Chronic PSES induce epigenetic changes which promote proinflammatory signaling
Various PSES have been shown to lead to DNA methylation and demethylation as well as histone modification, all of which affect expression of genes. The addition of a methyl group to cytosine serves to block transcription of the affected gene, while the removal a methyl group can promote transcription. Histones can be modified by the addition or removal of acetyl or methyl groups which also affect transcription. Through an interplay of these mechanisms, PSES have been shown to alter cytokine and immune cell responses potentially accelerating atherogenesis.