Vol.:(0123456789) 1 3 Molecular Biology Reports https://doi.org/10.1007/s11033-020-05570-9 REVIEW From air pollution to cardiovascular diseases: the emerging role of epigenetics Miruna‑Mihaela Micheu 1  · Marius‑Victor Birsan 2  · Róbert Szép 3,4,5  · Ágnes Keresztesi 3,4,5  · Ion‑Andrei Nita 2,6 Received: 20 January 2020 / Accepted: 5 June 2020 © Springer Nature B.V. 2020 Abstract The association between air pollution and a wide-ranging spectrum of acute and chronic disorders—including cardiovas- cular diseases—is widely acknowledged. Exposure to airborne pollutants triggers harmful mechanisms such as oxidative stress and systemic infammation, which lead to increased incidence of myocardial infarction, arterial hypertension, stroke, and heart failure. Sustained eforts have been made in recent years to discover how environmental exposures afect human health through epigenetic phenomena, such as DNA methylation, histone modifcations and non-coding RNA-mediated gene regulation. This review summarizes the current evidences on the relationship between air pollution exposure, epigenetic alterations and cardiovascular impact, in view of present implications and future perspectives. Keywords Myocardial infarction · Ischemic cardiac disease · DNA methylation · Histone modifcation · microRNA Introduction Increasing evidence acknowledges air pollution as an impor- tant risk factor for cardiovascular disease (CVD) and subse- quent premature mortality. Prior estimates specifed ambient air pollution to be responsible for almost a ffth of ischaemic heart disease and stroke cases registered globally, with lat- est data indicating a considerably higher CVD burden than previously anticipated [1–4]. Hence, the molecular mecha- nisms linking air pollution to the aforesaid adverse health efect have been extensively studied, both in animal models as well as in the clinical arena; oxidative stress, systemic infammation, endothelial dysfunction, atherothrombosis, and arrhythmogenesis have been demonstrated to be the key players involved in disease pathogenesis [5–8]. It is only in recent years that underlying epigenetic substratum has been started to be deciphered and comprehensively documented [9–11]. Epigenetics indicates modifcations in gene expres- sion regulation, but not due to variations in DNA sequence. Typically, these changes occur as a result of gene–environ- ment interactions and consist in activation or repression of specifc genes. Epigenetic mechanisms are extremely dynamic and permit the organism to promptly adapt to envi- ronmental variations. Decoding the epigenetic responses triggered by specifc environmental challenges (such as air pollution) could eventually help prompt the positive efects and counteract the negative ones. DNA methylation, histone modifcation, and microRNAs-mediated gene regulation are the most studied epigenetic mechanisms, and their associ- ation with ambient air pollution will be discussed in the present review. A basic overview of epigenetic mechanisms involved in pollutant-induced adverse cardiovascular efects is illustrated in Fig. 1. * Marius-Victor Birsan marius.birsan@gmail.com 1 Department of Cardiology, Clinical Emergency Hospital of Bucharest, Bucharest, Romania 2 Department of Research and Meteo Infrastructure Projects, Meteo Romania (National Meteorological Administration), Sos. Bucuresti-Ploiesti 97, 013686 Bucharest, Romania 3 Doctoral School of Chemistry, Faculty of Natural Sciences, University of Pécs, Pecs, Hungary 4 Institute for R&D in Hunting and Mountain Resources, Miercurea Ciuc, Romania 5 Department of Bioengineering, Faculty of Economics, Socio-Human Science and Engineering, Sapientia Hungarian University of Transylvania, Miercurea Ciuc, Romania 6 Doctoral School of Geosciences, Faculty of Geography and Geology, Alexandru Ioan Cuza University, Iaşi, Romania