With the advent of high-throughput sequencing and methodologies to interrogate chromatin state and DNA/RNA/protein interactions, an integrated understanding of epigenetics, functional genomics, and chromatin biology has blossomed into the current field of epigenomics.Įpigenetic effectors, enzymes capable of inducing changes in chromatin state, are varied and are often divided into three major categories-writers, erasers, and readers. This complex system has been referred to as the “epigenetic code,” and describes the fundamental information layer that cells rely on to integrate and process the impact of external stimuli, in the context of past stimuli and cell-type determination despite a fixed genetic sequence (Fig.

Epigenetic modifications can induce changes in the accessibility of DNA as it is wound around histones, cause regulatory sequences to become refractory or amenable to transcription factor binding, or drive compartmentalization to activate or inactivate whole genomic loci. This involves the modification of chemical signatures on DNA and its structures to alter the means by which transcription factors and other machinery interpret genetic information to control gene expression. At its core, epigenetics is focused on how cells control gene activity without changing the DNA sequence. In the 70 years since the term “epigenetics” was first coined, the field has yet to fulfill its true therapeutic potential, but has nonetheless proven a boon to basic researchers, to understand how cells process genetic information, differentiate, and respond to external stimuli. Novel therapeutic modalities leveraging epigenetics and epigenomics with increased precision are well positioned to advance the field and treat patients across disease areas in the coming years. Here, we review the promise and pitfalls of epigenetic drug development to date and provide an outlook on recent advances and their promise for future therapeutic applications. Recently, there has been marked progress in the field on a new generation of epigenomic therapies which address these challenges directly by targeting defined loci with highly precise, durable, and tunable approaches. Despite the overall promise of early approaches, however, these drugs have been plagued by poor pharmacokinetic and safety/tolerability profiles due in large part to off-target effects and a lack of specificity. Modulating the epigenome has long been considered a potential opportunity for therapeutic intervention in numerous disease areas with several approved therapies marketed, primarily for cancer.

The epigenetics revolution summary