The role of epigenetic modifications in systemic autoinflammatory diseases

Autoinflammatory diseases are a group of immune dysregulation disorders, with genetic mutations identified in approximately 50% of patients. However, patients with known pathogenic mutations may display a broad range of phenotypic diversity. Epigenetic modifications play a crucial role in regulating immune-mediated diseases, including autoinflammatory diseases, influencing disease course and complications. This review provides an overview of the current literature on the role of epigenetic changes in autoinflammatory diseases, examining their implications for disease mechanisms. To identify biological processes and pathways influenced by microRNAs across autoinflammatory diseases, we performed enrichment analyses in Gene Ontology biological processes. This analysis revealed enriched pathways reflecting the varying biological mechanisms implicated in familial Mediterranean fever (FMF), tumor necrosis factor associated periodic syndrome (TRAPS), and neonatal-onset multisystem inflammatory disease (NOMID). Notably, FMF was linked to clinically significant pathways, including those related to cytokine production, cardiovascular system, and neuroinflammation. These results highlight the potential of epigenetic modifications as biomarkers for autoinflammatory diseases. Given the role of epigenetic modifications in gene expression and the growing interest in their involvement in disease pathogenesis and therapy, including in rare disorders, further research into the epigenetic landscape of autoinflammatory diseases is essential. Furthermore, integrating genetic, epigenetic, and environmental factors will be key to addressing clinical variability and developing personalized treatment approaches.