rehabРеабилитологияJournal of Medical Rehabilitation2949-58732949-5881IRBIS Publishing House (IRBIS LLC)10.17749/2949-5873/rehabil.2023.2rehab-15Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESРоль эпигенетики в вопросах диагностики, лечения и реабилитации пациентов со злокачественными новообразованиямиThe role of epigenetics in the diagnosis, treatment and rehabilitation of patients with malignant neoplasmshttps://orcid.org/0000-0001-8660-7951ВласинаА. Ю.VlasinaA. Yu.

Власина Анастасия Юрьевна - к.м.н. WoS ResearcherID: AAF-3130-2020. Scopus Author ID: 1016902.

Ул. Трубецкая, д. 8/2, Москва 119048

Anastasia Yu. Vlasina – PhD. WoS ResearcherID: AAF-3130-2020. Scopus Author ID: 1016902.

8/2 Trubetskaya Str., Moscow 119991

anastasia@programist.ruhttps://orcid.org/0000-0003-2275-2257БеговичЁ.BegovichE.

Бегович Ёвана

Ул. Трубецкая, д. 8/2, Москва 119048

Evana Begovich

8/2 Trubetskaya Str., Moscow 119991

Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian Federation202306092024116979Copyright © Власина А.Ю., Бегович Ё., 20242024Власина А.Ю., Бегович Ё.Vlasina A.Y., Begovich E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rehabilitology.com/jour/article/view/15Актуальность

Актуальность. Эпигенетика является разделом генетики, изучающим влияние внешних факторов на экспрессию генов. Многочисленные исследования показали существенную роль эпигенетических механизмов в регуляции экспрессии генов, в т.ч. у пациентов со злокачественными новообразованиями (ЗНО). Несмотря на очевидную перспективность использования принципов и инструментов эпигенетики в диагностике, лечении и восстановлении пациентов, внедрение этой новой технологии остается на сравнительно низком уровне.

Цель

Цель: определить значимость эпигенетических механизмов в диагностике, прогнозировании исхода и реабилитации пациентов с онкологическими заболеваниями.

Материал и методы

Материал и методы. Поиск публикаций выполняли в научных базах данных и электронных библиотеках: PubMed/ MEDLINE, ScienceDirect, Google Schoolar, eLibrary. В обзор вошло 79 статей, посвященных роли эпигенетических механизмов в диагностике, лечении и реабилитации пациентов с ЗНО.

Результаты

Результаты. Среди наиболее изученных эпигенетических изменений (ЭГИ) у пациентов онкологического профиля выделяют метилирование ДНК, ковалентные модификации гистонов, регуляцию микроРНК. Представлен альтернативный подход к определению эпигенетических маркеров – жидкостная биопсия. Также определены биомаркеры, позволяющие диагностировать и прогнозировать течение онкологических заболеваний, в частности рака легких, рака молочной железы. Ряд ЭГИ соотносится с проведением реабилитационных мероприятий, таких как оказание нутритивной поддержки, физическая нагрузка, поддержание циркадных ритмов и иглоукалывание.

Заключение

Заключение. Проведенный анализ публикаций подтвердил существенную значимость ЭГИ в развитии ЗНО. Полученные результаты указали на достаточное количество исследований, посвященных поиску новых средств диагностики и прогнозированию исхода онкологических заболеваний с помощью биомаркеров ЭГИ. Однако отмечено сравнительно малое число исследований по механизмам ЭГИ в процессе реабилитации. Дальнейшее изучение особенностей эпигенетических механизмов изменчивости позволит существенно продвинуться в разработке таргетных препаратов и персонифицированной реабилитации пациентов с ЗНО.

Background

Background. Epigenetics is a branch of genetics that studies the influence of external factors on gene expression. Many studies have shown the role of epigenetic regulation mechanisms in gene expression, including patients with cancer. Despite the clear prospects of using the principles and methods of epigenetics in the diagnosis, treatment and recovery, the implementation of this new technology remains at a relatively low level.

Objective

Objective: to determine the importance of epigenetic mechanisms in the diagnosis, outcome prognosis and rehabilitation of patients with oncological diseases.

Material and methods

Material and methods. The search for publications was performed in scientific databases and electronic libraries: PubMed/ MEDLINE, ScienceDirect, Google Schoolar, eLibrary. The review included 79 articles on the role of epigenetic mechanisms in the diagnosis, treatment and rehabilitation of cancer patients.

Results

Results. DNA methylation, covalent histone modifications, and microRNA regulation are the most studied epigenetic changes (EGC) in cancer patients. Liquid biopsy is alternative approach to the detection of epigenetic biomarkers. A number of biomarkers were identified that make it possible to diagnose oncological diseases, e.g. lung cancer and breast cancer, and predict their course. Some EGC were assosiated with the implementation of rehabilitation measures, such as nutritional support, physical activity, maintaining circadian rhythms and acupuncture.

Conslusion

Conslusion. The analysis of publications confirmed the significant importance of EGC on the development of malignant neoplasms. The results indicated a sufficient number of studies dedicated to EGC biomarkers as new diagnostic tools and predicting the oncological disease outcome. But there is an insufficient number of studies on EGC mechanisms in rehabilitation. Further investigation on epigenetic mechanisms of variability will allow making significant progress in the development of targeted drugs and personalized rehabilitation of patients with malignant neoplasms.

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The authors declare that there are no conflicts of interest present.