Epigenetic advances in rheumatic heart disease

Rheumatic heart disease (RHD), an autoimmune injury triggered by group A streptococcus (GAS) infection, exerts a significant pathological impact on the human heart. The pathogenesis of RHD is closely associated with abnormal epigenetic regulation, and primarily involves the four core epigenetic mechanisms: DNA methylation, histone modification, non-coding RNAs (ncRNAs), and chromatin remodeling. Currently, researches on RHD have shifted from focusing on late-stage diagnosis and treatment to investigating its multiple etiologies. Therefore, this article presents a systematic literature review aimed at reviewing the latest progress in the epigenetic research of RHD, providing in-depth elucidation of the interactions between RHD and these four core mechanisms, highlighting the value of potential biomarkers for the disease's early diagnosis and treatment, and outlining future research directions, including combined multi-omics analysis, minimally invasive interventional techniques, and gene chip-based approaches. This review aims to address the limitations of single-subject studies and small-sample cross-sectional surveys in epigenetic studies of RHD, thereby providing new strategies for disease prevention, control, and health management.