**5. Application of transcriptional control on medical sciences**

Varieties of human diseases could be caused by the dysregulation in transcription of either or both protein-encoding genes and ncRNAs. Although, it has not been examined if alteration in transcription is applicable for treatment of the presently intractable diseases, it will be possible in principle. A number of natural and chemical compounds could affect gene expression. Alternatively, transcription could be modulated by the introduction of expression vectors, which express specific TFs in the target cells. In an effort to reach that goal, we have to develop reliable methods to deliver genes into abnormal or lesion cells.

#### **5.1 Natural and the derivative compounds that regulate transcription**

Natural compounds or phytochemicals could be applied on treatment of specific diseases. Some of them affect the JAK/STAT signaling pathway that activates cell cycle/proliferation-controlling factor-encoding gene expression [50]. Sulforaphane targets Nrf2 [51], which responds to oxidative stress, implying that it can be applied for the treatment of metabolic syndromes [52]. Tannic acid, coumarins, and chalcones suppress 12-*O*-tetra decanoylphorbol-13-acetate (TPA)-induced HIV promoter activity in human Jurkat cells [53]. Rsv induces promoter activities of DNA-repair factor-encoding genes, including *TP53*, *WRN*, *TERT*, and *HELB* [54–56]. The GGAA-containing motif and the GC-box have been suggested to play an essential role in the response. Vitamin E and the related compounds, including tocotrienols, activate transcription by binding to estrogen receptors [57] but inactivate NF-κB activity [58]. Curcumin, which is a diferuloylmethane from the Indian spice turmeric, also targets NF-κB and AP1 to affect survival and proliferation of cells [59], might be applied on the suppression of the *APP* and the beta-site APP cleaving enzyme 1-encoding *BACE1* gene expression [60].

These observations imply that phytochemicals could be used for therapeutic use. To minimize side effects, how the molecular mechanisms affect transcription should be elucidated. Next-generation therapies for intractable human diseases might be enabled by introduction of TF-expression vectors or by editing specific site(s) of the genome. Additionally, nucleotides or nucleic acid-based pharmaceutical compounds might be developed to ameliorate profile or status of gene expression in dysregulated cells.

#### **5.2 Dysregulation in transcription might cause aging-related diseases**

Indeed, aging is not a disease in principle. However, incidences of specific diseases are increased according to the process, for example, arteriosclerosis, cancer, sarcopenia, and neurodegenerative diseases, including AD. The causations of aging have been studied and discussed at the cellular level and they could be classified as follows:

#### *5.2.1 Genome instability, including telomere shortening*

Aging is thought to be accelerated by the accumulation of damage on chromosomal DNAs. This hypothesis is supported by the identification of responsive genes for premature aging, for example, LMNA, WRN, ATM, and SRPTN [61, 62]. Therefore, the aberrances in the nuclear architecture and DNA repair systems may cause premature aging. Cellular senescence is generally accompanied with the shortening of telomeres [63]. This is consistent with the observations that shortened telomeres cause genomic instabilities.

*Gene Expression and Control*

acetyl-CoA, ATP, and NAD+

trol (Rsv), which upregulates NAD+

in the gene expression regulatory regions.

lncRNAs could be applied for treatment of specific diseases.

**4. Analyses of gene expression in human diseases**

Increased NAD+

Cells are continuously receiving stresses, which are, for example, temperature, lights and radiations, proton and ionic gradient, nutrients, and pathogens, including bacteria and viruses. Therefore, responses to these stresses are essential for life [23]. The stress-induced signals will be converted to cellular responses, including secretion, gating ion channels, cellular behavior, proliferation, differentiation, senescence, apoptosis, and the development of organs. Some of the signals cause epigenetic changes or affect transcription of specific genes. We should remember that DNA methylations are required for setting accurate TSSs [24]. The epigenetic modification of DNAs, such as methylation, acetylation, and phosphorylation, and poly(ADPribosyl)ation, is dependent on the substrate molecules, S-adenosyl methionine,

learned from textbooks in biological chemistry. These molecules are so essential and indispensable for living things that they must be obtained from metabolism of nucleic acids, amino acids, lipids, and carbohydrates. Not only the epigenetic regulation, but also transcription is dependent on nutrients or the metabolites. For example, AMPK-FOXO pathway plays a role as a nutrient sensor to affect gene expression [26]. The AMPK has been shown to regulate NADPH homeostasis during energy stress [27].

*BRCA1* gene [28]. The transcriptional corepressor protein, CtBP1, which possesses an NADH binding domain [29, 30], is one of the candidates that play a role in the NAD+

NADH ratio-dependent transcription system. Importantly, several human DNArepair-factor encoding gene promoters respond to natural compound *trans*-resvera-

expression of the DNA-repair associated genes is partly regulated by metabolic state.

The next-generation sequencing (NGS) analysis greatly contributed for the identification of specific genetic errors [32]. Somatic mutations on cancer driver genes have been identified [33, 34] and the statistical data contribute for the prediction or diagnosis of cancer. In search of biomarkers and cancer-causing factors, transcriptome analyses have been applied on model animals and clinical samples from patients, gradually unveiling mechanisms of the cancer progression. Hot spot somatic mutations are observed in the promoter regions of the human cancer genomes [35]. Binding of the TFs on the promoter could regulate mutation rate to modulate both transcription and DNA-repair systems [36]. In melanomas, such mutations are highly found on the human *TERT* gene promoter [37, 38]. Thus, cancer-causing mutations are not only present in the protein-coding genes, but also

Transcriptome analysis does not only contribute to the diagnosis or prognosis of cancer but also other human diseases. For example, different gene expression patterns have been shown in autism [39], type 2 diabetes (T2DB) [40], schizophrenia [41], and neurodegenerative disease, including Alzheimer's disease (AD) [42, 43]. Accumulation of repeat containing RNAs in aberrant foci in nucleus has been observed in Huntington disease, muscular dystrophy, and amyotrophic lateral sclerosis (ALS) [44]. The noncoding RNAs (ncRNAs), the long ncRNAs (lncRNAs), or long intergenic ncRNAs (lincRNAs) play essential roles in epigenetic regulation and in conversion of the nuclear structures [45]. Therefore, not only the protein encoding genes but also the ncRNAs are thought to be involved in the pathogenesis [46–48]. The lncRNAs control chromatin structure and nuclear architecture to regulate transcription in eukaryotic cells [49]. Thus, it is very important to explore how the lncRNAs are being regulated. Conversely, introduction of

/NADH ratio serves as a metabolic switch for transcription of the

, respectively [25]. They are the metabolites that we have

/NADH ratio in HeLa S3 cells [31], implying that

/

**6**

#### *5.2.2 Accumulation of damage from oxidative stresses*

Neurotoxicity could be induced by numbers of factors. The oxidative stress or the oxidative damage would cause neurodegenerative diseases, including the AD. The oxidative stresses impact on the Keap1-NRF2-ARE signaling pathway to upregulate expression of stress response genes, such as *NRF2*, *KEAP1*, *SOD1*, and *ETS1* [64]. The observation is consistent with the theory that the incidence of the AD increases with the aging [65].

#### *5.2.3 Mitochondrial dysregulations and dysfunctions*

Morphology of mitochondria and the respiratory functions are declined by aging process, accompanied with the accumulation of mitochondrial DNAs (mtD-NAs) [66, 67]. The mutations on the mtDNAs are thought to be partly caused by the oxidative stresses. Nuclear-mitochondrial communication is thought to play a role in the regulation of longevity [68]. Moreover, telomere dysfunctions induce mitochondrial compromise [69]. In summary, interplay between mitochondria and nuclei would affect aging.

#### *5.2.4 Decrease in the cellular NAD+ level*

Nicotine amide adenine dinucleotide (NAD<sup>+</sup> ), which is required for the respiratory functions of mitochondria, regulating enzymes in TCA cycle, and oxidative phosphorylation (OXPHOS), is declined with aging [70, 71]. The NAD+ activates protein deacetylase Sirtuins, which regulate health span and life span. Moreover, the NAD<sup>+</sup> is a substrate for poly(ADP-ribose) (PARP), which plays an essential role in the DNA damage response [31].

#### *5.2.5 Alteration in the epigenetic regulations of the genomes*

The profiles of the methylation of DNAs and the modifications, including acetylation and methylation of histones, are altered in the aging process [72, 73]. These epigenetic changes will enhance or reduce transcription of specific genes.

#### *5.2.6 Alterations in immune response and cytokine dysregulation*

Cytokine dysregulation or prolonged inflammation is observed in aged person [74]. Numbers of proteins are involved in the inflammation process, suggesting that expression and degradation of proteins could accelerate or decelerate cellular senescence.

Aging might start from subtle changes in the TFs profile that regulate expression of genes encoding DNA-repair/mitochondrial/immune response-associated protein factors [31, 75]. Decline in metabolites, which target DNA-binding proteins and ncRNAs [46–48] to modulate epigenetic systems [24–30], would accelerate aging. Given that alterations in the transcription could cause the aging, it could be slowed by manipulating TFs profile.

#### **6. Concluding remarks and future prospects**

Homeostasis or negative feedback is not only required for endocrine system but also for biochemical reactions. Metabolites, including sugars, lipids and amino acids, and ionic substrates need to be maintained within biologically significant

**9**

**Acknowledgements**

**Conflict of interest**

interest.

**Figure 1.**

**Abbreviations**

*Introductory Chapter: Gene Expression Controlling System and Its Application to Medical Sciences*

level. Similarly, nucleic acids and proteins should be appropriately managed being continuously synthesized and degraded. The equilibrium will gradually change in accordance with aging. Homeostasis in organs would play a role in the cancer generation [76]. Senescence can be metaphorically expressed as a walk on a balance beam that is narrowed afterward. The younger cells proliferate faster and respond to stresses with more accuracy than the older ones. After repeated proliferation, cells will reach the point where they cannot go forward but initiate aging. Somatic cells can acquire a pluripotency by incorporation of TFs. So, is it not possible to reverse aged or abnormal cells into younger or healthy cells? Then, what molecules (nucleic acids, proteins, etc.) are required and how they are introduced (by specific vectors, genome-editing systems, etc.) into cells? That should be answered for the

next-generation therapeutics against aging-related diseases (**Figure 1**).

discussion and their outstanding technical assistance.

*Concept of the next-generation transcriptome-based therapeutics.*

ALS amyotrophic lateral sclerosis

GTF general transcription factor

NAD+ nicotine amide adenine dinucleotide

AD Alzheimer's disease

HD homeodomain

bHLH helix-loop-helix

The authors are grateful to Hiroshi Hamada, Sakiko Kawahara, Natsuki Mizuno,

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of

Yui Suzuki, Yuki Nakano, Monami Kusaka, Kaori Orino, and Daisuke Sudo for

*DOI: http://dx.doi.org/10.5772/intechopen.80676*

*Introductory Chapter: Gene Expression Controlling System and Its Application to Medical Sciences*

#### **Figure 1.**

*Gene Expression and Control*

AD increases with the aging [65].

nuclei would affect aging.

the NAD<sup>+</sup>

senescence.

by manipulating TFs profile.

*5.2.4 Decrease in the cellular NAD+*

in the DNA damage response [31].

*5.2.2 Accumulation of damage from oxidative stresses*

*5.2.3 Mitochondrial dysregulations and dysfunctions*

Nicotine amide adenine dinucleotide (NAD<sup>+</sup>

*5.2.5 Alteration in the epigenetic regulations of the genomes*

*5.2.6 Alterations in immune response and cytokine dysregulation*

**6. Concluding remarks and future prospects**

Neurotoxicity could be induced by numbers of factors. The oxidative stress or the oxidative damage would cause neurodegenerative diseases, including the AD. The oxidative stresses impact on the Keap1-NRF2-ARE signaling pathway to upregulate expression of stress response genes, such as *NRF2*, *KEAP1*, *SOD1*, and *ETS1* [64]. The observation is consistent with the theory that the incidence of the

Morphology of mitochondria and the respiratory functions are declined by aging process, accompanied with the accumulation of mitochondrial DNAs (mtD-NAs) [66, 67]. The mutations on the mtDNAs are thought to be partly caused by the oxidative stresses. Nuclear-mitochondrial communication is thought to play a role in the regulation of longevity [68]. Moreover, telomere dysfunctions induce mitochondrial compromise [69]. In summary, interplay between mitochondria and

), which is required for the respira-

activates

 *level*

phosphorylation (OXPHOS), is declined with aging [70, 71]. The NAD+

epigenetic changes will enhance or reduce transcription of specific genes.

tory functions of mitochondria, regulating enzymes in TCA cycle, and oxidative

protein deacetylase Sirtuins, which regulate health span and life span. Moreover,

is a substrate for poly(ADP-ribose) (PARP), which plays an essential role

The profiles of the methylation of DNAs and the modifications, including acetylation and methylation of histones, are altered in the aging process [72, 73]. These

Cytokine dysregulation or prolonged inflammation is observed in aged person [74]. Numbers of proteins are involved in the inflammation process, suggesting that expression and degradation of proteins could accelerate or decelerate cellular

Aging might start from subtle changes in the TFs profile that regulate expression of genes encoding DNA-repair/mitochondrial/immune response-associated protein factors [31, 75]. Decline in metabolites, which target DNA-binding proteins and ncRNAs [46–48] to modulate epigenetic systems [24–30], would accelerate aging. Given that alterations in the transcription could cause the aging, it could be slowed

Homeostasis or negative feedback is not only required for endocrine system but also for biochemical reactions. Metabolites, including sugars, lipids and amino acids, and ionic substrates need to be maintained within biologically significant

**8**

*Concept of the next-generation transcriptome-based therapeutics.*

level. Similarly, nucleic acids and proteins should be appropriately managed being continuously synthesized and degraded. The equilibrium will gradually change in accordance with aging. Homeostasis in organs would play a role in the cancer generation [76]. Senescence can be metaphorically expressed as a walk on a balance beam that is narrowed afterward. The younger cells proliferate faster and respond to stresses with more accuracy than the older ones. After repeated proliferation, cells will reach the point where they cannot go forward but initiate aging. Somatic cells can acquire a pluripotency by incorporation of TFs. So, is it not possible to reverse aged or abnormal cells into younger or healthy cells? Then, what molecules (nucleic acids, proteins, etc.) are required and how they are introduced (by specific vectors, genome-editing systems, etc.) into cells? That should be answered for the next-generation therapeutics against aging-related diseases (**Figure 1**).
