Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Queen Mary Hospital, Hong Kong SAR, China.
Adv Exp Med Biol. 2020;1253:309-374. doi: 10.1007/978-981-15-3449-2_12.
Multiple sclerosis (MS) is an aggravating autoimmune disease that cripples young patients slowly with physical, sensory and cognitive deficits. The break of self-tolerance to neuronal antigens is the key to the pathogenesis of MS, with autoreactive T cells causing demyelination that subsequently leads to inflammation-mediated neurodegenerative events in the central nervous system. The exact etiology of MS remains elusive; however, the interplay of genetic and environmental factors contributes to disease development and progression. Given that genetic variation only accounts for a fraction of risk for MS, extrinsic risk factors including smoking, infection and lack of vitamin D or sunshine, which cause changes in gene expression, contribute to disease development through epigenetic regulation. To date, there is a growing body of scientific evidence to support the important roles of epigenetic processes in MS. In this chapter, the three main layers of epigenetic regulatory mechanisms, namely DNA methylation, histone modification and microRNA-mediated gene regulation, will be discussed, with a particular focus on the role of epigenetics on dysregulated immune responses and neurodegenerative events in MS. Also, the potential for epigenetic modifiers as biomarkers and therapeutics for MS will be reviewed.
多发性硬化症(MS)是一种进行性自身免疫性疾病,会导致年轻患者逐渐出现身体、感觉和认知方面的缺陷。针对神经元抗原的自身免疫耐受的打破是 MS 发病机制的关键,自身反应性 T 细胞引起脱髓鞘,随后导致中枢神经系统的炎症介导的神经退行性事件。MS 的确切病因仍然难以捉摸;然而,遗传和环境因素的相互作用导致疾病的发展和进展。鉴于遗传变异仅占 MS 风险的一小部分,包括吸烟、感染和缺乏维生素 D 或阳光在内的外在风险因素会导致基因表达的变化,通过表观遗传调控促进疾病的发展。迄今为止,越来越多的科学证据支持表观遗传过程在 MS 中的重要作用。在这一章中,将讨论三种主要的表观遗传调控机制,即 DNA 甲基化、组蛋白修饰和 microRNA 介导的基因调控,并特别关注表观遗传在 MS 中失调的免疫反应和神经退行性事件中的作用。还将回顾表观遗传修饰剂作为 MS 的生物标志物和治疗药物的潜力。