Heritable germline mutations are estimated to drive 10% of all cancers, which can manifest as pediatric as well adult diseases. This series, curated by Agata Smogorzewska and JCI Associate Editor Mary Armanios, unravels how the biology and genetics underlying familial cancer predisposition syndromes informs understanding cancer etiology and biology. Reviews focus on cancer-driving mutations in transcription factors, in developmental and metabolic signals, and in pathways that control genetic stability and provide insights linking mechanistic studies with ongoing clinical research. Enhanced understanding of the biological basis for these familial cancers may inform the treatment of cancers driven by both germline and somatic mutations.
Published February 2019
Mitochondria transform nutrients and oxygen into chemical energy that powers a multitude of cellular functions. While mitochondrial aerobic glycolysis generates the majority of a cell’s ATP, its byproducts also have wide-ranging influences on cellular health and longevity. This review series, edited by Dr. Michael Sack, focuses on the many contributions of mitochondria to disease and aging. The reviews highlight evidence linking altered mitochondrial metabolism and oxidative stress to a range of pathophysiological phenomena: inflammation and immune dysfunction, heart failure, cancer development, metabolic disease, and more. In many diseases and conditions, mitochondrial dysfunction is considered the tipping point toward pathological progression. However, as these reviews discuss, therapeutic targeting of mitochondria may be a powerful strategy to subvert disease and aging processes.
Published August 2018
Infection and injury induce self-limited inflammatory responses that mount a defense against pathogens and initiate activities that expedite recovery. However, the benefits of inflammation recede when these responses fail to resolve in a timely manner. This series features a family of specialized lipid mediators that regulate the resolution of inflammation. The reviews, curated by Charles Serhan, highlight the wide-ranging involvement of these bioactive lipids in health and disease. Work by Serhan and others has revealed that the resolvin, protectin, and maresin families of pro-resolving mediators act as immunoresolvents and represent promising alternatives to immunosuppressant and anti-inflammatory therapies. Other lipid mediators, including leukotrienes, ceramides, and sphingolipids have roles in cancer, cardiovascular disease, and aging. Our evolving understanding of lipid mediators in regulating inflammation and disease pathogenesis presents promising opportunities for new therapeutic strategies.
Published July 2018
Cellular senescence is a normal consequence of aging, resulting from lifelong accumulation of DNA damage that triggers an end to cell replication. Although senescent cells no longer divide, they persist in their tissue of origin and develop characteristics that can hasten and exacerbate age-related disease. This series addresses the contribution of cellular senescence to cardiovascular, neurodegenerative, and arthritic disorders as well as the senescent phenotypes in various tissues and cell types. In addition to their cell-intrinsic effects, senescent cells develop the ability to negatively influence healthy neighboring cells and immune cells by secreting senescence-associated set of cytokines and mediators known as the SASP. These reviews also highlight ongoing efforts to accurately identify, target, and eliminate senescent cells or otherwise combat their deleterious effects in disease. One day, this work may provide the basis for therapies targeting aging cells in multiple organs.
Published April 2018
Fibrosis describes a maladaptive response to injury that results in pathogenic production of extracellular matrix, the formation of stiff scar tissue, and compromised organ function. Although it is most often associated with chronic liver conditions and progressive lung disease, fibrosis can affect any organ of the body. There are few treatment options for this progressive, often fatal condition, but as ongoing research identifies the molecular pathways that initiate and propagate fibrotic remodeling, therapeutic possibilities may become available. The reviews in this series discuss recent insights into genetic predisposition to fibrotic disorders, the origins of fibroblasts and myofibroblasts, scar tissue formation, organ regeneration, and more, revealing opportunities to interrupt or even reverse disease progression.
Published January 2018
Glia are central nervous system cells that surround neurons and hold them in place, supply them with nutrients and oxygen, serve to insulate neurons from each other, and to remove pathogens and dead neurons. Historically, these cells have been considered less interesting than neurons; however, in the past decade, they have emerged as critical regulators of brain development and homeostasis and are now being appreciated as drivers of disease. Reviews in this series describe the role of glia and the associated glymphatic system in normal physiology, neuronal metabolism, prion diseases, Alzheimer’s disease, ALS, spinal cord injury, and neurodegenerative disease.
Published September 2017
Organ and tissue transplantation are frequently life-extending procedures for patients with end-stage organ disease or hematological malignancies; however, the success of transplantation of organs and tissues to a recipient from a genetically non-identical donor is limited by immune-mediated complications, including rejection, graft dysfunction, graft-versus-host disease, and the side effects of preventing rejection. Despite over 100 years of research in this area, we are just now beginning to develop an in-depth understanding of the immune mechanisms that determine the success of allotransplantation. A detailed understanding of transplantation immunology will allow for better selection of donor/recipient pairs, the development of novel therapeutic strategies, and, ultimately, better outcomes. Reviews in this series explore the role of cytokines in both acute and chronic graft-versus-host disease; the effects of sterile inflammation, danger signals, and the inflammasome in solid organ transplantation; the mechanisms of humoral and cellular rejection; cell-based therapies to combat rejection and transplantation-associated infections; and the effects of both host-intrinsic and -extrinsic factors in transplantation outcomes.
Published June 2017
Nuclear receptors are a class of intracellular proteins that sense and respond to a variety of endogenous hormones, vitamins, and xenobiotic endocrine disruptors by modulating gene expression. These proteins have well-established roles in the regulation of energy balance and the skeletal system, and they are emerging as important players in other areas of human physiology and disease. Humans have 48 nuclear receptors that all possess an N-terminal transactivation domain, a highly conserved central region DNA-binding domain, and a C-terminal ligand-binding domain. Ligand binding results in the transactivation of specific genes within a given tissue. Notably, a number of nuclear receptors do not have a known endogenous ligand and structural studies indicate that they may not bind ligands at all, but instead recruit other nuclear receptors or chromatin modifiers to control gene expression. Nuclear receptor activity can be modulated through interactions with other nuclear receptors or transcriptional coactivator or corepressor proteins, as well as through modulation by numerous growth factor and cytokine signaling cascades that induce various posttranslational modifications. Reviews in this series examine the role of nuclear receptors in metabolic syndrome, cardiovascular disease, liver function, hormone-dependent cancers, responses to common therapeutic agents, genetic disorders, the effects of vitamin D, and parasitic disease.
Published April 2017
Metabolic syndrome constitutes a constellation of conditions, including central obesity, glucose intolerance, and dyslipidemia. These conditions enhance the risk of type 2 diabetes, cardiovascular disease, fatty liver/cirrhosis, hypertension, and cancer. The finding over 20 years ago that the inflammatory mediator TNF is overexpressed in adipose fundamentally changed our understanding of obesity and metabolic syndrome. We now know that metabolic syndrome in humans is characterized by chronic low-grade inflammation in multiple organs and we are now beginning to delineate the mechanisms by which inflammation and metabolism influence each other. Reviews in this series examine the activation of the innate and adaptive immune system in obesity; inflammation within diabetic islets, brain, liver, gut, and muscle; the role of inflammation in fibrosis and angiogenesis; the factors that contribute to the initiation of inflammation; and therapeutic approaches to modulate inflammation in the context of obesity and metabolic syndrome. We now know that an inflammatory program is activated early in adipose expansion and during chronic obesity, permanently skewing the immune system to a pro-inflammatory phenotype.
Published January 2017
Inflammation is a primary response to injury and or infection, allowing the body to eliminate pathogens and/or damaged tissue and to initiate repair processes. Low oxygen levels, or hypoxia, is a key feature of inflamed tissue and is due to damage to the local vasculature and increased oxygen consumption by pathogens and infiltrating immune cells. In addition to being a feature of inflammation, hypoxia also induces and regulates the inflammatory response by inducing the release of inflammatory cytokines, directing immune cell infiltration, and tuning the responses of the immune cells themselves. These effects are largely mediated by a family of hypoxia-inducible transcription factors (HIFs), which serve as the master regulators of cellular responses to inadequate oxygenation and HIFs and their regulatory factors are now emerging as therapeutic targets in a number of disease states. Reviews in this series discuss the roles of hypoxia and HIFs in the regulation of inflammatory pathways, immune cell metabolism, mucosal inflammation, the tumor microenvironment, intestinal inflammation and colorectal cancer, and recovery from radiation-induced gastrointestinal toxicity. Together, these reviews identify a number of hypoxia-regulated processes that could potentially be targeted to modulate inflammation.
Published October 2016