTIDEPRESSANT EFFECT OF RTMS IS ASSOCIATED WITH DENDRITIC REMODELING, WHICH IS PROBABLY REGULATED BY EPIGENETIC MECHANISMS. THESE DATA ARE A FIRST APPROXIMATION OF THE IMPACT OF RTMS AT THE EPIGENETIC LEVEL IN THE CONTEXT OF DEPRESSION. THEREFORE, IT IS NECESSARY TO ANALYZE IN FUTURE STUDIES AS TO WHICH GENES ARE REGULATED BY THESE MECHANISMS, AND HOW THEY ARE ASSOCIATED WITH THE NEUROPLASTIC MODIFICATIONS PROMOTED BY RTMS. 2023 12 143 32 ABERRANT DNA METHYLATION OF TWO TUMOR SUPPRESSOR GENES, P14(ARF) AND P15(INK4B), AFTER CHRONIC OCCUPATIONAL EXPOSURE TO LOW LEVEL OF BENZENE. BACKGROUND: EXPOSURE TO BENZENE WOULD BE ASSOCIATED WITH MANY DISEASES INCLUDING LEUKEMIA. EPIGENETIC ALTERATIONS SEEM TO BE AMONG THE MAIN MECHANISMS INVOLVED. OBJECTIVE: TO DETERMINE IF CHRONIC OCCUPATIONAL EXPOSURE TO LOW LEVEL OF BENZENE WOULD BE ASSOCIATED WITH DNA METHYLATION. METHODS: GLOBAL DNA METHYLATION AND PROMOTER-SPECIFIC METHYLATION OF THE TWO TUMOR SUPPRESSOR GENES, P14(ARF) AND P15(INK4B), WERE ASSESSED EMPLOYING METHYLATION-SPECIFIC PCR USING THE DNA EXTRACTED FROM 40 PETROCHEMICAL WORKERS EXPOSED TO AMBIENT BENZENE LEVELS OF <1 PPM, AND 31 OFFICE WORKERS NOT EXPOSED TO BENZENE OR ITS DERIVATIVES. RESULTS: WHILE AN INCREASE IN GLOBAL DNA METHYLATION OF 5% IN P14(ARF) (P=0.501) AND 28% IN P15(INK4B) (P=0.02) GENES WAS OBSERVED IN THE EXPOSED GROUP, NO HYPERMETHYLATION IN EITHER OF THE STUDIED GENES WAS OBSERVED IN THE UNEXPOSED GROUP. NO SIGNIFICANT ASSOCIATION WAS FOUND BETWEEN THE FREQUENCY OF ABERRANT METHYLATION AND EITHER OF AGE, WORK EXPERIENCE, AND SMOKING HABIT IN THE EXPOSED GROUP. CONCLUSION: CHRONIC OCCUPATIONAL EXPOSURE TO LOWER THAN THE PERMISSIBLE EXPOSURE LIMIT OF BENZENE MAY STILL RESULT IN DNA METHYLATION OF TUMOR SUPPRESSOR GENES THAT MAY ULTIMATELY LEAD TO DEVELOPMENT OF CANCER. 2018 13 852 41 CHOLANGIOCARCINOMA IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS (PSC): A COMPREHENSIVE REVIEW. CHOLANGIOCARCINOMA (CCA) IS THE MOST COMMON MALIGNANCY IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS (PSC) AND CARRIES A HIGH RATE OF MORTALITY. ALTHOUGH THE PATHOGENESIS OF CCA IN PSC IS LARGELY UNKNOWN, INFLAMMATION-DRIVEN CARCINOGENESIS CONCOMITANT WITH VARIOUS GENETIC AND EPIGENETIC ABNORMALITIES ARE UNDERLYING FACTORS. THE MAJORITY OF CCA CASES DEVELOP FROM A DOMINANT STRICTURE (DS), WHICH IS DEFINED AS A STRICTURE WITH A DIAMETER < 1.5 MM IN THE COMMON BILE DUCT OR < 1.0 MM IN THE HEPATIC DUCT. IN PSC PATIENTS PRESENTING WITH AN ABRUPT AGGRAVATION OF JAUNDICE, PAIN, FATIGUE, PRURITUS, WEIGHT LOSS, OR WORSENING LIVER BIOCHEMISTRIES, CCA SHOULD BE SUSPECTED AND EVALUATED UTILIZING A VARIETY OF DIAGNOSTIC MODALITIES. HOWEVER, EARLY RECOGNITION OF CCA IN PSC REMAINS A MAJOR CHALLENGE. IMPORTANTLY, 30-50% OF CCA IN PSC PATIENTS ARE OBSERVED WITHIN THE FIRST YEAR FOLLOWING THE DIAGNOSIS OF PSC FOLLOWED BY AN ANNUAL INCIDENCE RANGING FROM 0.5 TO 1.5 PER 100 PERSONS, WHICH IS NEARLY 10 TO 1000 TIMES HIGHER THAN THAT IN THE GENERAL POPULATION. CUMULATIVE 5-YEAR, 10-YEAR, AND LIFETIME INCIDENCES ARE 7%, 8-11%, AND 9-20%, RESPECTIVELY. WHEN PSC-ASSOCIATED CCA IS DIAGNOSED, MOST TUMORS ARE UNRESECTABLE, AND NO EFFECTIVE MEDICATIONS ARE AVAILABLE. GIVEN THE POOR THERAPEUTIC OUTCOME, THE SURVEILLANCE AND MANAGEMENT OF PSC PATIENTS WHO ARE AT AN INCREASED RISK OF DEVELOPING CCA ARE OF IMPORTANCE. SUCH PATIENTS INCLUDE OLDER MALES WITH LARGE-DUCT PSC AND POSSIBLY CONCURRENT ULCERATIVE COLITIS. THUS, MORE ATTENTION SHOULD BE PAID TO PATIENTS WITH THESE CLINICAL FEATURES, IN PARTICULAR WITHIN THE FIRST YEAR AFTER PSC DIAGNOSIS. IN CONTRAST, CCA IS LESS FREQUENTLY OBSERVED IN PEDIATRIC OR FEMALE PSC PATIENTS OR IN THOSE WITH SMALL-DUCT PSC OR CONCURRENT CROHN'S DISEASE. RECENTLY, NEW BIOMARKERS SUCH AS ANTIBODIES TO GLYCOPROTEIN 2 HAVE BEEN FOUND TO BE ASSOCIATED WITH AN INCREASED RISK OF DEVELOPING CCA IN PSC. HEREIN, WE REVIEW THE LITERATURE ON THE PATHOGENESIS, INCIDENCE, CLINICAL FEATURES, AND RISK FACTORS, WITH A FOCUS ON VARIOUS DIAGNOSTIC MODALITIES OF PSC-ASSOCIATED CCA. 2020 14 2439 38 EPIGENETIC SILENCING OF THE MLH1 PROMOTER IN RELATION TO THE DEVELOPMENT OF GASTRIC CANCER AND ITS USE AS A BIOMARKER FOR PATIENTS WITH MICROSATELLITE INSTABILITY: A SYSTEMATIC ANALYSIS. BACKGROUND/AIMS: HUMAN MUTL HOMOLOG 1 (MLH1) PROMOTER METHYLATION WAS REPORTED IN GASTRIC CANCER (GC). THIS STUDY DETERMINED THE CLINICOPATHOLOGICAL, PROGNOSTIC, AND DIAGNOSTIC EFFECTS OF MLH1 PROMOTER METHYLATION IN GC. METHODS: THE COMBINED ODDS RATIO (OR) OR HAZARD RATIO (HR) AND THEIR CORRESPONDING 95% CONFIDENCE INTERVALS (95% CI) WERE CALCULATED. THE POOLED SENSITIVITY, SPECIFICITY, AND AREA UNDER THE CURVE (AUC) WERE ANALYZED. RESULTS: A TOTAL OF 4654 GC PATIENTS AND 3669 NON-MALIGNANT CONTROLS WERE IDENTIFIED IN THIS SYSTEMATIC ANALYSIS. MLH1 PROMOTER METHYLATION WAS SIGNIFICANTLY HIGHER IN GC SAMPLES THAN IN GASTRIC ADENOMAS, CHRONIC GASTRITIS, ADJACENT TISSUES, NORMAL GASTRIC MUCOSA, AND NORMAL HEALTHY BLOOD SAMPLES, BUT IT EXHIBITED A SIMILAR FREQUENCY IN GC VS. INTESTINAL METAPLASIA AND DYSPLASIA SAMPLES. MLH1 PROMOTER METHYLATION CORRELATED WITH AGE AND MICROSATELLITE INSTABILITY (MSI), BUT IT WAS NOT ASSOCIATED WITH GENDER, H. PYLORI INFECTION, SMOKING, DRINKING BEHAVIORS, PATHOLOGICAL HISTOLOGY, TUMOR DIFFERENTIATION, CLINICAL STAGE, LYMPH NODE STATUS, DISTANT METASTASIS, OR OVERALL SURVIVAL OF GC. MLH1 PROMOTER METHYLATION EXHIBITED A POOR SENSITIVITY VALUE (< 0.5) IN PATIENTS WITH GC COMPARED WITH ADJACENT TISSUES, GASTRIC ADENOMAS, CHRONIC GASTRITIS, NORMAL GASTRIC MUCOSA, AND NORMAL HEALTHY BLOOD SAMPLES. THE POOLED SENSITIVITY, SPECIFICITY, AND AUC OF MLH1 PROMOTER METHYLATION IN GC WITH MSI VS. GC WITH MICROSATELLITE STABILITY (MSS) SAMPLES WERE 0.64, 0.96, AND 0.90, RESPECTIVELY. CONCLUSIONS: OUR RESULTS SUGGEST THAT THE DETECTION OF MLH1 PROMOTER METHYLATION MAY BE A POTENTIAL PROGNOSTIC BIOMARKER FOR GC PATIENTS WITH MSI. 2018 15 4986 31 PATIENT-REPORTED SYMPTOM OUTCOMES AND MICROSATELLITE INSTABILITY IN PATIENTS WITH METASTATIC COLORECTAL CANCER. BACKGROUND: THE SURVIVAL OF PATIENTS WITH METASTATIC COLORECTAL CANCER (MCRC) IS INFLUENCED BY THE GENETIC AND EPIGENETIC CHANGES THAT MIGHT INFLUENCE THE PATIENT EXPERIENCE OF SYMPTOM BURDEN. UNDERSTANDING THE ASSOCIATION OF MOLECULAR CHANGES WITH THE SYMPTOM BURDEN COULD HELP CLINICIANS GAIN INSIGHT INTO THE MOLECULAR BASIS OF SYMPTOM BURDEN AND IMPROVE TREATMENT TOLERANCE. TO DATE, NO STUDIES HAVE COMPARED THE PATIENT-REPORTED SYMPTOM BURDEN WITH THESE MOLECULAR SUBSETS AMONG PATIENTS WITH MCRC. PATIENTS AND METHODS: WE RECRUITED PATIENTS WITH MCRC THAT WAS REFRACTORY TO >/= 1 LINE OF THERAPY WHO HAD BEEN ENROLLED IN THE ASSESSMENT OF TARGETED THERAPIES AGAINST COLORECTAL CANCER TRIAL AT THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER. ALL PATIENTS COMPLETED A BASELINE GASTROINTESTINAL SYMPTOM INVENTORY (MD ANDERSON SYMPTOM INVENTORY, GASTROINTESTINAL). THE SYMPTOM BURDEN ACROSS KEY DEMOGRAPHIC VARIABLES AND MOLECULAR CHANGES, INCLUDING CRC-ASSOCIATED MUTATIONS, MICROSATELLITE INSTABILITY (MSI) STATUS, AND THE CPG ISLAND METHYLATOR PHENOTYPE (CIMP) WERE COMPARED USING CHI(2) TESTS. ASSOCIATION OF THE SYMPTOM BURDEN WITH OVERALL SURVIVAL WAS EXAMINED USING COX REGRESSION MODELS. RESULTS: PATIENTS WITH AN MSI-HIGH (MSI-H) PHENOTYPE REPORTED GREATER PAIN (ODDS RATIO [OR], 3.06; 95% CONFIDENCE INTERVAL [CI], 1.61-5.84), FATIGUE (OR, 2.78; 95% CI, 1.41-5.49), SLEEP (OR, 2.52; 95% CI, 1.32-4.08); AND DROWSINESS (OR, 2.51; 95% CI, 1.32-4.78) COMPARED WITH MICROSATELLITE STABLE PATIENTS. PATIENTS WITH AN MSI-H PHENOTYPE ALSO HAD GREATER ODDS OF OVERALL SYMPTOM BURDEN (OR, 2.48; 95% CI, 1.29-4.74) COMPARED WITH MICROSATELLITE STABLE PATIENTS. THE CIMP-HIGH PATIENTS EXPERIENCED GREATER ODDS OF PAIN COMPARED WITH THE CIMP-NEGATIVE PATIENTS (OR, 1.72; 95% CI, 1.06-2.80). A GREATER OVERALL SYMPTOM BURDEN WAS ASSOCIATED WITH POOR OVERALL SURVIVAL (HAZARD RATIO, 1.42; 95% CI, 0.98-2.06]), ALTHOUGH THE DIFFERENCE WAS NOT SIGNIFICANT (P = .06). CONCLUSION: CORRELATION OF MSI-H-ASSOCIATED TUMOR FEATURES WITH THE SYMPTOM BURDEN COULD HELP PROVIDE A BETTER UNDERSTANDING OF UNDERLYING MECHANISMS ASSOCIATED WITH OUR FINDINGS. 2020 16 6671 23 UROPATHOGENIC ESCHERICHIA COLI INFECTION-INDUCED EPITHELIAL TRAINED IMMUNITY IMPACTS URINARY TRACT DISEASE OUTCOME. PREVIOUS URINARY TRACT INFECTIONS (UTIS) CAN PREDISPOSE ONE TO FUTURE INFECTIONS; HOWEVER, THE UNDERLYING MECHANISMS AFFECTING RECURRENCE ARE POORLY UNDERSTOOD. WE PREVIOUSLY FOUND THAT UTIS IN MICE CAUSE DIFFERENTIAL BLADDER EPITHELIAL (UROTHELIAL) REMODELLING, DEPENDING ON DISEASE OUTCOME, THAT IMPACTS SUSCEPTIBILITY TO RECURRENT UTI. HERE WE COMPARED UROTHELIAL STEM CELL (USC) LINES ISOLATED FROM MICE WITH A HISTORY OF EITHER RESOLVED OR CHRONIC UROPATHOGENIC ESCHERICHIA COLI (UPEC) INFECTION, ELUCIDATING EVIDENCE OF MOLECULAR IMPRINTING THAT INVOLVED EPIGENETIC CHANGES, INCLUDING DIFFERENCES IN CHROMATIN ACCESSIBILITY, DNA METHYLATION AND HISTONE MODIFICATION. EPIGENETIC MARKS IN USCS FROM CHRONICALLY INFECTED MICE ENHANCED CASPASE-1-MEDIATED CELL DEATH UPON UPEC INFECTION, PROMOTING BACTERIAL CLEARANCE. INCREASED PTGS2OS2 EXPRESSION ALSO OCCURRED, POTENTIALLY CONTRIBUTING TO SUSTAINED CYCLOOXYGENASE-2 EXPRESSION, BLADDER INFLAMMATION AND MUCOSAL WOUNDING-RESPONSES ASSOCIATED WITH SEVERE RECURRENT CYSTITIS. THUS, UPEC INFECTION ACTS AS AN EPI-MUTAGEN REPROGRAMMING THE UROTHELIAL EPIGENOME, LEADING TO UROTHELIAL-INTRINSIC REMODELLING AND TRAINING OF THE INNATE RESPONSE TO SUBSEQUENT INFECTION. 2023 17 5667 27 SFRP TUMOUR SUPPRESSOR GENES ARE POTENTIAL PLASMA-BASED EPIGENETIC BIOMARKERS FOR MALIGNANT PLEURAL MESOTHELIOMA. MALIGNANT PLEURAL MESOTHELIOMA (MPM) IS ASSOCIATED WITH ASBESTOS EXPOSURE. ASBESTOS CAN INDUCE CHRONIC INFLAMMATION WHICH IN TURN CAN LEAD TO SILENCING OF TUMOUR SUPPRESSOR GENES. WNT SIGNALING PATHWAY CAN BE AFFECTED BY CHRONIC INFLAMMATION AND IS ABERRANTLY ACTIVATED IN MANY CANCERS INCLUDING COLON AND MPM. SFRP GENES ARE ANTAGONISTS OF WNT PATHWAY, AND SFRPS ARE POTENTIAL TUMOUR SUPPRESSORS IN COLON, GASTRIC, BREAST, OVARIAN, AND LUNG CANCERS AND MESOTHELIOMA. THIS STUDY INVESTIGATED THE EXPRESSION AND DNA METHYLATION OF SFRP GENES IN MPM CELLS LINES WITH AND WITHOUT DEMETHYLATION TREATMENT. SIXTY-SIX PATIENT FFPE SAMPLES WERE ANALYSED AND HAVE SHOWED METHYLATION OF SFRP2 (56%) AND SFRP5 (70%) IN MPM. SFRP2 AND SFRP5 TUMOUR-SUPPRESSIVE ACTIVITY IN ELEVEN MPM LINES WAS CONFIRMED, AND LONG-TERM ASBESTOS EXPOSURE LED TO REDUCED EXPRESSION OF THE SFRP1 AND SFRP2 GENES IN THE MESOTHELIUM (MET-5A) VIA EPIGENETIC ALTERATIONS. FINALLY, DNA METHYLATION OF SFRPS IS DETECTABLE IN MPM PATIENT PLASMA SAMPLES, WITH METHYLATED SFRP2 AND SFRP5 SHOWING A TENDENCY TOWARDS GREATER ABUNDANCE IN PATIENTS. THESE DATA SUGGESTED THAT SFRP GENES HAVE TUMOUR-SUPPRESIVE ACTIVITY IN MPM AND THAT METHYLATED DNA FROM SFRP GENE PROMOTERS HAS THE POTENTIAL TO SERVE AS A BIOMARKER FOR MPM PATIENT PLASMA. 2017 18 2095 20 EPIGENETIC EFFECTS OF BENZENE IN HEMATOLOGIC NEOPLASMS: THE ALTERED GENE EXPRESSION. BENZENE CARCINOGENIC ABILITY HAS BEEN REPORTED, AND CHRONIC EXPOSURE TO BENZENE CAN BE ONE OF THE RISK ELEMENTS FOR SOLID CANCERS AND HEMATOLOGICAL NEOPLASMS. BENZENE IS ACKNOWLEDGED AS A MYELOTOXIN, AND IT IS ABLE TO AUGMENT THE RISK FOR THE ONSET OF ACUTE MYELOID LEUKEMIA, MYELODYSPLASTIC SYNDROMES, APLASTIC ANEMIA, AND LYMPHOMAS. POSSIBLE MECHANISMS OF BENZENE INITIATION OF HEMATOLOGICAL TUMORS HAVE BEEN IDENTIFIED, AS A GENOTOXIC EFFECT, AN ACTION ON OXIDATIVE STRESS AND INFLAMMATION AND THE PROVOCATION OF IMMUNOSUPPRESSION. HOWEVER, IT IS BECOMING EVIDENT THAT GENETIC ALTERATIONS AND THE OTHER CAUSES ARE INSUFFICIENT TO FULLY JUSTIFY SEVERAL PHENOMENA THAT INFLUENCE THE ONSET OF HEMATOLOGIC MALIGNANCIES. ACQUIRED EPIGENETIC ALTERATIONS MAY PARTICIPATE WITH BENZENE LEUKEMOGENESIS, AS BENZENE MAY AFFECT NUCLEAR RECEPTORS, AND PROVOKE POST-TRANSLATIONAL ALTERATIONS AT THE PROTEIN LEVEL, THEREBY TOUCHING THE FUNCTION OF REGULATORY PROTEINS, COMPRISING ONCOPROTEINS AND TUMOR SUPPRESSOR PROTEINS. DNA HYPOMETHYLATION CORRELATES WITH STIMULATION OF ONCOGENES, WHILE THE HYPERMETHYLATION OF CPG ISLANDS IN PROMOTER REGIONS OF SPECIFIC TUMOR SUPPRESSOR GENES INHIBITS THEIR TRANSCRIPTION AND STIMULATES THE ONSET OF TUMORS. THE DISCOVERY OF THE SYSTEMS OF EPIGENETIC INDUCTION OF BENZENE-CAUSED HEMATOLOGICAL TUMORS HAS ALLOWED THE POSSIBILITY TO OPERATE WITH PHARMACOLOGICAL INTERVENTIONS ABLE OF STOPPING OR OVERTURNING THE NEGATIVE EFFECTS OF BENZENE. 2021 19 2844 24 FREQUENT EPIGENETIC INACTIVATION OF SFRP GENES IN HEPATOCELLULAR CARCINOMA. BACKGROUND: ACTIVATION OF THE WNT SIGNALING PATHWAY IS FREQUENTLY OBSERVED IN HEPATOCELLULAR CARCINOMA (HCC), THOUGH MUTATION OF THREE OF ITS COMPONENTS, CTNNB1, AXIN1, AND AXIN2, IS OBSERVED SUBSTANTIALLY LESS OFTEN. METHODS: WE EXAMINED THE RELATIONSHIP BETWEEN WNT SIGNALING AND EPIGENETIC ALTERATION OF SECRETED FRIZZLED-RELATED PROTEIN (SFRP) GENES IN HCC. RESULTS: WE FREQUENTLY DETECTED THE ACTIVE FORM OF BETA-CATENIN AND ACCUMULATION OF NUCLEAR BETA-CATENIN IN LIVER CANCER CELL LINES. WE DETECTED METHYLATION OF SFRP FAMILY GENES IN LIVER CANCER CELL LINES (SFRP1, 9/12, 75%; SFRP2, 7/12, 58%; SFRP4, 3/12, 25%; SFRP5, 7/12, 58%) AND PRIMARY HCCS (SFRP1, 9/19, 47%; SFRP2, 12/19, 63%; SFRP5, 8/19, 42%), THOUGH METHYLATION OF SFRP4 WAS NOT FOUND IN PRIMARY HCCS. SFRP METHYLATION ALSO WAS DETECTED IN HEPATITIS B OR C VIRUS-ASSOCIATED CHRONIC HEPATITIS (SFRP1, 6/37, 16%; SFRP2, 14/37, 38%; SFRP5, 5/37, 14%) AND LIVER CIRRHOSIS (SFRP1, 10/28, 36%; SFRP2, 9/28, 32%; SFRP5, 3/28, 11%), SUGGESTING THAT METHYLATION OF THESE GENES IS AN EARLY EVENT IN LIVER CARCINOGENESIS. ECTOPIC EXPRESSION OF SFRPS DOWNREGULATED T-CELL FACTOR/LYMPHOCYTE ENHANCER FACTOR (TCF/LEF) TRANSCRIPTIONAL ACTIVITY IN LIVER CANCER CELLS, WHILE OVEREXPRESSION OF A BETA-CATENIN MUTANT AND DEPLETION OF SFRP1 USING SIRNA SYNERGISTICALLY UPREGULATED TCF/LEF TRANSCRIPTIONAL ACTIVITY. CONCLUSIONS: OUR RESULTS CONFIRM THE FREQUENT METHYLATION AND SILENCING OF WNT ANTAGONIST GENES IN HCC, AND SUGGEST THAT THEIR LOSS OF FUNCTION CONTRIBUTES TO ACTIVATION OF WNT SIGNALING DURING HEPATOCARCINOGENESIS. 2008 20 6829 21 [HEPATITIS C VIRUS INFECTION AND HEPATOCARCINOGENESIS]. HEPATITIS C VIRUS INFECTION CAUSES APPROXIMATELY 4 MILLION NEW INFECTIONS WORLDWIDE, AND 399 000 DEATHS DUE TO ITS COMPLICATIONS, CIRRHOSIS AND HEPATOCELLULAR CARCINOMA (HCC). MICROENVIRONMENTAL CHANGES, CHRONIC INFLAMMATION, OXIDATIVE STRESS, ENDOPLASMIC RETICULUM STRESS CAUSED BY HCV INFECTION, VIA GENETIC AND EPIGENETIC CHANGES CAN RESULT IN PRIMARY LIVER CANCER DURING DECADES. THE DIRECT ONCOGENIC PROPERTY OF HCV IS WELLKNOWN. THE TRANSFORMING EFFECT OF FOUR HCV PROTEINS (CORE, NS3, NS4B, NS5A) HAS BEEN PROVEN. EFFECTIVE ANTIVIRAL THERAPY, SUSTAINED VIRAL RESPONSE DECREASES THE HCV-RELATED GENERAL AND LIVER-RELATED MORTALITY. INTERFERON-BASED THERAPY REDUCES THE RISK OF HCC DEVELOPMENT. SHORTER THERAPY WITH DIRECT ACTING ANTIVIRAL AGENTS (DAA) HAS HIGHER EFFICACY, FEWER SIDE-EFFECTS. PUBLICATIONS HAVE REPORTED THE UNEXPECTED EFFECTS OF DAA. THE AUTHORS REVIEW THE ARTICLES FOCUSING ON THE OCCURRENCE OF HCC IN CONNECTION WITH DAA THERAPIES. THERE IS A NEED FOR PROSPECTIVE, MULTICENTRIC STUDIES WITH LONGER FOLLOW-UP TO EXAMINE THE RISK OF HCC FORMATION. AFTER ANTIVIRAL THERAPY, HCC SURVEILLANCE IS OF HIGH IMPORTANCE WHICH MEANS ABDOMINAL ULTRASOUND EVERY 3-6-12 MONTHS IN SUSTAINED VIRAL RESPONSE PATIENTS AS WELL. ORV HETIL. 2019; 160(22): 846-853. 2019