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. 2023 Jul;25(3):404-416.
doi: 10.1177/10998004221147300. Epub 2022 Dec 20.

Epigenomic Links Between Social Determinants of Health and Symptoms: A Scoping Review

Mitali Ray  1 , McKenzie K Wallace  2 , Susan C Grayson  1 , Meredith H Cummings  1 , Jessica A Davis  1 , Jewel Scott  3 , Sarah M Belcher  4 , Tara S Davis  1 , Yvette P Conley  5
Affiliations

Epigenomic Links Between Social Determinants of Health and Symptoms: A Scoping Review

Mitali Ray et al. Biol Res Nurs. 2023 Jul.

Abstract

Social determinants of health (SDoH) impact health and wellness. The link between SDoH and adverse health outcomes, including symptom occurrence and severity, may be explained by an individual's physiologic response to one or more SDoH. One potential mechanism underlying this physiologic response linking SDoH and symptoms is the dynamic epigenome. The purpose of this scoping review of the literature was to examine differential susceptibility for symptoms by identifying and summarizing research linking SDoH and symptoms through epigenomic mechanisms. PubMed was searched to identify empirical research where at least one SDoH was an independent or dependent variable, at least one symptom was investigated, and the investigation included an epigenomic measure. Of the 484 articles initially retrieved, after thorough vetting, 41 articles met eligibility. The most studied symptom was depressive symptoms followed by anxiety, cognitive function, sleep dysfunction, and pain. The most frequently studied SDoH were: 1) stress, particularly early life stress and acculturative stress; and 2) trauma, predominantly childhood trauma. DNA methylation and telomere length were the most studied epigenomic measures. Four genes (SLC6A4, BDNF, NR3C1, OXTR) had evidence from multiple studies and across methodological approaches linking SDoH to symptoms. This review supports the inclusion of epigenomic approaches to better understand the link between SDoH and symptoms and provides evidence that SDoH impact telomere length and the methylation of genes involved in neurotransmitter signaling, neuronal survival, behavior, inflammation and stress response.

Keywords: DNA methylation; epigenetic; epigenomic; health inequities; social determinants of health; symptoms.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
World health organization conceptual framework for action on the social determinants of health (World_Health_Organization, 2010).
Figure 2.
Figure 2.
Social determinants of health search terms.
Figure 3.
Figure 3.
Literature review process showing identification, selection, and inclusion of publications. IV = independent variable; DV = dependent variable.
Figure 4.
Figure 4.
Results of ingenuity pathway analysis.
Figure 5.
Figure 5.
Conceptual framework linking SDoH to symptoms through biological changes. SDoH = Social Determinants of Health; eQTL = expression quantitative trait loci; meQTL = methylation quantitative trait loci.
See this image and copyright information in PMC

References

    1. Ambatipudi S., Cuenin C., Hernandez-Vargas H., Ghantous A., Le Calvez-Kelm F., Kaaks R., Barrdahl M., Boeing H., Aleksandrova K., Trichopoulou A., Lagiou P., Naska A., Palli D., Krogh V., Polidoro S., Tumino R., Panico S., Bueno-de-Mesquita B., Peeters P. H., Herceg Z. (2016, May). Tobacco smoking-associated genome-wide DNA methylation changes in the EPIC study. Epigenomics, 8(5), 599–618. 10.2217/epi-2016-0001 - DOI - PubMed
    1. Bakusic J., Schaufeli W., Claes S., Godderis L. (2017, Jan). Stress, burnout and depression: A systematic review on DNA methylation mechanisms. Journal of Psychosomatic Research, 92, 34–44. 10.1016/j.jpsychores.2016.11.005 - DOI - PubMed
    1. Baselmans B. M. L., Willems Y. E., van Beijsterveldt C. E. M., Ligthart L., Willemsen G., Dolan C. V., Boomsma D. I., Bartels M. (2018). Unraveling the genetic and environmental relationship between well-being and depressive symptoms throughout the lifespan. Front Psychiatry, 9, 261. 10.3389/fpsyt.2018.00261 - DOI - PMC - PubMed
    1. Bouvron B., Mackin L., Kober K. M., Paul S. M., Cooper B. A., Conley Y. P., Hammer M. J., Wright F., Levine J. D., Miaskowski C. (2022, Dec). Impact of worst pain severity and morning fatigue profiles on oncology outpatients’ symptom burden and quality of life. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 30(12), 9929–9944. 10.1007/s00520-022-07431-6 - DOI - PubMed
    1. Bustamante A. C., Aiello A. E., Guffanti G., Galea S., Wildman D. E., Uddin M. (2018, Jan). FKBP5 DNA methylation does not mediate the association between childhood maltreatment and depression symptom severity in the Detroit Neighborhood Health Study. Journal of Psychiatric Research, 96, 39–48. 10.1016/j.jpsychires.2017.09.016 - DOI - PMC - PubMed

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