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Cited by 23Posttraumatic Stress Disorder ResearchEpigenetics and DNA MethylationChild Abuse and Trauma

Exposure to war and conflict: The individual and inherited epigenetic effects on health, with a focus on post-traumatic stress disorder

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Raza, Zara, Hussain, Syeda F., Foster, Victoria S., Wall, Joseph, Coffey, Peter J., Martin, John F., Gomes, Renata S. M.·2023·Frontiers in Epidemiology
DOI 10.3389/fepid.2023.1066158PMC PMC10910933
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Abstract

War and conflict are global phenomena, identified as stress-inducing triggers for epigenetic modifications. In this state-of-the-science narrative review based on systematic principles, we summarise existing data to explore the outcomes of these exposures especially in veterans and show that they may result in an increased likelihood of developing gastrointestinal, auditory, metabolic and circadian issues, as well as post-traumatic stress disorder (PTSD). We also note that, despite a potential “healthy soldier effect”, both veterans and civilians with PTSD exhibit the altered DNA methylation status in hypothalamic–pituitary–adrenal (HPA) axis regulatory genes such as NR3C1. Genes associated with sleep (PAX8; LHX1) are seen to be differentially methylated in veterans. A limited number of studies also revealed hereditary effects of war exposure across groups: decreased cortisol levels and a heightened (sex-linked) mortality risk in offspring. Future large-scale studies further identifying the heritable risks of war, as well as any potential differences between military and civilian populations, would be valuable to inform future healthcare directives.

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Crossref · 10.3389/fepid.2023.1066158

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  • These exposures have been associated with coordinated alterations in stress-response regulation, circadian and sleep-related pathways, and metabolic processes.

    “These exposures have been associated with coordinated alterations in stress-response regulation, circadian and sleep-related pathways, and metabolic processes (102–115).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [110]

    The ‘Epigenetic impacts of war’ section (page unavailable) reports altered stress-hormone regulation and methylation changes in circadian and sleep-related genes. The ‘War and military personnel’ section (page unavailable) reports increased plasma lipids in veterans with PTSD, and Figure 1 lists obesity among outcomes of war exposure. The paper does not establish that alterations across all three domains are coordinated, or clearly document alterations in metabolic pathways themselves. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • These changes have been associated with variation in memory processing, sleep duration, and circadian rhythm regulation, as well as differences in PTSD symptom severity.

    “These changes have been associated with variation in memory processing, sleep duration, and circadian rhythm regulation, as well as differences in PTSD symptom severity (103, 109–111).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [110]

    The ‘Epigenetic impacts of war’ section reports methylation changes in a circadian-clock gene and sleep-related genes, while the ‘Post-Traumatic Stress Disorder’ section describes epigenetic marks as possible predictors of PTSD severity. But the paper links memory consolidation to sleep and sleep duration to the PAX8 gene; it does not establish that the epigenetic changes themselves are associated with variation in memory processing or sleep duration. No page numbers are available in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Differential methylation of sleep and circadian genes such as PAX8 and LHX1 has been reported in veterans with PTSD.

    “Differential methylation of sleep and circadian genes such as PAX8 and LHX1 has been reported in veterans with PTSD (103, 109–111).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [110]

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Cited by

Sorted by citations

Authors
Raza, Z., Hussain, S. F., Foster, V. S., Wall, J., Coffey, P. J., Martin, J. F., & Gomes, R. S. M.
Affiliations
  • University of York (GB)
  • St George's, University of London (GB)
  • University College London (GB)
  • Northumbria University (GB)
Corresponding author
Gomes, Renata S. M.
ORCID
Venue
Frontiers in Epidemiology
Publisher
Frontiers Media SA
Published
2023-02-16
Volume
3
Pages
1066158-1066158
ISSN
2674-1199 (ISSN-L)
DOI
10.3389/fepid.2023.1066158
PMC
PMC10910933
OpenAlex
W4321089666
Cited by
23
References
27
Citations by year
2026: 9 · 2025: 7 · 2024: 3 · 2023: 4
FWCI
1.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Epidemiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
war exposure, conflict exposure, post-traumatic stress disorder, epigenetics, DNA methylation, veterans, hypothalamic-pituitary-adrenal axis, NR3C1, cortisol, sleep genes, PAX8, Lhx1, gastrointestinal diseases, hearing disorders, metabolic disorders, circadian rhythm, offspring mortality

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