Through the epigenetic keyhole: the future of healthcare

8 years, 3 months ago


Epigenetics is the study of how chemical signals can turn genes on and off, with consequences for our wellbeing. Its growth will have a major impact on healthcare communications in the coming years. By Eliza Hazlerigg.

I’m sure we have all at least once wondered how we could make our lives more successful and fulfilled. Whether that is getting rich by winning the lottery or even wishing you had won the genetic lottery and had superhuman good looks. Epigenetics is the impact the environment has on your genes.  It is the tool we can use to find our potential, which we can leverage to shape our future.  Take control of your life, your children’s and even your grandchildren’s lives with the choices you make throughout life. We can all draw those winning numbers if we put our minds to it. 
I became fascinated in the phenomenon of epigenetics the moment I set eyes on it in Nature Neuroscience. A lunch meeting with ITV’s legendary Science Correspondent Lawrence McGinty reinforced my intrigue and it soon became an obsession, and an obsession that is undoubtedly routed back to my very own biology - I happen to be an identical twin. 
Twin studies are key to understanding epigenetics. Comparing two genetically identical people and finding out what is different about them and why? Even though my sister and I are genetically identical the decisions and choices we make in life, whether it be to smoke, eat healthily, take exercise, will ultimately influence our health.  We may be referred to as a single entity ‘The Twins’ – but we are completely different people who just share quite a few things in common.
What is epigenetics?
Epigenetics means literally ‘above genetics’ and describes the processes by which genes can be turned on or off and exactly how these mechanisms govern the way cells behave.
In tech speak; epigenetics is the study of methylation, the process by which chemicals influence your gene expression.  Environmental factors generate chemical signals in the form of methyl groups (CH3) that impact your DNA by switching genes on and off.  The addition of methyl groups to your DNA acts as a blocker to prevent genes from being read. This means that control over certain cellular functions controlled by these genes is lost until the methyl groups are removed.
Genetics is a recipe. Epigenetics is the chef who interprets the recipe and makes key choices about how to prepare it. Epigenetic research has shown us that the choices we make enable us to take control of our future.
Where it all began
Even before Darwin, scientists were fascinated by the idea of inheritance. By the 1800s, French biologist, Jean-Baptiste Lamarck incorporated the idea of ‘soft inheritance’ into the theory of evolution. He noted that individuals inherit the traits of their ancestors.  In other words, the impacts of your parents’ or grandparents’ environment and lifestyle have likely been passed down to you.
But Lamarckism was mostly abandoned for the next 150 years.  This was in part due to Darwin, who rejected the theory of inherited acquired characteristics.  Now, thanks to new discoveries, interest in Lamarckism has been reawakened.  Epigenetic studies have highlighted that traits such as diet and behaviour have been acquired across as many as three generations.  
In the 1950s, over 15 million people perished in China’s Great Famine.  History tells us that it is all behind us but in fact some of China’s children will still be experiencing its impact.  In fact, historical famines might in part explain our love for calorie laden food and the rise in obesity.  The passing down of epigenetic messages is believed to be an evolutionary tactic that aims to prevent us from dying from starvation, i.e. preparing us for what might happen again.  
Interestingly, a recent study from Nature Neuroscience has shown that even emotions can be passed down.  Rats taught to fear a certain smell, such as a cat, can pass that same fear onto their offspring.  In this case, epigenetic changes to the brain alter certain smell receptors, which when inherited ensure their offspring or grandchildren steer clear of predators they once faced.  
So what has changed? Before this epigenetic revolution, it was thought that a single environmental event could not live in cells past the lifetime of the person that had experienced it.  We thought the event was wiped clean every time a cell replicated.  Now we know that these epigenetic changes and ‘messages’ can be preserved.  If you think about it, this all makes sense; why else do you think the human race has been so successful?  It is part of our ability to adapt to environments we haven’t yet experienced.
Exposure during development
Another interesting finding in this new field is the fact that the most sensitive and influential time for these epigenetic changes is during a child’s development – before and soon after birth.  Abuse, neglect or exposure to stress could leave a child with chronic health or behavioural problems. 
Research from McGill University has found that a mother’s exposure to environmental toxins in pregnancy impacts the developing child, and the quality of care the infant receives is subsequently just as important. Behavioural epigenetic research with rats found that increased pup licking and grooming by rat mothers alters the offspring’s stress response because of changes in their methylation levels.  This can explain why for instance one twin, who is given less attention as a child, can experience depression later in life while the other doesn’t.
Therefore by the time a child is born, its future is powerfully influenced by the activities, experiences and toxic exposures of its mother. Those factors which are negative factors, such as the effects of nicotine, may act in future as stress factors, interfering with the future and potential of that individual.  
Seeing double - Twins, twins and more twins 
The book ‘Identically different – Why you can change your genes’ written by Professor Tim Spector of King’s College London explores epigenetics in detail, using his research on twins as a way of illustrating how it all works.   
By studying identical twins with different life experiences and different disease paths, scientists have blurred the lines between nature and nurture.  It is no longer nature vs. nurture but instead nature and nurture working together.  Scientists have found a high correlation between methylation levels (nurture) and the probability of disease (nature).
Even though genes play a big part in how we function they cannot do it alone; in fact, the cells that host them do all the work.  The millions of cells that make up our bodies are the entities affected by the environment. This is what creates the signals that turn genes on and off, which is what ultimately controls the way we function, behave and whether or not we get ill.
What this all means is that we aren’t as set in stone as we all originally thought.  If we change the external factors that surround us then we can change our genes and therefore our future.
What does epigenetics have in store for our future?
Uncovering the importance of genetic epidemiology (genes’ interaction with the environment) and how it shapes our future will no doubt change the face of the medicine we see today.  In fact, you can already see the impression it is making.  
Genetic testing is available in reproductive science, where parents can make sure their child is healthy even before it is born.  In ten years’ time, genetic testing and sequencing is likely to be performed as routinely as a blood test so that doctors can identify any genetic conditions you might have at intervals throughout your life.  These conditions will be treated using a personalised approach according to what has been read from your genetic road map.   This might even include a tailored diet.  Make way for the nutritionists! 
Effectively one day, we might be using genetics to realise our potential instead of our flaws.
Epigenetics and cancer
Research has shown how epigenetics is directly linked to cancer and how our chosen lifestyle has an impact on the odds of being diagnosed with it.   Scientists’ new found knowledge of epigenetics and the fact that gene expression is reversible have found ways to potentially stop cancer in its tracks.  
America is making its mark in the epigenetic revolution with promising therapies already on the market or in the pipeline. Last year, Syndax Pharmaceuticals received approval for a breakthrough breast cancer treatment, which employs epigenetic strategies to overcome the problem of resistance seen with current therapies.
GlaxoSmithKline (GSK), the UK’s largest pharmaceutical company, is also carrying out some detective work into epigenetic therapies. GSK have dedicated one of their drug discovery teams to epigenetic research, with scientists exploring the role epigenetics plays in the development and progression of cancers, including rare and difficult conditions that are resistant to current therapies. 
Predicting your own future is almost impossible but you can shape it for the better with the help of science. On the other hand, from a communications perspective I might be able to predict something of immediate value.  As epigenetics overtake genetics as the future of medicine with novel therapies coming to market, it is likely to become an essential part of healthcare communications.  It might therefore be worth having a further look through the epigenetic keyhole to learn more.
This whole area of research has certainly opened my eyes to how sensitive our bodies are to everything we do.  From my perspective, it made me think twice about lighting up a cigarette and I have now quit.  I am just hoping that my lovely twin sister will follow suit to improve her chances of a healthy adulthood. 
Thought Leader Profile
Eliza Hazlerigg is an Associate in the Healthcare practice of Burson-Marsteller, London. She works mainly with healthcare clients across their pharmaceuticals portfolios but also supports corporate clients with their global media strategy and media relations. Eliza tweets @ElizaHazlerigg

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The Author

Eliza Hazlerigg

Eliza Hazlerigg is an Associate in the Healthcare practice of Burson-Marsteller, London.

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