[Epigenetics : Important aspects for anesthesiologists, pain and intensive care physicians]

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.