Gene-Environment Interaction in the Pathogenesis of Craniofacial Microsomia: A Narrative Review.

Craniofacial microsomia (CFM), a congenital anomaly stemming from first and second branchial arch dysplasia, poses challenges due to its diverse clinical manifestations, necessitating a comprehensive understanding of its complex etiology. We explored gene-environment interactions in CFM, focusing on genetic factors, and environmental influences, aiming to enhance insights into its multifactorial origins and guide future research. Genetic studies suggest HOXA2, PAX3, and TBX1 as potential susceptibility genes, while epidemiological research links maternal smoking, diabetes, and alcohol use to increased risk. Gene-environment interactions may impact craniofacial development via epigenetic mechanisms, though the exact pathways remain unclear. Future studies should expand CFM cohorts for better G×E risk assessment and apply multiomics approaches to clarify mechanisms. Functional validation via animal models and stem cells will verify genetic and environmental impacts. Advancing personalized medicine with early screening, precise diagnostics, and prevention remains crucial for high-risk cases.