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PERSONALIZED EPIGENETICS Trygve O. TOllefsbOl AMSTERDAM • BOSTON • HEIDELBERG • LONDON NEW YORK • OXFORD • PARIS • SAN DIEGO SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic Press is an imprint of Elsevier Academic Press is an imprint of Elsevier 125 London Wall, London EC2Y 5AS, UK 525 B Street, Suite 1800, San Diego, CA 92101-4495, USA 225 Wyman Street, Waltham, MA 02451, USA The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK Copyright © 2015 Elsevier Inc. All rights reserved. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress British Library Cataloging-in-Publication Data A catalog record for this book is available from the British Library ISBN: 978-0-12-420135-4 For information on all Academic Press publications visit our website at http://store.elsevier.com/ Acquisition Editor: Catherine Van Der Laan Editorial Project Manager: Lisa Eppich Production Project Manager: Karen East and Kirsty Halterman Designer: Mark Rogers Typeset by TNQ Books and Journals www.tnq.co.in Printed and bound in the United States of America Contributors Vanessa Aguiar-Pulido School of Computing & Information Sciences, Florida International University, Miami, FL, USA; Department of Information & Communication Technologies, University of A Coruña, A Coruña, Spain Alexandre F. Aissa Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil Seena K. Ajit Department of Pharmacology & Physiology, Drexel University College of Medicine, Philadelphia, PA, USA Lusânia M.G. Antunes Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil Elisabeth B. Binder Max Planck Institute of Psychiatry, Translational Research, Munich, Germany Christopher Chang Division of Rheumatology, Allergy and Clinical Immunol- ogy, University of California at Davis, CA, USA Samit Chattopadhyay National Centre for Cell Science, Pune University Campus, Ganeshkhind, Pune, India Arpankumar Choksi National Centre for Cell Science, Pune University Campus, Ganeshkhind, Pune, India Fabio Coppedè Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy Jose M. Eirin-Lopez Department of Biological Sciences, Florida International University, North Miami, FL, USA Ammad A. Farooqi Laboratory for Translational Oncology and Personalized Medicine, Rashid Latif Medical College, Lahore, Pakistan Domniki Fragou Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Rebecca C. Fry Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC, USA; Curriculum in Toxicology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA Gunnar H. Heine Department of Internal Medicine IV, Nephrology and Hypertension, Saarland University Medical Center, Homburg, Germany Anke Hoffmann Max Planck Institute of Psychiatry, Translational Research, Munich, Germany Muhammad Ismail IBGE, Islamabad, Pakistan Leda Kovatsi Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece xiii vix CONTRIBUTORS Anders M. Lindroth Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea Ying Liu Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, Second Xiangya Hospital, Central South University, Hunan, China Angela Lopomo Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Doctoral School in Genetics, Oncology, and Clinical Medicine, University of Siena, Siena, Italy Kenneth Lundstrom PanTherapeutics, Lutry, Switzerland Qianjin Lu Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, Second Xiangya Hospital, Central South University, Hunan, China Emily Machiela Laboratory of Aging and Neurodegenerative Disease, Van Andel Research Institute, Grand Rapids, MI, USA Lucia Migliore Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy Giri Narasimhan School of Computing & Information Sciences, Florida International University, Miami, FL, USA Monica D. Nye Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC, USA Joo H. Park Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea Yoon J. Park Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea Sonal Patel National Centre for Cell Science, Pune University Campus, Ganeshkhind, Pune, India Jacob Peedicayil Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India Javier Pereira Department of Information & Communication Technologies, University of A Coruña, A Coruña, Spain Anthony Popkie Laboratory of Cancer Epigenomics, Van Andel Research Institute, Grand Rapids, MI, USA Muhammad Z. Qureshi Department of Chemistry, GCU, Lahore, Pakistan Nicole C. Riddle Department of Biology, The University of Alabama at Birmingham, Birmingham, AL, USA Lorenzo F. Sempere Laboratory of MicroRNA Diagnostics and Therapeutics, Van Andel Research Institute, Grand Rapids, MI, USA Dietmar Spengler Max Planck Institute of Psychiatry, Translational Research, Munich, Germany Victoria Suarez-Ulloa Department of Biological Sciences, Florida International University, North Miami, FL, USA D. Syndercombe Court Faculty of Biological Sciences and Medicine, King’s College London, London, UK CONTRIBUTORS vx Trygve O. Tollefsbol Department of Biology, University of Alabama at Birming- ham, Birmingham, AL, USA; Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, AL, USA; Nutrition Obesity Research Center, University of Alabama at Birmingham, Bir- mingham, AL, USA; Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL, USA Athina Vidaki Faculty of Biological Sciences and Medicine, King’s College London, London, UK Louis P. Watanabe Department of Biology, The University of Alabama at Birmingham, Birmingham, AL, USA Hehuang Xie Department of Biological Sciences, Virginia Bioinformatics Institute, Virginia Tech, Blacksburg, VA, USA Yeongran Yoo Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea Andrew E. Yosim Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC, USA Adam M. Zawada Department of Internal Medicine IV, Nephrology and Hypertension, Saarland University Medical Center, Homburg, Germany Peng Zhang Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, Second Xiangya Hospital, Central South University, Hunan, China Christoph A. Zimmermann Max Planck Institute of Psychiatry, Translational Research, Munich, Germany Preface It is now apparent that epigenetics is a central component of medicine. In light of that fact, future diagnostic, prognostic, and therapeutic advances will almost certainly increasingly rely on personalized epigenetics for the optimal management of many, if not most, health-related conditions. Personalized epigenetics notably stands out in that the emphasis is on the translatability of epigenetics to health management of individuals who have unique variations in their epigenetic signatures that can guide dis- order or disease prevention or therapy. The goal of this book on personal- ized epigenetics is to provide a comprehensive analysis of interindividual variability of epigenetic markers of human disease and to illuminate the bench to bedside advances that are readily advancing in this field. More specifically, the purpose of this book focusing on personalized epigenetics is to facilitate understanding of the application of medical prevention and therapy based in part on the unique health and disease susceptible epigenetic profile of each individual. This book is intended for those with interests ranging from basic molecular biology to clinical therapy and who have an interest in person- alized medicine. Trygve O. Tollefsbol xvii C H A P T E R 1 pE igtene i sc o f reP os ilan dez deM iic en rT gy ve .O lo T lesf lob 12, 5,4,3, 1 eD partem nt o f iB olog , y nU iev rsit y o f lA aab am at iB rim ngah ,m iB rim ngah ,m ,LA ;ASU 2 oC pm reeh nsiev aC ncer eC nter , nU iev rsit y o f lA aab am at iB rim ngah ,m iB rim ngah ,m ,LA ;ASU 3 oC pm reeh nsiev eC nter of r eH alt yh gA ing , nU iev rsit y o f lA aab am at iB rim ngah ,m iB rim ngah ,m ,LA ;ASU 4 tuN rition ebO sit y eR searc h eC nter , nU iev rsit y o f lA aab am at iB rim ngah ,m iB rim ngah ,m ,LA ;ASU 5 oC pm reeh nsiev iD aeb tes eC nter , nU iev rsit y o f lA aab am at iB rim ngah ,m iB rim ngah ,m ,LA ASU O U T L I N E .1 nI trodcu tion 4 .2 Epigenetic V ariations aom ng nI diiv dau ls 4 .3 iB oinof ram tics o f Personalized Epigenetics 6 .4 iD agnostic and Prognostic Epigenetic pA proaceh s to Personalized eM dicine 6 .5 Eniv ronem ntal Personalized Epigenetics 8 .6 Pah ram colog y and rD gu eD ev lopem nt o f Personalized Epigenetics 8 .7 Personalized Epigenetics o f iD sorders and iD sease aM nageem nt 9 .8 ahC llenges and tuF ru e iD rections 1 .9 oC nclsu ion 1 eR ef rences 21 Personalized Epigenetics 3 http://dx.doi.org/10.1016/B978-0-12-420135-4.00001-2 © 2015 Elsevier Inc. All rights reserved. 4 1. EPIGENETICS OF PERSONALIZED MEDICINE 1. INTRODCU TION While each species, cell, and system has a characteristic epigenetic pro- file, individuals also have an epigenetic profile that forms their unique epigenome. Epigenetic aberrations are known to play a key role in many human diseases, and the purpose of personalized epigenetics is to base medical prevention and therapeutics as well as diagnostics and prognos- tics on the distinctive health and disease susceptibility profile of each indi- vidual. In fact, interindividual differences in the epigenome are the basis of personalized epigenetics and these can manifest through epigenetic signatures that are characteristic of each individual. DNA methylation, for example, varies between individuals [1–2] as do the many different forms of epigenetic histone modifications [3–4]. In addition, noncoding RNA profiles are also variable from person to person [5–6]. These variations in epigenetic expression will undoubtedly become increasingly important as the potential for personalized epigenetics in medicine continues to grow. Personalized epigenetics can serve as a guide not only for the therapy of epigenetic-based diseases, but also for many other aspects of medicine. Epigenetic biomarkers comprising epigenomic signatures unique to each individual have increasingly been shown to provide not only valuable information with respect to the diagnosis of disorders and diseases, but also prognostic information pertaining to the likely progression of diseases such as cancer [7–8]. There are also many applications of personalized epi- genetics in forensics and in toxicology. Many toxic compounds leave dis- tinct epigenomic signatures that could have significant utility in terms of diagnosing toxicity as well as treatment of patients that have been exposed to toxins [9–10]. Similar concepts apply to environmental contaminants [11–12] and nutrients [13–14] that also have an impact on the epigenome. Equally exciting is the prospect of application of personalized epi- genetics to the many disorders and diseases that have epigenetic aber- rations as a component of their etiology or pathogenesis. For example, epigenetic alterations have been shown in a number of studies to be important in chronic pain, and studies are emerging that may lead to personalized management of pain based on the distinct epigenomic pro- file of the individual patient [15–16]. Approaches to patient management through personalized epigenetics are also rapidly developing for many other medical conditions such as obesity, cancer, autoimmune disorders, and cardiovascular diseases. .2 EPIGENETIC V ARIATIONS AMONG INDIIV DAU LS One of the most important components of the collective epigenetic changes that occur in cells and tissues is DNA methylation. The role of DNA methylation in modulating gene expression has been known for I. OEV RIV E W 2. EPIgENETIC VARIATIONs AMONg INdIVIdUALs 5 quite some time, although it has been more recently appreciated that it can vary considerably between individuals within a species. As Watanabe and Riddle explain in Chapter 2, the variation in DNA methylation between individuals is a common feature ranging from plants to humans. There are a number of possible causes for extensive variance of DNA methyla- tion among individuals, including gender, health status, age, and envi- ronmental exposures, as well as many other factors. The heterogeneity of DNA methylation patterns within individuals is of particular interest to those focused on personalized medicine. For example, interindividual dif- ferences in DNA methylation have considerable potential as a biomarker for a number of diseases as well as a means to guide therapy for diseases such as cancer. In fact, the optimal drug dosage that is administered to individual patients could be monitored through changes in the patient’s DNA methylation profile, which serves as a classic example of the util- ity of knowledge of personalized epigenetics as applied to medicine, as reviewed in Chapter 2. There are many different types of histone modifications that can modu- late epigenetic gene expression of an organism and these modifications are also subject to interindividual variation. The importance of individual het- erogeneity of histone modifications as well as techniques such as mapping of DNase I-hypersensitive sites and formaldehyde-assisted isolation of regulatory elements (FAIRE) and chromatin immunoprecipitation (ChIP), as well as their genomic counterparts (DNase-seq, FAIRE-seq, and ChIP- seqA), is highlighted in Chapter 3. Especially fascinating is the prospect of the potential use of induced pluripotent stem cells for elucidating chro- matin modifications and transcription differences in healthy and disease states as a “bottom-up” approach (Chapter 3) to advance our knowledge of chromatin heterogeneity between individuals and the potential applica- tion of this knowledge to personalized medicine. Noncoding RNA (ncRNA) variations have great importance to personalized epigenetics since ncRNAs such as microRNAs (miRNAs), trinucleotide repeats, and long noncoding RNAs not only regulate epigen- etic processes, but are in turn regulated by epigenetic processes as well. Variation in ncRNA sequences can modulate not only RNA stability, but also its processing, which can affect the regulatory capacity of ncRNAs. As delineated in Chapter 4, these differences in ncRNAs between individuals can lead to major epigenetic changes in disease processes and may also have utility as biomarkers of various diseases. For example, there is some evidence that miRNA expression signatures may distinguish Alzheimer’s disease and Parkinson’s disease from normal controls (Chapter 4). More- over, variations of ncRNAs between individuals could be employed for personalized medical therapy through monitoring of drug responses. Despite great excitement in the potential uses of interindividual epigenetic variations in personalized medicine, there are some limita- tions that must be overcome. For instance, there can be challenges in I. OVERVIEW 6 1. EPIGENETICS OF PERSONALIZED MEDICINE detecting true epi-mutations, and epigenetic signatures vary not only among individuals, but also between the various cell types within individuals (Chapter 5). There can also be complications with respect to allele-specific or asymmetric DNA methylation changes that can add to the complexity of interpretations of epigenetic differences between individuals. Neverthe- less, it is apparent that interindividual differences in epigenetic processes such as DNA methylation is substantial and the collective pattern differ- ences in response to medical interventions have considerable promise in leading to many advances in medical diagnosis, prognosis, and therapy. .3 IB OINFO RMATICS OF PERSONALIZED EPIGENETICS Although the heterogeneity of epigenetic events presents a challenge in monitoring reliable changes in epigenetic patterns between individuals and in response to medical interventions, computational epigenetics pro- vides many solutions to this challenge. Chapter 6 reviews the data types most often used in epigenetic studies and their use in medicine. Compu- tational approaches to DNA methylation patterns, histone modifications, and ncRNAs as well as quantitative protein analyses are greatly enhancing the ability to identify specific differences in epigenetic profiles between individuals that can be readily applied to personalized medicine. Technol- ogies such as grid computing, which involves coupling of networked and geographically dispersed computers that, in combination, will be able to perform the requisite computational tasks that will enable more accurate analyses of variations in epigenetic signatures, are discussed. .4 DIAGNOSTIC AND PROGNOSTIC EPIGENETIC APPROACEH S TO PERSONALIZED MEDICINE The further development of epigenetic biomarkers has considerable potential to significantly advance personalized medicine. Epigenetic sig- natures, for example, unique epigenetic features of DNA methylation or ncRNA, may be applied not only to diagnostic aspects of personalized care, but also to prognosticating the progression of diseases (Chapter 7). Moreover, epigenetic biomarkers are being developed to monitor the most efficacious approaches to therapy. The development of epigenetic biomarkers has been most readily apparent in the field of tumor biol- ogy. These biomarkers provide both diagnostic and prognostic informa- tion, since different epigenetic markers may be present at various stages of carcinogenesis, thereby conferring predictive potential of disease out- come in different individuals. Changes in the epigenetic signature during I. OEV RIV E W

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