1 1637 167 DOES DYSREGULATION OF KEY EPIGENETIC AND BIOCHEMICAL PATHWAYS OCCUR IN POSTULATED VASOACTIVE NEUROPEPTIDE AUTOIMMUNE DISORDERS? AUTOIMMUNE DYSFUNCTION OF CERTAIN VASOACTIVE NEUROPEPTIDES (VNS) HAS BEEN POSTULATED AS A CONTRIBUTING CAUSE OF SUDDEN INFANT DEATH SYNDROME (SIDS), CHRONIC FATIGUE SYNDROME (CFS), GULF WAR SYNDROME (GWS) AND OTHER FATIGUE-RELATED DISORDERS. THIS FAMILY OF VNS INCLUDES PITUITARY ADENYLATE CYCLASE ACTIVATING POLYPEPTIDE (PACAP), VASOACTIVE INTESTINAL PEPTIDE (VIP) AND CALCITONIN GENE RELATED PEPTIDE (CGRP). THE POSTULATED MECHANISM IS COMPROMISE OF ADENYLATE CYCLASE ACTIVATION, A VITAL AND UNIQUE STEP IN CYCLIC AMP PRODUCTION FROM ATP, THROUGH AUTOIMMUNE DYSFUNCTION OF VNS, THEIR RECEPTORS OR THEIR GENES POSSIBLY INVOLVING CYTOSINE-PHOSPHATE-GUANINE (CPG) FRAGMENTS. CPG FRAGMENTS ARE IMMUNOMODULATORY DINUCLEOTIDES SERVING AS 'FRIEND OR FOE' RECOGNITION SYSTEMS TO DIFFERENTIATE BACTERIAL AND VIRAL (HYPOMETHYLATED CPG) FROM MAMMALIAN (METHYLATED CPG) DNA. HOWEVER HYPOMETHYLATION DISORDERS AFFECTING THESE FRAGMENTS IN MAMMALS MAY CONVERT THEM TO DYSFUNCTIONAL STATES BY PROMOTING AUTOIMMUNE INFLAMMATORY REACTIONS. EPIGENETIC MECHANISMS ACTING ON GENE PROMOTER REGIONS MAY CONTRIBUTE TO THE DEVELOPMENT OF VN AUTOIMMUNE FATIGUE-RELATED DISORDERS THROUGH CPG FRAGMENTS LOCATED IN VITAL SEGMENTS OF VN/RECEPTOR GENES BY CAUSING SIGNALLING DEFECTS WITH PROFOUND IMPLICATIONS FOR VN FUNCTION. NEUROTRANSMITTER DYSFUNCTION PARTICULARLY GLUTAMATERGIC TRANSMISSION COULD ALSO RESULT WITH DISRUPTION OF NEURONAL CELLULAR BIOCHEMICAL FUNCTIONS SUCH AS AMMONIA REGULATION. ENDOSOMAL ACIDITY AND MITOCHONDRIAL MEMBRANE POTENTIAL MODIFIERS SUCH AS CHLOROQUINE, TOGETHER WITH IMMUNOREGULATORY THERAPIES, MAY HAVE THERAPEUTIC IMPLICATIONS IN PROTECTING AGAINST THESE APPARENT AUTOIMMUNE DISORDERS. THIS PAPER EXAMINES SPECIFIC EPIGENETIC AND BIOCHEMICAL MECHANISMS POSSIBLY MEDIATED BY VN OR RECEPTOR GENES RESULTING IN POSTULATED VN AUTOIMMUNE FATIGUE-RELATED DISORDERS. THESE MECHANISMS MAY HAVE IMPLICATIONS FOR TREATMENT AND PREVENTION OPTIONS FOR VN AUTOIMMUNE DISORDERS. VN AUTOIMMUNE PROCESSES HAVE IMPLICATIONS FOR MILITARY MEDICINE WHERE RADIOLOGICAL, CHEMICAL AND BIOLOGICAL AGENTS MAY PLAY AN IMPORTANT ROLE IN PATHOGENESIS. 2005 2 6438 58 THERAPEUTIC AND PREVENTIVE INTERVENTIONS FOR POSTULATED VASOACTIVE NEUROPEPTIDE AUTOIMMUNE FATIGUE-RELATED DISORDERS. MAJOR ADVANCES HAVE BEEN MADE IN UNDERSTANDING THE RELATIVELY NOVEL GROUP OF VASOACTIVE (VASODILATORY) NEUROPEPTIDES (VNS) IN HUMANS. VNS COMPRISE A NOVEL BUT EXPANDING GROUP OF SUBSTANCES HAVING IMMUNOREGULATION, INFLAMMATION MODULATION, NEUROTRANSMITTER, NEUROTROPHIC, HORMONAL AND METABOLIC FUNCTIONS. THESE SUBSTANCES MAY CONTROL GENE EXPRESSION FOR MRNA FOR THEMSELVES AND THEIR RECEPTORS. THEY HAVE COMPLEX RELATIONSHIPS WITH GASEOUS AND OTHER NEUROTRANSMITTERS AND XENOBIOTIC SUBSTANCES. THEORETICAL ARGUMENTS HAVE IMPLICATED THESE SUBSTANCES IN AUTOIMMUNE PHENOMENA RESULTING IN FATIGUE-RELATED CONDITIONS SUCH AS CHRONIC FATIGUE SYNDROME (CFS), SUDDEN INFANT DEATH SYNDROME (SIDS), FIBROMYALGIA (FM) AND GULF WAR SYNDROME (GWS) BUT REMAIN UNPROVEN. AS WELL AS POSSIBLY SPONTANEOUS ONSET, THE PRECIPITATING CAUSES OF VN AUTOIMMUNE DYSFUNCTION ARE LIKELY TO BE A COMBINATION OF GENETIC PREDISPOSITION, INFECTION AND XENOBIOTIC SUBSTANCES. THERAPEUTIC AND PREVENTIVE POSSIBILITIES FOR POSTULATED VN AUTOIMMUNE CONDITIONS WILL BE INFLUENCED BY THE COMPLEX PATHOLOPHYSIOLOGY UNDERPINNING THEM. SOME SPECULATIVE POSSIBILITIES ARE VN SUBSTITUTION/REPLACEMENT, PRESERVATION OF BIOLOGICAL EFFECT, EPIGENETIC DNA MODIFICATIONS, PLASMA EXCHANGE, ANTI-CHOLINESTERASES, E.G., PYRIDOSTIGMINE, CORTICOSTEROIDS AND OTHER DRUG TREATMENTS, THYMECTOMY, INTRAVENOUS IMMUNOGLOBULIN AND ANTI-IDIOTYPE ANTIBODIES, AND CPG/DNA VACCINES. PREVENTION AND TREATMENT OF POSSIBLE VN AUTOIMMUNE FATIGUE-RELATED DISORDERS MAY PROVE TO BE IMPORTANT AREAS FOR FUTURE RESEARCH AND DEVELOPMENT. 2005 3 6009 37 THE ANTI-INFLAMMATORY MEDIATOR, VASOACTIVE INTESTINAL PEPTIDE, MODULATES THE DIFFERENTIATION AND FUNCTION OF TH SUBSETS IN RHEUMATOID ARTHRITIS. GENETIC BACKGROUND, EPIGENETIC MODIFICATIONS, AND ENVIRONMENTAL FACTORS TRIGGER AUTOIMMUNE RESPONSE IN RHEUMATOID ARTHRITIS (RA). SEVERAL PATHOGENIC INFECTIONS HAVE BEEN RELATED TO THE ONSET OF RA AND MAY CAUSE AN INADEQUATE IMMUNOLOGICAL TOLERANCE TOWARDS CRITICAL SELF-ANTIGENS LEADING TO CHRONIC JOINT INFLAMMATION AND AN IMBALANCE BETWEEN DIFFERENT T HELPER (TH) SUBSETS. VASOACTIVE INTESTINAL PEPTIDE (VIP) IS A MEDIATOR THAT MODULATES ALL THE STAGES COMPRISED BETWEEN THE ARRIVAL OF PATHOGENS AND TH CELL DIFFERENTIATION IN RA THROUGH ITS KNOWN ANTI-INFLAMMATORY AND IMMUNOMODULATORY ACTIONS. THIS "NEUROIMMUNOPEPTIDE" MODULATES THE PATHOGENIC ACTIVITY OF DIVERSE CELL SUBPOPULATIONS INVOLVED IN RA AS LYMPHOCYTES, FIBROBLAST-LIKE SYNOVIOCYTES (FLS), OR MACROPHAGES. IN ADDITION, VIP DECREASES THE EXPRESSION OF PATTERN RECOGNITION RECEPTOR (PRR) SUCH AS TOLL-LIKE RECEPTORS (TLRS) IN FLS FROM RA PATIENTS. THESE RECEPTORS ACT AS SENSORS OF PATHOGEN-ASSOCIATED MOLECULAR PATTERN (PAMP) AND DAMAGE-ASSOCIATED MOLECULAR PATTERN (DAMP) CONNECTING THE INNATE AND ADAPTIVE IMMUNE SYSTEM. MOREOVER, VIP MODULATES THE IMBALANCE BETWEEN TH SUBSETS IN RA, DECREASING PATHOGENIC TH1 AND TH17 SUBSETS AND FAVORING TH2 OR TREG PROFILE DURING THE DIFFERENTIATION/POLARIZATION OF NAIVE OR MEMORY TH CELLS. FINALLY, VIP REGULATES THE PLASTICITY BETWEEN THESES SUBSETS. IN THIS REVIEW, WE PROVIDE AN OVERVIEW OF VIP EFFECTS ON THE AFOREMENTIONED FEATURES OF RA PATHOLOGY. 2018 4 4669 32 NEW INSIGHTS INTO PATHOPHYSIOLOGY OF VESTIBULAR MIGRAINE. VESTIBULAR MIGRAINE (VM) IS A COMMON DISORDER IN WHICH GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS PROBABLY CONTRIBUTE TO ITS DEVELOPMENT. THE PATHOPHYSIOLOGY OF VM IS UNKNOWN; NEVERTHELESS IN THE LAST FEW YEARS, SEVERAL STUDIES ARE CONTRIBUTING TO UNDERSTAND THE NEUROPHYSIOLOGICAL PATHWAYS INVOLVED IN VM. THE CURRENT HYPOTHESES ARE MOSTLY BASED ON THE KNOWLEDGE OF MIGRAINE ITSELF. THE EVIDENCE OF TRIGEMINAL INNERVATION OF THE LABYRINTH VESSELS AND THE LOCALIZATION OF VASOACTIVE NEUROPEPTIDES IN THE PERIVASCULAR AFFERENT TERMINALS OF THESE TRIGEMINAL FIBERS SUPPORT THE INVOLVEMENT OF THE TRIGEMINO-VASCULAR SYSTEM. THE NEUROGENIC INFLAMMATION TRIGGERED BY ACTIVATION OF THE TRIGEMINAL-VESTIBULOCOCHLEAR REFLEX, WITH THE SUBSEQUENT INNER EAR PLASMA PROTEIN EXTRAVASATION AND THE RELEASE OF INFLAMMATORY MEDIATORS, CAN CONTRIBUTE TO A SUSTAINED ACTIVATION AND SENSITIZATION OF THE TRIGEMINAL PRIMARY AFFERENT NEURONS EXPLAINING VM SYMPTOMS. THE RECIPROCAL CONNECTIONS BETWEEN BRAINSTEM VESTIBULAR NUCLEI AND THE STRUCTURES THAT MODULATE TRIGEMINAL NOCICEPTIVE INPUTS (ROSTRAL VENTROMEDIAL MEDULLA, VENTROLATERAL PERIAQUEDUCTAL GRAY, LOCUS COERULEUS, AND NUCLEUS RAPHE MAGNUS) ARE CRITICAL TO UNDERSTAND THE PATHOPHYSIOLOGY OF VM. ALTHOUGH CORTICAL SPREADING DEPRESSION CAN AFFECT CORTICAL AREAS INVOLVED IN PROCESSING VESTIBULAR INFORMATION, FUNCTIONAL NEUROIMAGING TECHNIQUES SUGGEST A DYSMODULATION IN THE MULTIMODAL SENSORY INTEGRATION AND PROCESSING OF VESTIBULAR AND NOCICEPTIVE INFORMATION, RESULTING FROM A VESTIBULO-THALAMO-CORTICAL DYSFUNCTION, AS THE PATHOGENIC MECHANISM UNDERLYING VM. THE ELEVATED PREVALENCE OF VM SUGGESTS THAT MULTIPLE FUNCTIONAL VARIANTS MAY CONFER A GENETIC SUSCEPTIBILITY LEADING TO A DYSREGULATION OF EXCITATORY-INHIBITORY BALANCE IN BRAIN STRUCTURES INVOLVED IN THE PROCESSING OF SENSORY INFORMATION, VESTIBULAR INPUTS, AND PAIN. THE INTERACTIONS AMONG SEVERAL FUNCTIONAL AND STRUCTURAL NEURAL NETWORKS COULD EXPLAIN THE PATHOGENIC MECHANISMS OF VM. 2015 5 2829 17 FLUSHING OUT CARCINOID SYNDROME: BENEFICIAL EFFECT OF THE ANTICANCER EPIGENETIC AGENT RRX-001 IN A PATIENT WITH A TREATMENT-REFRACTORY NEUROENDOCRINE TUMOR. NEUROENDOCRINE TUMORS (NET) ARE A HETEROGENEOUS GROUP OF NEOPLASMS DEFINED BY THE PRESENCE OF CELLS WITH SECRETORY GRANULES AND THE POTENTIAL TO PRODUCE AND RELEASE HIGH LEVELS OF VASOACTIVE PEPTIDES INTO THE CIRCULATION, LEADING TO SEVERE FLUSHING AND DIARRHEA, WHICH MAY ADVERSELY AFFECT QUALITY OF LIFE. THIS REPORT PRESENTS THE CASE OF A 64-YEAR-OLD MAN WITH CHRONIC REFRACTORY DIARRHEA DUE TO PULMONARY NET TREATED WITH THE EXPERIMENTAL ANTICANCER AGENT RRX-001 IN A PHASE II TRIAL CALLED TRIPLE THREAT WITH SUBSEQUENT RESOLUTION OF HIS DIARRHEA. 2015 6 1108 13 COMMENTARY ON SOME RECENT THESES RELEVANT TO COMBATING AGING: JUNE 2021. THESES REVIEWED IN THIS ISSUE INCLUDE "ENGINEERING PROTEIN DISAGGREGASES TO COUNTER ALPHA-SYNUCLEIN AND AMYLOID-BETA NEUROTOXICITY," "HYPERGLYCAEMIA INDUCED IMMUNOMODULATION OF MACROPHAGES IN DIABETIC VASCULAR DISEASE," "MICROVASCULATURE-ON-A-CHIP SYSTEMS FOR HUMAN DISEASE MODELING," "SENESCENCE SURVEILLANCE: THE INTERPLAY BETWEEN THE IMMUNE SYSTEM AND SENESCENT CELLS," "THE HMG TRANSCRIPTION FACTOR TOX INDUCES A TRANSCRIPTIONAL AND EPIGENETIC PROGRAM OF CD8(+) T CELL EXHAUSTION IN CHRONIC INFECTION AND CANCER," AND "ZERO TO ONE-TRANSLATIONAL ADVANCEMENTS IN THE FIELD OF XENOTRANSPLANTATION." 2021 7 6869 41 [PATHOGENESIS OF RHEUMATOID ARTHRITIS]. RHEUMATOID ARTHRITIS (RA) IS AN AUTOIMMUNE SYSTEMIC DISEASE THAT PRIMARILY AFFECTS JOINTS. ETIOLOGY AND THE PATHOGENESIS OF RA ARE COMPLEX, INVOLVING MANY TYPES OF CELLS, AMONG OTHERS MACROPHAGES, T AND B CELLS, FIBRO- BLASTS, CHONDROCYTES AND DENDRITIC CELLS. DESPITE WELL DOCUMENTED ROLE OF MANY GENES AND EPIGENETIC MODIFICATIONS IN THE DEVELOPMENT AND EVOLUTION OF THE DISEASE, IN MOST RA PATIENTS THERE IS NO CLEAR PREDISPOSING FACTOR PRESENT. ENVIRONMENTAL FACTORS INVOLVED IN RA PATHOGENESIS ARE CIGARETTE SMOKE, INDUSTRIAL POLLUTANTS LIKE SILICA CRYSTALS, DISTURBANCES OF INTESTINAL, LUNG, AND ORAL MICROBIOTA AND SOME SPECIFIC BACTERIAL AND VIRAL INFECTIOUS AGENTS AND THEIR COMPONENTS. IN THE INITIAL DISEASE STAGE THERE ARE QUALITATIVE AND QUANTITATIVE DISTURBANCES OFPEPTIDE CITRULINATION AS WELL AS OTHER PROTEIN MODIFICATIONS, FOLLOWED BY ANTIGEN PRESENTING CELL (APC) (MACROPHAGES AND DENDRITIC CELLS) AND FIBROBLAST LIKE SYNOVIOCYTES (FLS) ACTIVATION. SOME MICROBES FOSTER THIS PROCESSES BY APC AND FLS DIRECT AND INDIRECT ACTIVATION. IN THE SECOND STAGE APC'S ELICIT SPECIFIC HUMORAL B CELL RE- SPONSE RESULTING IN SPECIFIC ANTIBODIES PRODUCTION AND T CELL AUTOREACTIVITY. INHERITED AND ACQUIRED DEFECTS IN T AND B CELL RESPONSES CAUSED BY REPEATED ACTIVATION OF INNATE IMMUNITY AS WELL AS LOSS OF TOLERANCE, ELICIT CHRONIC AUTOIMMUNE INFLAMMATION, PRIMARILY OF SYNOVIAL MEMBRANES, AND DEVELOPMENT OF CELLULAR PANUS. PATHOLOGIC ACTIVATION OF THE OSTEOCLASTS AND RELEASE OF THE IMMUNE SYSTEM EFFECTOR MOLECULES AND THE PROTEOLYTIC ENZYMES DAMAGE THE CARTILAGE, BONE AND TENDONS COMPOSITION AND STRUCTURE. PERSISTENT INFLAMMATION THROUGH ITS COMPLEX MECHANISMS RESULTS IN MANY SYSTEMIC AND EXTRAARTICULAR RA MANIFESTATIONS OF ALMOST ALL ORGAN SYSTEMS, RESULTING IN SEVERE COMPLICATIONS AND COMORBIDITIES SUCH AS RHEUMATOID LUNG, CARDITIS, VASCULITIS, CAHEXIA, ANEMIA, ACCELERATED ATHEROSCLEROSIS, MYOCARDIAL AND CEREBROVASCULAR VASCULAR DISEASE, LYMPHOMA, OSTEOPOROSIS, DEPRESSION ETC. ACCUMULATED COMPLICATIONS AND COMORBIDITIES FINALLY RESULT IN HANDICAP, SOCIAL DYSFUNCTION AND PREMATURE DEATH. 2014 8 799 33 CELLULAR SIGNALING AND POTENTIAL NEW TREATMENT TARGETS IN DIABETIC RETINOPATHY. DYSFUNCTION AND DEATH OF MICROVASCULAR CELLS AND IMBALANCE BETWEEN THE PRODUCTION AND THE DEGRADATION OF EXTRACELLULAR MATRIX (ECM) PROTEINS ARE A CHARACTERISTIC FEATURE OF DIABETIC RETINOPATHY (DR). GLUCOSE-INDUCED BIOCHEMICAL ALTERATIONS IN THE VASCULAR ENDOTHELIAL CELLS MAY ACTIVATE A CASCADE OF SIGNALING PATHWAYS LEADING TO INCREASED PRODUCTION OF ECM PROTEINS AND CELLULAR DYSFUNCTION/DEATH. CHRONIC DIABETES LEADS TO THE ACTIVATION OF A NUMBER OF SIGNALING PROTEINS INCLUDING PROTEIN KINASE C, PROTEIN KINASE B, AND MITOGEN-ACTIVATED PROTEIN KINASES. THESE SIGNALING CASCADES ARE ACTIVATED IN RESPONSE TO HYPERGLYCEMIA-INDUCED OXIDATIVE STRESS, POLYOL PATHWAY, AND ADVANCED GLYCATION END PRODUCT FORMATION AMONG OTHERS. THE ABERRANT SIGNALING PATHWAYS ULTIMATELY LEAD TO ACTIVATION OF TRANSCRIPTION FACTORS SUCH AS NUCLEAR FACTOR-KAPPAB AND ACTIVATING PROTEIN-1. THE ACTIVITY OF THESE TRANSCRIPTION FACTORS IS ALSO REGULATED BY EPIGENETIC MECHANISMS THROUGH TRANSCRIPTIONAL COACTIVATOR P300. THESE COMPLEX SIGNALING PATHWAYS MAY BE INVOLVED IN GLUCOSE-INDUCED ALTERATIONS OF ENDOTHELIAL CELL PHENOTYPE LEADING TO THE PRODUCTION OF INCREASED ECM PROTEINS AND VASOACTIVE EFFECTOR MOLECULES CAUSING FUNCTIONAL AND STRUCTURAL CHANGES IN THE MICROVASCULATURE. UNDERSTANDING OF SUCH MECHANISTIC PATHWAYS WILL HELP TO DEVELOP FUTURE ADJUVANT THERAPIES FOR DIABETIC RETINOPATHY. 2007 9 6741 20 WHERE TO STAND WITH STROMAL CELLS AND CHRONIC SYNOVITIS IN RHEUMATOID ARTHRITIS? THE SYNOVIUM EXERCISES ITS MAIN FUNCTION IN JOINT HOMEOSTASIS THROUGH THE SECRETION OF FACTORS (SUCH AS LUBRICIN AND HYALURONIC ACID) THAT ARE CRITICAL FOR THE JOINT LUBRICATION AND FUNCTION. THE MAIN SYNOVIUM CELL COMPONENTS ARE FIBROBLAST-LIKE SYNOVIOCYTES, MESENCHYMAL STROMAL/STEM CELLS AND MACROPHAGE-LIKE SYNOVIAL CELLS. IN THE SYNOVIUM, CELLS OF MESENCHYMAL ORIGIN MODULATE LOCAL INFLAMMATION AND FIBROSIS, AND INTERACT WITH DIFFERENT FIBROBLAST SUBTYPES AND WITH RESIDENT MACROPHAGES. IN PATHOLOGIC CONDITIONS, SUCH AS RHEUMATOID ARTHRITIS, FIBROBLAST-LIKE SYNOVIOCYTES PROLIFERATE ABNORMALLY, RECRUIT MESENCHYMAL STEM CELLS FROM SUBCHONDRAL BONE MARROW, AND INFLUENCE IMMUNE CELL ACTIVITY THROUGH EPIGENETIC AND METABOLIC ADAPTATIONS. THE RESULTING SYNOVIAL HYPERPLASIA LEADS TO SECONDARY CARTILAGE DESTRUCTION, JOINT SWELLING, AND PAIN. IN THE PRESENT REVIEW, WE SUMMARIZE RECENT FINDINGS ON THE MOLECULAR SIGNATURE AND THE ROLES OF STROMAL CELLS DURING SYNOVIAL PANNUS FORMATION AND RHEUMATOID ARTHRITIS PROGRESSION. 2019 10 5507 25 RHEUMATOID ARTHRITIS PROGRESSION MEDIATED BY ACTIVATED SYNOVIAL FIBROBLASTS. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY DISEASE CHARACTERIZED BY SYNOVIAL HYPERPLASIA AND PROGRESSIVE JOINT DESTRUCTION. RHEUMATOID ARTHRITIS SYNOVIAL FIBROBLASTS (RASFS) ARE LEADING CELLS IN JOINT EROSION AND CONTRIBUTE ACTIVELY TO INFLAMMATION. RASFS SHOW AN ACTIVATED PHENOTYPE THAT IS INDEPENDENT OF THE INFLAMMATORY ENVIRONMENT AND REQUIRES THE COMBINATION OF SEVERAL FACTORS. ALTHOUGH NEW ASPECTS REGARDING RASF ACTIVATION VIA MATRIX DEGRADATION PRODUCTS, EPIGENETIC MODIFICATIONS, INFLAMMATORY FACTORS, TOLL-LIKE RECEPTOR (TLR) ACTIVATION AND OTHERS HAVE RECENTLY BEEN UNCOVERED, THE PRIMARY PATHOPHYSIOLOGICAL PROCESSES IN EARLY ARTHRITIS LEADING TO PERMANENT ACTIVATION ARE MOSTLY UNKNOWN. HERE, WE REVIEW NEW FINDINGS REGARDING RASF ACTIVATION AND THEIR ALTERED BEHAVIOR THAT CONTRIBUTE TO MATRIX DESTRUCTION AND INFLAMMATION AS WELL AS THEIR POTENTIAL TO SPREAD RA. 2010 11 5392 33 REDOXISOME AND DIABETIC RETINOPATHY: PATHOPHYSIOLOGY AND THERAPEUTIC INTERVENTIONS. DIABETIC RETINOPATHY (DR) IS A CHRONIC MICROVASCULAR COMPLICATION OF DIABETES MELLITUS (DM). IT IS A WORLDWIDE GROWING EPIDEMIC DISEASE CONSIDERED TO BE THE LEADING CAUSE OF VISION-LOSS AND BLINDNESS IN PEOPLE WITH DM. REDOX REACTIONS OCCURRING AT THE EXTRA- AND INTRACELLULAR LEVELS ARE ESSENTIAL FOR THE MAINTENANCE OF CELLULAR HOMEOSTASIS. DYSREGULATION OF REDOX HOMEOSTASIS ARE IMPLICATED IN THE ONSET AND DEVELOPMENT OF DR. THIOREDOXIN1 (TRX1) AND THIOREDOXIN2 (TRX2) ARE CYTOPLASMIC AND MITOCHONDRIALLY LOCALIZED ANTIOXIDANT PROTEINS UBIQUITOUSLY EXPRESSED IN VARIOUS CELLS AND CONTROL CELLULAR REACTIVE OXYGEN SPECIES (ROS) BY REDUCING THE DISULFIDES INTO THIOL GROUPS. THIOREDOXIN-INTERACTING PROTEIN (TXNIP) BINDS TO TRX SYSTEM AND INHIBITS THE ACTIVE REDUCED FORM OF TRX THROUGH DISULFIDE EXCHANGE REACTION. RECENT STUDIES INDICATE THE ASSOCIATION OF TRX/TXNIP WITH REDOX SIGNAL TRANSDUCTION PATHWAYS INCLUDING ACTIVATION OF NOD-LIKE RECEPTOR PYRIN DOMAIN CONTAINING PROTEIN-3 (NLRP3) INFLAMMASOME, APOPTOSIS, AUTOPHAGY/MITOPHAGY, EPIGENETIC MODIFICATIONS IN A REDOX-DEPENDENT MANNER. THUS, IT IS IMPORTANT TO GAIN A MORE IN-DEPTH UNDERSTANDING ABOUT THE CELLULAR AND MOLECULAR MECHANISMS THAT LINKS REDOXISOME AND ER/MITOCHONDRIAL DYSFUNCTION TO DRIVE THE PROGRESSION OF DR. THE PURPOSE OF THIS REVIEW IS TO PROVIDE A MECHANISTIC UNDERSTANDING OF THE COMPLEX MOLECULAR MECHANISMS AND PATHOPHYSIOLOGICAL ROLES ASSOCIATED WITH REDOXISOME, THE TRX/TXNIP REDOX SIGNALING COMPLEX UNDER OXIDATIVE STRESS IN THE DEVELOPMENT OF DR. ALSO, THE MOLECULAR TARGETS OF FDA APPROVED DRUGS AND CLINICAL TRIALS IN ADDITION TO EFFECTIVE ANTIOXIDANT STRATEGIES FOR THE TREATMENT OF DIABETIC RETINOPATHY ARE REVIEWED. 2022 12 4469 29 MOLECULAR NEUROLOGICAL CORRELATES OF ENDORPHINERGIC/DOPAMINERGIC MECHANISMS IN REWARD CIRCUITRY LINKED TO ENDORPHINERGIC DEFICIENCY SYNDROME (EDS). THE CONSENSUS OF THE CURRENT LITERATURE STRONGLY SUPPORTS THE CONCEPT THAT BRAIN NEUROTRANSMITTERS, AND SECOND MESSENGERS INVOLVED IN THE NET RELEASE OF DOPAMINE IN THE MESOLIMBIC REGION, ESPECIALLY THE NUCLEUS ACCUMBENS (NAC), IS DIRECTLY LINKED TO MOTIVATION, ANTI-STRESS, INCENTIVE SALIENCE (WANTING), AND WELL-BEING. THE ROLE OF DOPAMINE IN TERMS OF ALCOHOL WITHDRAWAL SYMPTOMOLOGY, COCAINE CRAVING BEHAVIOR, DOPAMINE -CONDENSATION PRODUCTS (TIQS), AND MORE RECENTLY, THE GENETIC ASPECTS OF DRUG-SEEKING AND PRO-DOPAMINE REGULATION, PROVIDE COMPELLING EVIDENCE OF THE RELEVANT MOLECULAR NEUROLOGICAL CORRELATES OF DOPAMINERGIC /ENDORPHINERGIC MECHANISMS IN REWARD CIRCUITRY DUE TO GENETIC POLYMORPHISMS AND EPIGENETIC INSULTS. IN THE FACE OF AN AMERICANS OPIOID EPIDEMIC, THE CLINICAL CONSENSUS IS TO TREAT OPIOID USE DISORDER (OUD) WITH LIFE-LONG OPIOID SUBSTITUTION THERAPY. HOWEVER, THE AUTHORS SUGGEST A PARADIGM SHIFT INVOLVING NOVEL MODALITIES LIKE TARGETING THE ENDORPHINERGIC SYSTEM LINKED TO DOPAMINE RELEASE AT THE NAC, IN TERMS OF THE INDUCTION OF REQUIRED "DOPAMINE HOMEOSTASIS." UTILIZING THE KNOWN GENETIC - ENVIRONMENTAL INTERACTION THEOREM P = G +E, THE AUTHORS PROVIDE A CLEAR RATIONALE FOR THE ADOPTION OF GENETIC RISK TESTING COUPLED WITH ENDORPHINERGIC/DOPAMINE REGULATION TO ADDRESS DYSFUNCTION ACROSS THE BRAIN REWARD CIRCUITRY. THE GOAL OF ALTERING RESTING-STATE, FUNCTIONAL CONNECTIVITY MAY REQUIRE A GENTLE "NEUROTRANSMITTER FIX" VIS ENKEPHALINASE INHIBITION TO OVERCOME OR COMBAT - SELF-INDUCTION OF ACUTE DOPAMINE RELEASE VIA PSYCHOACTIVE SUBSTANCE MISUSE RESULTING IN CHRONIC DOPAMINE DOWN-REGULATION. AS SUBSETS OF REWARD DEFICIENCY, WE ARE POISED TO PROVIDE NOVEL, GENETICALLY GUIDED THERAPY FOR ENDORPHINERGIC, OPIOIDERGIC, AND DOPAMINERGIC DEFICIENCIES AND RELATED SYNDROMES, UTILIZING "PRECISION ADDICTION MANAGEMENT. 2020 13 5046 37 PHARMACOLOGICAL AND DIETARY ANTIOXIDANT THERAPIES FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE. THE PROGRESSION AND EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE INTIMATELY ASSOCIATED WITH TOBACCO SMOKE/BIOMASS FUEL-INDUCED OXIDATIVE AND ALDEHYDE/CARBONYL STRESS. ALTERATIONS IN REDOX SIGNALING PROINFLAMMATORY KINASES AND TRANSCRIPTION FACTORS, STEROID RESISTANCE, UNFOLDED PROTEIN RESPONSE, MUCUS HYPERSECRETION, EXTRACELLULAR MATRIX REMODELING, AUTOPHAGY/APOPTOSIS, EPIGENETIC CHANGES, CELLULAR SENESCENCE/AGING, ENDOTHELIAL DYSFUNCTION, AUTOIMMUNITY, AND SKELETAL MUSCLE DYSFUNCTION ARE SOME OF THE PATHOLOGICAL HALLMARKS OF COPD. IN LIGHT OF THE ABOVE IT WOULD BE PRUDENT TO TARGET SYSTEMIC AND LOCAL OXIDATIVE STRESS WITH AGENTS THAT CAN MODULATE THE ANTIOXIDANTS/ REDOX SYSTEM OR BY BOOSTING THE ENDOGENOUS LEVELS OF ANTIOXIDANTS FOR THE TREATMENT AND MANAGEMENT OF COPD. IDENTIFICATION OF VARIOUS ANTIOXIDANT AGENTS, SUCH AS THIOL MOLECULES (GLUTATHIONE AND MUCOLYTIC DRUGS, SUCH AS N-ACETYL-L-CYSTEINE, N-ACYSTELYN, ERDOSTEINE, FUDOSTEINE, ERGOTHIONEINE, AND CARBOCYSTEINE LYSINE SALT), DIETARY NATURAL PRODUCT-DERIVED POLYPHENOLS AND OTHER COMPOUNDS (CURCUMIN, RESVERATROL, GREEN TEA CATECHINS, QUERCETIN SULFORAPHANE, LYCOPENE, ACAI, ALPHA-LIPOIC ACID, TOCOTRIENOLS, AND APOCYNIN) HAVE MADE IT POSSIBLE TO MODULATE VARIOUS BIOCHEMICAL ASPECTS OF COPD. VARIOUS RESEARCHES AND CLINICAL TRIALS HAVE REVEALED THAT THESE ANTIOXIDANTS CAN DETOXIFY FREE RADICALS AND OXIDANTS, CONTROL EXPRESSION OF REDOX AND GLUTATHIONE BIOSYNTHESIS GENES, CHROMATIN REMODELING, AND ULTIMATELY INFLAMMATORY GENE EXPRESSION. IN ADDITION, MODULATION OF CIGARETTE SMOKE-INDUCED OXIDATIVE STRESS AND RELATED CELLULAR CHANGES HAVE ALSO BEEN REPORTED TO BE EFFECTED BY SYNTHETIC MOLECULES. THIS INCLUDES SPECIFIC SPIN TRAPS LIKE ALPHA-PHENYL-N-TERT-BUTYL NITRONE, A CATALYTIC ANTIOXIDANT (ECSOD MIMETIC), PORPHYRINS (AEOL 10150 AND AEOL 10113), AND A SUPEROXIDE DISMUTASE MIMETIC M40419, LIPID PEROXIDATION AND PROTEIN CARBONYLATION BLOCKERS/INHIBITORS, SUCH AS EDARAVONE AND LAZAROIDS/TIRILAZAD, MYELOPEROXIDASE INHIBITORS, AS WELL AS SPECIALIZED PRO-RESOLVING MEDIATORS/INFLAMMATORY RESOLVING LIPID MEDIATORS, OMEGA-3 FATTY ACIDS, VITAMIN D, AND HYDROGEN SULFIDE. ACCORDING TO VARIOUS STUDIES IT APPEARS THAT THE ADMINISTRATION OF MULTIPLE ANTIOXIDANTS COULD BE A MORE EFFECTIVE MODE USED IN THE TREATMENT OF COPD. IN THIS REVIEW, VARIOUS PHARMACOLOGICAL AND DIETARY APPROACHES TO ENHANCE LUNG ANTIOXIDANT LEVELS AND BENEFICIAL EFFECTS OF ANTIOXIDANT THERAPEUTICS IN TREATING OR INTERVENING THE PROGRESSION OF COPD HAVE BEEN DISCUSSED. 2013 14 2715 32 EXERCISE-INDUCED BIOCHEMICAL CHANGES AND THEIR POTENTIAL INFLUENCE ON CANCER: A SCIENTIFIC REVIEW. AIM: TO REVIEW AND DISCUSS THE AVAILABLE INTERNATIONAL LITERATURE REGARDING THE INDIRECT AND DIRECT BIOCHEMICAL MECHANISMS THAT OCCUR AFTER EXERCISE, WHICH COULD POSITIVELY, OR NEGATIVELY, INFLUENCE ONCOGENIC PATHWAYS. METHODS: THE PUBMED, MEDLINE, EMBASE AND COCHRANE LIBRARIES WERE SEARCHED FOR PAPERS UP TO JULY 2016 ADDRESSING BIOCHEMICAL CHANGES AFTER EXERCISE WITH A PARTICULAR REFERENCE TO CANCER. THE THREE AUTHORS INDEPENDENTLY ASSESSED THEIR APPROPRIATENESS FOR INCLUSION IN THIS REVIEW BASED ON THEIR SCIENTIFIC QUALITY AND RELEVANCE. RESULTS: 168 PAPERS WERE SELECTED AND CATEGORISED INTO INDIRECT AND DIRECT BIOCHEMICAL PATHWAYS. THE INDIRECT EFFECTS INCLUDED CHANGES IN VITAMIN D, WEIGHT REDUCTION, SUNLIGHT EXPOSURE AND IMPROVED MOOD. THE DIRECT EFFECTS INCLUDED INSULIN-LIKE GROWTH FACTOR, EPIGENETIC EFFECTS ON GENE EXPRESSION AND DNA REPAIR, VASOACTIVE INTESTINAL PEPTIDE, OXIDATIVE STRESS AND ANTIOXIDANT PATHWAYS, HEAT SHOCK PROTEINS, TESTOSTERONE, IRISIN, IMMUNITY, CHRONIC INFLAMMATION AND PROSTAGLANDINS, ENERGY METABOLISM AND INSULIN RESISTANCE. SUMMARY: EXERCISE IS ONE OF SEVERAL LIFESTYLE FACTORS KNOWN TO LOWER THE RISK OF DEVELOPING CANCER AND IS ASSOCIATED WITH LOWER RELAPSE RATES AND BETTER SURVIVAL. THIS REVIEW HIGHLIGHTS THE NUMEROUS BIOCHEMICAL PROCESSES, WHICH EXPLAIN THESE POTENTIAL ANTICANCER BENEFITS. 2017 15 4096 32 MATRIX METALLOPROTEINASES, NEURAL EXTRACELLULAR MATRIX, AND CENTRAL NERVOUS SYSTEM PATHOLOGY. THE FUNCTIONALITY AND STABILITY OF THE CENTRAL NERVOUS SYSTEM (CNS) PABULUM, CALLED NEURAL EXTRACELLULAR MATRIX (NECM), IS PARAMOUNT FOR THE MAINTENANCE OF A HEALTHY NETWORK. THE LOOSENING OR THE DAMAGE OF THE SCAFFOLD DISRUPTS SYNAPTIC TRANSMISSION WITH THE CONSEQUENT IMBALANCE OF THE NEUROTRANSMITTERS, REACTIVE CELLS INVASION, ASTROCYTOSIS, NEW MATRIX DEPOSITION, DIGESTION OF THE PREVIOUS STRUCTURE AND ULTIMATELY, MALADAPTIVE PLASTICITY WITH THE LOSS OF NEURONAL VIABILITY. NECM IS CONSTANTLY AFFECTED BY CNS DISORDERS, PARTICULARLY IN CHRONIC MODIFYING SUCH AS NEURODEGENERATIVE DISEASE, OR IN ACUTE/SUBACUTE WITH CHRONIC SEQUELAE, LIKE CEREBROVASCULAR AND INFLAMMATORY PATHOLOGY. MATRIX METALLOPROTEINASES (MMPS) ARE THE MAIN INTERFERING AGENT OF NECM, GUIDING THE BALANCE OF DEGRADATION AND NEW DEPOSITION OF PROTEINS SUCH AS PROTEOGLYCANS AND GLYCOPROTEINS, OR GLYCOSAMINOGLYCANS, SUCH AS HYALURONIC ACID. ACTIVATION OF THESE ENZYMES IS MODULATED BY THEIR PHYSIOLOGIC INHIBITORS, THE TISSUE INHIBITORS OF MMPS OR VIA OTHER PROTEASES INHIBITORS, AS WELL AS GENETIC OR EPIGENETIC UP- OR DOWNREGULATION THROUGH MOLECULAR INTERACTION OR RECEPTOR ACTIVATION. THE APPROPRIATE UNDERSTANDING OF THE PATHWAYS UNDERLYING NECM MODIFICATIONS IN CNS PATHOLOGY IS PROBABLY ONE OF THE PIVOTAL FUTURE DIRECTIONS TO IDENTIFY THE HEALTHY BRAIN NETWORK AND SUBSEQUENTLY DESIGN NEW THERAPIES TO INTERFERE WITH THE PROGRESSION OF THE CNS DISEASE AND EVENTUALLY FIND APPROPRIATE THERAPIES. 2017 16 1276 27 DAMPS, AGEING, AND CANCER: THE 'DAMP HYPOTHESIS'. AGEING IS A COMPLEX AND MULTIFACTORIAL PROCESS CHARACTERIZED BY THE ACCUMULATION OF MANY FORMS OF DAMAGE AT THE MOLECULAR, CELLULAR, AND TISSUE LEVEL WITH ADVANCING AGE. AGEING INCREASES THE RISK OF THE ONSET OF CHRONIC INFLAMMATION-ASSOCIATED DISEASES SUCH AS CANCER, DIABETES, STROKE, AND NEURODEGENERATIVE DISEASE. IN PARTICULAR, AGEING AND CANCER SHARE SOME COMMON ORIGINS AND HALLMARKS SUCH AS GENOMIC INSTABILITY, EPIGENETIC ALTERATION, ABERRANT TELOMERES, INFLAMMATION AND IMMUNE INJURY, REPROGRAMMED METABOLISM, AND DEGRADATION SYSTEM IMPAIRMENT (INCLUDING WITHIN THE UBIQUITIN-PROTEASOME SYSTEM AND THE AUTOPHAGIC MACHINERY). RECENT ADVANCES INDICATE THAT DAMAGE-ASSOCIATED MOLECULAR PATTERN MOLECULES (DAMPS) SUCH AS HIGH MOBILITY GROUP BOX 1, HISTONES, S100, AND HEAT SHOCK PROTEINS PLAY LOCATION-DEPENDENT ROLES INSIDE AND OUTSIDE THE CELL. THESE PROVIDE INTERACTION PLATFORMS AT MOLECULAR LEVELS LINKED TO COMMON HALLMARKS OF AGEING AND CANCER. THEY CAN ACT AS INDUCERS, SENSORS, AND MEDIATORS OF STRESS THROUGH INDIVIDUAL PLASMA MEMBRANE RECEPTORS, INTRACELLULAR RECOGNITION RECEPTORS (E.G., ADVANCED GLYCOSYLATION END PRODUCT-SPECIFIC RECEPTORS, AIM2-LIKE RECEPTORS, RIG-I-LIKE RECEPTORS, AND NOD1-LIKE RECEPTORS, AND TOLL-LIKE RECEPTORS), OR FOLLOWING ENDOCYTIC UPTAKE. THUS, THE DAMP HYPOTHESIS IS NOVEL AND COMPLEMENTS OTHER THEORIES THAT EXPLAIN THE FEATURES OF AGEING. DAMPS REPRESENT IDEAL BIOMARKERS OF AGEING AND PROVIDE AN ATTRACTIVE TARGET FOR INTERVENTIONS IN AGEING AND AGE-ASSOCIATED DISEASES. 2015 17 4416 29 MOLECULAR AND CELLULAR PATHWAYS CONTRIBUTING TO JOINT DAMAGE IN RHEUMATOID ARTHRITIS. RHEUMATOID ARTHRITIS IS A CHRONIC AUTOIMMUNE SYNDROME ASSOCIATED WITH SEVERAL GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS AFFECTING THE ARTICULAR JOINTS CONTRIBUTING TO CARTILAGE AND BONE DAMAGE. ALTHOUGH ETIOLOGY OF THIS DISEASE IS NOT CLEAR, SEVERAL IMMUNE PATHWAYS, INVOLVING IMMUNE (T CELLS, B CELLS, DENDRITIC CELLS, MACROPHAGES, AND NEUTROPHILS) AND NONIMMUNE (FIBROBLASTS AND CHONDROCYTES) CELLS, PARTICIPATE IN THE SECRETION OF MANY PROINFLAMMATORY CYTOKINES, CHEMOKINES, PROTEASES (MMPS, ADAMTS), AND OTHER MATRIX LYSING ENZYMES THAT COULD DISTURB THE IMMUNE BALANCE LEADING TO CARTILAGE AND BONE DAMAGE. THE PRESENCE OF AUTOANTIBODIES PRECEDING THE CLINICAL ONSET OF ARTHRITIS AND THE INDUCTION OF BONE EROSION EARLY IN THE DISEASE COURSE CLEARLY SUGGEST THAT INITIATION EVENTS DAMAGING THE CARTILAGE AND BONE START VERY EARLY DURING THE AUTOIMMUNE PHASE OF THE ARTHRITIS DEVELOPMENT. DURING THIS PROCESS, SEVERAL SIGNALING MOLECULES (RANKL-RANK, NF-KAPPAB, MAPK, NFATC1, AND SRC KINASE) ARE ACTIVATED IN THE OSTEOCLASTS, CELLS RESPONSIBLE FOR BONE RESORPTION. HENCE, COMPREHENSIVE KNOWLEDGE ON PATHOGENESIS IS A PREREQUISITE FOR PREVENTION AND DEVELOPMENT OF TARGETED CLINICAL TREATMENT FOR RA PATIENTS THAT CAN RESTORE THE IMMUNE BALANCE IMPROVING CLINICAL THERAPY. 2020 18 43 18 A COMPREHENSIVE REVIEW OF THE GENETIC AND EPIGENETIC CONTRIBUTIONS TO THE DEVELOPMENT OF FIBROMYALGIA. THIS NARRATIVE REVIEW SUMMARIZES THE CURRENT KNOWLEDGE OF THE GENETIC AND EPIGENETIC CONTRIBUTIONS TO THE DEVELOPMENT OF FIBROMYALGIA (FM). ALTHOUGH THERE IS NO SINGLE GENE THAT RESULTS IN THE DEVELOPMENT OF FM, THIS STUDY REVEALS THAT CERTAIN POLYMORPHISMS IN GENES INVOLVED IN THE CATECHOLAMINERGIC PATHWAY, THE SEROTONERGIC PATHWAY, PAIN PROCESSING, OXIDATIVE STRESS, AND INFLAMMATION MAY INFLUENCE SUSCEPTIBILITY TO FM AND THE SEVERITY OF ITS SYMPTOMS. FURTHERMORE, EPIGENETIC CHANGES AT THE DNA LEVEL MAY LEAD TO THE DEVELOPMENT OF FM. LIKEWISE, MICRORNAS MAY IMPACT THE EXPRESSION OF CERTAIN PROTEINS THAT LEAD TO THE WORSENING OF FM-ASSOCIATED SYMPTOMS. 2023 19 4412 29 MOLECULAR AND CELLULAR BASIS OF RHEUMATOID JOINT DESTRUCTION. RHEUMATOID ARTHRITIS (RA) IS A CHRONIC INFLAMMATORY DISEASE ASSOCIATED WITH JOINT DESTRUCTION. SYNOVIAL FIBROBLASTS ARE KEY PLAYERS IN THIS PATHOLOGICAL PROCESS. THEY FAVORISE A PRO-INFLAMMATORY ENVIRONMENT IN THE SYNOVIAL TISSUE, INTERACT WITH THE IMMUNE SYSTEM AND REGULATE THE DIFFERENTIATION OF MONOCYTES INTO OSTEOCLASTS. SYNOVIAL HYPERPLASIA IS ANOTHER CHARACTERISTIC OF RA, REFLECTING NOT ONLY AN IMBALANCE BETWEEN PROLIFERATION AND APOPTOSIS, BUT ALSO THE MIGRATION OF CELLS INTO THE SYNOVIAL TISSUE. GENE TRANSFER EXPERIMENTS HAVE BEEN USED AS IMPORTANT TOOLS FOR THE UNDERSTANDING OF MOLECULAR AND CELLULAR CHANGES THAT CHARACTERIZE THE ACTIVATED RA SYNOVIAL FIBROBLASTS. ACTIVATED SYNOVIAL FIBROBLASTS CAN INVADE CARTILAGE AND BONE. SYNOVIAL ACTIVATION IS DRIVEN BY CYTOKINES, SUCH AS TNFALPHA AND IL-1, AS WELL AS IL-15, 16, 17, 18, 22, 23, BUT ALSO BY CYTOKINE-INDEPENDENT MECHANISMS THAT INVOLVE THE INNATE IMMUNE SYSTEM (I.E. TLRS), A UNIQUE COMMUNICATION NETWORK OF MICROPARTICLES AND EPIGENETIC CHANGES (E.G. L1 RETROELEMENTS). 2006 20 630 27 BIOLOGICAL AND MECHANICAL FACTORS AND EPIGENETIC REGULATION INVOLVED IN TENDON HEALING. TENDONS ARE AN IMPORTANT PART OF THE MUSCULOSKELETAL SYSTEM. CONNECTING MUSCLES TO BONES, TENDONS CONVERT FORCE INTO MOVEMENT. TENDON INJURY CAN BE ACUTE OR CHRONIC. NOTICEABLY, TENDON HEALING REQUIRES A LONG TIME SPAN AND INCLUDES INFLAMMATION, PROLIFERATION, AND REMODELING PROCESSES. THE MISMATCH BETWEEN ENDOGENOUS AND EXOGENOUS HEALING MAY LEAD TO ADHESION CAUSING FURTHER NEGATIVE EFFECTS. MANAGEMENT OF TENDON INJURIES AND COMPLICATIONS SUCH AS SUBSEQUENT ADHESION FORMATION ARE STILL CHALLENGES FOR CLINICIANS. DUE TO NUMEROUS FACTORS, TENDON HEALING IS A COMPLEX PROCESS. THIS REVIEW INTRODUCES THE ROLE OF VARIOUS BIOLOGICAL AND MECHANICAL FACTORS AND EPIGENETIC REGULATION PROCESSES INVOLVED IN TENDON HEALING. 2023