Medicine Across the Generations

Peter DAdamo, ND

Epigenetics is defined as "a post-genomic changes to the structure of DNA that does not involve changes to the pattern of sequencing itself." These epigenetic changes play a role in the process of cellular differentiation, allowing cells to stably maintain different characteristics despite containing the same genomic material. Evidence is rapidly accumulating which indicates that nutritional status and environmental conditions are two prime influences on epigenetic control, making it a premiere avenue of naturopathic approach.

It was with this appreciation - that a revolution was in the making, a revolution that will provide new context to fundamental underpinnings of naturopathic medicine-- that I created Epigenic Research.

Although there are many types of epigenetic inheritance, the three best known are:
  • Methylation and demethylation. Roughly half of all genes in mammalian genomes have cytosine-guanine (CpG) rich clusters (CpG islands) associated with the start of the gene, principally in the promoter sections. DNA methylation occurs almost exclusively at CpG nucleotides and has an important role in the regulation of gene expression and the silencing of repeat elements in the genome.
  • Histone modifications. Acetylation, methylation and phosphorylation of the histones--are important in transcriptional regulation and many are stably maintained during cell division. Proteins that mediate these modifications are often associated within the same complexes as those that regulate DNA methylation histone complexes, which activate gene silencing and activation through chromatin winding and unwinding.
  • Maternal effect. This is the phenomena where the genotype of a mother is expressed in the phenotype of its offspring, unaltered by paternal genetic influence. This is usually attributed to maternally produced molecules, such as mRNAs, that are deposited in the egg cell. Maternal effect genes often affect early developmental processes such as axis formation. Maternal-fetal interactions may play a critical role in 'anticipation' of prospective future environmental conditions which await the fetus upon birth. The maternal effect may account for Barker's "Thrifty Phenotype" theory and help explain the rising incidence of obesity and diabetes in the industrialized world.

The symbol of the company is the lowly volume control, like any that you would see on a typical appliance. It was selected because it proved to be the perfect metaphor for explaining epigenetics to my patients. Virtually everyone understands that their personal genome is immutable and permanent. But by simply explaining to them that even the most basic of their genes have tiny volume controls on them which regulate how 'loud' or 'soft' that gene is allowed to 'speak' even the most technophobic patients will understand just what is at work. When you add that initial settings of these thousands of individual volume controls is inherited - and, that through birth, adolescence and thereafter the environment is constantly adjusting and readjusting these volume controls, you have a basic thumbnail sketch of epigenetics.

Sound far-fetched? If so, just think back to some dumb thing you did as a teenager. Did you ever smoke a cigarette? Drink beyond your limit? Remember those unpleasant feelings? What happened if you persisted enough in to habituate yourself to the practice? It may have evolved from something unpleasant, to pleasant, to possibly addictive.

What had happened? Simply put, the change in environmental circumstances had sent a message which indicated a need for a reaction to a change in environmental conditions. This response may well have been the induction of a cytochrome enzyme, or a dehydrogenase. Although as doctors we might have been trained to see this as a simple stimuli-response model, in reality it is an epigenetic event.