the help of genomic biomarkers, sufficient sequencing power, the phylogenetical
reconstruction and the evolution of individual tumours and further identification,
mutations can be identified effectively (Campbell and Polyak 2007; Simon 2011).
9.4.2
Epigenetic Biomarkers in Drug Discovery
Conard Waddington in 1940s defined epigenetics as the modulation of expression of
a genotype into phenotypes by environment. Subsequently, in 1948, DNA methyla-
tion was first explained in bacterial genomes. In 1975, it has been first reported that
5-methyl cytosines can be duplicated through cell division and gene regulation.
Furthermore, epigenetic mechanisms were known to be flexible wherein it provides
molecular substrate during research that allows for the stable propagation of gene
expression states from one generation to the next cell generation. This epigenetic
mark must also be stable to mitosis. These studies eventually proposed that there
exists a relationship between epigenetic changes and disorders which includes, but
are not limited to, various known cancers and other conditions such as mental
retardation. The studies have demonstrated the effectiveness of histone acetylation
and methylation which control the gene expression.
The relationship is based on the data collected between an individual’s genetic
background, environmental condition, aging and disease pattern usually associated
with genetic disorders, immune disorders, neuropsychiatric disorders and paediatric
disorders. It has been a great challenge in focusing on the epigenetic factor such as
DNA methylation, histone modification, nucleosome positioning, non-coding RNA
(ncRNA) and microRNA (miRNA) are essential in the regulation of gene expres-
sion. It is important to consider while initiating the research that autoimmune
diseases are not known to have the same epidemiology, pathology and symptoms,
but it does have a common mechanism and origin that can be explained by the
sharing of immunogenetic mechanisms for understanding the disease pattern. How-
ever, identifying the cell-specific targets of epigenetic deregulation has been known
to serve as a clinical marker for diagnosis, disease progression and targeted
therapies. Biomarker is expected to be a growing sector wherein the primary focus
is being on the development of biomarkers which can substantially affect the
targeted drug development to modify the epigenome. Hence, the objective of a
clinical biomarker is to provide with clinically relevant information for the presence
or absence of disease, particularly in human diagnosis, wherein the patients’ disease
influences the treatment decisions such as in case of prognostic and therapy,
providing optimisation biomarkers. Additionally, it provides an accurate measure-
ment of epigenetic alterations in a patient either at single- or at multiple-genome
locus.
Currently, many epigenetic biomarkers focused on DNA methylation techniques
because of the practical considerations for being stable and easy to analyse, and it has
been a well-established and proven role of DNA methylation in cancer. The said
9
Biomarker-Based Drug Discovery with Reverse Translational Approach
133