Abstract
Over the last years, epigenetics has undergone a tremendous progress. Studies in rheumatic autoimmune diseases revealed that, in addition to a genetic predisposition, this group of disorders exhibit epigenetic components linked to chromatin remodeling, transcription factors, alternative splicing, and microRNA. The contribution of epigenetic alterations to autoimmunity development has mainly been addressed in systemic lupus erythematosus and rheumatoid arthritis, but there are indications that such alterations also exist in other diseases, such as systemic sclerosis. They include global DNA hypomethylations, methylation changes at the level of the promoters of certain genes, histone modifications, and abnormal expression of microRNA, such as miRNA-146. Additionally, certain drugs, such as hydralazine, can act as epigenetic modifiers and trigger a lupus syndrome. While it remains unclear whether the aberrant epigenetic expressions found are secondary to disease development or whether they contribute to their initial induction, the reversibility of some of the modifications observed opens up novel therapeutic avenues.
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