Epigenetic Landscapes in Ulcerative Colitis: From Mechanistic Insights to Clinical Translation.

Ulcerative colitis (UC) is distinguished by nonspecific inflammation and ulceration of the rectal and colonic mucosa. The conventional therapeutic modalities for UC exhibit restricted efficacy, underscoring the importance of advancing novel mechanisms and therapeutic interventions. The field of epigenetics, encompassing DNA methylation, histone modification, noncoding RNAs (ncRNAs), and RNA modification, is progressively illuminating the association with UC. Moreover, the current focus of intense scrutiny in drug development is the utilization of epigenetics as a potential target for anti-UC therapy. Significantly, the aberrant epigenetic modifications exert influence over various behaviors exhibited by intestinal epithelial cells and inflammatory cells. In this review, we have examined and synthesized current clinical and experimental research to comprehensively analyze the expression patterns and elucidate the underlying mechanisms of epigenetic alterations in the advancement of UC, with a particular focus on DNA methylation, histone modification, ncRNAs (miRNA, lncRNA, and circRNA), and RNA modification. Additionally, we discussed the obstacles and the potential future directions related to epigenetic modifications in UC. Deciphering the intricate epigenetic modifications in UC offers potential for yielding novel understandings of the disease's etiology and pathogenesis and the identification of diagnostic and therapeutic targets, thereby establishing a basis for achieving optimal outcomes in UC.