Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York.
Environ Mol Mutagen. 2014 Apr;55(3):231-43. doi: 10.1002/em.21836. Epub 2013 Dec 9.
Asthma is a complex disease with genetic and environmental influences and emerging evidence suggests that epigenetic regulation is also a major contributor. Here, we focus on the developing paradigm that epigenetic dysregulation in asthma and allergy may start as early as in utero following several environmental exposures. We summarize the pathways important to the allergic immune response that are epigenetically regulated, the key environmental exposures associated with epigenetic changes in asthma genes, and newly identified epigenetic biomarkers that have been linked to clinical asthma. We conclude with a brief discussion about the potential to apply newly developing technologies in epigenetics to the diagnosis and treatment of asthma and allergy. The inherent plasticity of epigenetic regulation following environmental exposures offers opportunities for prevention using environmental remediation, measuring novel biomarkers for early identification of those at risk, and applying advances in pharmaco-epigenetics to tailor medical therapies that maximize efficacy of treatment. 'Precision Medicine' in asthma and allergy is arriving. As the field advances this may involve an individually tailored approach to the prevention, early detection, and treatment of disease based on the knowledge of an individual's epigenetic profile.
哮喘是一种具有遗传和环境影响的复杂疾病，新出现的证据表明，表观遗传调控也是一个主要的贡献因素。在这里，我们关注的是一个正在发展的范例，即哮喘和过敏的表观遗传失调可能早在几个环境暴露后就从子宫内开始。我们总结了与过敏免疫反应有关的、受表观遗传调控的途径，与哮喘基因表观遗传变化相关的关键环境暴露，以及与临床哮喘相关的新发现的表观遗传生物标志物。最后，我们简要讨论了将新兴的表观遗传学技术应用于哮喘和过敏的诊断和治疗的潜力。环境暴露后表观遗传调控的固有可塑性为通过环境修复进行预防提供了机会，通过测量新型生物标志物来早期识别那些处于危险中的人，并应用药物表观遗传学的进展来定制最大限度提高治疗效果的医疗疗法。哮喘和过敏的“精准医学”正在到来。随着该领域的发展，这可能涉及根据个体的表观遗传特征，对疾病的预防、早期发现和治疗采取个性化的方法。
