Citation Information :
Varma SV, Varghese SS, Nair SV. Exploring the Epigenetic Landscape—Insights from Epigenomics in Periodontitis and Stress-related Health Implications: A Review. World J Dent 2024; 15 (1):72-78.
Background: The emerging field of epigenetics probes into the intricate modifications and information beyond the primary genetic code, investigating how gene function can be altered and inherited across cell generations without changes in deoxyribonucleic acid (DNA) sequences. This review specifically focuses on the epigenetic dimensions within two captivating areas—periodontitis and stress-related health implications.
Aim: The aim of this literature review is to comprehensively delve into current research, shedding light on the interplay between epigenetics, oral health, and overall well-being. It particularly explores the epigenetic intricacies associated with periodontitis and stress-related conditions.
Clinical significance: Despite the genetic complexity of periodontitis, the emergence of epigenetic biomarkers provides hope for early disease diagnosis and personalized management. Epigenetics, with established links to various diseases, including cancer, unfolds new therapeutic possibilities. While challenges persist in unraveling the intricacies of epigenetic regulation, it holds promise for advancing disease eradication, even for historically incurable conditions. Epigenetics stands as a hopeful avenue for treating stress-related disorders, although its full potential is still in the early stages of exploration.
Widschwendter M, Jones PA. DNA methylation and breast carcinogenesis. Oncogene 2002;21(35):5462–5482. DOI: 10.1038/sj.onc.1205606
Larsson L, Castilho RM, Giannobile WV. Epigenetics and its role in periodontal diseases: a state-of-the-art review. J Periodontol 2015;86(4):556–568. DOI: 10.1902/jop.2014.140559
Meyle J, Chapple I. Molecular aspects of the pathogenesis of periodontitis. Periodontol 2000 2015;69(1):7–17. DOI: 10.1111/prd.12104. PMID: 26252398
Koolhaas JM, Bartolomucci A, Buwalda B, et al. Stress revisited: a critical evaluation of the stress concept. Neurosci Biobehav Rev 2011;35(5):1291–1301. DOI: 10.1016/j.neubiorev.2011.02.003
Stabholz A, Soskolne WA, Shapira L. Genetic and environmental risk factors for chronic periodontitis and aggressive periodontitis. Periodontol 2000 2010;53:138–153. DOI: 10.1111/j.1600-0757.2010.00340.x
Issa JP. Age-related epigenetic changes and the immune system. Clin Immunol 2003;109(1):103–108. DOI: 10.1016/s1521-6616(03)00203-1
Vivier E, Raulet DH, Moretta A, et al. Innate or adaptive immunity? The example of natural killer cells. Science 2011;331(6013):44–49. DOI: 10.1126/science.1198687
Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res 2002;53(4):865–871. DOI: 10.1016/s0022-3999(02)00429-4
Loos BG, Van Dyke TE. The role of inflammation and genetics in periodontal disease. Periodontol 2000 2020;83(1):26–39. DOI: 10.1111/prd.12297
Smale ST. Transcriptional regulation in the innate immune system. Curr Opin Immunol 2012;24(1):51–57. DOI: 10.1016/j.coi.2011.12.008
Carpenter S, Ricci EP, Mercier BC, et al. Post-transcriptional regulation of gene expression in innate immunity. Nat Rev Immunol 2014;14(6):361–376. DOI: 10.1038/nri3682
Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol 2008;79(8 Suppl):1560–1568. DOI: 10.1902/jop.2008.080213
Waddington CH. The epigenotype. 1942. Int J Epidemiol 2012;41(1):10–13. DOI: 10.1093/ije/dyr184
Waddington CH. Towards a theoretical biology. Nature 1968;218(5141):525–527. DOI: 10.1038/218525a0
Egger G, Liang G, Aparicio A, et al. Epigenetics in human disease and prospects for epigenetic therapy. Nature 2004;429(6990):457–463. DOI: 10.1038/nature02625
Hamilton JP. Epigenetics: principles and practice. Dig Dis 2011;29(2):130–135. DOI: 10.1159/000323874
Feil R, Fraga MF. Epigenetics and the environment: emerging patterns and implications. Nat Rev Genet 2012;13(2):97–109. DOI: 10.1038/nrg3142
McGowan PO, Sasaki A, D'Alessio AC, et al. Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nat Neurosci 2009;12(3):342–348. DOI: 10.1038/nn.2270
Berger SL, Kouzarides T, Shiekhattar R, et al. An operational definition of epigenetics. Genes Dev 2009;23(7):781–783. DOI: 10.1101/gad.1787609
Tsankova NM, Berton O, Renthal W, et al. Sustained hippocampal chromatin regulation in a mouse model of depression and antidepressant action. Nat Neurosci 2006;9(4):519–525. DOI: 10.1038/nn1659
Holliday R, Pugh JE. DNA modification mechanisms and gene activity during development. Science 1975;187(4173):226–232. DOI: 10.1126/science.187.4173.226
Riggs AD. X inactivation, differentiation, and DNA methylation. Cytogenet Cell Genet 1975;14(1):9–25. DOI: 10.1159/000130315
Szyf M. The early life social environment and DNA methylation: DNA methylation mediating the long-term impact of social environments early in life. Epigenetics 2011;6(8):971–978. DOI: 10.4161/epi.6.8.16793
Héberlé É, Bardet AF. Sensitivity of transcription factors to DNA methylation. Essays Biochem 2019;63(6):727–741. DOI: 10.1042/EBC20190033
Kohli RM, Zhang Y. TET enzymes, TDG and the dynamics of DNA demethylation. Nature 2013;502(7472):472–479. DOI: 10.1038/nature12750
Kriaucionis S, Heintz N. The nuclear DNA base 5-hydroxymethylcytosine is present in Purkinje neurons and the brain. Science 2009;324(5929):929–930. DOI: 10.1126/science.1169786
Fischle W, Tseng BS, Dormann HL, et al. Regulation of HP1-chromatin binding by histone H3 methylation and phosphorylation. Nature 2005;438(7071):1116–1122. DOI: 10.1038/nature04219
ENCODE Project Consortium. An integrated encyclopedia of DNA elements in the human genome. Nature 2012;489(7414):57–74. DOI: 10.1038/nature11247
Zaratiegui M, Irvine DV, Martienssen RA. Noncoding RNAs and gene silencing. Cell 2007;128(4):763–776. DOI: 10.1016/j.cell.2007.02.016
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390(10100):1211–1259. DOI: 10.1016/S0140-6736(17)32154-2
Sanz M, D'Aiuto F, Deanfield J, et al. European workshop in periodontal health and cardiovascular disease. Eur Heart J Suppl 2010;12(Suppl B):B3–B12 DOI: 10.1093/eurheartj/suq003
Jin LJ, Lamster IB, Greenspan JS, et al. Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis 2016;22(7):609–619. DOI: 10.1111/odi.12428
Nibali L, Bayliss-Chapman J, Almofareh SA, et al. What Is the heritability of periodontitis? A systematic review. J Dent Res 2019;98(6):632–641. DOI: 10.1177/0022034519842510
Michalowicz BS, Aeppli DP, Kuba RK, et al. A twin study of genetic variation in proportional radiographic alveolar bone height. J Dent Res 1991;70(11):1431–1435. DOI: 10.1177/00220345910700110701
Mucci LA, Björkman L, Douglass CW, et al. Environmental and heritable factors in the etiology of oral diseases–a population-based study of Swedish twins. J Dent Res 2005;84(9):800–805. DOI: 10.1177/154405910508400904
Chatzopoulos GS, Doufexi AE, Kouvatsi A. Clinical response to non-surgical periodontal treatment in patients with interleukin-6 and interleukin-10 polymorphisms. Med Oral Patol Oral Cir Bucal 2017;22(4): e446–e457. DOI: 10.4317/medoral.21795
Chatzopoulos GS, Doufexi AE, Zarenti S, et al. Periodontal disease progression and gene polymorphisms: results after 3 years of active periodontal treatment. Minerva Dent Oral Sci 2022;71(6):329–338. DOI: 10.23736/S2724-6329.22.04709-X
Hernández HG, Hernández-Castañeda AA, Pieschacón MP, et al. ZNF718, HOXA4, and ZFP57 are differentially methylated in periodontitis in comparison with periodontal health: epigenome-wide DNA methylation pilot study. J Periodontal Res 2021;56(4):710–725. DOI: 10.1111/jre.12868
Kurushima Y, Tsai PC, Castillo-Fernandez J, et al. Epigenetic findings in periodontitis in UK twins: a cross-sectional study. Clin Epigenetics 2019;11(1):27. DOI: 10.1186/s13148-019-0614-4
Hart TC. Genetic considerations of risk in human periodontal disease. Curr Opin Periodontol 1994:3–11. PMID: 8032464.
Schafer AS, Jepsen S, Loos BG. Periodontal genetics: a decade of genetic association studies mandates better study designs. J Clin Periodontol 2011;38(2):103–107. DOI: 10.1111/j.1600-051X.2010.01653.x
Loos BG, Velden UV. Clinical Periodontology and Implant Dentistry, 4th edition. Jaypee Brothers; 2003. pp. 387–399.
Michalowicz BS, Aeppli D, Virag JG, et al. Periodontal findings in adult twins. J Periodontal 1991;62(5):293–299. DOI: 10.1902/jop.1991.62.5.293
Larsson L. Current concepts of epigenetics and its role in periodontitis. Curr Oral Health Rep 2017;4(4):286–293. DOI: 10.1007/s40496-017-0156-9
Khouly I, Braun RS, Ordway M, et al. The role of DNA methylation and histone modification in periodontal disease: a systematic review. Int J Mol Sci 2020;21(17):6217. DOI: 10.3390/ijms21176217
Williams SD, Hughes TE, Adler CJ, et al. Epigenetics: a new frontier in dentistry. Aust Dent J 2014;59(Suppl 1):23–33. DOI: 10.1111/adj.12155
De Souza AP, Planello AC, Marques MR, et al. High-throughput DNA analysis shows the importance of methylation in the control of immune inflammatory gene transcription in chronic periodontitis. Clin Epigenet 2014;6(1):15. DOI: 10.1186/1868-7083-6-15
Li X, Lu J, Teng W, et al. Quantitative evaluation of MMP-9 and TIMP-1 promoter methylation in chronic periodontitis. DNA Cell Biol 2018;37(3):168–173. DOI: 10.1089/dna.2017.3948
Martins MD, Jiao Y, Larsson L, et al. Epigenetic modifications of histones in periodontal disease. J Dent Res 2016;95(2):215–222. DOI: 10.1177/0022034515611876
Zhu ZX, Liu Y, Wang J, et al. A novel lncRNA-mediated epigenetic regulatory mechanism in periodontitis. Int J Biol Sci 2023;19(16):5187–5203. DOI: 10.7150/ijbs.87977
Loos BG, Papantonopoulos G, Jepsen S, et al. What is the contribution of genetics to periodontal risk? Dent Clin North Am 2015;59(4):761–780. DOI: 10.1016/j.cden.2015.06.005
Radley JJ, Kabbaj M, Jacobson L, et al. Stress risk factors and stress-related pathology: neuroplasticity, epigenetics and endophenotypes. Stress 2011;14(5):481–497. DOI: 10.3109/10253890.2011.604751
Karatsoreos IN, McEwen BS. Annual research review: the neurobiology and physiology of resilience and adaptation across the life course. J Child Psychol Psychiatry 2013;54(4):337–347. DOI: 10.1111/jcpp.12054
Yehuda R, Bierer LM. Transgenerational transmission of cortisol and PTSD risk. Prog Brain Res 2008;167:121–135. DOI: 10.1016/S0079-6123(07)67009-5
Goyal S, Gupta G, Thomas B, et al. Stress and periodontal disease: the link and logic! Ind Psychiatry J 2013;22(1):4–11. DOI: 10.4103/0972-6748.123585
Warren KR, Postolache TT, Groer ME, et al. Role of chronic stress and depression in periodontal diseases. Periodontol 2000 2014;64(1):127–138. DOI: 10.1111/prd.12036
Lu XT, Zhao YX, Zhang Y, et al. Psychological stress, vascular inflammation, and atherogenesis: potential roles of circulating cytokines. J Cardiovasc Pharmacol 2013;62(1):6–12. DOI: 10.1097/FJC.0b013e3182858fac
Hilgert JB, Hugo FN, Bandeira DR, et al. Stress, cortisol, and periodontitis in a population aged 50 years and over. J Dent Res 2006;85(4):324–328. DOI: 10.1177/154405910608500408
Cakmak O, Tasdemir Z, Aral CA, et al. Gingival crevicular fluid and saliva stress hormone levels in patients with chronic and aggressive periodontitis. J Clin Periodontol 2016;43(12):1024–1031. DOI: 10.1111/jcpe.12614
Jaiswal R, Shenoy N, Thomas B. Evaluation of association between psychological stress and serum cortisol levels in patients with chronic periodontitis - estimation of relationship between psychological stress and periodontal status. J Indian Soc Periodontol 2016;20(4):381–385. DOI: 10.4103/0972-124X.193165
Mousavijazi M, Naderan A, Ebrahimpoor M, et al. Association between psychological stress and stimulation of inflammatory responses in periodontal disease. J Dent (Tehran) 2013;10(1):103–111. PMID: 23724208.
Goyal S, Jajoo S, Nagappa G, et al. Estimation of relationship between psychosocial stress and periodontal status using serum cortisol level: a clinico-biochemical study. Indian J Dent Res 2011;22(1):6–9. DOI: 10.4103/0970-9290.79966
Slatkin M. Epigenetic inheritance and the missing heritability problem. Genetics 2009;182(3):845–850. DOI: 10.1534/genetics.109.102798
Tsankova N, Renthal W, Kumar A, et al. Epigenetic regulation in psychiatric disorders. Nat Rev Neurosci 2007;8(5):355–367. DOI: 10.1038/nrn2132
Siegmund KD, Connor CM, Campan M, et al. DNA methylation in the human cerebral cortex is dynamically regulated throughout the life span and involves differentiated neurons. PLoS One 2007;2(9):e895. DOI: 10.1371/journal.pone.0000895
Cirillo N, Prime SS. Keratinocytes synthesize and activate cortisol. J Cell Biochem 2011;112(6):1499–1505. DOI: 10.1002/jcb.23081
Dhabhar FS, McEwen BS. Acute stress enhances while chronic stress suppresses cell-mediated immunity in vivo: a potential role for leukocyte trafficking. Brain Behav Immun 1997;11(4):286–306. DOI: 10.1006/brbi.1997.0508
Baybutt HN, Holsboer F. Inhibition of macrophage differentiation and function by cortisol. Endocrinology 1990;127(1):476–480. DOI: 10.1210/endo-127-1-476
Gatti G, Cavallo R, Sartori ML, et al. Inhibition by cortisol of human natural killer (NK) cell activity. J Steroid Biochem 1987;26(1):49–58. DOI: 10.1016/0022-4731(87)90030-6
Gallacher DV, Petersen OH. Stimulus-secretion coupling in mammalian salivary glands. Int Rev Physiol 1983;28:1–52. PMID: 6307913.
Cohen-Cole SA, Cogen RB, Stevens AW, et al. Psychiatric, psychosocial, and endocrine correlates of acute necrotizing ulcerative gingivitis (trench mouth): a preliminary report. Psychiatr Med 1983;1(2):215–225. PMID: 6599850.
Neupane SP, Virtej A, Myhren LE, et al. Biomarkers common for inflammatory periodontal disease and depression: a systematic review. Brain Behav Immun Health 2022;21:100450. DOI: 10.1016/j.bbih.2022.100450
Walton E, Hass J, Liu J, et al. Correspondence of DNA methylation between blood and brain tissue and its application to schizophrenia research. Schizophr Bull 2016;42(2):406–414. DOI: 10.1093/schbul/sbv074
Cho YD, Kim WJ, Ryoo HM, et al. Current advances of epigenetics in periodontology from ENCODE project: a review and future perspectives. Clin Epigenetics 2021;13(1):92. DOI: 10.1186/s13148-021-01074-w