Epigenetics and its implication in clinical practice
Title: Epigenetics and its implication in clinical practice
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Epigenetics and its implication in clinical practice
The study of the heritable changes in the expression of genes, without a change in the gene sequence. In other words, it is defined as the study of phenotype – the set of observable characteristics of an organism, without changes in the genotype. The study is based on the fact that by adding some chemical compounds, it is possible to change the expression of genes or to regulate their activity. The study, therefore, includes looking into those chemicals that modify gene expression, and their characteristics. It is important to note that in some instances, changes to gene expression are inheritable (Tkacs, Herrmann, & Johnson, 2020). Over time, scientists have established several forms of changing gene expression. One of the most common of these is gene methylation. Here, a methyl molecule (CHO) is added to a specific gene to stop its expression, or simply, switching it off.
The implication of epigenetics in clinical practice
Epigenetics has resulted in improving the quality of care given to patients. One of the most common uses of this has been in treating patients with low-risk myelodysplasia, as well as acute myeloid Leukemia. Clinicians use compounds with hypomethylating agents, including azacitidine, as well as decitabine, to improve patients’ chances of survival, as well as helping reduce their transfusion frequency. The compounds are also involved in histone modification, which is a key aspect in the treatment of blood – related ailments, and in particular, leukemia. In some instances, epigenetics has been used even after therapy, especially as post-remission therapy to boost patients’ chances of surviving leukemia even further (Clark, Adamian, & Taylor, 2013).
The effects of childbirth on gene expression have been hypothesized for decades, with a primary concern being the secondary effects of the type of delivery (either normal or caesarian) on gene expression in the mother and child after the delivery process. Research has solidified the hypothesized link between the caesarian section and asthma, obesity, and even multiple sclerosis. This relationship is traced in one part to antibiotics used during the operation, but more importantly, drugs such as synthetic oxytocin, which affects epigenetic remodeling processes that occur around this time. During the period pf physiological labor, the levels of oxytocin, cortisol, and adrenalin vary. This has fetal epigenetic processes, in a way that can in the future be characterized by abnormal gene expression. It is, therefore, necessary for clinicians to be alive to the effects that the different processes may have, and advise their patients accordingly, while mitigating any negative effects that the epigenetic processes may cause (Bennett & Licht, 2018).
Epigenetics has led to the development of treatment and therapies that help patients with metabolic disorders. Nurses have linked epigenetics to issues such as obesity, cardiovascular disease, and diabetes, which, among other factors, are caused by metabolic issues. Things such as maternal issues in the prenatal stage, such as diet, cause epigenetic changes that may predispose the newborn to obesity. Armed with this information, nurses can train expectant mothers on the importance of observing their diets, since this will directly impact the child. Besides metabolic disorders, cancer, and even infertility may be linked to altered genetic expression, primarily caused by epigenetic compounds, especially those that methylate the phenotype. This information is also key in the fight to eradicate some cancers, and infertility (Clark, Adamian, & Taylor, 2013).
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References
Bennett, R. L., & Licht, J. D. (2018). Targeting epigenetics in cancer. Annual review of pharmacology and toxicology, 58, 187-207.
Clark, A., Adamian, M., & Taylor, J. (2013). An Overview of Epigenetics in Nursing. Nursing Clinics of North America, 4(8).
Tkacs, N., Herrmann, L., & Johnson, R. (2020). Advanced Physiology and Pathophysiology: Essentials for Clinical Practice. Springer Publishing Company.
