Over the past decade, awareness of the importance of epigenetic alterations in the pathogenesis of rheumatic diseases has grown in parallel with a general recognition of the fundamental role of epigenetics in the regulation of gene expression. Large-scale efforts to generate genome-wide maps of epigenetic modifications in different cell types, as well as in physiological and pathological contexts, illustrate the increasing recognition of the relevance of epigenetics. To date, although several reports have demonstrated the occurrence of epigenetic alterations in a wide range of inflammatory rheumatic conditions, epigenomic information is rarely used in a clinical setting. By contrast, several epigenetic biomarkers and treatments are currently in use for personalized therapies in patients with cancer. This Review highlights advances from the past 5 years in the field of epigenetics and their application to inflammatory rheumatic diseases, delineating the future lines of development for a rational use of epigenetic information in clinical settings and in personalized medicine. These advances include the identification of epipolymorphisms associated with clinical outcomes, DNA methylation as a contributor to disease susceptibility in rheumatic conditions, the discovery of novel epigenetic mechanisms that modulate disease susceptibility and the development of new epigenetic therapies.

中文翻译：

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炎性风湿病表观遗传学的新见解

在过去的十年中，人们对表观遗传学改变在风湿性疾病发病机理中的重要性的认识与对表观遗传学在调节基因表达中的基本作用的普遍认识相一致。在不同细胞类型以及生理和病理背景下，为生成表观遗传修饰的全基因组图谱所做的大规模努力说明了对表观遗传学相关性的日益认识。迄今为止，尽管一些报道已经证明在广泛的炎性风湿病中会发生表观遗传学改变，但表观基因组学信息很少在临床环境中使用。相比之下，几种表观遗传生物标志物和治疗方法目前正用于癌症患者的个性化治疗。这篇综述重点介绍了表观遗传学及其在炎性风湿性疾病领域中过去五年的进展，描绘了在临床环境和个性化医学中合理使用表观遗传学信息的未来发展方向。这些进展包括与临床结果相关的表型多态性的鉴定，风湿病中疾病易感性的DNA甲基化，调节疾病易感性的新表观遗传机制的发现以及新表观遗传疗法的发展。