Identification of genes predisposing their carriers to complex diseases is a much more complicated task than finding genes involved in simple mendelian diseases. The dynamic epigenetic mechanisms provide an alternative explanation for some of the features of complex diseases which include late onset, gender effects; parents of origin effect, discordance of MZ twins and fluctuation of symptoms in complex diseases (Petronis, 2001).
MZ twins share the same genotype because they are derived from the same zygote. However, monozygotic twins have several phenotypic differences that determine their susceptibility to diseases. Recent studies suggest that phenotypic discordance between monozygotic twins is, at least to some extent, due to epigenetic factors that change over the lifetime of a multi-cellular organism. Acute environmental factors are directly associated with epigenetic-dependent disease phenotypes. This is demonstrated by the increased CpG-island promoter hyper-methylation of tumor suppressor genes in the normal oral mucosa of smokers (Poulsen, Esteller, Vaag, and Fraga, 2007).
MZ twins who are discordant for disease are an excellent example of how genetically identical individuals can exhibit differences and represent a unique model for studying the contribution and role of environmental factors in disease development. Since monozygotic twins are genetically identical, they are considered ideal experimental models for studying the role of environmental factors as determinants of complex diseases and phenotypes
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