1 2883 109 G9A INHIBITS CREB-TRIGGERED EXPRESSION OF MU OPIOID RECEPTOR IN PRIMARY SENSORY NEURONS FOLLOWING PERIPHERAL NERVE INJURY. NEUROPATHIC PAIN, A DISTRESSING AND DEBILITATING DISORDER, IS STILL POORLY MANAGED IN CLINIC. OPIOIDS, LIKE MORPHINE, REMAIN THE MAINSTAY OF PRESCRIBED MEDICATIONS IN THE TREATMENT OF THIS DISORDER, BUT THEIR ANALGESIC EFFECTS ARE HIGHLY UNSATISFACTORY IN PART DUE TO NERVE INJURY-INDUCED REDUCTION OF OPIOID RECEPTORS IN THE FIRST-ORDER SENSORY NEURONS OF DORSAL ROOT GANGLIA. G9A IS A REPRESSOR OF GENE EXPRESSION. WE FOUND THAT NERVE INJURY-INDUCED INCREASES IN G9A AND ITS CATALYZED REPRESSIVE MARKER H3K9M2 ARE RESPONSIBLE FOR EPIGENETIC SILENCING OF OPRM1, OPRK1, AND OPRD1 GENES IN THE INJURED DORSAL ROOT GANGLIA. BLOCKING THESE INCREASES RESCUED DORSAL ROOT GANGLIA OPRM1, OPRK1, AND OPRD1 GENE EXPRESSION AND MORPHINE OR LOPERAMIDE ANALGESIA AND PREVENTED THE DEVELOPMENT OF MORPHINE OR LOPERAMIDE-INDUCED ANALGESIC TOLERANCE UNDER NEUROPATHIC PAIN CONDITIONS. CONVERSELY, MIMICKING THESE INCREASES REDUCED THE EXPRESSION OF THREE OPIOID RECEPTORS AND PROMOTED THE MU OPIOID RECEPTOR-GATED RELEASE OF PRIMARY AFFERENT NEUROTRANSMITTERS. MECHANISTICALLY, NERVE INJURY-INDUCED INCREASES IN THE BINDING ACTIVITY OF G9A AND H3K9ME2 TO THE OPRM1 GENE WERE ASSOCIATED WITH THE REDUCED BINDING OF CYCLIC AMP RESPONSE ELEMENT BINDING PROTEIN TO THE OPRM1 GENE. THESE FINDINGS SUGGEST THAT G9A PARTICIPATES IN THE NERVE INJURY-INDUCED REDUCTION OF THE OPRM1 GENE LIKELY THROUGH G9A-TRIGGERED BLOCKAGE IN THE ACCESS OF CYCLIC AMP RESPONSE ELEMENT BINDING PROTEIN TO THIS GENE. 2016 2 4618 62 NERVE INJURY-INDUCED EPIGENETIC SILENCING OF OPIOID RECEPTORS CONTROLLED BY DNMT3A IN PRIMARY AFFERENT NEURONS. OPIOIDS ARE THE GOLD STANDARD FOR PHARMACOLOGICAL TREATMENT OF NEUROPATHIC PAIN, BUT THEIR ANALGESIC EFFECTS ARE UNSATISFACTORY IN PART DUE TO NERVE INJURY-INDUCED DOWNREGULATION OF OPIOID RECEPTORS IN DORSAL ROOT GANGLIA (DRG) NEURONS. HOW NERVE INJURY DRIVES SUCH DOWNREGULATION REMAINS ELUSIVE. DNA METHYLTRANSFERASE (DNMT)-TRIGGERED DNA METHYLATION REPRESSES GENE EXPRESSION. WE SHOW HERE THAT BLOCKING THE NERVE INJURY-INDUCED INCREASE IN DRG DNMT3A (A DE NOVO DNMT) RESCUED THE EXPRESSION OF OPRM1 AND OPRK1 MRNAS AND THEIR RESPECTIVE ENCODING MU-OPIOID RECEPTOR (MOR) AND KAPPA-OPIOID RECEPTOR (KOR) PROTEINS IN THE INJURED DRG. BLOCKING THIS INCREASE ALSO PREVENTED THE NERVE INJURY-INDUCED INCREASE IN DNA METHYLATION IN THE PROMOTER AND 5'-UNTRANSLATED REGION OF THE OPRM1 GENE IN THE INJURED DRG, RESTORED MORPHINE OR LOPERAMIDE (A PERIPHERAL ACTING MOR PREFERRING AGONIST) ANALGESIC EFFECTS, AND ATTENUATED THE DEVELOPMENT OF THEIR ANALGESIC TOLERANCE UNDER NEUROPATHIC PAIN CONDITIONS. MIMICKING THIS INCREASE REDUCED THE EXPRESSION OF OPRM1 AND OPRK1 MRNAS AND THEIR CODING MOR AND KOR IN DRG AND AUGMENTED MOR-GATED NEUROTRANSMITTER RELEASE FROM THE PRIMARY AFFERENTS. MECHANISTICALLY, DNMT3A REGULATION OF OPRM1 GENE EXPRESSION REQUIRED THE METHYL-CPG-BINDING PROTEIN 1, MBD1, AS MBD1 KNOCKOUT RESULTED IN THE DECREASED BINDING OF DNMT3A TO THE OPRM1 GENE PROMOTER AND BLOCKED THE DNMT3A-TRIGGERED REPRESSION OF OPRM1 GENE EXPRESSION IN DRG NEURONS. THESE DATA SUGGEST THAT DNMT3A IS REQUIRED FOR NERVE INJURY-INDUCED AND MBD1-MEDIATED EPIGENETIC SILENCING OF THE MOR AND KOR IN THE INJURED DRG. DNMT3A INHIBITION MAY SERVE AS A PROMISING ADJUVANT THERAPY FOR OPIOID USE IN NEUROPATHIC PAIN MANAGEMENT. 2017 3 3275 19 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 4 3340 27 HISTONE DEACETYLASE MEDIATED TRANSCRIPTIONAL ACTIVATION REDUCES PROVIRAL LOADS IN HTLV-1 ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS PATIENTS. EPIGENETIC MODIFICATIONS OF CHROMATIN MAY PLAY A ROLE IN MAINTAINING VIRAL LATENCY AND THUS PERSISTENCE OF THE HUMAN T-LYMPHOTROPIC VIRUS TYPE 1 (HTLV-1), WHICH IS RESPONSIBLE FOR HTLV-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS (HAM/TSP). A MAJOR DETERMINANT OF DISEASE PROGRESSION IS INCREASED PERIPHERAL BLOOD PROVIRAL LOAD (PVL), POSSIBLY VIA THE ACCUMULATION OF INFECTED CELLS IN THE CENTRAL NERVOUS SYSTEM (CNS) CREATING A DAMAGING INFLAMMATORY RESPONSE. CURRENT THERAPEUTIC APPROACHES THAT FOCUS ON REDUCING EITHER CELL PROLIFERATION, VIRAL REPLICATION, OR TISSUE INVASION ARE STILL UNSATISFACTORY. CONTRASTING WITH THESE INHIBITORY STRATEGIES, WE EVALUATED THE EFFICACY OF A NOVEL APPROACH AIMED, PARADOXICALLY, AT ACTIVATING VIRAL GENE EXPRESSION TO EXPOSE VIRUS-POSITIVE CELLS TO THE HOST IMMUNE RESPONSE. WE USED VALPROATE (VPA), A HISTONE DEACETYLASE INHIBITOR THAT HAS BEEN USED FOR DECADES AS A CHRONIC, SAFE TREATMENT FOR EPILEPTIC DISORDERS. BASED ON IN VITRO AND IN VIVO DATA, WE PROVIDE EVIDENCE THAT TRANSIENT ACTIVATION OF THE LATENT VIRAL RESERVOIR CAUSES ITS COLLAPSE, A PROCESS THAT MAY ALLEVIATE THE CONDITION OF HAM/TSP. THIS REPRESENTS THE FIRST SUCH APPROACH TO TREATING HAM/TSP, USING GENE ACTIVATION THERAPY TO TILT THE HOST-PATHOGEN BALANCE IN FAVOR OF AN EXISTING ANTIVIRAL RESPONSE. THIS TRIAL IS REGISTERED AT HTTP://CLINICALTRIALS.GOV/AS NO. NCT00519181. 2007 5 2401 27 EPIGENETIC REPROGRAMMING PROMOTES THE ANTIVIRAL ACTION OF IFNALPHA IN HBV-INFECTED CELLS. CHRONIC HEPATITIS B VIRUS (HBV) INFECTIONS REMAIN A HEALTH BURDEN AFFECTING ~250 MILLION PEOPLE WORLDWIDE. THUS FAR, AVAILABLE INTERFERON-ALPHA (IFNALPHA)-BASED THERAPIES HAVE SHOWN UNSATISFACTORY CURE RATES, AND ALTERNATIVE THERAPEUTIC MOLECULES ARE STILL REQUIRED. HOWEVER, THEIR DEVELOPMENT HAS BEEN HAMPERED BECAUSE ACCESSIBLE CELL MODELS SUPPORTING RELEVANT HBV REPLICATION AND APPROPRIATE ANTIVIRAL ACTIVITY ARE LACKING. STRATEGIES THAT REVERSE EPIGENETIC ALTERATIONS OFFER A UNIQUE OPPORTUNITY FOR CELL REPROGRAMMING, WHICH IS VALUABLE FOR RESTORING ALTERED CELLULAR FUNCTIONS IN HUMAN CELL LINES. THIS WORK AIMED TO INVESTIGATE THE FEASIBILITY OF CONVERTING HEPG2 CELLS THAT STABLY OVEREXPRESS THE HBV ENTRY RECEPTOR (SODIUM/TAUROCHOLATE COTRANSPORTING POLYPEPTIDE, NTCP) TOWARD IFNALPHA-RESPONSIVE CELLS USING EPIGENETIC REPROGRAMMING. HEREIN, WE SHOWED THAT AN EPIGENETIC REGIMEN WITH NON-CYTOTOXIC DOSES OF THE DEMETHYLATING COMPOUND 5-AZACYTIDINE RESTORED THE ANTI-HBV ACTION OF IFNALPHA IN EPIGENETICALLY REPROGRAMMED HEPG2-NTCP-C4 CELLS, NAMED REP-HEPG2-NTCP CELLS. THUS, A SIGNIFICANT INHIBITION IN HBV DNA LEVELS WAS MEASURED IN REP-HEPG2-NTCP CELLS AFTER IFNALPHA TREATMENT. THIS INHIBITORY EFFECT WAS ASSOCIATED WITH THE ENHANCEMENT OF IFNALPHA-MEDIATED INDUCTION OF CRITICAL INTERFERON-STIMULATED GENES (ISGS), WHICH WAS LIMITED IN NON-REPROGRAMMED CELLS. IN PARTICULAR, OUR DATA INDICATED THAT RE-EXPRESSION OF 2'-5'-OLIGOADENYLATE SYNTHETASE 1 (OAS1) AND INTERFERON REGULATORY FACTOR 9 (IRF9) WAS THE RESULT OF AN EPIGENETICALLY DRIVEN UNMASKING OF THESE GENES IN REPROGRAMMED CELLS. AT LAST, WE EVALUATED THE THERAPEUTIC POTENTIAL OF THE IFN ANALOG CDM-3008 IN REP-HEPG2-NTCP CELLS AND DEMONSTRATED THE EFFICIENCY OF THIS CHEMICAL COMPOUND IN TRIGGERING ISG INDUCTION AND HBV INHIBITION. IN SUMMARY, THIS STUDY SHOWS THAT EPIGENETIC REPROGRAMMING PROMOTES THE IFNALPHA RESPONSE IN HBV-INFECTED CELLS AND IS POTENTIALLY ATTRACTIVE FOR CELL-BASED EXPERIMENTAL SCREENING OF IFN-LIKE COMPOUNDS. 2021 6 105 20 A REVIEW OF MICROBIOTA AND IRRITABLE BOWEL SYNDROME: FUTURE IN THERAPIES. IRRITABLE BOWEL SYNDROME (IBS), ONE OF THE MOST FREQUENT DIGESTIVE DISORDERS, IS CHARACTERIZED BY CHRONIC AND RECURRENT ABDOMINAL PAIN AND ALTERED BOWEL HABIT. THE ORIGIN SEEMS TO BE MULTIFACTORIAL AND IS STILL NOT WELL DEFINED FOR THE DIFFERENT SUBTYPES. GENETIC, EPIGENETIC AND SEX-RELATED MODIFICATIONS OF THE FUNCTIONING OF THE NERVOUS AND IMMUNE-ENDOCRINE SUPERSYSTEMS AND REGULATION OF BRAIN-GUT PHYSIOLOGY AND BILE ACID PRODUCTION AND ABSORPTION ARE CERTAINLY INVOLVED. ACQUIRED PREDISPOSITION MAY ACT IN CONJUNCTION WITH INFECTIOUS, TOXIC, DIETARY AND LIFE EVENT-RELATED FACTORS TO ENHANCE EPITHELIAL PERMEABILITY AND ELICIT MUCOSAL MICROINFLAMMATION, IMMUNE ACTIVATION AND DYSBIOSIS. NOTABLY, STRONG EVIDENCE SUPPORTS THE ROLE OF BACTERIAL, VIRAL AND PARASITIC INFECTIONS IN TRIGGERING IBS, AND TARGETING MICROBIOTA SEEMS PROMISING IN VIEW OF THE POSITIVE RESPONSE TO MICROBIOTA-RELATED THERAPIES IN SOME PATIENTS. HOWEVER, THE LACK OF HIGHLY PREDICTIVE DIAGNOSTIC BIOMARKERS AND THE COMPLEXITY AND HETEROGENEITY OF IBS PATIENTS MAKE MANAGEMENT DIFFICULT AND UNSATISFACTORY IN MANY CASES, REDUCING PATIENT HEALTH-RELATED QUALITY OF LIFE AND INCREASING THE SANITARY BURDEN. THIS ARTICLE REVIEWS SPECIFIC ALTERATIONS AND INTERVENTIONS TARGETING THE GUT MICROBIOTA IN IBS, INCLUDING PREBIOTICS, PROBIOTICS, SYNBIOTICS, NON-ABSORBABLE ANTIBIOTICS, DIETS, FECAL TRANSPLANTATION AND OTHER POTENTIAL FUTURE APPROACHES USEFUL FOR THE DIAGNOSIS, PREVENTION AND TREATMENT OF IBS. 2018 7 5365 13 RECENT ADVANCES IN HEPATITIS B TREATMENT. HEPATITIS B VIRUS INFECTION AFFECTS OVER 250 MILLION CHRONIC CARRIERS, CAUSING MORE THAN 800,000 DEATHS ANNUALLY, ALTHOUGH A SAFE AND EFFECTIVE VACCINE IS AVAILABLE. CURRENTLY USED ANTIVIRAL AGENTS, PEGYLATED INTERFERON AND NUCLEOS(T)IDE ANALOGUES, HAVE MAJOR DRAWBACKS AND FAIL TO COMPLETELY ERADICATE THE VIRUS FROM INFECTED CELLS. THUS, ACHIEVING A "FUNCTIONAL CURE" OF THE INFECTION REMAINS A REAL CHALLENGE. RECENT FINDINGS CONCERNING THE VIRAL REPLICATION CYCLE HAVE LED TO DEVELOPMENT OF NOVEL THERAPEUTIC APPROACHES INCLUDING VIRAL ENTRY INHIBITORS, EPIGENETIC CONTROL OF CCCDNA, IMMUNE MODULATORS, RNA INTERFERENCE TECHNIQUES, RIBONUCLEASE H INHIBITORS, AND CAPSID ASSEMBLY MODULATORS. PROMISING PRECLINICAL RESULTS HAVE BEEN OBTAINED, AND THE LEADING MOLECULES UNDER DEVELOPMENT HAVE ENTERED CLINICAL EVALUATION. THIS REVIEW SUMMARIZES THE KEY STEPS OF THE HBV LIFE CYCLE, EXAMINES THE CURRENTLY APPROVED ANTI-HBV DRUGS, AND ANALYZES NOVEL HBV TREATMENT REGIMENS. 2021 8 5835 21 STRESS-INDUCED VISCERAL PAIN: TOWARD ANIMAL MODELS OF IRRITABLE-BOWEL SYNDROME AND ASSOCIATED COMORBIDITIES. VISCERAL PAIN IS A GLOBAL TERM USED TO DESCRIBE PAIN ORIGINATING FROM THE INTERNAL ORGANS, WHICH IS DISTINCT FROM SOMATIC PAIN. IT IS A HALLMARK OF FUNCTIONAL GASTROINTESTINAL DISORDERS SUCH AS IRRITABLE-BOWEL SYNDROME (IBS). CURRENTLY, THE TREATMENT STRATEGIES TARGETING VISCERAL PAIN ARE UNSATISFACTORY, WITH DEVELOPMENT OF NOVEL THERAPEUTICS HINDERED BY A LACK OF DETAILED KNOWLEDGE OF THE UNDERLYING MECHANISMS. STRESS HAS LONG BEEN IMPLICATED IN THE PATHOPHYSIOLOGY OF VISCERAL PAIN IN BOTH PRECLINICAL AND CLINICAL STUDIES. HERE, WE DISCUSS THE COMPLEX ETIOLOGY OF VISCERAL PAIN REVIEWING OUR CURRENT UNDERSTANDING IN THE CONTEXT OF THE ROLE OF STRESS, GENDER, GUT MICROBIOTA ALTERATIONS, AND IMMUNE FUNCTIONING. FURTHERMORE, WE REVIEW THE ROLE OF GLUTAMATE, GABA, AND EPIGENETIC MECHANISMS AS POSSIBLE THERAPEUTIC STRATEGIES FOR THE TREATMENT OF VISCERAL PAIN FOR WHICH THERE IS AN UNMET MEDICAL NEED. MOREOVER, WE DISCUSS THE MOST WIDELY DESCRIBED RODENT MODELS USED TO MODEL VISCERAL PAIN IN THE PRECLINICAL SETTING. THE THEORY BEHIND, AND APPLICATION OF, ANIMAL MODELS IS KEY FOR BOTH THE UNDERSTANDING OF UNDERLYING MECHANISMS AND DESIGN OF FUTURE THERAPEUTIC INTERVENTIONS. TAKEN TOGETHER, IT IS APPARENT THAT STRESS-INDUCED VISCERAL PAIN AND ITS PSYCHIATRIC COMORBIDITIES, AS TYPIFIED BY IBS, HAS A MULTIFACETED ETIOLOGY. MOREOVER, TREATMENT STRATEGIES STILL LAG FAR BEHIND WHEN COMPARED TO OTHER PAIN MODALITIES. THE DEVELOPMENT OF NOVEL, EFFECTIVE, AND SPECIFIC THERAPEUTICS FOR THE TREATMENT OF VISCERAL PAIN HAS NEVER BEEN MORE PERTINENT. 2015 9 4754 14 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 10 5952 19 TARGETING VIRAL CCCDNA FOR CURE OF CHRONIC HEPATITIS B. PURPOSE OF REVIEW: CHRONIC HEPATITIS B (CHB), CAUSED BY HEPATITIS B VIRUS (HBV), IS A MAJOR CAUSE OF ADVANCED LIVER DISEASE AND HEPATOCELLULAR CARCINOMA (HCC) WORLDWIDE. HBV REPLICATION IS CHARACTERIZED BY THE SYNTHESIS OF COVALENTLY CLOSED CIRCULAR (CCC) DNA WHICH IS NOT TARGETED BY ANTIVIRAL NUCLEOS(T)IDE ANALOGUES (NUCS) THE KEY MODALITY OF STANDARD OF CARE. WHILE HBV REPLICATION IS SUCCESSFULLY SUPPRESSED IN TREATED PATIENTS, THEY REMAIN AT RISK FOR DEVELOPING HCC. WHILE FUNCTIONAL CURE, CHARACTERIZED BY LOSS OF HBSAG, IS THE FIRST GOAL OF NOVEL ANTIVIRAL THERAPIES, CURATIVE TREATMENTS ELIMINATING CCCDNA REMAIN THE ULTIMATE GOAL. THIS REVIEW SUMMARIZES RECENT ADVANCES IN THE DISCOVERY AND DEVELOPMENT OF NOVEL THERAPEUTIC STRATEGIES AND THEIR IMPACT ON CCCDNA BIOLOGY. RECENT FINDINGS: WITHIN THE LAST DECADE, SUBSTANTIAL PROGRESS HAS BEEN MADE IN THE UNDERSTANDING OF CCCDNA BIOLOGY INCLUDING THE DISCOVERY OF HOST DEPENDENCY FACTORS, EPIGENETIC REGULATION OF CCCDNA TRANSCRIPTION AND IMMUNE-MEDIATED DEGRADATION. SEVERAL APPROACHES TARGETING CCCDNA EITHER IN A DIRECT OR INDIRECT MANNER ARE CURRENTLY AT THE STAGE OF DISCOVERY, PRECLINICAL OR EARLY CLINICAL DEVELOPMENT. EXAMPLES INCLUDE GENOME-EDITING APPROACHES, STRATEGIES TARGETING HOST DEPENDENCY FACTORS OR EPIGENETIC GENE REGULATION, NUCLEOCAPSID MODULATORS AND IMMUNE-MEDIATED DEGRADATION. SUMMARY: WHILE DIRECT-TARGETING CCCDNA STRATEGIES ARE STILL LARGELY AT THE PRECLINICAL STAGE OF DEVELOPMENT, CAPSID ASSEMBLY MODULATORS AND IMMUNE-BASED APPROACHES HAVE REACHED THE CLINICAL PHASE. CLINICAL TRIALS ARE ONGOING TO ASSESS THEIR EFFICACY AND SAFETY IN PATIENTS INCLUDING THEIR IMPACT ON VIRAL CCCDNA. COMBINATION THERAPIES PROVIDE ADDITIONAL OPPORTUNITIES TO OVERCOME CURRENT LIMITATIONS OF INDIVIDUAL APPROACHES. 2020 11 5921 20 TARGETING CLINICAL EPIGENETIC REPROGRAMMING FOR CHEMOPREVENTION OF METABOLIC AND VIRAL HEPATOCELLULAR CARCINOMA. OBJECTIVE: HEPATOCELLULAR CARCINOMA (HCC) IS THE FASTEST-GROWING CAUSE OF CANCER-RELATED MORTALITY WITH CHRONIC VIRAL HEPATITIS AND NON-ALCOHOLIC STEATOHEPATITIS (NASH) AS MAJOR AETIOLOGIES. TREATMENT OPTIONS FOR HCC ARE UNSATISFACTORY AND CHEMOPREVENTIVE APPROACHES ARE ABSENT. CHRONIC HEPATITIS C (CHC) RESULTS IN EPIGENETIC ALTERATIONS DRIVING HCC RISK AND PERSISTING FOLLOWING CURE. HERE, WE AIMED TO INVESTIGATE EPIGENETIC MODIFICATIONS AS TARGETS FOR LIVER CANCER CHEMOPREVENTION. DESIGN: LIVER TISSUES FROM PATIENTS WITH NASH AND CHC WERE ANALYSED BY CHIP-SEQ (H3K27AC) AND RNA-SEQ. THE LIVER DISEASE-SPECIFIC EPIGENETIC AND TRANSCRIPTIONAL REPROGRAMMING IN PATIENTS WAS MODELLED IN A LIVER CELL CULTURE SYSTEM. PERTURBATION STUDIES COMBINED WITH A TARGETED SMALL MOLECULE SCREEN FOLLOWED BY IN VIVO AND EX VIVO VALIDATION WERE USED TO IDENTIFY CHROMATIN MODIFIERS AND READERS FOR HCC CHEMOPREVENTION. RESULTS: IN PATIENTS, CHC AND NASH SHARE SIMILAR EPIGENETIC AND TRANSCRIPTOMIC MODIFICATIONS DRIVING CANCER RISK. USING A CELL-BASED SYSTEM MODELLING EPIGENETIC MODIFICATIONS IN PATIENTS, WE IDENTIFIED CHROMATIN READERS AS TARGETS TO REVERT LIVER GENE TRANSCRIPTION DRIVING CLINICAL HCC RISK. PROOF-OF-CONCEPT STUDIES IN A NASH-HCC MOUSE MODEL SHOWED THAT THE PHARMACOLOGICAL INHIBITION OF CHROMATIN READER BROMODOMAIN 4 INHIBITED LIVER DISEASE PROGRESSION AND HEPATOCARCINOGENESIS BY RESTORING TRANSCRIPTIONAL REPROGRAMMING OF THE GENES THAT WERE EPIGENETICALLY ALTERED IN PATIENTS. CONCLUSION: OUR RESULTS UNRAVEL THE FUNCTIONAL RELEVANCE OF METABOLIC AND VIRUS-INDUCED EPIGENETIC ALTERATIONS FOR PATHOGENESIS OF HCC DEVELOPMENT AND IDENTIFY CHROMATIN READERS AS TARGETS FOR CHEMOPREVENTION IN PATIENTS WITH CHRONIC LIVER DISEASES. 2021 12 6479 26 TOWARD A NEW ERA OF HEPATITIS B VIRUS THERAPEUTICS: THE PURSUIT OF A FUNCTIONAL CURE. HEPATITIS B VIRUS (HBV) INFECTION, ALTHOUGH PREVENTABLE BY VACCINATION, REMAINS A GLOBAL HEALTH PROBLEM AND A MAJOR CAUSE OF CHRONIC LIVER DISEASE. ALTHOUGH CURRENT TREATMENT STRATEGIES SUPPRESS VIRAL REPLICATION VERY EFFICIENTLY, THE OPTIMAL ENDPOINT OF HEPATITIS B SURFACE ANTIGEN (HBSAG) CLEARANCE IS RARELY ACHIEVED. MOREOVER, THE THORNY PROBLEMS OF PERSISTENT CHROMATIN-LIKE COVALENTLY CLOSED CIRCULAR DNA AND THE PRESENCE OF INTEGRATED HBV DNA IN THE HOST GENOME ARE IGNORED. THEREFORE, THE SCIENTIFIC COMMUNITY HAS FOCUSED ON DEVELOPING INNOVATIVE THERAPEUTIC APPROACHES TO ACHIEVE A FUNCTIONAL CURE OF HBV, DEFINED AS UNDETECTABLE HBV DNA AND HBSAG LOSS OVER A LIMITED TREATMENT PERIOD. A DEEPER UNDERSTANDING OF THE HBV LIFE CYCLE HAS LED TO THE INTRODUCTION OF NOVEL DIRECT-ACTING ANTIVIRALS THAT EXERT THEIR FUNCTION THROUGH MULTIPLE MECHANISMS, INCLUDING INHIBITION OF VIRAL ENTRY, TRANSCRIPTIONAL SILENCING, EPIGENETIC MANIPULATION, INTERFERENCE WITH CAPSID ASSEMBLY, AND DISRUPTION OF HBSAG RELEASE. IN PARALLEL, ANOTHER CATEGORY OF NEW DRUGS AIMS TO RESTORE DYSREGULATED IMMUNE FUNCTION IN CHRONIC HEPATITIS B ACCOMPANIED BY LETHARGIC CELLULAR AND HUMORAL RESPONSES. STIMULATION OF INNATE IMMUNITY BY PATTERN-RECOGNITION RECEPTOR AGONISTS LEADS TO UPREGULATION OF ANTIVIRAL CYTOKINE EXPRESSION AND APPEARS TO CONTRIBUTE TO HBV CONTAINMENT. IMMUNE CHECKPOINT INHIBITORS AND ADOPTIVE TRANSFER OF GENETICALLY ENGINEERED T CELLS ARE BREAKTHROUGH TECHNOLOGIES CURRENTLY BEING EXPLORED THAT MAY ELICIT POTENT HBV-SPECIFIC T-CELL RESPONSES. IN ADDITION, SEVERAL CLINICAL TRIALS ARE ATTEMPTING TO CLARIFY THE ROLE OF THERAPEUTIC VACCINATION IN THIS SETTING. ULTIMATELY, IT IS INCREASINGLY RECOGNIZED THAT ELIMINATION OF HBV REQUIRES A TREATMENT REGIMEN BASED ON A COMBINATION OF MULTIPLE DRUGS. THIS REVIEW DESCRIBES THE RATIONALE FOR PROGRESSIVE THERAPEUTIC INTERVENTIONS AND DISCUSSES THE LATEST FINDINGS IN THE FIELD OF HBV THERAPEUTICS. 2021 13 6536 29 TRANSCRIPTIONAL REGULATION OF TYPE-2 METABOTROPIC GLUTAMATE RECEPTORS: AN EPIGENETIC PATH TO NOVEL TREATMENTS FOR CHRONIC PAIN. ACTIVATION OF METABOTROPIC GLUTAMATE 2 (MGLU2) RECEPTORS INHIBITS PAIN TRANSMISSION AT THE SYNAPSES BETWEEN PRIMARY AFFERENT FIBERS AND NEURONS IN THE DORSAL HORN OF THE SPINAL CORD. IN ADDITION, MGLU2 RECEPTORS ARE FOUND IN PERIPHERAL NOCICEPTORS, AND IN PAIN-REGULATORY CENTERS OF THE BRAIN STEM AND FOREBRAIN. MGLU2 RECEPTOR AGONISTS PRODUCE ANALGESIA IN MODELS OF INFLAMMATORY AND NEUROPATHIC PAIN, BUT THEIR USE IS LIMITED BY THE DEVELOPMENT OF TOLERANCE. A NEW THERAPEUTIC STRATEGY COULD BE BASED ON THE TRANSCRIPTIONAL REGULATION OF MGLU2 RECEPTORS VIA THE ACETYLATION-PROMOTED ACTIVATION OF THE P65/RELA TRANSCRIPTION FACTOR. "EPIGENETIC" DRUGS THAT INCREASE MGLU2 RECEPTOR EXPRESSION, INCLUDING L-ACETYLCARNITINE AND INHIBITORS OF HISTONE DEACETYLASES, HAVE A DIFFERENT ANALGESIC PROFILE WITH NO TOLERANCE TO THE THERAPEUTIC EFFECT AFTER REPEATED DOSING. 2010 14 2915 23 GENE THERAPY FOR CHRONIC HBV-CAN WE ELIMINATE CCCDNA? CHRONIC INFECTION WITH THE HEPATITIS B VIRUS (HBV) IS A GLOBAL HEALTH CONCERN AND ACCOUNTS FOR APPROXIMATELY 1 MILLION DEATHS ANNUALLY. AMONGST OTHER LIMITATIONS OF CURRENT ANTI-HBV TREATMENT, FAILURE TO ELIMINATE THE VIRAL COVALENTLY CLOSED CIRCULAR DNA (CCCDNA) AND EMERGENCE OF RESISTANCE REMAIN THE MOST WORRISOME. VIRAL REBOUND FROM LATENT EPISOMAL CCCDNA RESERVOIRS OCCURS FOLLOWING CESSATION OF THERAPY, PATIENT NON-COMPLIANCE, OR THE DEVELOPMENT OF ESCAPE MUTANTS. SIMULTANEOUS VIRAL CO-INFECTIONS, SUCH AS BY HIV-1, FURTHER COMPLICATE THERAPEUTIC INTERVENTIONS. THESE CHALLENGES HAVE PROMPTED DEVELOPMENT OF NOVEL TARGETED HEPATITIS B THERAPIES. GIVEN THE EASE WITH WHICH HIGHLY SPECIFIC AND POTENT NUCLEIC ACID THERAPEUTICS CAN BE RATIONALLY DESIGNED, GENE THERAPY HAS GENERATED INTEREST FOR ANTIVIRAL APPLICATION. GENE THERAPY STRATEGIES DEVELOPED FOR HBV INCLUDE GENE SILENCING BY HARNESSING RNA INTERFERENCE, TRANSCRIPTIONAL INHIBITION THROUGH EPIGENETIC MODIFICATION OF TARGET DNA, GENOME EDITING BY DESIGNER NUCLEASES, AND IMMUNE MODULATION WITH CYTOKINES. DNA-BINDING DOMAINS AND EFFECTORS BASED ON THE ZINC FINGER (ZF), TRANSCRIPTION ACTIVATOR-LIKE EFFECTOR (TALE), AND CLUSTERED REGULARLY INTERSPACED SHORT PALINDROMIC REPEAT (CRISPR) SYSTEMS ARE REMARKABLY WELL SUITED TO TARGETING EPISOMAL CCCDNA. THIS REVIEW DISCUSSES RECENT DEVELOPMENTS AND CHALLENGES FACING THE FIELD OF ANTI-HBV GENE THERAPY, ITS POTENTIAL CURATIVE SIGNIFICANCE AND THE PROGRESS TOWARDS CLINICAL APPLICATION. 2018 15 6712 17 VIRUS-HOST INTERPLAY IN HEPATITIS B VIRUS INFECTION AND EPIGENETIC TREATMENT STRATEGIES. WORLDWIDE, CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS A MAJOR HEALTH PROBLEM AND NO CURE EXISTS. IMPORTANTLY, HEPATOCYTE INTRUSION BY HBV PARTICLES RESULTS IN A COMPLEX DEREGULATION OF BOTH VIRAL AND HOST CELLULAR GENETIC AND EPIGENETIC PROCESSES. AMONG THE ATTEMPTS TO DEVELOP NOVEL THERAPEUTIC APPROACHES AGAINST HBV INFECTION, SEVERAL OPTIONS TARGETING THE EPIGENOMIC REGULATION OF HBV REPLICATION ARE GAINING ATTENTION. THESE INCLUDE THE EXPERIMENTAL TREATMENT WITH 'EPIDRUGS'. MOREOVER, AS A TARGETED APPROACH, THE PRINCIPLE OF 'EPIGENETIC EDITING' RECENTLY IS BEING EXPLOITED TO CONTROL VIRAL REPLICATION. SILENCING OF HBV BY SPECIFIC REWRITING OF EPIGENETIC MARKS MIGHT DIMINISH VIRAL REPLICATION, VIREMIA, AND INFECTIVITY, EVENTUALLY CONTROLLING THE DISEASE AND ITS COMPLICATIONS. ADDITIONALLY, EPIGENETIC EDITING CAN BE USED AS AN EXPERIMENTAL TOOL TO INCREASE OUR LIMITED UNDERSTANDING REGARDING THE ROLE OF EPIGENETIC MODIFICATIONS IN VIRAL INFECTIONS. AIMING FOR PERMANENT EPIGENETIC REPROGRAMMING OF THE VIRAL GENOME WITHOUT UNSPECIFIC SIDE EFFECTS, THIS BREAKTHROUGH MAY PAVE THE ROADS FOR AN AMBITIOUS TECHNOLOGICAL PURSUIT: TO START DESIGNING A CURATIVE APPROACH UTILIZING MANIPULATIVE MOLECULAR THERAPIES FOR VIRAL INFECTIONS IN VIVO. 2017 16 4850 32 OPIOIDS AND OPIOID RECEPTORS; UNDERSTANDING PHARMACOLOGICAL MECHANISMS AS A KEY TO THERAPEUTIC ADVANCES AND MITIGATION OF THE MISUSE CRISIS. OPIOIDS ARE A MAINSTAY IN ACUTE PAIN MANAGEMENT AND PRODUCE THEIR EFFECTS AND SIDE EFFECTS (E.G., TOLERANCE, OPIOID-USE DISORDER AND IMMUNE SUPPRESSION) BY INTERACTION WITH OPIOID RECEPTORS. I WILL DISCUSS OPIOID PHARMACOLOGY IN SOME CONTROVERSIAL AREAS OF ENQUIRY OF ANAESTHETIC RELEVANCE. THE MAIN OPIOID TARGET IS THE MICRO (MU,MOP) RECEPTOR BUT OTHER MEMBERS OF THE OPIOID RECEPTOR FAMILY, DELTA (DELTA; DOP) AND KAPPA (KAPPA; KOP) OPIOID RECEPTORS ALSO PRODUCE ANALGESIC ACTIONS. THESE ARE NALOXONE-SENSITIVE. THERE IS IMPORTANT CLINICAL DEVELOPMENT RELATING TO THE NOCICEPTIN/ORPHANIN FQ (NOP) RECEPTOR, AN OPIOID RECEPTOR THAT IS NOT NALOXONE-SENSITIVE. BETTER UNDERSTANDING OF THE DRIVERS FOR OPIOID EFFECTS AND SIDE EFFECTS MAY FACILITATE SEPARATION OF SIDE EFFECTS AND PRODUCTION OF SAFER DRUGS. OPIOIDS BIND TO THE RECEPTOR ORTHOSTERIC SITE TO PRODUCE THEIR EFFECTS AND CAN ENGAGE MONOMER OR HOMO-, HETERODIMER RECEPTORS. SOME LIGANDS CAN DRIVE ONE INTRACELLULAR PATHWAY OVER ANOTHER. THIS IS THE BASIS OF BIASED AGONISM (OR FUNCTIONAL SELECTIVITY). OPIOID ACTIONS AT THE ORTHOSTERIC SITE CAN BE MODULATED ALLOSTERICALLY AND POSITIVE ALLOSTERIC MODULATORS THAT ENHANCE OPIOID ACTION ARE IN DEVELOPMENT. AS WELL AS TARGETING LIGAND-RECEPTOR INTERACTION AND TRANSDUCTION, MODULATING RECEPTOR EXPRESSION AND HENCE FUNCTION IS ALSO TRACTABLE. THERE IS EVIDENCE FOR EPIGENETIC ASSOCIATIONS WITH DIFFERENT TYPES OF PAIN AND ALSO SUBSTANCE MISUSE. AS LONG AS THE OPIOID NARRATIVE IS DEFINED BY THE 'OPIOID CRISIS' THE DRIVE TO REMOVE THEM COULD GATHER PACE. THIS WILL DENY USE WHERE THEY ARE EFFECTIVE, AND ACCESS TO MORPHINE FOR PAIN RELIEF IN LOW INCOME COUNTRIES. 2023 17 442 16 ANTIVIRAL THERAPIES FOR HEPATITIS B VIRUS-RELATED HEPATOCELLULAR CARCINOMA. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS A CRITICAL RISK FACTOR FOR THE CARCINOGENESIS AND PROGRESSION OF HEPATOCELLULAR CARCINOMA (HCC). IT PROMOTES HCC DEVELOPMENT BY INDUCING LIVER FIBROGENESIS, GENETIC AND EPIGENETIC ALTERATIONS, AND THE EXPRESSION OF ACTIVE VIRAL-CODED PROTEINS. EFFECTIVE ANTIVIRAL TREATMENTS INHIBIT THE REPLICATION OF HBV, REDUCE SERUM VIRAL LOAD AND ACCELERATE HEPATITIS B E ANTIGEN SERUM CONVERSION. TIMELY INITIATION OF ANTIVIRAL TREATMENT IS NOT ONLY ESSENTIAL FOR PREVENTING THE INCIDENCE OF HCC IN CHRONIC HEPATITIS B PATIENTS, BUT ALSO IMPORTANT FOR REDUCING HBV REACTIVATION, IMPROVING LIVER FUNCTION, REDUCING OR DELAYING HCC RECURRENCE, AND PROLONGING OVERALL SURVIVAL OF HBV-RELATED HCC PATIENTS AFTER CURATIVE AND PALLIATIVE THERAPIES. THE SELECTION OF ANTIVIRAL DRUGS, MONITORING OF INDICATORS SUCH AS HBV DNA AND HEPATITIS B SURFACE ANTIGEN, AND TIMELY RESCUE TREATMENT WHEN NECESSARY, ARE ESSENTIAL IN ANTIVIRAL THERAPIES FOR HBV-RELATED HCC. 2015 18 4532 26 MULTIMODAL ANALGESIA FOR PERIOPERATIVE MANAGEMENT OF PATIENTS PRESENTING FOR SPINAL SURGERY. MULTIMODAL, NON-OPIOID BASED ANALGESIA HAS BECOME THE CORNERSTONE OF ERAS PROTOCOLS FOR EFFECTIVE ANALGESIA AFTER SPINAL SURGERY. OPIOID SIDE EFFECTS, DEPENDENCE AND LEGISLATION RESTRICTING LONG TERM OPIOID USE HAS LED TO A RESURGENCE IN INTEREST IN OPIOID SPARING TECHNIQUES. THE INCREASING ARRAY OF MULTIMODAL OPIOID SPARING ANALGESICS AVAILABLE FOR SPINAL SURGERY TARGETING NOVEL RECEPTORS, TRANSMITTERS, AND ALTERING EPIGENETICS CAN HELP PROVIDE AN OPTIMAL PERIOPERATIVE EXPERIENCE WITH LESS OPIOID SIDE EFFECTS AND LONG-TERM DEPENDENCE. EPIGENETIC MECHANISMS OF PAIN MAY ENHANCE OR SUPPRESS GENE EXPRESSION, WITHOUT ALTERING THE GENOME ITSELF. SUCH MECHANISMS ARE COMPLEX, DYNAMIC AND RESPONSIVE TO ENVIRONMENT. ALTERATIONS THAT OCCUR CAN AFFECT THE PATHOPHYSIOLOGY OF PAIN MANAGEMENT AT A DNA LEVEL, MODIFYING PERCEIVED PAIN RELIEF. IN THIS REVIEW, WE PROVIDE A BRIEF OVERVIEW OF EPIGENETICS OF PAIN, SYSTEMIC LOCAL ANESTHETICS AND NEURAXIAL TECHNIQUES THAT CONTINUE TO REMAIN USEFUL FOR SPINAL SURGERY, NEUROPATHIC AGENTS, AS WELL AS OTHER COMMON AND LESS COMMON TARGET RECEPTORS FOR A TRULY MULTIMODAL APPROACH TO PERIOPERATIVE PAIN MANAGEMENT. 2019 19 3374 20 HISTONE POST-TRANSLATIONAL MODIFICATIONS AS POTENTIAL THERAPEUTIC TARGETS FOR PAIN MANAGEMENT. EFFECTIVE PHARMACOLOGICAL MANAGEMENT OF PAIN ASSOCIATED WITH TISSUE PATHOLOGY IS AN UNMET MEDICAL NEED. TRANSCRIPTIONAL MODIFICATIONS IN NOCICEPTIVE PATHWAYS ARE PIVOTAL FOR THE DEVELOPMENT AND THE MAINTENANCE OF PAIN ASSOCIATED WITH TISSUE DAMAGE. ACCUMULATING EVIDENCE HAS SHOWN THE IMPORTANCE OF THE EPIGENETIC CONTROL OF TRANSCRIPTION IN NOCICEPTIVE PATHWAYS VIA HISTONE POST-TRANSLATIONAL MODIFICATIONS (PTMS). HENCE, HISTONE PTMS COULD BE TARGETS FOR NOVEL EFFECTIVE ANALGESICS. HERE, WE DISCUSS THE CURRENT UNDERSTANDING OF HISTONE PTMS IN THE MODULATION OF GENE EXPRESSION AFFECTING NOCICEPTION AND PAIN PHENOTYPES FOLLOWING TISSUE INJURY. WE ALSO PROVIDE A CRITICAL VIEW OF THE TRANSLATIONAL IMPLICATIONS OF PRECLINICAL MODELS AND DISCUSS OPPORTUNITIES AND CHALLENGES OF TARGETING HISTONE PTMS TO RELIEVE PAIN IN CLINICALLY RELEVANT TISSUE INJURIES. 2021 20 6138 28 THE ETIOLOGICAL CHANGES OF ACETYLATION IN PERIPHERAL NERVE INJURY-INDUCED NEUROPATHIC HYPERSENSITIVITY. NEUROPATHIC PAIN IS A COMMON CHRONIC PAIN CONDITION WITH MECHANISMS FAR CLEARLY BEEN ELUCIDATED. MOUNTING PRECLINICAL AND CLINICAL STUDIES HAVE SHOWN NEUROPATHIC PAIN IS HIGHLY ASSOCIATED WITH HISTONE ACETYLATION MODIFICATION, WHICH FOLLOWS EXPRESSION REGULATION OF VARIOUS PAIN-RELATED MOLECULES SUCH AS MGLUR1/5, GLUTAMATE ASPARTATE TRANSPORTER, GLUTAMATE TRANSPORTER-1, GAD65, NA(V)1.8, KV4.3, MU-OPIOID RECEPTOR, BRAIN-DERIVED NEUROTROPHIC FACTOR, AND CERTAIN CHEMOKINES. AS TWO TYPES OF PIVOTAL ENZYMES INVOLVED IN HISTONE ACETYLATION, HISTONE DEACETYLASES INDUCE HISTONE DEACETYLATION TO SILENCE GENE EXPRESSION; IN CONTRAST, HISTONE ACETYL TRANSFERASES FACILITATE HISTONE ACETYLATION TO POTENTIATE GENE TRANSCRIPTION. ACCORDINGLY, UPREGULATION OR BLOCKADE OF ACETYLATION MAY BE A PROMISING INTERVENTION DIRECTION FOR NEUROPATHIC PAIN TREATMENT. IN FACT, NUMEROUS ANIMAL STUDIES HAVE SUGGESTED VARIOUS HISTONE DEACETYLASE INHIBITORS, SIRT (CLASS III HISTONE DEACETYLASES) ACTIVATORS, AND HISTONE ACETYL TRANSFERASES INHIBITORS ARE EFFECTIVE IN NEUROPATHIC PAIN TREATMENT VIA TARGETING SPECIFIC EPIGENETIC SITES. IN THIS REVIEW, WE SUMMARIZE THE CHARACTERISTICS OF THE MOLECULES AND MECHANISMS OF NEUROPATHY-RELATED ACETYLATION, AS WELL AS THE ACETYLATION UPREGULATION AND BLOCKADE FOR NEUROPATHIC PAIN THERAPY. FINALLY, WE WILL DISCUSS THE CURRENT DRUG ADVANCES FOCUSING ON NEUROPATHY-RELATED ACETYLATION ALONG WITH THE UNDERLYING TREATMENT MECHANISMS. 2018