Background

Globally, individuals of African ancestry have a relatively greater stroke preponderance compared to other racial/ethnic groups. The higher prevalence of traditional stroke risk factors in this population, however, only partially explains this longstanding disparity. Epigenetic signatures are transgenerational and could be a plausible therapeutic target to further bend the stroke disparities curve for people of African ancestry. There is, however, limited data on epigenetics and stroke risk in this population.

Purpose

To examine existing evidence and knowledge gaps on the potential contribution of epigenetics to excess stroke risk in people of African ancestry and avenues for mitigation.

Materials and methods

We conducted a scoping review of studies published between January 2003 and July 2023, on epigenetics and stroke risk. We then summarized our findings, highlighting the results for people of African ancestry.

Results

Of 104 studies, there were only 6 studies that specifically looked at epigenetic mechanisms and stroke risk in people of African ancestry. Results of these studies show how patterns of DNA methylation and non-coding RNA interact with lifestyle choices, xenobiotics, and FVIII levels to raise stroke risk in people of African ancestry. However, no studies evaluated epigenetic patterns as actionable targets for the influence of psychosocial stressors or social context and excess stroke risk in this population (versus others). Also, no studies interrogated the role of established or novel therapeutic agents with the potential to reprogram DNA by adding or removing epigenetic markers in people of African ancestry.

Conclusion

Epigenetics potentially offers a promising target for modifying the effects of lifestyle, environmental exposures, and other factors that differentially affect people of African ancestry and place them at relatively greater stroke risk compared to other populations. Studies that precisely assess the pathways by which epigenetic mechanisms modulate population-specific disparities in the risk of stroke are needed.

中文翻译：

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表观遗传学作为降低非洲血统人群过度中风风险的目标：范围界定审查

背景

在全球范围内，与其他种族/族裔群体相比，非洲血统的人中风的患病率相对较高。然而，该人群中传统中风危险因素的患病率较高，只能部分解释这种长期存在的差异。表观遗传特征是跨代的，可能成为进一步改变非洲血统人群中风差异曲线的合理治疗目标。然而，有关该人群的表观遗传学和中风风险的数据有限。

目的

研究表观遗传学对非洲血统人群中风风险过高的潜在贡献以及缓解途径的现有证据和知识差距。

材料和方法

我们对 2003 年 1 月至 2023 年 7 月期间发表的关于表观遗传学和中风风险的研究进行了范围审查。然后，我们总结了我们的发现，重点介绍了针对非洲血统的人的结果。

结果

在 104 项研究中，只有 6 项专门研究非洲血统人群的表观遗传机制和中风风险。这些研究的结果表明，DNA 甲基化和非编码 RNA 的模式如何与生活方式选择、异生素和 FVIII 水平相互作用，从而增加非洲血统人群中风的风险。然而，没有研究评估表观遗传模式作为该人群（相对于其他人群）心理社会压力源或社会背景和过度中风风险影响的可行目标。此外，还没有研究质疑现有或新型治疗剂是否有可能通过添加或去除非洲血统的表观遗传标记来重新编程 DNA。

结论

表观遗传学可能为改变生活方式、环境暴露和其他因素的影响提供了一个有希望的目标，这些因素对非洲血统的人有不同的影响，并使他们与其他人群相比具有相对较高的中风风险。需要进行精确评估表观遗传机制调节人群​​特定中风风险差异的途径的研究。