[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-327254-105":59,"doc-detail-327254-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","gastric-cancer-in-the-era-of-epigenetics-review","Gastric Cancer in the Era of Epigenetics - Review","","Gastric cancer (GC) remains a major cause of cancer-related death, and emerging high-throughput techniques have clarified key epigenetic drivers of gene-expression control. Epigenetic features support molecular taxonomy and create cancer-specific patterns, including DNA methylation changes linked to Helicobacter pylori infection and Epstein–Barr virus activity. Histone modifications and additional, less common alterations influence oncogene activation, tumor-suppressor silencing, metastasis, and therapy resistance.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/gastric-cancer-in-the-era-of-epigenetics-review/327254/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/gastric-cancer-in-the-era-of-epigenetics-review/327254.png","ImageObject",300,407,{"name":92,"@type":93},"Olivia Brown","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What role do epigenetic mechanisms play in gastric cancer?","Question",{"text":113,"@type":114},"Epigenetic characteristics shape molecular taxonomy and generate cancer-specific epigenetic patterns that contribute to gastric tumor development and behavior.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How do Helicobacter pylori and Epstein–Barr virus influence epigenetics in GC?",{"text":118,"@type":114},"Helicobacter pylori affects aberrant DNA methylation via its CagA protein and chronic inflammation, while Epstein–Barr virus dysregulates DNA methyltransferase activity to trigger DNA methylation changes.",{"name":120,"@type":111,"acceptedAnswer":121},"Which epigenetic regulators are highlighted as important for GC outcomes and treatment resistance?",{"text":122,"@type":114},"Distinct histone modifications, methylation-related enzymes such as NNMT, and non-coding RNAs (lncRNAs, circRNAs, and miRNAs) are described as regulators linked to GC development, metastasis, poor outcomes, and therapy resistance.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},327254,1790323585,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review  \nGastric Cancer in the Era of Epigenetics  \nGrigorios Christodoulidis 1, Konstantinos-Eleftherios Koumarelas 1, Marina-Nektaria Kouliou 1, Eleni Thodou 2 and Maria Samara 2, *  \nCitation: Christodoulidis, G.;  \nKoumarelas, K.-E.; Kouliou, M.-N.; Thodou, E.; Samara, M. Gastric Cancer in the Era of Epigenetics. Int. J. Mol.  \nSci. 2024, 25, 3381. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/ijms25063381](10.3390/ijms25063381)  \nAcademic Editor: Nam Deuk Kim  \nReceived: 7 December 2023  \nRevised: 12 March 2024  \nAccepted: 13 March 2024  \nPublished: 16 March 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of General Surgery, University Hospital of Larissa, University of Thessaly, Biopolis Campus, 41110 Larissa, Greece; gregsurg@yahoo.gr (G.C.); [kostaskoumarelas@gmail.com](kostaskoumarelas@gmail.com) (K.-E.K.); [marinakouliou@gmail.com](marinakouliou@gmail.com) (M.-N.K.)  \n2 Department of Pathology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis Campus, 41110 Larissa, Greece; [ethodou@uth.gr](ethodou@uth.gr)  \n* [Correspondence: msamar@med.uth.gr](Correspondence: msamar@med.uth.gr)  \nAbstract: Gastric cancer (GC) remains a significant contributor to cancer-related mortality. Novel highthroughput techniques have enlightened the epigenetic mechanisms governing gene-expression regulation. Epigenetic characteristics contribute to molecular taxonomy and give rise to cancer-specific epigenetic patterns. Helicobacter pylori (Hp) infection has an impact on aberrant DNA methylation either through its pathogenic CagA protein or by inducing chronic inflammation. The hypomethylation of specific repetitive elements generates an epigenetic field effect early in tumorigenesis. Epstein–Barr virus (EBV) infection triggers DNA methylation by dysregulating DNA methyltransferases (DNMT) enzyme activity, while persistent Hp-EBV co-infection leads to aggressive tumor behavior. Distinct histone modifications are also responsible for oncogene upregulation and tumor-suppressor gene silencing in gastric carcinomas. While histone methylation and acetylation processes have been extensively studied, other less prevalent alterations contribute to the development and migration of gastric cancer via a complex network of interactions. Enzymes, such as Nicotinamide N-methyltransferase (NNMT), which is involved in tumor’s metabolic reprogramming, interact with methyltransferases and modify gene expression. Non-coding RNA molecules, including long non-coding RNAs, circular RNAs, and miRNAs serve as epigenetic regulators contributing to GC development, metastasis, poor outcomes and therapy resistance. Serum RNA molecules hold the potential to serve as non-invasive biomarkers for diagnostic, prognostic or therapeutic applications. Gastric fluids represent a valuable source to identify potential biomarkers with diagnostic use in terms of liquid biopsy. Ongoing clinical trials are currently evaluating the efficacy of next-generation epigenetic drugs, displaying promising outcomes. Various approaches including multiple miRNA inhibitors or targeted nanoparticles carrying epigenetic drugs are being designed to enhance existing treatment efficacy and overcome treatment resistance.  \nKeywords: gastric cancer; epigenetics; histone modifications; DNA methylation; non-coding RNAs; miRNAs; epidrugs  \n1. Introduction  \nGastric cancer (GC) ranks fourth in terms of cancer-related mortality and stands asthe fifth most prevalent cancer worldwide. There is a pronounced gender disparity, with males experiencing a two-fold higher incidence rate compared to females [1] . While the incidence and morta","cbCaikzMpjUqJEgE","https://ap.wps.com/l/cbCaikzMpjUqJEgE","pdf",836045,26,"English","# Introduction\n## Molecular subtypes and risk factors\n## Epigenetic mechanisms in gastric cancer","[{\"question\":\"What role do epigenetic mechanisms play in gastric cancer?\",\"answer\":\"Epigenetic characteristics shape molecular taxonomy and generate cancer-specific epigenetic patterns that contribute to gastric tumor development and behavior.\"},{\"question\":\"How do Helicobacter pylori and Epstein–Barr virus influence epigenetics in GC?\",\"answer\":\"Helicobacter pylori affects aberrant DNA methylation via its CagA protein and chronic inflammation, while Epstein–Barr virus dysregulates DNA methyltransferase activity to trigger DNA methylation changes.\"},{\"question\":\"Which epigenetic regulators are highlighted as important for GC outcomes and treatment resistance?\",\"answer\":\"Distinct histone modifications, methylation-related enzymes such as NNMT, and non-coding RNAs (lncRNAs, circRNAs, and miRNAs) are described as regulators linked to GC development, metastasis, poor outcomes, and therapy resistance.\"}]","Gastric Cancer in the Era of Epigenetics - Review | PDF",1789976837,66]