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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fphar.2019.01510</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Epigenetic Regulation of Excitatory Amino Acid Transporter 2 in Neurological Disorders</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Alam</surname>
<given-names>Mohammad Afaque</given-names>
</name>
<uri xlink:href="https://loop.frontiersin.org/people/803829"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Datta</surname>
<given-names>Prasun K.</given-names>
</name>
<xref ref-type="author-notes" rid="fn001"><sup>*</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/133767"/>
</contrib>
</contrib-group>
<aff id="aff1"><institution>Department of Neuroscience, Center for Comprehensive NeuroAIDS, Lewis Katz School of Medicine at Temple University</institution>, <addr-line>Philadelphia, PA</addr-line>, <country>United States</country></aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Chandravanu Dash, Meharry Medical College, United States</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Lin Cheng, The University of Iowa, United States; Gurudutt Pendyala, University of Nebraska Medical Center, United States</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Prasun K. Datta, <email xlink:href="mailto:dattapk@temple.edu">dattapk@temple.edu</email></p>
</fn>
<fn fn-type="other" id="fn002">
<p>This article was submitted to Pharmacogenetics and Pharmacogenomics, a section of the journal Frontiers in Pharmacology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>13</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="collection">
<year>2019</year>
</pub-date>
<volume>10</volume>
<elocation-id>1510</elocation-id>
<history>
<date date-type="received">
<day>04</day>
<month>07</month>
<year>2019</year>
</date>
<date date-type="accepted">
<day>21</day>
<month>11</month>
<year>2019</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2019 Alam and Datta</copyright-statement>
<copyright-year>2019</copyright-year>
<copyright-holder>Alam and Datta</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Excitatory amino acid transporter 2 (EAAT2) is the predominant astrocyte glutamate transporter involved in the reuptake of the majority of the synaptic glutamate in the mammalian central nervous system (CNS). Gene expression can be altered without changing DNA sequences through epigenetic mechanisms. Mechanisms of epigenetic regulation, include DNA methylation, post-translational modifications of histones, chromatin remodeling, and small non-coding RNAs. This review is focused on neurological disorders, such as glioblastoma multiforme (GBM), Alzheimer&#x2019;s disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson&#x2019;s disease (PD), bipolar disorder (BD), and neuroHIV where there is evidence that epigenetics plays a role in the reduction of EAAT2 expression. The emerging field of pharmaco-epigenetics provides a novel avenue for epigenetics-based drug therapy. This review highlights findings on the role of epigenetics in the regulation of EAAT2 in different neurological disorders and discusses the current pharmacological approaches used and the potential use of novel therapeutic approaches to induce EAAT2 expression in neurological disorders using CRISPR/Cas9 technology.</p>
</abstract>
<kwd-group>
<kwd>glutamate</kwd>
<kwd>microRNA</kwd>
<kwd>excitatory amino acid transporter 2</kwd>
<kwd>DNA methyltransferase</kwd>
<kwd>histone deacetylase</kwd>
<kwd>CRISPR/Cas9</kwd>
</kwd-group>
<contract-sponsor id="cn001">National Institute on Drug Abuse<named-content content-type="fundref-id">10.13039/100000026</named-content>
</contract-sponsor>
<counts>
<fig-count count="3"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="105"/>
<page-count count="10"/>
<word-count count="4111"/>
</counts>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>The human excitatory amino acid transporter 2 (EAAT2) or glutamate transporter 1 (GLT-1) in the rodents is the primary glutamate transporter in the astrocytes (<xref ref-type="bibr" rid="B79">Rothstein et al., 1996</xref>; <xref ref-type="bibr" rid="B81">Sheldon and Robinson, 2007</xref>; <xref ref-type="bibr" rid="B50">Kim et al., 2011</xref>), and handles 90% of total glutamate uptake in the CNS (<xref ref-type="bibr" rid="B89">Tanaka et al., 1997</xref>). The SLC1A2 (solute carrier family, member 2) gene, located on chromosome codes for EAAT2 in humans (<xref ref-type="bibr" rid="B65">Meyer et al., 1997</xref>), while in mouse, it is located on chromosome 2 and is known as glutamate transporter 1 (GLT1). The size of the human and mouse EAAT2 gene is &#x223c;11.7 and &#x223c;11.5 kb, respectively, and both genes contain 11 exons (<xref ref-type="fig" rid="f1"><bold>Figure 1A</bold></xref>).</p>
<fig id="f1" position="float">
<label>Figure 1</label>
<caption>
<p><bold>(A)</bold>. Schematic representation of the organization of introns and exons of SLC1A2 gene in human and mouse based on UCSC genome browser. The size of SLC1A2 gene is 11704 bp in human and 11565 bp in mouse. <bold>(B)</bold>. Schematic depiction of the organization of EAAT2 in the plasma membrane as deduced from crystallographic data (<xref ref-type="bibr" rid="B100">Yernool et al., 2004</xref>) and adapted from <xref ref-type="bibr" rid="B8">Boston-Howes et al. (2006)</xref>. The protein contains eight transmembrane domains and two helical hairpin loops (HP1) and (HP2). These hairpin structures are involved in transport of amino acids mainly -glutamate. <bold>(C)</bold>. Schematic representation of the mechanism of glutamate-mediated excitotoxicity in the synaptic cleft due to dysregulation of EAAT2 expression in astrocytes. In normal scenario, depolarization of nerve terminal (presynaptic) glutamate is released from synaptic vesicles. Released glutamate then binds to ionotropic glutamate receptors (NMDA-R and AMPA-R) on the postsynaptic terminal that results in depolarization and action potential generation. Glutamate is then removed quickly from the synaptic cleft by astrocyte EAAT2 transporter to prevent the overstimulation of glutamate receptors. However, excessive glutamate accumulation in the synaptic cleft due to dysregulation of astrocyte EAAT2 expression causes overstimulation of NMDA and AMPA receptors that results in the build-up of intracellular Ca<sup>++</sup> ions leading to neuronal death or excitotoxicity.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphar-10-01510-g001.tif"/>
</fig>
<p>The promoter analysis of the human EAAT2 gene reveals that it harbors transcription factor binding sites for Nuclear factor kappa-B (NF&#x3ba;B), Specificity protein 1 (Sp1), cAMP responsive element binding protein (CREB), Ying-yang 1 (YY1), and peroxisome proliferator activated receptor (PPAR) response element (<xref ref-type="bibr" rid="B85">Su et al., 2003</xref>; <xref ref-type="bibr" rid="B83">Sitcheran et al., 2005</xref>; <xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>; <xref ref-type="bibr" rid="B77">Romera et al., 2007</xref>; <xref ref-type="bibr" rid="B2">Allritz et al., 2010</xref>; <xref ref-type="bibr" rid="B91">Unger et al., 2012</xref>; <xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>; <xref ref-type="bibr" rid="B92">Vartak-Sharma et al., 2014</xref>). Also, the proximal promoter harbors CpG islands at position &#x2212;1472 to &#x2212;1146 and &#x2212;680 to &#x2212;494, with 17 CpG and 15 CpG dinucleotides, respectively (<xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>). The human EAAT2 cDNA harbors an unusually long 3&#x2019;-UTR of 9684 bp (<xref ref-type="bibr" rid="B51">Kim et al., 2003</xref>). Sequence analysis shows that the 3'-UTR of EAAT2 cDNA is nearly identical and conserved in human, macaque, rat, and mouse (<xref ref-type="bibr" rid="B51">Kim et al., 2003</xref>). This observation suggests that it is likely that EAAT2 mRNA expression can be regulated at the post-transcriptional level by miRNAs.</p>
<p>EAAT2 is a plasma membrane sodium-dependent, high-affinity amino acid transporter that mediates the uptake of L-glutamate (<xref ref-type="bibr" rid="B4">Arriza et al., 1994</xref>). In brief, the protein has eight transmembrane domains with the amino- and carboxy-terminal located intracellularly (<xref ref-type="fig" rid="f1"><bold>Figure 1B</bold></xref>). It clears the excitatory neurotransmitter glutamate from the extracellular space at synapses in the brain (<xref ref-type="bibr" rid="B79">Rothstein et al., 1996</xref>). Glutamate clearance by astrocyte is critical for proper synaptic activation, and also glutamate is converted to glutamine and transported out of the astrocytes into neurons for reuse in glutamate synthesis (<xref ref-type="bibr" rid="B24">Ereci&#x144;ska and Silver, 1990</xref>). Furthermore, reuptake of glutamate by EAAT2 also prevents neuronal damage caused by excessive activation of NMDA receptors (<xref ref-type="fig" rid="f1"><bold>Figure 1C</bold></xref>), a phenomenon known as excitotoxicity (<xref ref-type="bibr" rid="B69">Olney and Sharpe, 1969</xref>).</p>
</sec>
<sec id="s2">
<title>Epigenetic Regulators: The Writers, Readers, and Erasers</title>
<p>Epigenetics is defined as changes in gene expression without the involvement of changes in the DNA sequence. The epigenetic &#x201c;writers&#x201d; are enzymes such as DNA methyltransferases, histone lysine methyltransferases, protein arginine methyltransferases, and histone acetyltransferases that catalyze the addition of a functional group to a protein or nucleic acid (<xref ref-type="bibr" rid="B29">Gillette and Hill, 2015</xref>). The epigenetic &#x201c;readers&#x201d; are proteins or enzymes such as methyl CpG binding proteins, histone methylation readers, and histone acetylation readers that recognize methylated DNA, methylated lysine residues in proteins and acetylated histones, respectively. The epigenetic &#x201c;erasers&#x201d; are enzymes, such as ten-eleven translocation (TET) family of proteins, histone demethylases, and histone deacetylases (HDAC) that demethylate DNA, demethylate lysine residues on histone proteins, and deacetylate histone proteins (see reviews; <xref ref-type="bibr" rid="B29">Gillette and Hill, 2015</xref>; <xref ref-type="bibr" rid="B7">Biswas and Rao, 2018</xref>).</p>
</sec>
<sec id="s3">
<title>DNA Methyltransferases (DNMTs)</title>
<p>DNMTs are classified into three categories, DNMT1, DNMT2, DNMT3 [DNMT3a, DNMT3b, and DNMT3L] (<xref ref-type="bibr" rid="B63">Lyko, 2018</xref>; <xref ref-type="bibr" rid="B31">Gujar et al., 2019</xref>). DNMT1 is involved in the maintenance methylation (<xref ref-type="bibr" rid="B76">Ren et al., 2018</xref>). DNMT3a and DNMT3b methylate cytosine residues in CpG island(s) and considered as <italic>de novo</italic> methyltransferases. DNMT1, DNMT3a, and DNMT3b catalyze the addition of a methyl group from S-adenosylmethionine (SAM) to cytosine resulting in 5-mC. 5-mC acts as a stable transcriptional repressor (<xref ref-type="bibr" rid="B52">Kitsera et al., 2017</xref>). DNMT2 and DNMT3L are non-canonical family members, as they do not possess catalytic DNMT activity (<xref ref-type="bibr" rid="B63">Lyko, 2018</xref>).</p>
</sec>
<sec id="s4">
<title>Ten-Eleven Translocation</title>
<p>DNA demethylation involves the TET family of methylcytosine dioxygenases that are &#x3b1;-KG-dependent enzymes (<xref ref-type="bibr" rid="B53">Koivunen and Laukka, 2018</xref>). This family consists of TET1, TET2, and TET3, which participate in the conversion of 5-mC to 5-hmC to promote reversal of methylation (<xref ref-type="bibr" rid="B40">Ito et al., 2010</xref>; <xref ref-type="bibr" rid="B64">Melamed et al., 2018</xref>). Besides, studies have shown that Tet enzymes also catalyze the conversion of 5-hmC to 5-formylcytosine (5-fC), and 5-carboxylcytosine (5-caC). These modifications serve as DNA demethylation intermediates and are subject to deamination, glycosylase-dependent excision, and repair, resulting in a reversion to unmodified cytosine (<xref ref-type="bibr" rid="B3">Antunes et al., 2019</xref>).</p>
</sec>
<sec id="s5">
<title>DNMT Expression in Astrocytes</title>
<p>In late-stage embryonic development in the brain, DNMT3a is ubiquitously expressed, while DNMT3b expression level decreases but remains high in comparison to early-stage embryos (<xref ref-type="bibr" rid="B68">Okano et al., 1999</xref>). The expression of DNMT1 and DNMT3a has been documented in rat brain cortical astrocytes (<xref ref-type="bibr" rid="B103">Zhang et al., 2014</xref>).</p>
</sec>
<sec id="s6">
<title>TET Expression in Astrocytes</title>
<p>In the brain, NeuN positive neuronal cells express all forms of TETs (<xref ref-type="bibr" rid="B46">Kaas et al., 2013</xref>; <xref ref-type="bibr" rid="B60">Li et al., 2014</xref>). These observations are tune with reports that neuronal cells are enriched for 5hmC (<xref ref-type="bibr" rid="B86">Szulwach et al., 2011</xref>). TET1 expression has been documented in glial fibrillary acidic protein (GFAP) positive astrocytes in the adult mouse hippocampus (<xref ref-type="bibr" rid="B46">Kaas et al., 2013</xref>). It has been observed that TET enzymatic activity is inhibited by increased production of 2-hydroxyglutarate in gliomas as a consequence of oncogenic mutations in the metabolic regulators IDH1 (isocitrate dehydrogenase 1) and IDH2 (isocitrate dehydrogenase 2) (<xref ref-type="bibr" rid="B75">Reiter-Brennan et al., 2018</xref>).</p>
</sec>
<sec id="s7">
<title>Histone Deacetylases</title>
<p>HDACs based on their amino acid sequence, organization of the domains, and catalytic dependence are grouped into four classes (<xref ref-type="bibr" rid="B21">de Ruijter et al., 2003</xref>). Class I, II, and IV HDACs are zinc-dependent, while class III are nicotinamide adenine dinucleotide (NAD+) dependent. The class I HDACs include HDAC1, -2, -3, and -8, while class II includes HDAC4, -5, -6, -7, -9, and -10, and class IV is represented by HDAC11 (<xref ref-type="bibr" rid="B21">de Ruijter et al., 2003</xref>). Class III HDACs include sirtuins 1&#x2013;7 (SIRT1&#x2013;7) that are structurally unrelated to the other HDACs (<xref ref-type="bibr" rid="B13">Carafa et al., 2016</xref>).</p>
</sec>
<sec id="s8">
<title>HDAC Expression in Astrocytes</title>
<p>A comprehensive study was the first to demonstrate the expression of HDACs in rat brain using high-resolution <italic>in situ</italic> hybridization (ISH) coupled with immunohistochemistry in astrocytes, oligodendrocytes, neurons, and endothelial cells (<xref ref-type="bibr" rid="B11">Broide et al., 2007</xref>). The study showed that GFAP-positive astrocytes expressed HDAC3 to HDAC11 (<xref ref-type="bibr" rid="B11">Broide et al., 2007</xref>). However, a recent study reported that only HDAC1, 2, and 4 are expressed in rat astrocytes (<xref ref-type="bibr" rid="B47">Kalinin et al., 2013</xref>). HDAC 1, 2, 3, and 8 are expressed in normal human astrocytes, and glioblastoma multiforme (GBM) derived astrocytic cell lines (<xref ref-type="bibr" rid="B104">Zhang et al., 2016</xref>).</p>
</sec>
<sec id="s9">
<title>Sirtuins Expression in Astrocytes</title>
<p>Among the class III HDACs, SIRT1 is the most conserved member of the sirtuin family of NAD+ dependent protein deacetylases (<xref ref-type="bibr" rid="B16">Cohen et al., 2004</xref>) and is predominantly a nuclear enzyme but also present in the mitochondria (<xref ref-type="bibr" rid="B90">Tang, 2016</xref>). SIRT1 is expressed in mouse (<xref ref-type="bibr" rid="B61">Li M et al., 2018</xref>), rat, and human astrocytes (<xref ref-type="bibr" rid="B39">Hu et al., 2017</xref>). SIRT2 is a cytoplasmic enzyme (<xref ref-type="bibr" rid="B10">Braidy et al., 2015</xref>), and its expression was observed in rat hippocampus and cerebral cortex. Unlike SIRT1, which is primarily a nuclear enzyme SIRT3, 4, 5 are mitochondrial enzymes (<xref ref-type="bibr" rid="B41">J&#x119;&#x15b;ko et al., 2017</xref>; <xref ref-type="bibr" rid="B82">Sidorova-Darmos et al., 2018</xref>). The expression of SIRT3 was shown in rat astrocytes (<xref ref-type="bibr" rid="B62">Li X et al., 2018</xref>). SIRT4 is highly expressed in rat astrocytes (<xref ref-type="bibr" rid="B54">Komlos et al., 2013</xref>). It is reported that SIRT5 is expressed in rat striatum (<xref ref-type="bibr" rid="B70">Omonijo et al., 2014</xref>). Not much is known about the astrocyte-specific expression of SIRT6 and SIRT7, that are nuclear enzymes except for that fact that they are expressed in rat hippocampus and cerebral cortex (<xref ref-type="bibr" rid="B10">Braidy et al., 2015</xref>).</p>
</sec>
<sec id="s10">
<title>Noncoding RNA: miRNAs</title>
<p>miRNAs are small noncoding RNAs (20&#x2013;22 nucleotides) regulate gene expression by binding to seed sequences located in the 3'-UTR of mRNAs (<xref ref-type="bibr" rid="B34">He and Hannon, 2004</xref>; <xref ref-type="bibr" rid="B5">Bartel, 2009</xref>). The complementarity between the miRNA seed sequence and its target mRNA determines the fate of the mRNA resulting in either translational repression or mRNA cleavage (<xref ref-type="bibr" rid="B32">Guo et al., 2010</xref>). A single miRNA can regulate many different mRNAs or can bind to a single site or multiple sites within the 3'-UTR of the mRNA.</p>
</sec>
<sec id="s11">
<title>Neurological Disorders and EAAT2 Expression</title>
<p>In this section, we describe the various neurological disorders where dysregulation of EAAT2 expression have been reported. A summary of the epigenetic changes affecting EAAT2 gene is presented in <xref ref-type="table" rid="T1"><bold>Table 1</bold></xref>. The epigenetic changes that are involved in EAAT2 expression is shown in <xref ref-type="fig" rid="f2"><bold>Figure 2</bold></xref>.</p>
<table-wrap id="T1" position="float">
<label>Table 1</label>
<caption>
<p>Epigenetic modifications involved in dysregulation of EAAT2 expression.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top">Type of Epigenetic modification</th>
<th valign="top">Tissue/cell type</th>
<th valign="top">Effect on EAAT2/GLT-1</th>
<th valign="top">References</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" colspan="4"><bold>DNA methylation</bold></td>
</tr>
<tr>
<td valign="top">Promoter CpG island methylation</td>
<td valign="top">Glioma cell lines.</td>
<td valign="top">Reduced EAAT2 mRNA expression.</td>
<td valign="top"><xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>.</td>
</tr>
<tr>
<td valign="top">Enhanced DNMT1 activity.</td>
<td valign="top">Brain tissues of HIV-infected methamphetamine users.</td>
<td valign="top">Increase in global DNA methylation.</td>
<td valign="top"><xref ref-type="bibr" rid="B23">Desplats et al., 2014</xref>.</td>
</tr>
<tr>
<td valign="top">Hypermethylation of CpG island in promoter.</td>
<td valign="top"/>
<td valign="top">Not determined.</td>
<td valign="top"><xref ref-type="bibr" rid="B23">Desplats et al., 2014</xref>.</td>
</tr>
<tr>
<td valign="top">Hypermethylation of CpG island in promoter region.</td>
<td valign="top">Blood DNA.</td>
<td valign="top">Not determined</td>
<td valign="top"><xref ref-type="bibr" rid="B43">Jia et al., 2017</xref>.</td>
</tr>
<tr>
<td valign="top">CpG site demethylation.</td>
<td valign="top">Rat brain astrocytes.</td>
<td valign="top">Increase in GLT-1 mRNA expression.</td>
<td valign="top"><xref ref-type="bibr" rid="B71">Perisic et al., 2010</xref>.</td>
</tr>
<tr>
<td valign="top" colspan="4"><bold>Histone modifications</bold></td>
</tr>
<tr>
<td valign="top">Overexpression of HDAC1 and -3 (class I), and HDAC6 and -7 (class II).</td>
<td valign="top">Rat brain astrocytes.</td>
<td valign="top">Decrease in EAAT2 promoter activity.</td>
<td valign="top"><xref ref-type="bibr" rid="B48">Karki et al., 2014</xref></td>
</tr>
<tr>
<td valign="top">Coexpression of HDACs with YY1 or NF&#x3ba;B.</td>
<td valign="top">Rat brain astrocytes.</td>
<td valign="top">Decrease in EAAT2 promoter activity.</td>
<td valign="top"><xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>.</td>
</tr>
<tr>
<td valign="top">HDAC inhibition (SAHA, TSA, Romidepsin).</td>
<td valign="top">Rat brain astrocytes.</td>
<td valign="top">Increase in EAAT2 promoter activity.</td>
<td valign="top"><xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>.</td>
</tr>
<tr>
<td valign="top">HDAC inhibition (TSA).</td>
<td valign="top">Glioma cell lines.</td>
<td valign="top">Increase in EAAT2 mRNA expression.</td>
<td valign="top"><xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>.</td>
</tr>
<tr>
<td valign="top">HDAC inhibition (MC1568).</td>
<td valign="top">Mouse glia.</td>
<td valign="top">Increase in EAAT2 mRNA and protein expression.</td>
<td valign="top"><xref ref-type="bibr" rid="B56">Lapucci et al., 2017</xref>.</td>
</tr>
<tr>
<td valign="top"/>
<td valign="top">Spinal cord of rodent model of ALS.</td>
<td valign="top">Increase in EAAT2 mRNA and protein expression.</td>
<td valign="top"/>
</tr>
<tr>
<td valign="top" colspan="4"><bold>Sirtuins</bold></td>
</tr>
<tr>
<td valign="top">SIRT5 knock-out.</td>
<td valign="top">Mice brain cortex.</td>
<td valign="top">Reduced expression of EAAT2 mRNA.</td>
<td valign="top"><xref ref-type="bibr" rid="B55">Koronowski et al., 2018</xref>.</td>
</tr>
<tr>
<td valign="top" colspan="4"><bold>Non coding RNA</bold></td>
</tr>
<tr>
<td valign="top">miR-107.</td>
<td valign="top">Nerve cell hypoxia/reoxygenation (H/R) injury.</td>
<td valign="top">Inhibition of GLT-1 expression.</td>
<td valign="top"><xref ref-type="bibr" rid="B99">Yang et al., 2014</xref>.</td>
</tr>
<tr>
<td valign="top">miR-124a.</td>
<td valign="top">Mice neurons.</td>
<td valign="top">Induction of GLT-1 expression in astrocytes.</td>
<td valign="top"><xref ref-type="bibr" rid="B66">Morel et al., 2013</xref>.</td>
</tr>
<tr>
<td valign="top">miR-124.</td>
<td valign="top">Human neural precursor cells and astrocytes.</td>
<td valign="top">Induction of EAAT2 expression.</td>
<td valign="top"><xref ref-type="bibr" rid="B58">Lee et al., 2014</xref>.</td>
</tr>
<tr>
<td valign="top">miR-218.</td>
<td valign="top">Dying motor neurons from rat model of ALS.</td>
<td valign="top">Inhibition of EAAT2 expression in astrocytes.</td>
<td valign="top"><xref ref-type="bibr" rid="B38">Hoye et al., 2018</xref>.</td>
</tr>
<tr>
<td valign="top">miR-146a</td>
<td valign="top">Glioma cell line and human fetal brain astrocytes.</td>
<td valign="top">Inhibition of EAAT2 expression in astrocytes.</td>
<td valign="top"><xref ref-type="bibr" rid="B22">Deshmane et al., 2018</xref>.</td>
</tr>
<tr>
<td valign="top"><bold>Sumoylation</bold></td>
<td valign="top">Spinal cord astrocytes from SOD1-G93A transgenic mice model of ALS.</td>
<td valign="top">Reduced plasma membrane EAAT2 expression due to retention of EAAT2 in the cytoplasm.</td>
<td valign="top"><xref ref-type="bibr" rid="B25">Foran et al., 2014</xref>.</td>
</tr>
</tbody>
</table>
</table-wrap>
<fig id="f2" position="float">
<label>Figure 2</label>
<caption>
<p>Schematic representation of the epigenetic mechanisms that are involved in astrocyte EAAT2 expression. <bold>(A)</bold>. DNA modification by methylation and demethylation. Hypermethylation of CpG islands on the EAAT2 promoter can repress transcription of EAAT2 gene by inhibiting binding of transcription factors. On the contrary, demethylation of DNA in CpG island can promote transcription factor interaction with DNA and EAAT2 gene transcription. <bold>(B)</bold>. Chromatin remodeling by histone modifications. The observation that HDAC inhibitors induce EAAT2 expression demonstrate that HDAC activity inhibits EAAT2 expression, on the other hand, histone acetylation by HATs can lead to open chromatin and increased accessibility of transcription factors to open chromatin and induce EAAT2 expression. <bold>(C)</bold>. miRNA mediated regulation. Binding of miRNA to the 3&#x2019;-UTR of EAAT2 mRNA can result in miRNA mediated mRNA degradation or repression of translation resulting in reduced expression of EAAT2. HAT, Histone acetyltransferase; HDAC, Histone deacetylase; DNMT, DNA methyltransferase; TET, Ten eleven translocation enzyme.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphar-10-01510-g002.tif"/>
</fig>
</sec>
<sec id="s12">
<title>Glioblastoma Multiforme (GBM)</title>
<p>GBM, a WHO grade IV astrocytoma is an extremely aggressive, invasive, and destructive primary brain tumor in the adult population (<xref ref-type="bibr" rid="B27">Geraldo et al., 2019</xref>). Lee and co-workers demonstrated a strong negative correlation between the expression of Astrocyte Elevated Gene-1 (AEG-1), an oncogene, and EAAT2 by immunofluorescence analyses in human glioma tissue arrays (<xref ref-type="bibr" rid="B57">Lee et al., 2011</xref>). Dysregulation of EAAT2 expression is also seen in cell lines derived from tumors (<xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>; <xref ref-type="bibr" rid="B57">Lee et al., 2011</xref>). In two different glioma cell lines, A172 and LN18 that lack EAAT2 expression profiling of DNA methylation by bisulfite sequencing revealed hypermethylation in both CpG islands of EAAT2 promoter (<xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>).</p>
</sec>
<sec id="s13">
<title>Alzheimer&#x2019;s Disease (AD)</title>
<p>AD is a chronic neurodegenerative disorder that contributes to 60% to 70% of dementia worldwide. Most forms of AD are sporadic, and less than 1% of all cases are familial AD. Early-onset AD is caused by mutations of the genes for APP (amyloid precursor protein), PSEN1 (presenilin 1), and PSEN2 (presenilin 2) (<xref ref-type="bibr" rid="B28">Giau et al., 2019</xref>). The pathological hallmarks are &#x3b2;-amyloid plaques localized extracellularly and neurofibrillary tangles, which are localized intracellularly, especially in the frontal cortex and hippocampus (<xref ref-type="bibr" rid="B73">Pinheiro and Faustino, 2019</xref>). Studies have shown decreased EAAT2 protein expression in AD brains (<xref ref-type="bibr" rid="B59">Li et al., 1997</xref>; <xref ref-type="bibr" rid="B42">Jacob et al., 2007</xref>). EAAT2 expression is reduced in astrocytes by oligomeric A&#x3b2; by NFAT signaling (<xref ref-type="bibr" rid="B1">Abdul et al., 2009</xref>). Dysregulation of EAAT2 expression has been linked in the pathogenesis of AD in APPSw/Ind mice, a transgenic mouse of AD (<xref ref-type="bibr" rid="B88">Takahashi et al., 2015</xref>).</p>
</sec>
<sec id="s14">
<title>Amyotrophic Lateral Sclerosis (ALS)</title>
<p>ALS is a late-onset and devastating neurodegenerative disorder that is characterized by progressive degeneration of motor neurons in the motor cortex, spinal cord, and brainstem (<xref ref-type="bibr" rid="B93">Verber et al., 2019</xref>). Studies have shown that there is a loss of EAAT2 protein in the motor cortex and spinal cord in ALS patients (<xref ref-type="bibr" rid="B78">Rothstein et al., 1995</xref>). In the transgenic mice or rats expressing familial ALS-linked mutant SOD1 reduced expression of EAAT2 protein has also been observed (<xref ref-type="bibr" rid="B12">Bruijn et al., 1997</xref>; <xref ref-type="bibr" rid="B6">Bendotti et al., 2001</xref>; <xref ref-type="bibr" rid="B37">Howland et al., 2002</xref>). In addition, another epigenetic modulator, known as sumoylation was shown to regulate localization of EAAT2 expression in SOD1-G93A mouse model of inherited ALS, wherein the cytosolic carboxy-terminal domain is cleaved from EAAT2, conjugated to SUMO1, and results in the accumulation of EAAT2 in the cytoplasm instead of expression in the plasma membrane (<xref ref-type="bibr" rid="B25">Foran et al., 2014</xref>).</p>
</sec>
<sec id="s15">
<title>Parkinson&#x2019;s Disease (PD)</title>
<p>PD is a complex neurodegenerative disorder that impacts the dopaminergic neurons located in the midbrain nucleus substantia nigra (<xref ref-type="bibr" rid="B20">Dauer and Przedborski, 2003</xref>). The pathological hallmark of PD is the accumulation of &#x3b1;-synuclein oligomers to form Lewy bodies (<xref ref-type="bibr" rid="B95">Wong and Krainc, 2017</xref>). In PD, induced in mouse models by 6-hydroxydopamine injection into the nigrostriatal pathway (<xref ref-type="bibr" rid="B15">Chung et al., 2008</xref>) and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (<xref ref-type="bibr" rid="B36">Holmer et al., 2005</xref>) EAAT2 expression is reduced. Studies have shown that high manganese (Mn) levels induce manganism, symptoms of which are similar to those of PD (<xref ref-type="bibr" rid="B9">Bowman et al., 2011</xref>). In this regard, Mn treatment of astrocytes inhibited EAAT2 expression by upregulating YY1 expression that repressed EAAT2 expression at the mRNA and protein level (<xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>).</p>
</sec>
<sec id="s16">
<title>Bipolar Disorder (BD)</title>
<p>BD is a complex neurobiological disease (<xref ref-type="bibr" rid="B33">Harrison et al., 2018</xref>). In BD, both glial cells and neurons are affected and dysregulation of monoamines, altered glutamatergic neurotransmission, increase in oxidative stress, mitochondrial dysfunction, and neuroinflammation play a role in the etiology of the disease (<xref ref-type="bibr" rid="B102">Yuksel and Ongur, 2010</xref>; <xref ref-type="bibr" rid="B18">Data-Franco et al., 2017</xref>). It is reported that a T-to-G polymorphism in the SLC1A2 gene promoter affects EAAT2 expression in BD (<xref ref-type="bibr" rid="B17">Dallaspezia et al., 2012</xref>). A recent study using high resolution melting PCR (HRM-PCR) and thymine-adenine (TA) cloning reported that the SLC1A2 promoter region was hypermethylated in BD (<xref ref-type="bibr" rid="B43">Jia et al., 2017</xref>).</p>
</sec>
<sec id="s17">
<title>HIV-Associated Neurocognitive Disorder (HAND)</title>
<p>HAND or NeuroHIV persists despite effective antiretroviral therapy (<xref ref-type="bibr" rid="B80">Saylor et al., 2016</xref>). HIV-1 and gp120 have been shown to inhibit EAAT2 expression in human fetal brain astrocyte (<xref ref-type="bibr" rid="B94">Wang et al., 2003</xref>). Studies using immunohistochemistry have demonstrated that in HAND-positive brain tissues, expression of EAAT2 is reduced in comparison to uninfected brain tissue (<xref ref-type="bibr" rid="B96">Xing et al., 2009</xref>). Furthermore, it was shown that treatment of human brain astrocytes with a pro-inflammatory cytokine IL-1&#x3b2;, induced AEG-1 expression that, in turn, upregulated YY1 expression and inhibited EAAT2 transcription (<xref ref-type="bibr" rid="B92">Vartak-Sharma et al., 2014</xref>). Elucidation of global DNA methylation status in brain tissues of HIV-individuals who used methamphetamine showed increased levels of DNMT1 activity and also hypermethylation of CpG nucleotides in SLC1A2 promoter (<xref ref-type="bibr" rid="B23">Desplats et al., 2014</xref>).</p>
</sec>
<sec id="s18">
<title>Role of HDACS and Sirtuins in EAAT2 Expression</title>
<p>Overexpression of HDAC1 and -3 (class I), and HDAC6 and -7 (class II) was shown to inhibit EAAT2 promoter activity in rat astrocytes (<xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>). In the same study, the coexpression of HDACs with YY1 or NF&#x3ba;B further attenuated EAAT2 promoter activity (<xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>). There is a lack of information on the effect of SIRTs in the regulation of EAAT2 expression. A recent metabolomics study using SIRT5 knock-out mice model showed dysregulation of glutamate levels in brain cortex and reduced expression of EAAT2 at mRNA level (<xref ref-type="bibr" rid="B55">Koronowski et al., 2018</xref>).</p>
</sec>
<sec id="s19">
<title>Role of miRNA in EAAT2 Expression</title>
<p>The upregulation of miR-107 was shown to inhibit GLT-1 expression in a rodent model of nerve cell hypoxia/reoxygenation (H/R) injury (<xref ref-type="bibr" rid="B99">Yang et al., 2014</xref>). Our preliminary studies show that miR-146a reduces EAAT2 expression in U251 cells and human fetal brain astrocytes (<xref ref-type="bibr" rid="B22">Deshmane et al., 2018</xref>). A recent report demonstrated that murine neuronal miR-124a induces astroglial EAAT2 not by targeting EAAT2 3&#x2019;-UTR but by indirectly modulating astrocyte-derived factors that regulate EAAT2 expression (<xref ref-type="bibr" rid="B66">Morel et al., 2013</xref>). Also, exosome-mediated delivery of miR-124 was shown to induce the expression of EAAT2 in human neural precursor cells and astrocytes (<xref ref-type="bibr" rid="B58">Lee et al., 2014</xref>). In a recent study, a novel mechanism of neurodegeneration in a rat model of ALS was described extracellular miR-218 released from dying motor neurons inhibited EAAT2 expression in astrocytes (<xref ref-type="bibr" rid="B38">Hoye et al., 2018</xref>).</p>
</sec>
<sec id="s20">
<title>Pharmaco-Epigenetic Strategies to Activate EAAT2 Expression</title>
<p>A successful approach in the treatment of neurodegenerative diseases where epigenetics regulate gene expression could be the use of therapeutic drugs that target epigenetic mechanisms, such as DNA methylation, chromatin, and histone modifications. In this regard, significant advancements have been made to develop drugs that can restore or alter epigenetic mechanisms. In this section, we highlight the findings reported so far with DNMT inhibitors and HDAC inhibitors in the restoration of EAAT2 expression <italic>in vitro</italic> and <italic>in vivo</italic>.</p>
</sec>
<sec id="s21">
<title>DNMT Inhibitors</title>
<p>DNMT inhibitors prevent DNA methylation as a consequence reduce promoter hypermethylation, which leads to re-expression of silenced genes. DNMT inhibitors have been widely used as anticancer drugs since hypermethylation of promoters of tumor suppressor genes occurs in numerous cancers (<xref ref-type="bibr" rid="B72">Pfister and Ashworth, 2017</xref>). DNMT inhibitors that are approved by the US Food and Drug Administration (FDA) and widely used as anticancer drugs are nucleoside analogs. These are azacytidine (5-aza-deoxycytidine) (<xref ref-type="bibr" rid="B84">Sorm and Vesely, 1964</xref>; <xref ref-type="bibr" rid="B14">Christman, 2002</xref>) and decitabine (5-aza-2'-deoxycytidine) (<xref ref-type="bibr" rid="B74">Pliml and Sorm, 1964</xref>). In this regard, DNMT inhibitor azacytidine was shown to restore EAAT2 expression in a glioma cell line (<xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>).</p>
</sec>
<sec id="s22">
<title>HDAC Inhibitors</title>
<p>Among the four major structural families of HDAC inhibitors viz., short-chain aliphatic acids, hydroxamic acids, benzamides, and cyclic tetrapeptides and depsipeptide only the efficacy of short-chain aliphatic acids, hydroxamic acids, and cyclic tetrapeptides and depsipeptide have been evaluated in inducing EAAT2 expression.</p>
<p>Valproic acid (VPA short-chain aliphatic acid), an FDA-approved anti-epileptic agent and sodium butyrate that inhibits class I and II HDACs (<xref ref-type="bibr" rid="B26">G&#xf6;ttlicher et al., 2001</xref>) were reported to prevent manganese-induced inhibition of GLT1 expression in mice (<xref ref-type="bibr" rid="B44">Johnson et al., 2018a</xref>; <xref ref-type="bibr" rid="B45">Johnson et al., 2018b</xref>). VPA induced CpG site demethylation and acetylated histone H4 enrichment in the distal part of the GLT-1 promoter in rat astrocytes (<xref ref-type="bibr" rid="B71">Perisic et al., 2010</xref>).</p>
<p>Hydroxamic acids, Trichostatin A (TSA) (<xref ref-type="bibr" rid="B101">Yoshida et al., 1990</xref>) was shown to induce EAAT2 mRNA expression in glioma cells (<xref ref-type="bibr" rid="B105">Zschocke et al., 2007</xref>), and EAAT2 promoter activity in rodent astrocyte (<xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>).</p>
<p>Suberoylanilide hydroxamic acid (SAHA), an FDA approved drug, also induced EAAT2 promoter activity in rodent astrocyte (<xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>).</p>
<p>Among the cyclic tetrapeptides and depsipeptide, Romidepsin has been shown to induce EAAT2 promoter activity (<xref ref-type="bibr" rid="B48">Karki et al., 2014</xref>). MC1568, a class II HDAC inhibitor, was reported to upregulate the expression of EAAT2 <italic>in vitro</italic> and also in the spinal cord of SOD1-G93A mice, a rodent model of ALS (<xref ref-type="bibr" rid="B56">Lapucci et al., 2017</xref>).</p>
</sec>
<sec id="s23">
<title>Potential Use of CRISPR/Cas9 for EAAT2 Gene Expression</title>
<p>With the discovery of several genome editing technologies such as zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALEN), and clustered regularly interspaced short palindromic repeat (CRISPR)/Cas9 system (<xref ref-type="bibr" rid="B19">Datta et al., 2016</xref>; <xref ref-type="bibr" rid="B49">Khalili et al., 2017</xref>), it is possible not only to edit genes but also activate genes (<xref ref-type="bibr" rid="B35">Hilton et al., 2015</xref>) that are epigenetically repressed. Since epigenetic modifying enzymes can be fused to the inactivated dCas9 (D10A mutation in RuvC and H840A in HNH nuclease domain), it is possible to target specific gene promoters using guide RNAs (<xref ref-type="bibr" rid="B87">Tadi&#x107; et al., 2019</xref>) and thereby prevent off-target effects of either overexpression or knockdown of epigenetic modifying enzymes. In the context of EAAT2 gene activation, two CRISPR tools can be used. dCas9 fused to (a) histone acetyltransferase p300 (dCas9-p300) activation domain (<xref ref-type="bibr" rid="B35">Hilton et al., 2015</xref>), and (b) DNA demethylase catalytic domain from the TET family (<xref ref-type="bibr" rid="B97">Xu et al., 2016</xref>). In the former scenario, the recruitment of dCas9-p300 by guide RNAs can result in histone acetylation mediated EAAT2 gene transcription (<xref ref-type="fig" rid="f3"><bold>Figure 3A</bold></xref>), and in the latter situation, DNA hypermethylation of the EAAT2 gene CpG islands can potentially be reversed by targeted demethylation of cytosine residues using the Tet catalytic domain (Tet-CD) and guide RNA (<xref ref-type="fig" rid="f3"><bold>Figure 3B</bold></xref>). This strategy can be accomplished <italic>in vivo</italic> since several viral vectors, including adeno-associated virus, lentivirus, and adenovirus (<xref ref-type="fig" rid="f3"><bold>Figure 3C</bold></xref>), have been employed for delivery of Cas9 and gRNAs (<xref ref-type="bibr" rid="B30">Gori et al., 2015</xref>; <xref ref-type="bibr" rid="B67">Mout et al., 2017</xref>).</p>
<fig id="f3" position="float">
<label>Figure 3</label>
<caption>
<p>Schematic representation of the CRISPR/Cas9 tools that can be used to activate EAAT2 expression. <bold>(A)</bold>. Epigenome editing by a gRNA, CRISPR-Cas9-based acetyltransferase, dCas9-p300. <bold>(B)</bold>. Epigenome demethylation by a gRNA, CRISPR-Cas9-based demethylase, dCas9-Tet-CD. <bold>(C)</bold>. Strategies for delivery of dCas9/gRNA using different viral vectors in rodent models of neurodegenerative diseases.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fphar-10-01510-g003.tif"/>
</fig>
</sec>
<sec id="s24" sec-type="conclusions">
<title>Conclusions and Future Directions</title>
<p>A large body of evidence demonstrates the involvement of epigenetic mechanisms, including DNA methylation and histone modification at the pre-transcriptional level and miRNAs at the posttranscriptional level in the dysregulation of EAAT2 expression in numerous neurodegenerative diseases. The mechanisms may also act in concert while regulating EAAT2 expression. The involvement of other epigenetic features, including posttranslational histone modifications, including acetylation, methylation, and phosphorylation, in the regulation of EAAT2/GLT1 promoter activation in astrocytes remains to be investigated in future studies. With the development of new epigenetic drugs with increased sensitivity, specificity, and decreased toxicity it might be possible to upregulate EAAT2 expression in neurological disorders depending on the epigenetic modification that is involved in repression of EAAT2 expression. However, it is likely that in addition to gene-specific modulation, genome wide reactivation or inactivation of genes at random can have potentially deleterious effects. The proposed CRISPR/Cas9 mediated EAAT2 gene regulation can, therefore, be employed in animal models to mitigate glutamate-mediated excitotoxicity.</p>
</sec>
<sec id="s25">
<title>Author Contributions</title>
<p>MAA contributed to writing the initial draft of the manuscript and illustrations. PD contributed to writing the review and editing.</p>
</sec>
<sec id="s26" sec-type="funding-information">
<title>Funding</title>
<p>PD was supported by the National Institutes of Health through grants from National Institute of Drug Abuse, 5R01DA033213, and in part by 5P01DA037830-05.</p>
</sec>
<sec id="s27">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
</body>
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