A Primer on Epigenetics: The Science Behind Historic Trauma

James N. Jarvis, M.D.

Dept. of Pediatrics

University at Buffalo

Faculty/Presenter Disclosure

I, James N. Jarvis, have no relevant financial

relationships with the manufacturer(s) of

commercial services discussed in this CME

activity.

Bienvenu!

St. Regis Indian Mission: Where my

great grandmother was baptized

Early Brain Development:

700 New Neural Connections Per Second

ROBUST gene transcription occurs in the CNS during this time

(more on this in a moment).

Child Health and Adult Outcomes:

Early Work

Early Stress

TOXIC STRESS

Chronic “fight or flight;” cortisol /

norepinephrine

Changes in Brain Architecture

Hyper-responsive stress response;

calm/coping

CHILDHOOD STRESS

Defining Adversity or Stress

• How do you define/measure adversity?

• Huge individual variability

– Perception of adversity or stress (subjective)

– Reaction to adversity or stress (objective)

• National Scientific Council on the Developing Child (Dr. Jack Shonkoff and colleagues)

– Positive Stress

– Tolerable Stress

– Toxic Stress

Based on the REACTION

(objective physiologic responses)

• Positive Stress

– Brief, infrequent, mild to moderate

intensity

– Most normative childhood stress

• Inability of the 15 month old to

express their desires

• The 2 year old who stumbles while

running

• Beginning school or daycare

• The big project in middle school

– Social-emotional buffers allow a return to

baseline

(responding to non-verbal clues,

consolation, reassurance, assistance in

planning)

– Builds motivation and resiliency

Defining Adversity or Stress

• Toxic Stress

– Long lasting, frequent, or strong intensity

– More extreme precipitants of childhood stress (ACEs)

• Physical, sexual, emotional abuse

• Physical, emotional neglect

• Household dysfunction

– Insufficient social-emotional buffering

(Deficient levels of emotion coaching, re-processing, reassurance and support)

– Potentially permanent changes and long-term effects

• Epigenetics (there are life long / intergenerational changes in how the genetic program is turned ON or OFF)

• Brain architecture (the mediators of stress impact upon the mechanisms of brain development / connectivity)

Defining Adversity or Stress

Adverse Childhood Events: Where Physical Health and Community Health Are Joined

1. Recurrent physical

or emotional abuse.

2. Sexual abuse.

3. ETOH or other

substance abuser in

the home.

4. Incarcerated

household member.

5. Someone who is

chronically depressed,

suicidal, or otherwise

mentally ill.

6. Mother being

treated violently.

7. One or no parents.

8. Emotional or

physical neglect.

ACE Score and Smoking Status

ACE Score and Smoking Status

ACE and Illicit Drug use

Inter-Generational Risk

Epigenetics: The Wounds of Our Parents

Epigenetics: Genes and

Environment

Epigenetics-Definition

Alterations to DNA or

its associated

proteins that do not

change the actual

coding sequence of

the DNA but which

may have effects on

DNA function.

Epigenetic Alterations

Regulation of Transcription

Genetic Risk: It’s NOT in Our Genes!

Most population-based genetic

studies show that the risk for most

complex illnesses (high blood

pressure, heart attacks, type 2

diabetes, rheumatoid arthritis) is

not in our genes, per se, but in the

the parts of the genome that

regulate how and when genes get

turned on or turned off.

These regions are highly

associated with and sensitive to

epigenetic changes.

DNA Methylation and Risk for

Juvenile Arthritis

Importance of Epigenetic Changes: The Key to “Gene-Environment Interactions” ?

1. Can be environmentally-

induced (e.g., by diet, stress

hormones, etc)

2. Can be passed on trans-

generationally.

Epigenetics and Behavior

Dias BG and Ressler K, Nature Neurosci 2014; 17: 89

Epigenetics and Behavior:

Brain Rewiring

Dias BG and Ressler K, Nature Neurosci 2014; 17: 89

Beta galactosidase staining of select olfactory regions: F1 offspring

Epigenetics and Behavior: Methylation of Olfr51

Biology Physiologic Adaptations

and Disruptions

Life Course Science

Through epigenetic mechanisms, the early childhood ecology becomes

biologically embedded, influencing how the genome functions

Developing a Model of

Human Health and Disease

Healthy Children-Healthy Generations

Epigenetic

alterations are

stable and heritable

through the

generations…..but

may be reversible

in nurturing

environments!!

CONCLUSION:

It is easier to build strong children

than to repair broken men.

Frederick Douglass