Gescher Dorothee Maria, Kahl Kai G, Hillemacher Thomas, Frieling Helge, Kuhn Jens, Frodl Thomas
Department of Psychiatry and Psychotherapy, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany.
Front Psychiatry. 2018 Nov 19;9:579. doi: 10.3389/fpsyt.2018.00579. eCollection 2018.
Epigenetic mechanisms have been described in several mental disorders, such as mood disorders, anxiety disorders and schizophrenia. However, less is known about the influence of epigenetic mechanisms with regard to personality disorders (PD). Therefore, we conducted a literature review on existing original data with regards to epigenetic peculiarities in connection with personality disorders. Systematic literature review using PRISMA guidelines. Search was performed via NCBI PubMed by keywords and their combinations. Used search terms included "epigenetic," "methylation," "acetylation" plus designations of specified personality traits and disorders according to DSM-IV. Search yielded in total 345 publications, 257 thereof with psychiatric topic, 72 on personality disorder or traits, 43 of which were in humans and epigenetic, 23 thereof were original studies. Lastly, 23 original publications fulfilled the intended search criteria and were included. Those are 13 studies on gene methylation pattern with aggressive, antisocial and impulsive traits, 9 with borderline personality disorder (BPD), and 2 with antisocial personality disorder (ASPD). The results of these studies showed significant associations of PD with methylation aberrances in system-wide genes and suggest evidence for epigenetic processes in the development of personality traits and personality disorders. Environmental factors, of which childhood trauma showed a high impact, interfered with many neurofunctional genes. Methylation alterations in ASPD and BPD repeatedly affected , and genes. Epigenetic studies in PD seem to be a useful approach to elucidate the interaction of co-working risk factors in the pathogenesis of personality traits and disorders. However, the complexity of pathogenesis leads to divergent results and impedes an explicit interpretation. Differing methylation patterns within the selected PD could indicate subgroups which would benefit from patient-oriented therapeutic adjustments. They might play a major role in the future design and observation of early therapeutic intervention and thus could help to prevent severe dysfunctional conduct or full-blown personality disorder in risk subjects.
表观遗传机制已在多种精神障碍中有所描述，如情绪障碍、焦虑症和精神分裂症。然而，关于表观遗传机制对人格障碍（PD）的影响，我们所知甚少。因此，我们针对与人格障碍相关的表观遗传特性的现有原始数据进行了文献综述。采用PRISMA指南进行系统的文献综述。通过NCBI PubMed使用关键词及其组合进行检索。使用的检索词包括“表观遗传”“甲基化”“乙酰化”以及根据《精神疾病诊断与统计手册第四版》（DSM-IV）指定的人格特质和障碍名称。检索共得到345篇出版物，其中257篇涉及精神病学主题，72篇关于人格障碍或特质，其中43篇是关于人类和表观遗传学的，23篇是原始研究。最后，23篇原始出版物符合预期检索标准并被纳入。这些研究包括13项关于具有攻击性、反社会和冲动特质的基因甲基化模式的研究，9项关于边缘型人格障碍（BPD）的研究，以及2项关于反社会人格障碍（ASPD）的研究。这些研究结果表明，人格障碍与全基因组范围内基因的甲基化异常存在显著关联，并为个性特质和人格障碍发展中的表观遗传过程提供了证据。环境因素，其中童年创伤显示出很大影响，干扰了许多神经功能基因。ASPD和BPD中的甲基化改变反复影响了 和 基因。PD的表观遗传学研究似乎是阐明个性特质和障碍发病机制中共同作用的风险因素相互作用的有用方法。然而，发病机制的复杂性导致结果存在差异，并阻碍了明确的解释。所选人格障碍中不同的甲基化模式可能表明存在亚组，这些亚组将受益于以患者为导向的治疗调整。它们可能在未来早期治疗干预的设计和观察中发挥重要作用，从而有助于预防高危人群出现严重的功能失调行为或全面发展的人格障碍。
