[Early determinants of health and disease: epigenetics and environment]

Several studies of the developmental origins of health and disease and metabolic programming have identified links between early nutrition, epigenetic processes and long-term illness. The ways in which epigenetic modifications fix the effects of early environmental events, leading to sustained responses to transient stimuli, modified gene expression patterns and altered phenotypes in later life, is a topic of considerable interest. This review focuses on recently discovered mechanisms, and challenges prevailing views on the dynamics, position and functions of epigenetic marks. Most epigenetic studies have addressed long-term effects of environmental stressors on a small number of epigenetic marks, at the pan-genomic or individual gene level, in humans and animal models. In parallel, studies of humans and mice, using high-throughput technologies, have revealed additional complexity in epigenetic processes, notably highlighting the importance of crosstalk between different epigenetic marks. A self-propagating epigenetic cycle has also been identified. Recent studies have shown clear sexual dimorphism both in programming trajectories and in response to a given environmental insult. Despite recent progress we are still far from understanding how, when and where environmental stressors disturb key epigenetic mechanisms. Further work is needed to identify original key marks and their changes during development, throughout an individual's lifetime or over several generations, and to determine how to revert malprogramming with a view to prevention and treatment.