Modifications épigénétiques et cancer

Si l’étude des causes génétiques du cancer (mutations, amplification ou perte de matériel chromosomique, translocations récurrentes) a longtemps occupé le devant de la scène, l’explosion récente des connaissances sur les acteurs moléculaires et les mécanismes sous-jacents qui, en modulant la structure de la chromatine, contrôlent l’expression des gènes a révélé le rôle prépondérant joué par des modifications épigénétiques dans le déclenchement et la progression de nombreuses maladies, en particulier des cancers. De plus, contrairement aux modifications génétiques, les modifications épigénétiques sont dynamiques et réversibles. La caractérisation d’inhibiteurs spécifiques de certains effecteurs épigénétiques a ouvert une nouvelle voie thérapeutique, la thérapie épigénétique, qui semble très prometteuse, certaines molécules étant déjà en essais cliniques.Epigenetics is defined as « the study of mitotically and/or meiotically heritable changes in gene expression that cannot be explained by changes in the DNA sequence ». Setting up the epigenetic program is crucial for correct development and its stable inheritance throughout its lifespan is essential for the maintenance of the tissue- and cell-specific functions of the organism. For many years, the genetic causes of cancer have hold centre stage. However, the recent wealth of information about the molecular mechanisms which, by modulating the chromatin structure, can regulate gene expression has high-lighted the predominant role of epigenetic modifications in the initiation and progression of numerous pathologies, including cancer. The nucleosome is the major target of these epigenetic regulation mechanisms. They include a series of tightly interconnected steps which starting with the setting (« writing ») of the epigenetic mark till its «reading» and interpretation will result in long-term gene regulation. The major epigenetic changes associated with tumorigenesis are aberrant DNA methylation of CpG islands located in the promoter region of tumor suppressor gene, global genomic hypomethylation and covalent modifications of histone N-terminal tails which are protruding out from the nucleosome core. In sharp contrast with genetic modifications, epigenetic modifications are highly dynamic and reversible. The characterization of specific inhibitors directed against some key epigenetic players has opened a new and promising therapeutic avenue, the epigenetic therapy, since some inhibitors are already used in clinical trials