International Journal of Molecular Medical Science, 2024, Vol.14, No.4, 227-238 http://medscipublisher.com/index.php/ijmms 235 Finally, translating these findings into clinical practice through the development of novel diagnostic tools and personalized therapies should be a primary goal (Hussain et al., 2021; Davalos and Esteller, 2022). Addressing these priorities will require collaborative efforts across disciplines, including molecular biology, bioinformatics, and clinical research. 9 Concluding Remarks The epigenetic landscape of colon cancer is profoundly influenced by DNA methylation, which plays a crucial role in the initiation and progression of the disease. DNA methylation patterns are significantly altered in colon cancer, affecting gene expression and chromatin structure. Key findings from the reviewed literature include: 1) DNA Methylation and Chromatin Structure: DNA methylation impacts chromatin organization, particularly at enhancers and CpG island (CGI) promoters, leading to changes in nucleosomal phasing and chromatin accessibility. 2) Global Methylation Changes: Colon cancer is characterized by global hypomethylation and localized hypermethylation, particularly at CpG island shores, which are crucial for gene regulation and tissue differentiation. 3) Epigenetic Biomarkers: Aberrant DNA methylation patterns serve as potential biomarkers for early detection, prognosis, and treatment response in colorectal cancer (CRC). 4) Prognostic Signatures: Specific DNA methylation signatures have been identified that can predict recurrence-free survival (RFS) and overall prognosis in colon cancer patients. The findings on DNA methylation have significant implications for the diagnosis and treatment of colon cancer: 1) Diagnostic Biomarkers: DNA methylation markers, such as those found in stool and blood, offer non-invasive methods for early detection of CRC. These biomarkers can help identify patients at risk and monitor disease progression. 2) Prognostic Tools: Methylation signatures, such as those identified for RFS, provide valuable prognostic information that can guide treatment decisions and patient management. 3) Therapeutic Targets: The reversibility of epigenetic changes makes them attractive targets for therapy. Epigenetic drugs that modify DNA methylation and histone modifications are being explored in clinical trials, showing promise in improving treatment outcomes. 4) Personalized Medicine: Understanding the specific epigenetic alterations in individual patients can lead to more personalized and effective treatment strategies, aligning with the principles of precision medicine. The study of DNA methylation in colon cancer has provided deep insights into the molecular mechanisms driving the disease. Future research should focus on: 1) Advanced Profiling Techniques: Continued development and application of advanced DNA methylation profiling techniques, such as single-cell methods and ultra-long read sequencing, will enhance our understanding of the epigenetic landscape in colon cancer. 2) Integration with Other Omics: Integrating DNA methylation data with other omics data (e.g., transcriptomics, proteomics) will provide a more comprehensive view of the molecular alterations in CRC and identify novel therapeutic targets. 3) Clinical Translation: Efforts should be made to translate epigenetic findings into clinical practice, including the development of standardized assays for methylation biomarkers and the validation of epigenetic drugs in larger clinical trials. Acknowledgments The authors extends sincere thanks to two anonymous peer reviewers for their feedback on the manuscript of this study.
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