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For many epigenetic pathways, however, direct measures of activity are unknown, making their role in various cancers difficult to assess.
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Many different epigenetic pathways act in mammalian cells and recent work has highlighted extensive interactions between them 1.
Therefore, many drugs targeted at epigenetic pathways, such as DNA methyltransferase and histone deacetylase inhibitors, have been developed, and some have been approved as cancer therapies [ 52].
Activation of many signaling pathways, including the epigenetic pathways investigated here, does not always correlate with expression, as pathway activity levels can be determined by many factors, including RNA expression, protein ubiquitination, and expression levels of other proteins in the complexes.
As discussed above, cross-talk between the nucleus and mitochondria occurs partly via epigenetic pathways with many potential mitochondrial/epigenetic interactions, such as nDNA methylation effects on transcription of mRNA for mitochondrial proteins or the effects of mtDNA depletion on altered nDNA methylation.
Epigenetic pathways act at many levels to regulate immune functions: in immune system development, in response to infection, in immune surveillance to tumors and in autoimmunity [ 28].
If epigenetic pathways are blocked, often many developmental aberrations arise resulting in a complex phenotype.
Such pathway-level consistency seems particularly relevant considering the stochastic nature of many epigenetic events that lead to disease states.
Interestingly, a recent study showed that human retinoblastomas contain many epigenetic changes, such as histone modifications and DNA methylation, at the genomic loci of genes involved in multiple signaling pathways (Zhang et al. 2012).
Oncogenic activating mutations are now known to occur in a number of epigenetic modifiers (i.e. IDH1/2, EZH2, DNMT3A), pinpointing epigenetic pathways that are involved in tumorigenesis.
Undoubtedly, the discovery of epigenetic pathways with novel epigenetic-related mechanisms constitutes a promising advance in cancer biomarker discovery.
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