1 1061 179 CLINICAL REMISSION OF SIGHT-THREATENING NON-INFECTIOUS UVEITIS IS CHARACTERIZED BY AN UPREGULATION OF PERIPHERAL T-REGULATORY CELL POLARIZED TOWARDS T-BET AND TIGIT. BACKGROUND: NON-INFECTIOUS UVEITIS CAN CAUSE CHRONIC RELAPSING AND REMITTING OCULAR INFLAMMATION, WHICH MAY REQUIRE HIGH DOSE SYSTEMIC IMMUNOSUPPRESSION TO PREVENT SEVERE SIGHT LOSS. IT HAS BEEN CLASSICALLY DESCRIBED AS AN AUTOIMMUNE DISEASE, MEDIATED BY PRO-INFLAMMATORY TH1 AND TH17 T-CELL SUBSETS. STUDIES SUGGEST THAT NATURAL IMMUNOSUPPRESSIVE CD4(+)CD25(+)FOXP3(+) T-REGULATORY CELLS (TREGS) ARE INVOLVED IN RESOLUTION OF INFLAMMATION AND MAY BE INVOLVED IN THE MAINTENANCE OF CLINICAL REMISSION. OBJECTIVE: TO INVESTIGATE WHETHER THERE IS A PERIPHERAL BLOOD IMMUNOREGULATORY PHENOTYPE ASSOCIATED WITH CLINICAL REMISSION OF SIGHT-THREATENING NON-INFECTIOUS UVEITIS BY COMPARING PERIPHERAL BLOOD LEVELS OF TREG, TH1, AND TH17, AND ASSOCIATED DNA METHYLATION AND CYTOKINE LEVELS IN PATIENTS WITH ACTIVE UVEITIC DISEASE, CONTROL SUBJECTS AND PATIENTS (WITH PREVIOUSLY ACTIVE DISEASE) IN CLINICAL REMISSION INDUCED BY IMMUNOSUPPRESSIVE DRUGS. METHODS: ISOLATED PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMC) FROM PERIPHERAL BLOOD SAMPLES FROM PROSPECTIVELY RECRUITED SUBJECTS WERE ANALYZED BY FLOW CYTOMETRY FOR CD3, CD4, FOXP3, TIGIT, T-BET, AND RELATED ORPHAN RECEPTOR GAMMAT. EPIGENETIC DNA METHYLATION LEVELS OF FOXP3 TREG-SPECIFIC DEMETHYLATED REGION (TSDR), FOXP3 PROMOTER, TBX21, RORC2, AND TIGIT LOCI WERE DETERMINED IN CRYOPRESERVED PBMC USING A NEXT-GENERATION SEQUENCING APPROACH. RELATED CYTOKINES WERE MEASURED IN BLOOD SERA. FUNCTIONAL SUPPRESSIVE CAPACITY OF TREG WAS ASSESSED USING T-CELL PROLIFERATION ASSAYS. RESULTS: FIFTY PATIENTS WITH UVEITIS (INTERMEDIATE, POSTERIOR, AND PANUVEITIS) AND 10 CONTROL SUBJECTS WERE RECRUITED. THE FREQUENCY OF CD4(+)CD25(+)FOXP3(+) TREG, TIGIT(+) TREG, AND T-BET(+) TREG AND THE RATIO OF TREG TO TH1 WERE SIGNIFICANTLY HIGHER IN REMISSION PATIENTS COMPARED WITH PATIENTS WITH ACTIVE UVEITIC DISEASE; AND TIGIT(+) TREGS WERE A SIGNIFICANT PREDICTOR OF CLINICAL REMISSION. TREG FROM PATIENTS IN CLINICAL REMISSION DEMONSTRATED A HIGH LEVEL OF IN VITRO SUPPRESSIVE FUNCTION COMPARED WITH TREG FROM CONTROL SUBJECTS AND FROM PATIENTS WITH UNTREATED ACTIVE DISEASE. PBMC FROM PATIENTS IN CLINICAL REMISSION HAD SIGNIFICANTLY LOWER METHYLATION LEVELS AT THE FOXP3 TSDR, FOXP3 PROMOTER, AND TIGIT LOCI AND HIGHER LEVELS AT RORC LOCI THAN THOSE WITH ACTIVE DISEASE. CLINICAL REMISSION WAS ALSO ASSOCIATED WITH SIGNIFICANTLY HIGHER SERUM LEVELS OF TRANSFORMING GROWTH FACTOR BETA AND IL-10, WHICH POSITIVELY CORRELATED WITH TREG LEVELS, AND LOWER SERUM LEVELS OF IFNGAMMA, IL-17A, AND IL-22 COMPARED WITH PATIENTS WITH ACTIVE DISEASE. CONCLUSION: CLINICAL REMISSION OF SIGHT-THREATENING NON-INFECTIOUS UVEITIS HAS AN IMMUNOREGULATORY PHENOTYPE CHARACTERIZED BY UPREGULATION OF PERIPHERAL TREG, POLARIZED TOWARD T-BET AND TIGIT. THESE FINDINGS MAY ASSIST WITH INDIVIDUALIZED THERAPY OF UVEITIS, BY INFORMING WHETHER DRUG THERAPY HAS INDUCED PHENOTYPICALLY STABLE TREG ASSOCIATED WITH LONG-TERM CLINICAL REMISSION. 2018 2 5758 42 SOCS3 DELETION IN T LYMPHOCYTES SUPPRESSES DEVELOPMENT OF CHRONIC OCULAR INFLAMMATION VIA UPREGULATION OF CTLA-4 AND EXPANSION OF REGULATORY T CELLS. SUPPRESSORS OF CYTOKINE SIGNALING (SOCS) PROTEINS ARE NEGATIVE-FEEDBACK REGULATORS OF THE JAK/STAT PATHWAY, AND SOCS3 CONTRIBUTES TO HOST IMMUNITY BY REGULATING THE INTENSITY AND DURATION OF CYTOKINE SIGNALS AND INFLAMMATORY RESPONSES. MICE WITH SOCS3 DELETION IN MYELOID CELLS EXHIBIT ENHANCED STAT3 SIGNALING, EXPANSION OF TH1 AND TH17 CELLS, AND DEVELOP SEVERE EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS. INTERESTINGLY, DEVELOPMENT OF THE UNIQUE IL-17/IFN-GAMMA DOUBLE-PRODUCING (TH17/IFN-GAMMA AND TC17/IFN-GAMMA) SUBSETS THAT EXHIBIT STRONG CYTOTOXIC ACTIVITIES AND ARE ASSOCIATED WITH PATHOGENESIS OF SEVERAL AUTOIMMUNE DISEASES HAS RECENTLY BEEN SHOWN TO DEPEND ON EPIGENETIC SUPPRESSION OF SOCS3 EXPRESSION, FURTHER SUGGESTING INVOLVEMENT OF SOCS3 IN AUTOIMMUNITY AND TUMOR IMMUNITY. IN THIS STUDY, WE GENERATED MICE WITH SOCS3 DELETION IN THE CD4 T CELL COMPARTMENT (CD4-SOCS3 KNOCKOUT [KO]) TO DETERMINE IN VIVO EFFECTS OF THE LOSS OF SOCS3 IN THE T CELL-MEDIATED AUTOIMMUNE DISEASE, EXPERIMENTAL AUTOIMMUNE UVEITIS (EAU). IN CONTRAST TO THE EXACERBATION OF EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS IN MYELOID-SPECIFIC SOCS3-DELETED MICE, CD4-SOCS3KO MICE WERE PROTECTED FROM ACUTE AND CHRONIC UVEITIS. PROTECTION FROM EAU CORRELATED WITH ENHANCED EXPRESSION OF CTLA-4 AND EXPANSION OF IL-10-PRODUCING REGULATORY T CELLS WITH AUGMENTED SUPPRESSIVE ACTIVITIES. WE FURTHER SHOW THAT SOCS3 INTERACTS WITH CTLA-4 AND NEGATIVELY REGULATES CTLA-4 LEVELS IN T CELLS, PROVIDING A MECHANISTIC EXPLANATION FOR THE EXPANSION OF REGULATORY T CELLS IN CD4-SOCS3 DURING EAU. CONTRARY TO IN VITRO EPIGENETIC STUDIES, TH17/IFN-GAMMA AND TC17/IFN-GAMMA POPULATIONS WERE MARKEDLY REDUCED IN CD4-SOCS3KO, SUGGESTING THAT SOCS3 PROMOTES EXPANSION OF THE TH17/IFN-GAMMA SUBSET ASSOCIATED WITH DEVELOPMENT OF SEVERE UVEITIS. THUS, SOCS3 IS A POTENTIAL THERAPEUTIC TARGET IN UVEITIS AND OTHER AUTOINFLAMMATORY DISEASES. 2013 3 4272 30 MICROBIOME AND BEHCET'S DISEASE: A SYSTEMATIC REVIEW. THE AIM OF THIS REVIEW WAS TO DESCRIBE THE CHANGES IN THE MICROBIOTA OF PATIENTS WITH BEHCET'S DISEASE (BD) AND THE MECHANISMS INVOLVED IN THE RELATIONSHIP BETWEEN THE MICROBIOME AND IMMUNITY IN BD. A SYSTEMATIC SEARCH FOR RELEVANT ARTICLES WAS MADE ON PUBMED AND THE COCHRANE LIBRARY DATABASE USING THE FOLLOWING TERMS: "MICROBIOTA AND BEHCET'S DISEASE" OR "MICROBIOME AND BEHCET'S DISEASE". SIXTEEN ARTICLES WERE INCLUDED IN A QUALITATIVE SYNTHESIS. THIS SYSTEMATIC REVIEW ON THE MICROBIOME AND BEHCET'S DISEASE UNDERLINES THE PRESENCE OF GUT DYSBIOSIS IN BD PATIENTS. THIS DYSBIOSIS IS MARKED BY (I) A DECREASE IN BUTYRATE-PRODUCING BACTERIA, WHICH COULD AFFECT T CELL DIFFERENTIATION AND EPIGENETIC REGULATION OF IMMUNE-RELATED GENES, (II) A MODIFICATION OF TRYPTOPHAN-METABOLISING BACTERIA, WHICH COULD BE LINKED TO DYSREGULATED IL-22 SECRETION, AND (III) A DECREASE IN BACTERIA KNOWN TO HAVE ANTI-INFLAMMATORY PROPERTIES. REGARDING ORAL MICROBIOTA, THIS REVIEW UNDERLINES THE POSSIBLE ROLE OF STREPTOCOCCUS SANGUINIS THROUGH MOLECULAR MIMICRY AND NETOSIS. CLINICAL STUDIES OF BD HAVE SHOWN THAT (I) NEED FOR DENTISTRY IS ASSOCIATED WITH A MORE SEVERE COURSE IN BD, AND (II) ANTIBIOTIC-SUPPLEMENTED MOUTHWASH REDUCES PAIN AND ULCERS. FECAL TRANSPLANTATION OF BD PATIENTS' MICROBIOTA INTO MOUSE MODELS LED TO DECREASED SCFA PRODUCTION, NEUTROPHIL ACTIVATION, AND TH1/TH17 RESPONSES.RECIPIENT MICE SHOWED EXACERBATED EXPERIMENTAL AUTOIMMUNE UVEITIS (EAU) AND EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS (EAE). IN HERPES VIRUS SIMPLEX-1 (HSV-1) INFECTED MICE MIMICKING BD, ADMINISTRATION OF BUTYRATEPRODUCING BACTERIA IMPROVED SYMPTOMS AND IMMUNE VARIABLES. THE MICROBIOME MAY THUS BE INVOLVED IN BD THROUGH IMMUNITY REGULATION AND EPIGENETIC MODIFICATIONS. 2023 4 3548 26 IMMUNOPATHOGENESIS OF BEHCET DISEASE. BACKGROUND: BEHCET'S DISEASE (BD, OMIM 109650) IS A CHRONIC RELAPSING INFLAMMATORY DISEASE OF UNKNOWN ETIOLOGY WITH UNPREDICTABLE EXACERBATIONS AND REMISSIONS. FIRST DESCRIBED IN 1937 BY THE TURKISH DERMATOLOGIST HULUSIBEHCET, AS A TRISYMPTON COMPLEX (ORAL AND GENITAL ULCERS AND UVEITIS), IT IS NOW RECOGNIZED AS A MULTISYSTEMIC DISEASE. THE SYNDROME CAN MANIFEST IN DIVERSE WAYS AND CAN INVOLVE NEARLY EVERY ORGAN SYSTEM. SEVERAL STUDIES HAVE IMPLICATED T CELLS AND MONOCYTES IN THE PATHOGENESIS OF BD ESPECIALLY WHEN THESE CELLS ARE STIMULATED BY HEAT SHOCK PROTEINS AND STREPTOCOCCAL ANTIGEN. THIS ARTICLE PRESENTS A REVIEW OF THE RELEVANT PUBLISHED LITERATURE ABOUT THE IMMUNOPATHOGENESIS OF BD. RESULT: THE AUTHORS USED MESH TERMS "BEHCET'S DISEASE" WITH "PATHOPHYSIOLOGY," "PATHOGENESIS," "GENETIC", "EPIGENETIC", "IMMUNOGENETIC" OR "IMMUNE RESPONSE" TO SEARCH THE PUBMED DATABASE. ALL THE RELEVANT STUDIES IDENTIFIED WERE INCLUDED. 2020 5 4843 42 ONE YEAR IN REVIEW 2019: BEHCET'S SYNDROME. SEVERAL EPIDEMIOLOGIC STUDIES REPORT ON THE PREVALENCE OF BEHCET'S SYNDROME (BS) AND DEMOGRAPHIC AND CLINICAL FINDINGS IN PATIENTS FROM DIFFERENT COUNTRIES AND ETHNICITIES. ALTHOUGH THESE STUDIES POINT OUT GEOGRAPHIC DIFFERENCES IN DISEASE COURSE, METHODOLOGIC DIFFERENCES MAKE IT DIFFICULT TO COMPARE THE RESULTS OF THESE STUDIES. RECENT DATA SUGGEST THAT NEUTROPHIL EXTRACELLULAR TRAP LEVELS ARE ELEVATED IN PATIENTS WITH BS, AND THAT IT MAY BE A POTENTIAL THERAPEUTIC TARGET FOR THE REDUCTION OR PREVENTION OF BS-ASSOCIATED THROMBOTIC RISK. DETAILS ON THE MODE OF FUNCTIONING OF ERAP HAVE BEEN DELINEATED AND FURTHER EPIGENETIC DATA REPORTED. WALL THICKNESS OF LOWER EXTREMITY VEINS IS INCREASED AMONG BS PATIENTS WITHOUT ANY APPARENT CLINICAL INVOLVEMENT. MAGNETIC RESONANCE (MR) VENOGRAPHY AND DOPPLER ULTRASONOGRAPHY (USG) WERE COMPARABLE IN THE DIAGNOSIS OF CHRONIC DEEP VEIN THROMBOSIS, WHILE MR VENOGRAPHY IS MORE EFFECTIVE IN DETECTING COLLATERAL FORMATIONS. RESULTS WERE ALSO COLLECTED ON SOME DIETARY AND NON-DIETARY FACTORS IN TRIGGERING ORAL ULCERS, WHILE SMOKING SEEMS TO HAVE A PROTECTIVE ROLE. WITH REGARDS TO THE THERAPY, IT HAS BEEN DEMONSTRATED THAT ENDOVASCULAR INTERVENTIONS CARRY THE RISK OF INDUCING PATHERGY PHENOMENON. APREMILAST HAS BEEN CONVINCINGLY SHOWN TO BE USEFUL FOR ORAL ULCERS OF BS AND CLASSICAL IMMUNOSUPPRESSIVES ARE EFFECTIVE AS FIRST LINE THERAPY IN MORE THAN HALF OF PATIENTS WITH UVEITIS. WHILE INFLIXIMAB AND ADALIMUMAB SEEM TO BE EQUALLY EFFECTIVE IN THE TREATMENT OF REFRACTORY UVEITIS OF BS, THE COMBINATION OF ADALIMUMAB AND IMMUNOSUPPRESSIVES APPEARS TO BE SUPERIOR TO IMMUNOSUPPRESSIVES ALONE FOR VENOUS THROMBOSIS OF THE EXTREMITIES. IN ADDITION, TOCILIZUMAB MIGHT BE AN ALTERNATIVE TO ANTI-TNF AGENTS FOR PATIENTS WITH ARTERIAL INVOLVEMENT REFRACTORY TO IMMUNOSUPPRESSIVES. ON THE OTHER HAND, THE PLACE OF IL-17 INHIBITION IN THE TREATMENT OF BS STILL REMAINS QUESTIONABLE. 2019 6 1226 24 CRITICAL ROLE OF GUT MICROBIOTA AND EPIGENETIC FACTORS IN THE PATHOGENESIS OF BEHCET'S DISEASE. BEHCET'S DISEASE (BD) IS A CHRONIC REFRACTORY MULTISYSTEM AUTOINFLAMMATORY DISEASE, CHARACTERIZED BY TYPICAL CLINICAL FEATURES OF NON-SPECIFIC VASCULITIS, ORAL AND GENITAL ULCERS, UVEITIS, AS WELL AS SKIN LESIONS. THE EXACT ETIOPATHOGENESIS OF BD REMAINS UNKNOWN, EXISTING STUDIES HAVE INDICATED THAT GENETICS AND ENVIRONMENTAL FACTORS CONTRIBUTE TO THE INCREASED DEVELOPMENT OF BD. RECENTLY, SEVERAL STUDIES HAVE SHOWN THAT EXTERNAL ENVIRONMENTAL FACTORS CAN AFFECT THE PROCESS OF EPIGENETIC MODIFICATION, AND ABNORMALITIES OF EPIGENETIC FACTORS HAVE BEEN CONFIRMED TO BE INVOLVED IN THE OCCURRENCE OF BD. AT THE SAME TIME, ABNORMALITIES OF GUT MICROBIOTA (GM) IN THE BODY, HAVE ALSO BEEN CONFIRMED TO PARTICIPATE IN THE PATHOGENESIS OF BD BY REGULATING THE BALANCE OF TH17/TREGS. THIS ARTICLE REVIEWS THE PATHOGENESIS OF BD AND SUMMARIZES NUMEROUS CLINICAL STUDIES, FOCUSING ON THE MECHANISM OF GM AND EPIGENETIC FACTORS IMPACTING ON BD, AND PROVIDING NEW IDEAS FOR FURTHER ELUCIDATING THE PATHOGENESIS OF BD. 2021 7 6289 30 THE POTENTIAL ROLE OF GENETICS, ENVIRONMENTAL FACTORS, AND GUT DYSBIOSIS IN THE ABERRANT NON-CODING RNA EXPRESSION TO MEDIATE INFLAMMATION AND OSTEOCLASTOGENIC/OSTEOGENIC DIFFERENTIATION IN ANKYLOSING SPONDYLITIS. ANKYLOSING SPONDYLITIS (AS) OR RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS IS A CHRONIC IMMUNE-MEDIATED RHEUMATIC DISORDER CHARACTERIZED BY THE INFLAMMATION IN THE AXIAL SKELETON, PERIPHERAL JOINTS, AND SOFT TISSUES (ENTHESIS, FASCIA, AND LIGAMENT). IN ADDITION, THE EXTRA-SKELETAL COMPLICATIONS INCLUDING ANTERIOR UVEITIS, INTERSTITIAL LUNG DISEASES AND AORTITIS ARE FOUND. THE PATHOGENESIS OF AS IMPLICATES AN INTRICATE INTERACTION AMONG HLA (HLA-B27) AND NON-HLA LOCI [ENDOPLASMIC RETICULUM AMINOPEPTIDASE 1 (ERAP1), AND INTERLEUKIN-23 RECEPTOR (IL23R), GUT DYSBIOSIS, IMMUNE PLASTICITY, AND NUMEROUS ENVIRONMENTAL FACTORS (INFECTIONS, HEAVY METALS, STRESS, CIGARETTE SMOKING, ETC.) THE LATTER MULTIPLE NON-GENETIC FACTORS MAY EXERT A POWERFUL STRESS ON EPIGENETIC REGULATIONS. THESE EPIGENETIC REGULATIONS OF GENE EXPRESSION CONTAIN DNA METHYLATION/DEMETHYLATION, HISTONE MODIFICATIONS AND ABERRANT NON-CODING RNAS (NCRNAS) EXPRESSION, LEADING TO INFLAMMATION AND IMMUNE DYSFUNCTIONS. IN THE PRESENT REVIEW, WE SHALL DISCUSS THESE CONTRIBUTORY FACTORS THAT ARE INVOLVED IN AS PATHOGENESIS, ESPECIALLY THE ABERRANT NCRNA EXPRESSION AND ITS EFFECTS ON THE PROINFLAMMATORY CYTOKINE PRODUCTIONS (TNF-ALPHA, IL-17 AND IL-23), T CELL SKEWING TO TH1/TH17, AND OSTEOCLASTOGENIC/OSTEOGENIC DIFFERENTIATION. FINALLY, SOME POTENTIAL INVESTIGATORY APPROACHES ARE RAISED FOR SOLVING THE PUZZLES IN AS PATHOGENESIS. 2021 8 5049 41 PHARMACOLOGICAL INHIBITION OF RORC2 ENHANCES HUMAN TH17-TREG STABILITY AND FUNCTION. INFLAMMATORY BOWEL DISEASES (IBD) ARE CHRONIC CONDITIONS THAT RESULT FROM UNCONTROLLED INTESTINAL INFLAMMATION. PATHOGENIC TH17 CELLS, CHARACTERIZED BY PRODUCTION OF IL-17A IN THE ABSENCE OF IL-10, ARE THOUGHT TO CONTRIBUTE TO THIS INFLAMMATION, BUT IN HUMANS, ANTIBODY-MEDIATED BLOCKADE OF IL-17A IS AN INEFFECTIVE IBD THERAPY WHEREAS IL-23 BLOCKADE IS EFFECTIVE. HERE, WE INVESTIGATED THE EFFECTS OF PHARMACOLOGICAL INHIBITION OF RORC2, THE TH17 CELL LINEAGE-DEFINING TRANSCRIPTION FACTOR, ON IN VIVO-DIFFERENTIATED HUMAN TH17 CELLS AND TH17-LIKE TREGS (TH17-TREGS). BMS-336, A SMALL MOLECULE RORC2 INVERSE AGONIST, INHIBITED EXPRESSION OF RORC2-REGULATED GENES IN PERIPHERAL TH17 CELLS (CD4(+) CD25(-) CD127(+) CXCR3(-) CCR4(+) CCR6(+) ) IN A DOSE-DEPENDENT MANNER, WITH SIMILAR INHIBITORY EFFECTS ON LAMINAR PROPRIA MONONUCLEAR CELLS FROM IBD AND NON-IBD SUBJECTS. EXPOSURE OF PERIPHERAL TH17-TREGS (CD4(+) CD25(HI) CD127(LO) CXCR3(-) CCR4(+) CCR6(+) ) TO BMS-336 ALSO INHIBITED IL-17A PRODUCTION AND PREVENTED INFLAMMATORY CYTOKINE-INDUCED DESTABILIZATION, AS EVIDENCED BY PRESERVED FOXP3 EXPRESSION AND EPIGENETIC STATUS OF THE TREG-SPECIFIC DEMETHYLATION REGION. IN PARALLEL, RORC2 INHIBITION INCREASED THE PRODUCTION OF IL-10 IN TH17-TREGS, RESULTING IN ENHANCED SUPPRESSION OF INFLAMMATORY CYTOKINES FROM MYELOID CELLS. THUS, VIA ITS ABILITY TO SIMULTANEOUSLY INHIBIT TH17 CELLS AND ENHANCE THE STABILITY AND FUNCTION OF TH17-TREGS, PHARMACOLOGICAL INHIBITION OF RORC2 IS A PROMISING APPROACH TO SUPPRESS INFLAMMATION AND PROMOTE IMMUNE REGULATION IN IBD. 2020 9 4287 39 MICRORNA EXPRESSION PROFILING IN BEHCET'S DISEASE. BACKGROUND: BEHCET'S DISEASE (BD) IS A CHRONIC INFLAMMATORY MULTISYSTEM DISEASE CHARACTERIZED BY ORAL AND GENITAL ULCERS, UVEITIS, AND SKIN LESIONS. MICRORNAS (MIRNAS) ARE KEY REGULATORS OF IMMUNE RESPONSES. DIFFERENTIAL EXPRESSION OF MIRNAS HAS BEEN REPORTED IN SEVERAL INFLAMMATORY AUTOIMMUNE DISEASES; HOWEVER, THEIR ROLE IN BD IS NOT FULLY ELUCIDATED. WE AIMED TO IDENTIFY MIRNA EXPRESSION SIGNATURES ASSOCIATED WITH BD AND TO INVESTIGATE THEIR POTENTIAL IMPLICATION IN THE DISEASE PATHOGENESIS. METHODS: MIRNA MICROARRAY ANALYSIS WAS PERFORMED IN BLOOD CELLS OF BD PATIENTS AND HEALTHY CONTROLS. MIRNA EXPRESSION PROFILES WERE ANALYZED USING AFFYMETRIX ARRAYS WITH A COMPREHENSIVE COVERAGE OF MIRNA SEQUENCES. PATHWAY ANALYSES WERE PERFORMED, AND THE GLOBAL MIRNA PROFILING WAS COMBINED WITH TRANSCRIPTOMA DATA IN BD. DEREGULATION OF SELECTED MIRNAS WAS VALIDATED BY REAL-TIME PCR. RESULTS: WE IDENTIFIED SPECIFIC MIRNA SIGNATURES ASSOCIATED WITH BD PATIENTS WITH ACTIVE DISEASE. THESE MIRNAS TARGET PATHWAYS RELEVANT IN BD, SUCH AS TNF, IFN GAMMA, AND VEGF-VEGFR SIGNALING CASCADES. NETWORK ANALYSIS REVEALED SEVERAL MIRNAS REGULATING HIGHLY CONNECTED GENES WITHIN THE BD TRANSCRIPTOMA. CONCLUSIONS: THE COMBINED ANALYSIS OF DEREGULATED MIRNAS AND BD TRANSCRIPTOME SHEDS LIGHT ON SOME EPIGENETIC ASPECTS OF BD IDENTIFYING SPECIFIC MIRNAS, WHICH MAY REPRESENT PROMISING CANDIDATES AS BIOMARKERS AND/OR FOR THE DESIGN OF NOVEL THERAPEUTIC STRATEGIES IN BD. 2018 10 3789 29 INTERLEUKIN 17 CONTRIBUTES TO THE CHRONICITY OF INFLAMMATORY DISEASES SUCH AS RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY DISEASE LEADING TO JOINT DESTRUCTION AND BONE RESORPTION. THE PROINFLAMMATORY CYTOKINE INTERLEUKIN 17 (IL-17), PRIMARILY PRODUCED BY TH17 CELLS, HAS BEEN SHOWN TO BE INVOLVED IN ALL STAGES OF THE DISEASE AND TO BE AN IMPORTANT CONTRIBUTOR OF RA CHRONICITY. THREE MAJOR PROCESSES DRIVE THE IL-17-MEDIATED CHRONICITY. SEVERAL EPIGENETIC EVENTS, ENHANCED IN RA PATIENTS, LEAD TO THE INCREASED PRODUCTION OF IL-17 BY TH17 CELLS. IL-17 THEN INDUCES THE PRODUCTION OF SEVERAL INFLAMMATORY MEDIATORS IN THE DISEASED SYNOVIUM, WHICH ARE FURTHER SYNERGISTICALLY ENHANCED VIA COMBINATIONS OF IL-17 WITH OTHER CYTOKINES. IL-17 ALSO PROMOTES THE SURVIVAL OF BOTH THE SYNOVIOCYTES AND INFLAMMATORY CELLS AND PROMOTES THE MATURATION OF THESE IMMUNE CELLS. THIS LEADS TO AN INCREASED NUMBER OF SYNOVIOCYTES AND INFLAMMATORY CELLS IN THE SYNOVIAL FLUID AND IN THE SYNOVIUM LEADING TO THE HYPERPLASIA AND EXACERBATED INFLAMMATION OBSERVED IN JOINTS OF RA PATIENTS. FURTHERMORE, THESE IL-17-DRIVEN EVENTS INITIATE SEVERAL FEEDBACK-LOOP MECHANISMS LEADING TO INCREASED EXPANSION OF TH17 CELLS AND THEREBY INCREASED PRODUCTION OF IL-17. IN THIS REVIEW, WE AIM TO DEPICT A COMPLETE PICTURE OF THE IL-17-DRIVEN VICIOUS CIRCLE LEADING TO RA CHRONICITY AND TO PINPOINT THE KEY ASPECTS THAT REQUIRE FURTHER EXPLORATION. 2014 11 3026 36 GENETICS OF BEHCET'S DISEASE: FUNCTIONAL GENETIC ANALYSIS AND ESTIMATING DISEASE HERITABILITY. BEHCET'S DISEASE IS A CHRONIC MULTISYSTEMIC INFLAMMATORY DISORDER CHARACTERIZED BY RECURRENT ORAL AND GENITAL ULCERS. ALTHOUGH ITS ETIOLOGY REMAINS UNCLEAR, IT IS THOUGHT THAT BOTH GENETIC AND ENVIRONMENTAL FACTORS CONTRIBUTE TO THE ONSET AND PROGRESSION OF BEHCET'S DISEASE. HERE, WE PROVIDE AN UPDATED VIEW OF THE GENETIC LANDSCAPE AND ARCHITECTURE OF BEHCET'S DISEASE. LARGE-SCALE GENETIC STUDIES PERFORMED TO DATE REVEALED 21 GENETIC SUSCEPTIBILITY LOCI ASSOCIATED WITH THE DISEASE AT A GWAS LEVEL OF SIGNIFICANCE (P-VALUE = 5 X 10(-8)). WE PERFORMED EPIGENETIC PATTERN ENRICHMENT ANALYSIS IN BEHCET'S DISEASE ASSOCIATED LOCI, PROVIDING NEW INSIGHTS INTO THE MOLECULAR MECHANISMS UNDERLYING ITS PATHOPHYSIOLOGY. OUR DATA SUGGEST THE CRUCIAL INVOLVEMENT OF SEVERAL IMMUNE CELL TYPES, INCLUDING NATURAL KILLER CELLS, MONOCYTES, AND B CELLS IN THE PATHOGENESIS OF THE DISEASE. PATHWAY ENRICHMENT ANALYSIS IDENTIFIED IMPORTANT BIOLOGICAL PROCESSES INVOLVED. USING LARGE-SCALE GENETIC DATA AVAILABLE FROM ~200 IMMUNE-RELATED LOCI (IMMUNOCHIP), WE ESTIMATE BEHCET'S DISEASE HERITABILITY TO BE AT LEAST 16%. WE FURTHER USED THE SAME APPROACH TO ESTIMATE THE HERITABILITY EXPLAINED BY THE KNOWN BEHCET'S DISEASE-ASSOCIATED LOCI, SUGGESTING THAT THEY EXPLAIN ~ 60% OF THE GENETIC COMPONENT UNDERLYING BEHCET'S DISEASE. THESE RESULTS INDICATE A SIGNIFICANT ROLE OF NON-GENETIC FACTORS IN CAUSING BEHCET'S DISEASE AND THAT ADDITIONAL GENETIC VARIATION INFLUENCING THE RISK OF BEHCET'S DISEASE REMAINS TO BE IDENTIFIED. FINALLY, WE CALCULATED A CUMULATIVE GENETIC RISK SCORE ACROSS POPULATIONS REINFORCING THE LINK BETWEEN GEOGRAPHIC VARIATIONS IN DISEASE PREVALENCE WITH ITS GENETIC COMPONENT. 2021 12 3023 35 GENETICS AND IMMUNODYSFUNCTION UNDERLYING BEHCET'S DISEASE AND IMMUNOMODULANT TREATMENT APPROACHES. BEHCET'S DISEASE (BD) IS A CHRONIC AUTOIMMUNE CONDITION PRIMARILY PREVALENT IN POPULATIONS ALONG THE MEDITERRANEAN SEA. THE EXACT ETIOLOGY OF BD HAS NOT BEEN FULLY EXPLAINED YET, BUT THE DISEASE OCCURRENCE IS ASSOCIATED WITH A GENETIC FACTOR, HUMAN LEUKOCYTE ANTIGEN (HLA)-B51 ANTIGEN. AMONG THE VARIOUS IMMUNODYSFUNCTIONS THAT ARE FOUND IN BD, PATIENTS ARE INCREASED NEUTROPHIL MOTILITY AND SUPEROXIDE PRODUCTION, AS WELL AS ELEVATED PRODUCTION OF TUMOR NECROSIS FACTOR (TNF)-ALPHA AND DECREASED PRODUCTION OF INTERLEUKIN (IL)-10. ELEVATED LEVELS OF INFLAMMATORY CYTOKINES LIKE IL-1 AND IL-17 IN BD HAVE BEEN FOUND ASSOCIATED WITH ABERRANT EXPRESSION OF MICRORNA. GENE POLYMORPHISMS IN BD PATIENTS HAVE BEEN OBSERVED IN MOLECULES INVOLVED IN RESPONSES TO PATHOGENS THAT CAN ULTIMATELY MODULATE THE HOST ANTIMICROBIAL RESPONSE. MOREOVER, SEVERAL SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS) HAVE BEEN REPORTED IN GENES ENCODING CHEMOKINES AND ADHESION MOLECULES; MANY OF THESE CHANGES MANIFEST AS INCREASES IN VASCULAR INFLAMMATION AND VASCULAR DAMAGE. LASTLY, GENETIC AND EPIGENETIC CHANGES HAVE BEEN SUGGESTED AS INVOLVED IN THE PATHOGENESIS OF BD. MODIFICATIONS IN DNA METHYLATION HAVE BEEN FOUND IN BD PATIENT MONOCYTES AND LYMPHOCYTES, LEADING TO ADVERSE FUNCTION OF THESE CELLS. THIS REVIEW PRESENTS A COMPREHENSIVE COMPILATION OF THE LITERATURE WITH REGARD TO THE IMMUNODYSFUNCTION UNDERLYING BD, AS WELL AS OF THE GENETICS, NEWLY DESCRIBED CLINICAL SPECIFICATIONS AND NOVEL TREATMENT STRATEGIES USING IMMUNOMODULANTS BASED ON THE CURRENT UNDERSTANDING OF BD. 2017 13 3454 54 HYPOMETHYLATION AT THE REGULATORY T CELL-SPECIFIC DEMETHYLATED REGION IN CD25HI T CELLS IS DECOUPLED FROM FOXP3 EXPRESSION AT THE INFLAMED SITE IN CHILDHOOD ARTHRITIS. THE MAINTENANCE OF FOXP3 EXPRESSION IN CD25(HI) REGULATORY T CELLS (TREGS) IS CRUCIAL TO THE CONTROL OF INFLAMMATION AND ESSENTIAL FOR SUCCESSFUL TREG TRANSFER THERAPIES. COEXPRESSION OF CD25 AND FOXP3 IN COMBINATION WITH A HYPOMETHYLATED REGION WITHIN THE FOXP3 GENE, CALLED THE TREG-SPECIFIC DEMETHYLATED REGION (TSDR), IS CONSIDERED THE HALLMARK OF STABLE TREGS. THE TSDR IS AN EPIGENETIC MOTIF THAT IS IMPORTANT FOR STABLE FOXP3 EXPRESSION AND IS USED AS A BIOMARKER TO MEASURE TREG LINEAGE COMMITMENT. IN THIS STUDY, WE REPORT THAT, UNLIKE IN PERIPHERAL BLOOD, CD4(+) T CELL EXPRESSION OF CD25 AND FOXP3 IS FREQUENTLY DISSOCIATED AT THE INFLAMED SITE IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS, WHICH LED US TO QUESTION THE STABILITY OF HUMAN TREGS IN CHRONIC INFLAMMATORY ENVIRONMENTS. WE DESCRIBE A NOVEL CD4(+)CD127(LO)CD25(HI) HUMAN T CELL POPULATION THAT EXHIBITS EXTENSIVE TSDR AND PROMOTER DEMETHYLATION IN THE ABSENCE OF STABLE FOXP3 EXPRESSION. THIS POPULATION EXPRESSES HIGH LEVELS OF CTLA-4 AND CAN SUPPRESS T CONVENTIONAL CELL PROLIFERATION IN VITRO. THESE DATA COLLECTIVELY SUGGEST THAT THIS POPULATION MAY REPRESENT A CHRONICALLY ACTIVATED FOXP3(LO) TREG POPULATION. WE SHOW THAT THESE CELLS HAVE DEFECTS IN IL-2 SIGNALING AND REDUCED EXPRESSION OF A DEUBIQUITINASE IMPORTANT FOR FOXP3 STABILITY. CLINICALLY, THE PROPORTIONS OF THESE CELLS WITHIN THE CD25(HI) T CELL SUBSET ARE INCREASED IN PATIENTS WITH THE MORE SEVERE COURSES OF DISEASE. OUR STUDY DEMONSTRATES, THEREFORE, THAT HYPOMETHYLATION AT THE TSDR CAN BE DECOUPLED FROM FOXP3 EXPRESSION IN HUMAN T CELLS AND THAT ENVIRONMENT-SPECIFIC BREAKDOWN IN FOXP3 STABILITY MAY COMPROMISE THE RESOLUTION OF INFLAMMATION IN JUVENILE IDIOPATHIC ARTHRITIS. 2014 14 555 24 AXIAL SPONDYLOARTHRITIS: RESHAPE THE FUTURE-FROM THE "2022 GISEA INTERNATIONAL SYMPOSIUM". THE TERM "AXIAL SPONDYLOARTHRITIS" (AXSPA) REFERS TO A GROUP OF CHRONIC RHEUMATIC DISEASES THAT PREDOMINANTLY INVOLVE THE AXIAL SKELETON AND CONSIST OF ANKYLOSING SPONDYLITIS, REACTIVE ARTHRITIS, ARTHRITIS/SPONDYLITIS ASSOCIATED WITH PSORIASIS (PSA) AND ARTHRITIS/SPONDYLITIS ASSOCIATED WITH INFLAMMATORY BOWEL DISEASES (IBD). MOREOVER, PAIN IS AN IMPORTANT AND COMMON SYMPTOM OF AXSPA. IT MAY PROGRESS TO CHRONIC PAIN, A MORE COMPLICATED BIO-PSYCHOSOCIAL PHENOMENA, LEADING TO A SIGNIFICANT WORSENING OF QUALITY OF LIFE. THE DEVELOPMENT OF THE AXSPA INFLAMMATORY PROCESS IS GROUNDED IN THE COMPLEX INTERACTION BETWEEN GENETIC (SUCH AS HLA B27), EPIGENETIC, AND ENVIRONMENTAL FACTORS ASSOCIATED WITH A DYSREGULATED IMMUNE RESPONSE. CONSIDERING THE PIVOTAL CONTRIBUTION OF IL-23 AND IL-17 IN AXSPA INFLAMMATION, THE INHIBITION OF THESE CYTOKINES HAS BEEN EVALUATED AS A POTENTIAL THERAPEUTIC STRATEGY. WITH THIS CONTEXT, HERE WE DISCUSS THE MAIN PATHOGENETIC MECHANISMS, THERAPEUTIC APPROACHES AND THE ROLE OF PAIN IN AXSPA FROM THE 2022 INTERNATIONAL GISEA/OEG SYMPOSIUM. 2022 15 3985 32 LONG-TERM MAINTENANCE OF THE MUCOSAL HEALING INDUCED BY AZACITIDINE THERAPY IN A PATIENT WITH INTESTINAL BEHCET'S-LIKE DISEASE ACCOMPANIED WITH MYELODYSPLASTIC SYNDROME INVOLVING TRISOMY 8. MYELODYSPLASTIC SYNDROMES (MDSS) ARE A GROUP OF MYELOID NEOPLASMS CHARACTERIZED BY BLOOD CELL DEFORMATION AND DYSFUNCTION, AND MDS WITH TRISOMY 8 IS CLOSELY LINKED WITH INTESTINAL BEHCET'S-LIKE DISEASES. INTESTINAL BEHCET'S-LIKE DISEASE IS REFRACTORY TO CONVENTIONAL THERAPIES, INCLUDING PREDNISOLONE, IMMUNOMODULATORS, AND ANTI-TUMOR NECROSIS FACTOR ALPHA AGENTS. HERE, WE DESCRIBE A 56-YEAR-OLD WOMAN WITH INTESTINAL BEHCET'S-LIKE DISEASE ASCRIBED TO MDS WITH TRISOMY 8 WHO HAD MULTIPLE INTRACTABLE INTESTINAL ULCERS. SHE PRESENTED WITH PERIODIC FEVER AND ABDOMINAL PAIN. THE GENETIC ANALYSIS SHOWED A HETEROZYGOUS E148Q MUTATION IN THE MEDITERRANEAN FEVER GENE. THE PATIENT DID NOT TOLERATE TREATMENT WITH COLCHICINE BECAUSE OF DIARRHEA; THEREFORE, AZACITIDINE THERAPY WAS INITIATED. ONE CYCLE OF AZACITIDINE THERAPY IMPROVED THE MULTIPLE INTESTINAL ULCERS, AND THE PERIODIC FEVER AND ABDOMINAL PAIN GRADUALLY DISAPPEARED. AFTER EIGHT CYCLES OF AZACITIDINE THERAPY, ILEOCOLONOSCOPY, HISTOLOGICAL ASSESSMENT AND CAPSULE ENDOSCOPY REVEALED MUCOSAL HEALING. AZACITIDINE THERAPY WAS CONTINUED, AND MUCOSAL HEALING WAS MAINTAINED FOR MORE THAN 2 YEARS. THIS CASE SUGGESTS THAT AZACITIDINE THERAPY WHICH HAS IMMUNOREGULATORY EFFECTS AND EPIGENETIC MODULATIONS, MIGHT CONTROL INTESTINAL BEHCET'S-LIKE DISEASE ASSOCIATED WITH MDS INVOLVING TRISOMY 8. 2019 16 3662 49 INDUCTION OF STABLE HUMAN FOXP3(+) TREGS BY A PARASITE-DERIVED TGF-BETA MIMIC. IMMUNE HOMEOSTASIS IN THE INTESTINE IS TIGHTLY CONTROLLED BY FOXP3(+) REGULATORY T CELLS (TREGS), DEFECTS OF WHICH ARE LINKED TO THE DEVELOPMENT OF CHRONIC CONDITIONS, SUCH AS INFLAMMATORY BOWEL DISEASE (IBD). AS A MECHANISM OF IMMUNE EVASION, SEVERAL SPECIES OF INTESTINAL PARASITES BOOST TREG ACTIVITY. THE PARASITE HELIGMOSOMOIDES POLYGYRUS IS KNOWN TO SECRETE A MOLECULE (HP-TGM) THAT MIMICS THE ABILITY OF TGF-BETA TO INDUCE FOXP3 EXPRESSION IN CD4(+) T CELLS. THE STUDY AIMED TO INVESTIGATE WHETHER HP-TGM COULD INDUCE HUMAN FOXP3(+) TREGS AS A POTENTIAL THERAPEUTIC APPROACH FOR INFLAMMATORY DISEASES. CD4(+) T CELLS FROM HEALTHY VOLUNTEERS WERE EXPANDED IN THE PRESENCE OF HP-TGM OR TGF-BETA. TREG INDUCTION WAS MEASURED BY FLOW CYTOMETRIC DETECTION OF FOXP3 AND OTHER TREG MARKERS, SUCH AS CD25 AND CTLA-4. EPIGENETIC CHANGES WERE DETECTED USING CHIP-SEQ AND PYROSEQUENCING OF FOXP3. TREG PHENOTYPE STABILITY WAS ASSESSED FOLLOWING INFLAMMATORY CYTOKINE CHALLENGE AND TREG FUNCTION WAS EVALUATED BY CELLULAR CO-CULTURE SUPPRESSION ASSAYS AND CYTOMETRIC BEAD ARRAYS FOR SECRETED CYTOKINES. HP-TGM EFFICIENTLY INDUCED FOXP3 EXPRESSION (> 60%), IN ADDITION TO CD25 AND CTLA-4, AND CAUSED EPIGENETIC MODIFICATION OF THE FOXP3 LOCUS TO A GREATER EXTENT THAN TGF-BETA. HP-TGM-INDUCED TREGS HAD SUPERIOR SUPPRESSIVE FUNCTION COMPARED WITH TGF-BETA-INDUCED TREGS, AND RETAINED THEIR PHENOTYPE FOLLOWING EXPOSURE TO INFLAMMATORY CYTOKINES. FURTHERMORE, HP-TGM INDUCED A TREG-LIKE PHENOTYPE IN IN VIVO DIFFERENTIATED TH1 AND TH17 CELLS, INDICATING ITS POTENTIAL TO RE-PROGRAM MEMORY CELLS TO ENHANCE IMMUNE TOLERANCE. THESE DATA INDICATE HP-TGM HAS POTENTIAL TO BE USED TO GENERATE STABLE HUMAN FOXP3(+) TREGS TO TREAT IBD AND OTHER INFLAMMATORY DISEASES. 2021 17 3173 18 GUT MICROBIOTA-MICRORNA INTERACTIONS IN ANKYLOSING SPONDYLITIS. ANKYLOSING SPONDYLITIS (AS) IS A CHRONIC AUTOIMMUNE INFLAMMATORY DISABILITY THAT IS PART OF THE RHEUMATIC DISEASE GROUP OF SPONDYLOARTHROPATHIES. AS COMMONLY INFLUENCES THE JOINTS OF THE AXIAL SKELETON. THE CONTRIBUTIONS TO AS PATHOGENESIS OF GENETIC SUSCEPTIBILITY (PARTICULARLY HLA-B27 AND ERAP-1) AND EPIGENETIC MODIFICATIONS, LIKE NON-CODING RNAS, AS WELL AS ENVIRONMENTAL FACTORS, HAVE BEEN INVESTIGATED OVER THE LAST FEW YEARS. BUT THE FUNDAMENTAL ETIOLOGY OF AS REMAINS ELUSIVE TO DATE. THE EVIDENCE SUMMARIZED HERE INDICATES THAT IN THE IMMUNOPATHOGENESIS OF AS, MICRORNAS AND THE GUT MICROBIOME PERFORM CRITICAL FUNCTIONS. WE DISCUSS SIGNIFICANT ADVANCES IN THE IMMUNOLOGICAL MECHANISMS UNDERLYING AS AND ADDRESS POTENTIAL CROSS-TALK BETWEEN THE GUT MICROBIOME AND HOST MICRORNAS. THIS CRITICAL INTERACTION IMPLICATES A CO-EVOLUTIONARY SYMBIOTIC LINK BETWEEN HOST IMMUNITY AND THE GUT MICROBIOME. 2021 18 4967 37 PATHOLOGICAL CONDITIONS RE-SHAPE PHYSIOLOGICAL TREGS INTO PATHOLOGICAL TREGS. CD4(+)FOXP3(+) REGULATORY T CELLS (TREGS) ARE A SUBSET OF CD4 T CELLS THAT PLAY AN ESSENTIAL ROLE IN MAINTAINING PERIPHERAL IMMUNE TOLERANCE, CONTROLLING ACUTE AND CHRONIC INFLAMMATION, ALLERGY, AUTOIMMUNE DISEASES, AND ANTI-CANCER IMMUNE RESPONSES. OVER THE PAST 20 YEARS, SIGNIFICANT PROGRESS HAS BEEN MADE SINCE TREGS WERE FIRST CHARACTERIZED IN 1995. MANY CONCEPTS AND PRINCIPLES REGARDING TREGS GENERATION, PHENOTYPIC FEATURES, SUBSETS (TTREGS, PTREGS, ITREGS, AND ITREG35), TISSUE SPECIFICITY (CENTRAL TREGS, EFFECTOR TREGS, AND TISSUE RESIDENT TREGS), HOMEOSTASIS (HIGHLY DYNAMIC AND APOPTOTIC), REGULATION OF TREGS BY RECEPTORS FOR PAMPS AND DAMPS, TREG PLASTICITY (RE-DIFFERENTIATION TO OTHER CD4 T HELPER CELL SUBSETS, TH1, TH2, TFH AND TH17), AND EPIGENETIC REGULATION OF TREGS PHENOTYPES AND FUNCTIONS HAVE BEEN INNOVATED. IN THIS CONCISE REVIEW, WE WANT TO BRIEFLY ANALYZE THESE EIGHT NEW PROGRESSES IN THE STUDY OF TREGS. WE HAVE ALSO PROPOSED FOR THE FIRST TIME A NOVEL CONCEPT THAT "PHYSIOLOGICAL TREGS" HAVE BEEN RE-SHAPED INTO "PATHOLOGICAL TREGS" IN VARIOUS PATHOLOGICAL ENVIRONMENTS. CONTINUING OF THE IMPROVEMENT IN OUR UNDERSTANDING ON THIS IMPORTANT CELLULAR COMPONENT ABOUT THE IMMUNE TOLERANCE AND IMMUNE SUPPRESSION, WOULD LEAD TO THE FUTURE DEVELOPMENT OF NOVEL THERAPEUTICS APPROACHES FOR ACUTE AND CHRONIC INFLAMMATORY DISEASES, ALLERGY, ALLOGENEIC TRANSPLANTATION-RELATED IMMUNITY, SEPSIS, AUTOIMMUNE DISEASES, AND CANCERS. 2015 19 4368 40 MIRNA-DEPENDENT CD4(+) T CELL DIFFERENTIATION IN THE PATHOGENESIS OF MULTIPLE SCLEROSIS. MULTIPLE SCLEROSIS (MS) IS CHARACTERIZED BY MULTIFOCAL LESIONS, CHRONIC INFLAMMATORY CONDITION, AND DEGENERATIVE PROCESSES WITHIN THE CENTRAL NERVOUS SYSTEM (CNS) LEADING TO DEMYELINATION. THE MOST IMPORTANT CELLS INVOLVED IN ITS PATHOGENESIS ARE THOSE WHICH ARE CD4(+), PARTICULARLY PROINFLAMMATORY TH1/TH17 AND REGULATORY TREG. SIGNAL CASCADES ASSOCIATED WITH CD4(+) DIFFERENTIATION ARE REGULATED BY MICRORNAS (MIRNAS): SHORT, SINGLE-STRANDED RNAS, RESPONSIBLE FOR NEGATIVE REGULATION OF GENE EXPRESSION AT THE POSTTRANSCRIPTIONAL LEVEL. SEVERAL MIRNAS HAVE BEEN CONSISTENTLY REPORTED AS SHOWING DYSREGULATED EXPRESSION IN MS, AND THEIR EXPRESSION PATTERNS MAY BE ELEVATED OR DECREASED, DEPENDING ON THE FUNCTION OF SPECIFIC MIRNA IN THE IMMUNE SYSTEM. STUDIES IN MS PATIENTS INDICATE THAT, AMONG OTHERS, MIR-141, MIR-200A, MIR-155, MIR-223, AND MIR-326 ARE UPREGULATED, WHILE MIR-15B, MIR-20B, MIR-26A, AND MIR-30A ARE DOWNREGULATED. DYSREGULATION OF THESE MIRNAS MAY CONTRIBUTE TO THE IMBALANCE BETWEEN PRO- AND ANTI-INFLAMMATORY PROCESSES, SINCE THEIR TARGETS ARE ASSOCIATED WITH THE REGULATION OF TH1/TH17 AND TREG CELL DIFFERENTIATION. HIGHLY EXPRESSED MIRNAS CAN IN TURN SUPPRESS TRANSLATION OF KEY TH1/TH17 DIFFERENTIATION INHIBITORS. MIRNA DYSREGULATION MAY RESULT FROM THE IMPACT OF VARIOUS FACTORS AT EACH STAGE OF THEIR BIOGENESIS. IMMATURE MIRNA UNDERGOES MULTISTAGE TRANSCRIPTIONAL AND POSTTRANSCRIPTIONAL MODIFICATIONS; THEREFORE, ANY PROTEIN INVOLVED IN THE PROCESSING OF MIRNAS CAN POTENTIALLY LEAD TO DISTURBANCES IN THEIR EXPRESSION. EPIGENETIC MODIFICATIONS THAT HAVE A DIRECT IMPACT ON MIRNA GENE TRANSCRIPTION MAY ALSO PLAY AN IMPORTANT ROLE. 2021 20 373 30 AN EMERGING ROLE OF NEUTROPHILS AND NETOSIS IN CHRONIC INFLAMMATION AND FIBROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND ANCA-ASSOCIATED VASCULITIDES (AAV): IMPLICATIONS FOR THE PATHOGENESIS AND TREATMENT. NEUTROPHILS DERIVE FROM HEMATOPOIETIC STEM CELLS (HSCS) WITH SYSTEMIC INFLAMMATION DRIVING THEIR ACTIVATION AND DIFFERENTIATION TO MYELOID PROGENITORS TO ENSURE ENHANCED MYELOPOIESIS. EPIGENETIC REPROGRAMING AND RE-EDUCATION OF THESE HSCS PRODUCES NEUTROPHILS PRIMED TOWARDS ELIMINATION OF PATHOGENS AND INCREASED INFLAMMATORY RESPONSE. NEUTROPHILS -AN IMPORTANT COMPONENT OF ACUTE INFLAMMATION- ARE NOT PRESENT IN CHRONIC INFLAMMATORY TISSUES LEADING TO THE FALSE ASSUMPTION THAT THEY MAY NOT BE AS IMPORTANT FOR THE LATTER. ACTIVATED NEUTROPHILS MAY RELEASE NEUTROPHIL EXTRACELLULAR TRAPS (NETS) DURING A DISTINCT FORM OF CELL DEATH, NAMED NETOSIS; NETS ARE RICH IN BIOACTIVE MOLECULES THAT PROMOTE THROMBOSIS (INCLUDING ATHEROTHROMBOSIS), INFLAMMATION AND FIBROSIS. THUS, ALTHOUGH NEUTROPHILS MAY NOT BE PRESENT IN CHRONIC INFLAMMATORY LESIONS, THEIR REMNANTS MAY AMPLIFY THE INFLAMMATORY RESPONSE BEYOND THEIR SHORT LIFE-SPAN IN THE TISSUES. HEREIN, WE REVIEW CURRENT EVIDENCE SUPPORTING A ROLE OF NEUTROPHILS AND NETOSIS IN TISSUE INJURY AND DYSFUNCTION IN SYSTEMIC AUTOIMMUNITY USING AS DISEASE PARADIGMS SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND THE ANCA-ASSOCIATED VASCULITIDES (AAV). WE ALSO DISCUSS THE MECHANISMS INVOLVED AND THEIR POTENTIAL AS TARGETS FOR NOVEL THERAPY AND DRUG REPOSITIONING. 2019