Epigenetic Mechanisms of Integrative Medicine

Figure 3

Overview of the proposed epigenetic mechanism through which IM modulates healing. The figure represents two different routes through which IM can modify the epigenome leading to altered gene expression. Effects exerted by IM can lead to direct and indirect effects. Green represents direct effects and red represents indirect effects. The direct pathway can operate in two different ways, namely, Type 1 and Type 2. In Type 1 direct pathway, IM directly exerts an effect on the epigenetic enzymes such as DNMTs, HDACs, HATs, HMTs, and HDMs, such that there is an altered bioavailability of these enzymes in the cell. A Type 2 direct effect is when IM interferes with a biochemical pathway such that there is altered availability of a metabolite required for constituting an epigenetic tag. Both cases can result in beneficial recruitment of epigenetic tags to promoters, ultimately establishing an altered epigenetic profile. In the indirect pathway, IM indirectly exerts an effect on the epigenome by first interfering with signaling pathways in the cell. An acute exposure to the IM modality can cause altered expression of growth factors, receptors, ion channels, and so on resulting in nonhomeostatic cellular processes. This in turn might lead to an altered status of transcriptional machinery (bound or unbound to the promoter/enhancer) and its bioavailability in a cell. A chronic exposure to the IM modality might lead to retention of such state of transcriptional machinery (bound or unbound to the promoter/enhancer) causing altered gene expression as well as beneficial recruitment of epigenetic enzymes, leading to permanent addition or removal of epigenetic tags to specific promoter/enhancers. This consequently establishes an altered, preferable “healed” epigenetic profile.