Epigenetics: DNA is Not Destiny

Hallmark of Aging #3

Many people believe that DNA is our destiny. We blame our parents' genes for everything that was wrong with us, and thank them for our positive traits. But now, we know that our genes are far from the only factor that determines who we are. Epigenetics is the study of how outside factors can affect our genes, without actually changing the DNA sequence. This can include things like diet, stress, or exposure to toxins. Epigenetic alterations can lead to changes in gene expression that are associated with diseases like cancer or Alzheimer's.

All cells in our body share the same DNA. But then, why are different body parts and organs so different in form and function? The differentiation of human cells is a result of epigenetics. These chemical markers attached to our DNA strands are used by our body to know when to produce a type of protein (turn on the gene) and when to prevent that production (turn off the gene). The proteins needed to create brains cells and tissue are different than heart cells, requiring different combinations of genes. Epigenetic patterns serve as the instruction manual for using the correct genes at the right time and place.

A helpful metaphor for epigenetic alterations is the scratches on a DVD. Although this problem is becoming an artifact of the past, when DVDs accumulate enough scratches they become dysfunctional, skipping scenes and disrupting the digital instructions needed to play the video fluidly. As we age, dysfunctional epigenetic changes accumulate throughout our years, resulting in poor genetic instructions that cause compounding problems within our cells and organs. Our bodies "DVD video" can no longer play without skipping vital scenes entirely.

There are now tests available to detect epigenetic alterations, which will transform how we diagnose disease in the future. Companies like GRAIL and Freenome are using DNA methylation to detect cancer. This diagnostic technology is called a liquid biopsy and its diagnosis capabilities are powered by understanding epigenetic alterations. A liquid biopsy test can analyze epigenetic DNA methylation from a simple blood draw. The data that results from this analysis can be used to detect cancer early before a patient has symptoms.

So what does this all mean? Epigenetics is an exciting new field of study with the potential to improve our health in many ways. Notabliy, epigenetic changes can be heritable, so they can be passed down from one generation to the next. But, epigenetics is also dynamic, which means that epigenetic changes (both positive and negative) can happen throughout our lifetime.

We now know that epigenetic changes play a role in aging, and we can take steps toward prevent these changes from happening. I will sound like a broken record, but common healthy lifestyle changes like good nutrition, consistent exercise, and sufficient sleep are closely associated with strong epigenetic health.

Beyond these common recommendations, researchers and start-ups are devising novel technologies to influence epigenetic patterns in revolutionary ways. One example is the cutting-edge field of "Epigenetic Reprogramming."  This is the process of using drugs or other external stimuli to erase harmful epigenetic marks and essentially to reset cells to a younger, healthier state.  A few companies are already commercializing this technology. One, EpiMax, offers a "Epigenetic Rejuvenation Treatment" that they claim can treat wrinkles, baldness, and graying hair. Another company called Ocugen is developing a gene therapy delivery platform that they hope will one day be used to target epigenetic marks associated with disease. Despite the promise of these new technologies, they are not mature enough to be trusted and bold "rejuvenation" claims should be looked upon with skepticism. Epigenetic reprogramming is still in its early days, but it shows great promise as a way to treat age-related diseases and perhaps even reverse the aging process itself in the long-term. (More on epigenetic reprogramming and how the technology works in a future post).

Our knowledge on epigenetic changes is only at the tip of the iceberg, and I am excited to track the evolution of this field. As is the case with all areas of biological research, scientists and companies are at the cusp of validating epigenetic breakthroughs that could have immense impact on diagnosing disease or even reversing it. We are beginning to see that our growing knowledge on the "Hallmarks of Aging" may be the most exciting because of our ability to influence many various Hallmarks in parallel with various overlapping technologies and lifestyle changes.

Biology is immensely complex, but it is also a fluid system. Changes to unique biological components like our genome, our epigenetic patterns, and others can compound upon each other for an overall healthier system. The exploration of the remaining six Hallmarks should continue to demonstrate this idea.

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Images Credit: Created using software from Midjourney

Sorry for this clunky disclaimer but I need to include it...

Disclaimer: I am not intending to provide professional medical advice. Always seek the advice of your physician or other certified healthcare providers with any questions you may have regarding diagnosis, cure, treatment, mitigation, or prevention of any disease or other medical condition.