Improved transplantation outcome by epigenetic changes

Epigenetics and transplantation seem an odd couple. The influence of epigenetic changes on the immune response of the host following an organ graft is not one of the more obvious connections. However, modifying host immunity to a graft via epigenetic changes of immune related genes could have unexpected ramifications for therapy post transplantation. This review discusses various studies concerning the effects of epigenetic alterations on transplantation-associated pathologies. We present tools for improving transplantation outcome, such as histone deacetylase inhibition, DNA methyltransferase inhibition or venous systemic oxygen persufflation. This will allow a reduction of immunosuppressive medication, leading to fewer side effects. We also show, however, that much effort needs to be put into the elucidation of the molecular mechanisms underlying these advantageous effects. Taken together, altering epigenetics in transplanted organs will ultimately lead to a higher quality of life for transplant patients.