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Epigenetik

Wichtiges für Anästhesisten, Schmerz- und Intensivmediziner

Epigenetics

Important aspects for anesthesiologists, pain and intensive care physicians

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Zusammenfassung

Epigenetik, die Wissenschaft, die sich mit der geänderten Ablesung des Genoms ohne Veränderung der Gene selbst beschäftigt, gelangt wissenschaftlich zunehmend in den Fokus. Unterschieden werden Veränderungen an der DNA von Modifikationen der Histone und nichtkodierenden RNA, die die messenger (m)RNA verändern. Epigenetische Modifikationen können durch Lebensumstände oder andere äußere Faktoren ausgelöst werden und somit das Auftreten von Erkrankungen beeinflussen. Die Epigenetik ist für Anästhesisten, Schmerzmediziner und Intensivmediziner von besonderem Interesse, weil anästhesiologische Medikamente einen längerfristigen Einfluss auf die Proteintranskription haben und so beispielsweise zur Chronifizierung von postoperativen Schmerzen sowie zu Veränderungen der Neurokognition nach Narkose oder der Immunreaktion bei Sepsis führen können. Die veränderte Expression nichtkodierender microRNA bei perioperativ relevanten Vorerkrankungen, wie z. B. dem Herzinfarkt, verändert ist, prädestiniert sie als potenzielle prognostische Marker für das perioperative Risiko. Ferner gibt es Möglichkeiten, epigenetische Veränderungen durch Lebensstil und bestimmte Medikamente zu beeinflussen. In diesem Übersichtsbeitrag werden exemplarisch einige anästhesie-, intensivmedizin- und schmerzmedizinrelevante Erkrankungen und der Einfluss der Epigenetik auf diese dargestellt.

Abstract

Epigenetics, i.e. an altered reading of the genome without altering the genes themselves is a growing scientific field. A distinction is made between changes in the DNA by modification of the histones and non-coding RNA that alter the messenger (m)RNAs. Epigenetic modifications can be triggered by personal circumstances or other external factors and therefore influence the occurrence of diseases. Epigenetics are therefore of particular interest to anesthesiologists, pain specialists and intensive care physicians, as anesthetic drugs may have a long-term influence on protein transcription leading for example to alterations in neurocognition after anesthesia, chronification of postoperative pain and immune response in sepsis. Non-coding microRNAs known to be altered in a variety of perioperatively relevant diseases e. g. heart infarct, might serve as prognostic factors of perioperative outcome. Moreover, there are ways to influence epigenetic changes through life style and certain medications. In this review article, examples of anesthesia, intensive care and pain medicine-relevant diseases and the influence of epigenetics on them are presented.

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Authors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland

    A.-K. Reinhold &  H. L. Rittner

  2. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland

    E. Jentho &  M. Bauer

  3. Klinik für Anästhesiologie, Ludwig-Maximilians-Universität, München, Deutschland

    S. T. Schäfer

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  1. A.-K. Reinhold
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Reinhold, AK., Jentho, E., Schäfer, S.T. et al. Epigenetik. Anaesthesist 67, 246–254 (2018). https://doi.org/10.1007/s00101-018-0424-7

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