Clinical Aspects of Transgenerational Epigenetics

The concept of transgenerational epigenetics is generally accepted and has been receiving much attention lately. However, its impact on disease remains unclear, because it is often difficult to distinguish between epigenetic effects, heritable genetic changes, and the effects of sharing of environments between parents and their offspring. Here, we will describe some physiological and pathophysiological consequences of different routes through which transgenerational epigenetics are mediated, mainly focusing on DNA methylation, histone modification, and RNA interference. Physiological consequences include changes in behavior and fertility; pathophysiological consequences include diseases like Prader-Willi, but also diabetes, cardiovascular disease, and cancer. Secondly, we will study clinical applications, starting with ways to investigate transgenerational epigenetics and ways to use epigenetics for diagnostics and prognosis. We will discuss potential lifestyle and pharmacological interventions targeting epigenetic changes, including nutrition during pregnancy. Lastly, we will focus on another aspect of clinical applications of transgenerational epigenetics, namely epigenetic changes induced, partly by doctors, through radiation or toxic agents such as chemotherapy.

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