“…Our data indicates that where there was previously no evidence of methylation changes in gene promoters during OA, such as ACAN and p21WAF1/CIPl, that dynamic methylation at enhancers regulating such genes should be considered (Poschl et al , 2005; Sesselmann et al , 2009). A number of studies have also identified DNA methylation changes in OA or damaged cartilage but it remains to be determined whether these correspond to enhancer regions (den Hollander et al , 2014; Fernandez-Tajes et al , 2014; Jeffries et al , 2014; Alvarez-Garcia et al , 2016; Bonin et al , 2016; Zhang et al , 2016; Steinberg et al , 2017). The subset of chondrogenesis DMLs also significantly altered in OA become hypomethylated consistent with the cells reactivating developmental pathways (Loeser et al , 2012; Reynard, 2017).…”