“Beautiful science” was how Dr Nessa Carey described epigenetics at the Society’s Annual Symposium Public Lecture, held at the University of Leeds on 11 December. Dr Carey, who works at Pfizer, explained that whilst the DNA double helix remains one of the most iconic images of biology, we are only now beginning to gain a clearer picture of how specialised cells ‘wriggle in the troughs of specialisation’; retaining their functions but also responding to the environment. Using a literary analogy, Dr Carey explained that DNA is a script, not a template.
Identical mice kept under standardised conditions will not be identical. A maggot and a fly must use the same genetic script. In some crocodiles, you cannot tell from the DNA whether individuals are male or female. This is epigenetics at play, and we are “masterpieces of epigenetics”, Dr Carey explained. Up until now we have only been able to describe these phenomena. Now we are starting to understand how they actually happen.
In many chronic conditions there is nothing wrong with the genes, but they are locked into inappropriate patterns of expression. Epigenetics is therefore now starting to become a fertile area for designing new drugs, particularly in cancer. For example, Zolinza affects proteins which contribute to the modification of histones, for the treatment of cutaneous T Cell lymphoma. Vidaza interferes with the DNA methylation process and ribosome function for the treatment of myelodysplastic syndrome.
Unfortunately, no drugs are free of side-effects, and we are not able to pre-empt most disease cases to a significant degree of accuracy. Therefore, the use of drugs to counter the possible epigenetic causes of chronic or persistent diseases such as diabetes and heart disease might do more harm than good, we heard. How could clinical trials be run for these scenarios? Who would we treat and when? And what about combatting the epigenetic effects of childhood neglect? Would this distract from the search for sociological solutions? These are vitally important ethical questions.
There are still many unknowns and in the meantime, we risk epigenetics becoming a catch-all phrase for everything we don’t understand. This is a burgeoning field, which could lead to exciting yet complex medical implications. However, we need to play the long game and debate it appropriately.
The full version of this article can be read on the BioNews website.