title: Clinical relevance of epigenetic dysregulation in chronic kidney disease-associated cardiovascular disease.
abstract: Across the spectrum of clinical medicine, the field of epigenetics has gained substantial scientific interest in recent years. Epigenetics refers to modifications in gene expression which are not explained by changes in DNA sequence. Classical components of epigenetic regulation comprise DNA methylation, histone modifications and RNA interference. In chronic kidney disease (CKD), several features of uraemia, such as hyperhomocysteinemia and inflammation, may contribute to changes in epigenetic gene regulation. It has been suggested that these changes may affect genes related to cardiovascular disease. Thereby, a uraemia-associated disturbance in epigenetic regulation may contribute to the substantial increase in cardiovascular morbidity in CKD patients. The present review aims to summarize current knowledge of epigenetic dysregulation in cardiovascular disease from a nephrological perspective, with a special focus on DNA methylation. We first describe the impact of altered epigenetic regulation in non-CKD-associated arteriosclerosis, and next characterize uraemic features which may affect epigenetic gene regulation in the context of cardiovascular disease. Finally, we conclude that substantial additional work is needed before epigenetic regulatory mechanisms may become therapeutic targets in CKD-associated cardiovascular disease.
authors.affiliation: Department of Internal Medicine IV, Saarland University Medical Center, D-66421 Homburg, Germany.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Zawada
authors.forename: Kyrill S
authors.initials: KS
authors.lastname: Rogacev
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Heine
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D019175:DNA Methylation; D044127:Epigenesis, Genetic; D005786:Gene Expression Regulation; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000235:genetics*
keywords: DNA methylation; arteriosclerosis; cardiovascular disease; chronic kidney disease; epigenetics