Translational Gastroenterology Unit, Nuffield Department of Experimental Medicine, University of Oxford, Oxford, United Kingdom.
Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Gastroenterology. 2023 Jul;165(1):44-60.e2. doi: 10.1053/j.gastro.2023.03.238. Epub 2023 Apr 14.
Recent advances in our understanding of the pathogenesis of inflammatory bowel disease (IBD) have highlighted the complex interplay between the genome, the epigenome, and the environment. Despite the exciting advances in genomics that have enabled the identification of over 200 susceptibility loci, these only account for a small proportion of the disease variance and the estimated heritability in IBD. It is likely that gene-environment (GxE) interactions contribute to "missing heritability" and these may act through epigenetic mechanisms. Several environmental factors, such as the microbiome, nutrition, and tobacco smoking, induce alterations in the epigenome of children and adults, which may impact disease susceptibility. Other mechanisms for GxE interactions are also directly pertinent in early life. We discuss a model in which environmental factors imprint disease risk in a window of susceptibility during infancy that may contribute to later disease onset, whereas other elements of the exposome act later in life and contribute directly to the pathogenesis and course of the disease. Understanding the mechanisms underlying GxE interactions may provide the basis for new therapeutic targets or preventative strategies for IBD.
我们对炎症性肠病 (IBD) 发病机制的理解的最新进展强调了基因组、表观基因组和环境之间的复杂相互作用。尽管基因组学的令人兴奋的进展使我们能够确定超过 200 个易感性位点,但这些仅占疾病变异和 IBD 估计遗传率的一小部分。基因-环境 (GxE) 相互作用可能导致“遗传缺失”,并且这些相互作用可能通过表观遗传机制起作用。许多环境因素,如微生物组、营养和吸烟,会诱导儿童和成人的表观基因组发生变化,从而可能影响疾病易感性。GxE 相互作用的其他机制在生命早期也直接相关。我们讨论了一种模型,其中环境因素在婴儿期的易感窗口期内印记疾病风险,这可能导致以后疾病的发作,而外显子组的其他因素则在以后的生活中发挥作用,并直接导致疾病的发病机制和病程。了解 GxE 相互作用的机制可能为 IBD 的新治疗靶点或预防策略提供基础。