Epigenetics and miRNAs in the diagnosis and treatment of multiple sclerosis

The risk of developing multiple sclerosis (MS) depends on both genetic and environmental factors. Although the genetic susceptibility to MS has been investigated in great detail, reports describing epigenetic changes in the context of MS have only recently appeared. Epigenetic changes to DNA influence gene expression without altering the underlying DNA sequence. DNA methylation, histone modification, and miRNA-associated silencing are the three most important epigenetic mechanisms that influence gene expression. In this review, we summarize recent studies investigating epigenetic changes and miRNA as biomarkers for diagnosing MS and predicting disease course or treatment response. We also discuss how the current studies address important clinical questions and how future studies could be designed to best inform clinical practice.