Pediatric Diseases and Epigenetics

Abstract Epigenetics plays a role in many disorders that are present in the pediatric populations (eg, in early human development, including—embryologic and fetal life, infancy, childhood, and adolescence). Many syndromes were described because of their characteristic clinical features before epigenetic mechanisms were understood. Because time in development (age), as well as tissue specific and gender specific gene expression are so important in early development, it is not surprising that disturbances in control of gene expression will lead to pathologic conditions. These groups of disorders are important in pediatrics, and, thus, to the pediatrician. Mammalian flexibility in response to environmental change is now recognized to play a role in transgenerational programming for many chronic diseases of adults that appear to have their genesis in very early life. Working out the pathways and mechanisms for these disorders holds the promise for therapy in the future. Small for dates (IUGR) newborns should avoid excess weight gain during infancy and early childhood as this may help prevent some chronic diseases. Recording data on the placenta at birth is likely to be important for future research and possibly therapy. A new type of family history including multigenerational information on birth weights, environmental exposures, pregnancy histories, and exposure to various types of stress will be important for future medical care.