Clinical epigenetics settings for cancer and cardiovascular diseases: real-life applications of network medicine at the bedside

Abstract

Despite impressive efforts invested in epigenetic research in the last 50 years, clinical applications are still lacking. Only a few university hospital centers currently use epigenetic biomarkers at the bedside. Moreover, the overall concept of precision medicine is not widely recognized in routine medical practice and the reductionist approach remains predominant in treating patients affected by major diseases such as cancer and cardiovascular diseases. By its' very nature, epigenetics is integrative of genetic networks. The study of epigenetic biomarkers has led to the identification of numerous drugs with an increasingly significant role in clinical therapy especially of cancer patients. Here, we provide an overview of clinical epigenetics within the context of network analysis. We illustrate achievements to date and discuss how we can move from traditional medicine into the era of network medicine (NM), where pathway-informed molecular diagnostics will allow treatment selection following the paradigm of precision medicine.

Keywords: Algorithms; CVD; Cancer; Epi-drugs; Epigenetics; Network medicine; Precision medicine.

Fig. 1

Application of NM in disease. Principles of network medicine methods (top) considering the differences of DNA methylation between disease and control samples. Network reconstruction (NR) methods build a disease network de novo while network analysis methods (NA) identify disease modules in existing networks based on prior knowledge (middle). Overview of commonly employed network medicine methods, their expected input and the concept they employ (bottom)