Keywords
Epigenetic reprogramming
Precision medicine
DNA methylation
Histone modifications
How to Cite
Abstract
Background Epigenetic dysregulation is a central hallmark of numerous complex diseases, including cancer, neurodegenerative disorders, metabolic syndromes, and immune-mediated conditions. Unlike genetic mutations, epigenetic alterations are reversible, rendering them highly attractive therapeutic targets. Recent advances in pharmaco-epigenomics-integrating pharmacology with epigenomic profiling-have opened unprecedented opportunities for precision medicine. Objective This review critically synthesizes current knowledge on pharmaco-epigenomic reprogramming, highlighting mechanistic insights, therapeutic agents, technological advances, clinical progress and emerging challenges. Methods A structured literature search was conducted across PubMed, Scopus, and Web of Science databases (2020-2025), focusing on epigenetic drugs, pharmaco-epigenomic biomarkers and translational applications. Studies were screened following PRISMA-inspired trend-based review methodology. Results Epigenetic therapeutics, including DNA methyltransferase inhibitors, histone modification modulators, and chromatin remodelling agents, demonstrate disease-modifying potential across oncology and non-oncological domains. Integration of multi-omics, AI-driven drug response modeling, and single-cell epigenomics is reshaping therapeutic stratification. However, challenges such as off-target effects, epigenetic plasticity and interindividual variability remain unresolved. Conclusion Pharmaco-epigenomic reprogramming represents a transformative therapeutic paradigm. Future success depends on precise targeting, combinatorial strategies and robust epigenomic biomarkers to enable personalized and durable clinical outcomes.
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