article and image by Lisa Lowry, M.D.
Published in TYLER TODAY Magazine
The sun was laughing at the clouds, just daring them to get in the way. The resulting warmth, like pale golden honey, was sweet and welcomed against the slightest chill still nipping at the air. Blue skies, only sparsely interrupted by soft white clouds declaring their surrender, gave a backdrop to Nature’s supremacy over the weather app predictions of a dreary, rain-soaked afternoon in England. Underfoot, grass greener than anything we were seeing in Texas at this time of year, slid easily under my anxious gate carrying me towards a lifelong dream: visiting Stonehenge.
How odd when the ordinary flips, switchlike, into the extraordinary. How a walk across a grassy field transforms from a casual perusal to a moment of AWE. As I rose to the view, towering, shimmering, weathered, and chiseled stones came into focus. So massive they stood like giants, (some had fallen like giants), their commanding presence drew every ounce of wonder within me. I stood motionless, moments fell around me, and despite crowds and chatter, a stillness and peace predominated.
As I gathered my senses and set upon the designated viewing path, the historical significance of these marvels gradually unveiled itself. Through archaeological, mathematical, and engineering studies, the “how did they do it” has been laid out in plausible diagrams. The “why” did they do it has been partially answered through items that have been discovered there. It was a place for ceremony and a place for burial. The careful placement of the stones displays the marking of time, evident in how sunlight passes through the alignment during the solstice.
The fascination with the passage and documentation of time continues today in many different ways and for many reasons. “Longevity” is now a big buzzword. People who have made it over the 100-year mark are poked, prodded, and analyzed to determine their secret sauce. What I find most of my patients interested in, however, is not how long they can live, but rather how well. Something some are calling “Health Span.” How long they are physically and mentally able to maintain independence and pursue desired activities.
A fascinating field with extensive applications to many aspects of our lives including longevity and health span, is Epigenetics. A relatively small word, it packs a powerful punch, and like Stonehenge, houses many layers of secrets. It is an important field for all of us interested in our health to become familiar with. Like any major undertaking, it is much simpler if you break it down into small information bites which can then be used to build the bigger picture.
“Epi” derived from Greek meaning “above” or “on top of,” and “genetics” refers to the DNA passed to you from your mother and father. Let’s start with DNA. Reaching back to your middle school brain, you probably remember a picture of a double-stranded helix composed of repeating sugars, phosphate groups, and base pairs. The sequence, or order, of these base pairs creates codes or genes. All your genes together comprise your genome. The double-stranded helix can “unzip,” exposing the code, or instructions, for providing whatever information is needed by the body to produce something, like an enzyme for digestion, or muscle to make you stronger.
The DNA strands are not just hanging around all naked like, waiting to zip and unzip. They are folded around, in very specific ways, things called histones. Additionally, things called methyl groups are thrown in as well, like decorations on a Christmas tree.
The important message here is DNA does not have free will. Yes, it contains the very code your mom and dad lovingly handed down to you, which for the most part is not something we readily change. (that’s an entirely different essay). But the folding and unfolding, or the exposure of that key information to make everything you need, or to stop stuff you don’t need, is controlled by what sits ON the DNA, mainly those methyl groups we just talked about.
That is really powerful when you think about it.
It controls what genes get to come out and play. Think about how a football game might look very different depending on who gets off the bench and takes the field.
It determines what type of cell a little cell grows up to be and stays. It is why a muscle cell is good at being a muscle cell but not good at producing insulin.
As if that information wasn’t enough to rock your world, listen to this. Scientists are defining PATTERNS of methylation (and a few other things that I do not have the word count to extrapolate on) that is giving them all sorts of new information. The pattern of what is on your DNA can provide clues to … How you are aging, faster? Slower? In line with everyone else your same chronological age? Things called Epigenetic Clocks are seeking to answer what people have wondered about for years. If you feel like you’re seventy but your driver’s license clearly clocks you in at 60, why the discrepancy? Now these are not actual devices you can pick up and hold, they are specific types of testing. There are multiple variations of these “clocks,” and they all have their pros and cons. Some are research tools and others are crossing over to the consumer world. Important things to know about these clocks are they may measure different tissues, use additional parameters besides methylation, and have different end goals, reliability, and validity. Some seek to tell you how long you might live, others what your biologic fitness level is, and still others what your weakest organ system is or where you might run into health challenges. Before you invest in this type of testing, do some of your own research into what information the test provides. Check in with yourself about how you will use this information, and whether you could/would/should make changes now even without testing.
Cancer Screening, Diagnosis, Treatment, Monitoring. Cancer is on the heels of cardiovascular disease for becoming the number one killer, and it is going after people at younger ages. That is just not ok. We need screening tools that can catch earlier stages and a higher variety of cancers. Researchers are finding that certain DNA methylation patterns, present in the blood before symptoms of cancer develop, can indicate the presence of cancer, AND help point to what type of cancer may be present. Some of these tests are hitting the commercial market. As with anything new, their exact role will most likely change as we learn more about the tests. We need to know how good they are at picking up disease when it is present as well as how good they are at calling a negative a negative. Not giving us false signals. We need to know what populations they work best in and be accountable for diverse populations. Researchers are also working on similar types of tests that can be used to monitor how well a cancer patient is doing. Is the cancer responding to treatment? Is it mutating? And the best follow-up to this: they are working on ways to change the methylation patterns to better equip the body to fight off cancer.
-Brain diseases, including Alzheimer’s, Parkinson’s, and Mood disorders are being explored from an epigenetic perspective. Researchers are finding links between the patterns of DNA methylation (and other epigenetic biomarkers) and the development of these diseases. This can ultimately lead to earlier detection and possibly more therapeutic options for these devastating conditions.
-The list just goes on. Epigenetic mechanisms may be used as research tools that can speed up our acquisition of knowledge. An example in my world of dermatology is the use of epigenetics to analyze the effects of a product/drug on the skin as opposed to having to perform a biopsy to get similar information. In some cases, this comes down to using a strip of tape applied to the skin and then removed vs the standard of numbing and removing a piece of tissue from the patient.
Epigenetics may play a significant role in the development of personalized medicine, from what diseases you may be specifically susceptible to and when, to which lifestyle alterations or medications may work best for you.
The best part of all of this, I believe, is that we have the opportunity to exert our free will. Scientists are learning that many simple lifestyle changes in nutrition, exercise, sleep, stress regulation, and environmental exposure can alter the epigenetic state of your DNA, thus helping select which of your genes get to come out and play. These are changes you can start making now, while the rest of the science fills in.
Winding my way around the path at Stonehenge, I thought about how 5,000 years ago people gathered in that very spot to mourn the loss of their friends and family, express thanks for the life they had, and wonder about their role, and their place in time. I felt a deep gratitude for the opportunity to connect with this, and then, all too quickly, it was time to go.
